Changes in training of doctors, pharmacists and dentists

The Moroccan Ministry of Higher Education has decided to reduce the period of medical training in its nine public and private institutions from seven to six years, starting from 2023.

The decision to reduce the training period for medicine, pharmacy, and dentistry students by one year, informed by a growing shortage of healthcare professionals, was presented by Abdellatif Miraoui, the minister of higher education, in a note to the presidents of public universities published by Morocco World News earlier in 2022.

The decision aims at achieving the health framework standards set by the World Health Organization by 2025 and is in line with the objectives Morocco’s new development model wants to achieve by 2035. The model envisages medical services across the country through an increase in the number of high-quality healthcare professionals.

Medical students in Morocco spend five years in medical school, then join university hospitals from the sixth year as trainee doctors, and in the seventh year they join regional hospitals.

The seventh year for medical students “was not necessary, and it is a lost year in the doctor’s journey, because the only beneficiary is Morocco’s Ministry of Health to fill the shortage of doctors in regional hospitals, and for it they were cheap labour,” according to a 19 February article titled ‘Does reducing medical school years affect the quality of training of future doctors?’

Expanding further in a statement, the National Commission of Medical Students in Morocco indicated that students currently in their fourth year of medicine will be the first promotion affected by this reform.

The commission added: “According to the current system, there will be no change in the training programme of the first to the fifth year of study in medicine.”

Regarding the sixth and seventh years of study, they will be collapsed into a single year, during which the student will complete the required hospital internships. It will be concluded with the discussion of a student’s doctoral thesis, according to the commission.

“The internship and residency requirements (speciality) and everything that comes after the sixth year of medical training have not been modified,” the commission pointed out.

Shortage of healthcare professionals

The number of medical and paramedical staff providing direct patient care in Morocco has barely exceeded 1.65 per 1,000 people, which is well below the critical threshold of 4.45 care staff per 1,000 people required according to suggested ratios, according to the April 2020 report entitled The truth about health in Morocco: No health without workforce development.

The report estimated the deficit of medical staff in Morocco to be 32,387 and the paramedical shortage at 97,161.

“This deficit will worsen over the next 10 years with the retirement of 24% of acting paramedical staff: more than 8,500 people,” according to the report.

Miraoui also announced an increase in the admission of students to the faculties of medicine, pharmacy and dentistry.

“All required financial and educational resources will be mobilised through a contractual programme between the government and universities concerned,” Miraoui said.

Expanding further, a commission statement indicated that the “gradual increase in educational seats within public faculties of medicine will be directly related to financial (management budgets, investments), human (pedagogical, administrative, technical) capacities and logistics necessary to support the theoretical and practical training of students in general medicine, pharmacy and dentistry”.

The commission said: “Reforming medical and pharmaceutical training and the health system requires a comprehensive and clear strategic approach for all levels within the two sectors.

“It is not enough to increase the number of new medical, dental and pharmacy students and reduce the training period, so that the system remains a victim of emigration and attrition of doctors, pharmacists and dentists abroad,” the commission added.

An October 2021 study titled ‘Migration intention of final-year medical students’ indicated that policymakers should improve working conditions, training quality and the salaries of health workers to reduce medical student migration.

Up to 70% of final-year medical students had the intention of leaving the country, of which about 64% were female, according to the study.

“However, a real-time review [is needed] of the social status of the doctor, pharmacist and dentist along with improving their remunerative status as well as providing all appropriate conditions to motivate them within the sector,” the commission said.

“Effective and urgent preparation of hospital and health centres by updating their management systems and injecting sufficient financial resources into their budgets in accordance with international standards are also needed,” the commission pointed out.

The commission indicated its wishes to contribute to this reform in order to improve the training system and the university course of students, and it called on the supervising ministry to adopt “full transparency” in its interaction with all the actors concerned.