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SWITZERLAND

Basic medical education

The reformed third year of our curriculum is over. Although after all the evaluations, with a lot of things to change, we think it is successful. We will continue with the system of topic-centered lectures in the morning and workshops in small groups in the afternoon. Twice an OSCE after each semester with credit points (ECTS) stands for the assessment.

For political reasons the reform of the 4.-6. year is stopped. So we continue with the system of rotation of the same small groups within every speciality (still without general practice). At beginning and end of this two years period (4 and 5) takes place a block of lectures with a substantial part of GP's organising these topic-centered activities, bringing together different specialists and a GP.

From our department we concentrate our fight for the implementation of a 4-weeks block in the 5^th year in GP. That means 140 students in 140 teaching practices. Half day they would follow practice routine, the rest of the time they deal with 1 or 2 patients and 1 halfday per week they gather into groups for a workshop. But up to now, for the lack of money, it is still put on ice.

Postgraduate education

We still run our 6 months practice training, because of the same boring money store, as a pilot in the frame of a study to get some research funds. So we cannot declare it as compulsory and a lot of trainees reach final exam without any practice training. For the moment this story seems to be blocked for years. The national society organises every year some 1-day courses as preparation for the individual practice start. So no great news from this side.

CME

In comparison to my last report no important changes have taken place. But we see an increasing number of quality-circles mostly on local initiatives by small groups of practitioners. For the moment they work very separately, the outcome is not transmitted to others. Something we will try to change from the different departments of our 5 medical schools to collect these data and encourage research work.

Politics

The politicians have stopped the plans of the private medical school, for the moment it seems to be buried. The implementation of the new tarif is deferred year after year, what leaves us in uncertainty with changes every year.

More and more women start medical schools, the total number of students remain the same.

Older doctors leave their practices without a successor, the first sign of shortage we fear to become substantial within some years.

In sum, the most problems of health policy are frequently discussed but remain unsolved.