June 13, 2021

“The CHU, this” flagship “of our health system, is taking water, especially on the academic side”

CCreated by the Debré ordinances in 1958, the hospital and university centers (CHU) aimed to integrate care, teaching and research into the same system, thus preventing medical professors from being monopolized by their medical practice. to the detriment of research and teaching.

Student training thus becomes more professional thanks to teaching by university hospitals: these teacher-researchers, whose main employer is the university, can provide their teaching and carry out part of their research at the hospital where they exercise their activity of practitioner.

It is by entering into an agreement with the university that the regional hospitals have become “CHUs”, with an organization shared between the hospital and university missions, conducted in the faculties of medicine.

Beyond the university hospital staff, it is the entire medico-technical and care environment developed by the CHUs that has made it an internationally recognized model. We salute the role of hospital practitioners, admirably invested in teaching and research missions in the training of health professionals as well as in the contribution to scientific and medical progress.

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But in recent years, the “flagship” of our health system has been taking water, especially on the academic side. Every ten years, we celebrate our anniversary by launching new distress signals each time without the supervisory ministries – higher education, research and innovation, health and solidarity – not worrying about them.

In 2018, the Court of Auditors examined the role of CHUs in higher education and medical research. The diagnosis was alarming: France’s decline in biomedical research, a triple mission of care-teaching-research too focused on care, an unsuitable funding model and financial imbalance …

The attractiveness of careers in free fall

The directors of CHU, pressed by an economic logic, can not do much, but must nevertheless face it. The installation of activity-based pricing and the organization by the HPST (hospital, patients, health, territories) law of 2009 with more managerial governance, not very medical and dissociated from the university, have gradually moved our CHU of their initial academic trajectory… not without consequences.

The attractiveness of university hospital careers is in free fall, many medical professors are leaving their jobs to work in the liberal sector. More serious, the breeding ground is drying up because the hospital-university career is no longer dreaming. The big losers are the students, who rightly denounce the shortcomings of their supervision in their hospital placements.

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