Paris, Wednesday May 17, 2023 – More than half of the dental surgeons who settled in France in 2022 were trained abroad.
If we often speak of the medical desertification from which France suffers, our country is also a dental desert. The number of dental surgeons per inhabitant in France is lower than the European average and the peripheral and rural areas are sorely lacking in dentists. The solution to this problem could simply be to train more dentists in France. Our country has chosen another: to import dentists trained abroad.
According to the national order of dental surgeons, in 2022, for the first time, the majority of professionals who settled in France had obtained their diploma abroad, 1,313 in total. Among these, a little more than half, 687 exactly, are French people who have left their country to go and train abroad. The phenomenon is on the increase: in 2015, only a third of new dental surgeons were trained abroad.
Spain, Eldorado of dentists
The explanation of this phenomenon lies in two Latin words: numerus clausus. From 1971 to 2021, young French people wishing to become dentists had to go through the formidable first year of study common to health studies (Paces) and obtain, after a difficult competition, access to one of the rare places open in dental studies. ” The successive governments of the 1970s and 1980s thought that, to reduce health costs, it was necessary to reduce the supply of care and therefore the number of practitioners likely to provide it. explains Dr. Philippe Pommarède, President of the National Council of the Order of Dental Surgeons. A political will supported by the profession, which viewed favorably the fact of limiting competition between caregivers agrees Dr. Marie Biserte, vice-president of the Federation of Liberal Dental Unions.
In 2021, the numerus clausus was abolished, to be finally replaced by a quite similar system, the numerus apertus. ” Our institutions continue to have a fixed number of training positions underlines Prof. Vianney Descroix, president of the conference of deans of odontology. Under these conditions, the flight of young French people wishing to become dentists abroad is likely to continue. Most of those who return to France today to practice have failed their Paces once or twice before setting sail.
This movement of exodus was made possible in particular by a European directive of 2005 which set up the system of ” automatic recognition » diplomas within the European Union: anyone with a diploma from a European university has the right to practice wherever they want in any Member State. Most of these dentists who return to practice in their native country were trained in Spain (502 dentists settled in France in 2022), in Portugal (399) and in Romania (283). In these countries, universities have set up courses specially adapted to French students. Going abroad has several advantages for the French: admission to faculty is done on file, without having to pass a competition and training generally lasts five years compared to six in France. Main downside: French students must pay for their tuition, with prices of up to 19,000 euros per year.
Foreign training that sometimes leaves something to be desired
But the installation of these students trained abroad in France worries some. If the training provided in some European universities has nothing to envy to that available in France, in others, it leaves a little more to be desired. Outside our borders, the training would be too theoretical and not practical enough. In 2016, Dr. Marco Mazevet, general delegate of the union of dental surgeons of France, found that a third of future dentists trained abroad had never placed a crown and that 10% had had no training. convenient.
Based on this observation, the Order of Dental Surgeons requested in 2016 the establishment of compulsory practice hours for future professionals trained abroad. But such a request comes up against European legislation “ which obliges us to enroll any European graduate, there is no possibility of controlling the quality of teaching notes Dr. Pommarède bitterly.
If the importation of dentists trained abroad makes it possible to maintain the stability of the density of professionals in France, it does not in any way constitute a remedy against dental desertification. These professionals trained abroad benefit, like their colleagues who studied in France, from the freedom of installation and prefer to choose the big cities. In 2022, 200 first-time registrants out of 2,609 chose Paris (which already has 156 practitioners per 100,000 inhabitants), while only two chose Orne and none Corrèze.
In an attempt to stem this desertification, the government has decided to create eight new university dental training sites in provincial towns (Dijon, Amiens, Rouen, etc.) in the hope that students will decide to practice where they have been trained. But the problem is the same as for medical desertification: it takes six years to train a dentist, while the problem is already present. ” In the meantime, fortunately there are students who leave for training outside France commented Dr. Biserte.