Teaching hospital. New idea for internships and placements for medical students

The Ministry of Health has published a proposed enrollment limit for medical and medical-dental faculties for the 2023/2024 academic year. The draft regulation on the matter implies increases over the previous academic year for both medical and medical-dental faculties. Compared to the limits allocated for the 2022/2023 academic year, the current academic year's overall enrollment limit for medical and medical-dental majors has increased by 359 places. The question of the quality of education in the context of the inadequate number of places available to hospitals for practical classes with students is most legitimate. Although Polish medical universities have teaching facilities, simulation centers and partner hospitals, the number of places offered in teaching hospitals, for example, is insufficient.

At the recent Public Health Congress, the issue of providing students with comfortable access to patients under the supervision of experienced physicians, i.e. practical training indispensable to the didactic process, was addressed by the rector of the Warsaw Medical University, Professor Zbigniew Gaciong. The curricula at Polish universities are in line with international medical standards, and these require an increasing share of practical classes at each stage of study. There is no doubt that this is the best way to acquire medical knowledge and practical skills. That's why expanding the base of hospital sites for didactic classes should become a priority.

As it turns out, it is not at all obvious for universities to find a hospital that makes its departments available, even though the university has to pay for the student's stay in practical classes. There is no single set rate, and depending on the place, the director's decisions vary by up to several hundred percent. This is surprising, since public hospitals do not significantly deviate from each other in terms of standard or types of services provided. Some hospitals do not accept "trainees" at all. Given that state universities and public hospitals are financed through taxes, it may seem strange that there are no systemic regulations so far to define the rules for the practical training of future doctors. Especially since this would be a good way for hospitals to attract medical staff in the future. Students would already have a chance to become "emotionally" attached to the hospital during their studies and return to it after graduation.

According to Professor Zbigniew Gaciong, the way to expand the base of hospitals that would accept students is to create teaching hospitals. Such status could be given to both provincial and county hospitals. This would make it easier for medical universities to organize practical classes and for hospitals to have the added prestige of a place training medical staff. In turn, students would have the opportunity to learn what work in hospitals of different levels of reference is all about. Some of the hospitals that currently have specialty places accredited by CMKP are not interested in training students. Since they have the potential to educate," stresses the WUM rector, "they should also make places available to students. In the future, it would be advisable to combine all threads into one: the possibility of postgraduate education with student training and the possibility of accreditation. Of course, prestige alone will not compensate hospitals for all the hardships associated with the presence of students. Thus, the National Health Service, in order to encourage treatment entities, should add a set fraction, such as 0.2 percent of the total amount, to the hospital's contract for the provision of services. This would completely cover the costs of practical training, the so-called "capitation" costs. Given the need to educate more physicians and the fact that many non-medical universities are planning to open medical faculties, the creation of an adequate base for practical training seems to be an urgent systemic necessity . After all, taxpayers expect doctors arriving on the job market to be well educated in accordance with the requirements of modern medicine. Of course, the quality of education also relies on the involvement of the student himself. That is why it is necessary to create the right conditions for him to do it really well.