Two years of pandemic have exacerbated the problem of getting enough doctors. The shortage of medical specialists has doubled in the last three years. At the same time, 150,000 Norwegians are without a GP. In Bergen, medical students are now studying for the final exam, after six years of education. More people dream of becoming a GP, but are not allowed to start on the next mandatory stage. – Many in this country are without a GP, and then it is a bit paradoxical that it should be so difficult to get an education, says student Hannah Brøyn Skuggevik. She wants to be a GP. In order to specialize and get a permanent job as a doctor, newly qualified doctors must complete LIS1. What used to be called the rotation service. This is the “learning period” for the doctors. The LIS1 scheme LIS stands for «doctor in specialization», and LIS1 is the first part in the specialist course for persons with a medical degree. LIS1 corresponds to what was previously called the shift service. The LIS1 positions are standardized at 1.5 years. One year in hospital service and half a year in municipal health services. The LIS1 positions are advertised in the job portal of the Norwegian Directorate of Health by the health enterprises in collaboration with the municipalities. There are two application rounds every quarter, in the spring and autumn. Without LIS1, one can be employed in a temporary position, but one cannot progress in the specialist race without LIS1. Source: The Norwegian Directorate of Health and the Large Medical Encyclopaedia Each LIS1 position in health trusts has hundreds of applicants. – On hold – The whole career is seen on hold. I have to find intermediate solutions and try to make myself more attractive for the next round, says Skuggevik. She is from Tvedestrand, but is studying medicine at the University of Bergen. And she is rare. Very few medical students envisage a future as a GP. . FINAL QUESTION: The last exam of the medical study for Hannah Brøyn Skuggevik is approaching. Now she fears that it will take a long time for her to progress in the educational race. Photo: Brynjar Mangor Myrtveit Osgjerd / NRK Ho and the cohabitant have already bought a house in Arendal. – I just have to try to find a temporary position between the application deadlines. It is very disability-friendly, and it is difficult to plan a family, for example. I know that many go into temporary employment with poor conditions, she says. About half of Hannah’s fellow students are in the same situation. They are stuck in a queue to complete their education. Frustrated Fellow Student Tonje Bjørnestad may also consider becoming a GP. Now she takes on temporary staff as a hospital doctor while she completes her medical studies. She has two children aged ten and one. In the old rotation system, she had had an advantage on a rotation place in Bergen, but now she has to fight against hundreds of applicants. HEAVY: Tonje Bjørnestad says the doctors must impress to get in. Photo: Private Neither she nor Skuggevik have any idea how long they will be able to get started with the specialization. – It is very frustrating. At the same time, one has to go through heavy application processes every six months. One must impress to make room. I really want to get a job and have a stable life, but now there is a lot of uncertainty, she says. Photo: Brynjar Mangor Myrtveit Osgjerd / NRK Asks the government to assess the need for doctors 200 new LIS1 positions have been created since 2019. Nevertheless, there is a fierce battle for places when they are advertised twice a year. Last spring, there were 1,240 applicants for 544 LIS1 positions. Almost half of the applicants were offered a position, according to the Norwegian Directorate of Health. – One is completely dependent on having completed LIS1 to constitute an important resource in the health care system, and it feels very frustrating for the doctors who are left without a place. That is the victory of leader Maja Elisabeth Mikkelsen in the Norwegian Medical Student Association. MATCH: Maja Elisabeth Mikkelsen says students must send many applications before they get a chance. Photo: Øystein Otterdal / NRK – Many apply for positions throughout the country, and on average people send 16-17 applications, says Mikkelsen. Ho thinks the number of LIS1 positions should reflect the need for doctors in the future. – Right now there is no calculation of how big the need will be in the future and how many we have to educate. The number of LIS1 positions and study places must be regulated according to that need. More than 450 applicants for a few positions Helse Fonna in Western Norway is among the health enterprises that twice a year must evaluate hundreds of hopeful LIS1 candidates. Annually, the three hospitals Haugesund, Stord and Odda employ 44 people in LIS1 positions. This spring they had 463 applicants. These are applicants who have submitted applications in many places. The tenants in the health trust are unsure whether they have the capacity to fill many more LIS1 positions. – I can not stand on my own two feet to answer whether we should have double the number of seats. Then we do not risk being able to give them the good training they should have, says CEO Olav Klausen. UNSURE: The shortage of medical specialists has doubled in the last three years. Olav Klausen, CEO of Helse Fonna, is not sure whether the number of places should be doubled. Photo: Rosa Irén Villalobos / NRK – Preliminary measures The Ministry of Health and Care Services has no plans to increase the number of LIS1 positions. – We have great access to doctors who are studying in other countries. The number of LIS1 positions is dimensioned on the basis of calculations of the future need for medical specialists, not on the basis of the number of applicants, according to State Secretary Ole Henrik Bjørkholt (Labor Party). He points out that in recent years, 200 new LIS1 positions have been created, and that the number is now in line with the recommendations from the Norwegian Directorate of Health. – Medical students who want to become GPs, think it is a paradox that so many are left without a LIS1 position. How important is it to get more GPs and specialists trained now? – When it comes to the GP scheme, this has gone from bad to worse. The government takes the GP crisis very seriously and takes strong action to ensure a viable scheme, says Bjørkholt. In December last year, the government appointed a health personnel commission to assess the need for personnel and competence by 2040.
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Hannah (29) wants to become a GP – get stuck in the application queue – NRK Vestland
