I know many medical students, we train 250 each year at the University of Oslo. One of my students had intended to become a GP, but is now facing reality: She completed her studies in the normal time and in an excellent manner, and passed all exams at the first attempt. Since she got her student licence, she has worked as a doctor’s assistant part-time and during holidays. This, on top of an otherwise spotless CV, should make her attractive in the competition for an education position. Without these 18 months of LIS1 position, or rotation position as it was called previously, she will not be able to work independently as a doctor. But after a long education and relevant practice, there is no response from Helse-Norge. She is not alone, 400 newly qualified doctors are standing in the same queue. The Norwegian Directorate of Health has calculated that we need 1,150 new doctors through rotation each year. Therefore, more positions have been created in the last two years, and more should be in place in the spring. But then the Minister of Health put the brakes on. Hospitals and municipalities received counter notices and had to cancel planned appointments. Doctors in training have to put their lives on hold. Some turn to an alternative medical market that provides services on the side of the public system. Others get temporary jobs as students with a licence, and try to gain more or less relevant professional experience in order to make a stronger case in the next round of applications. They can hope for a gray position for “waiting on duty”, who are in reality underqualified “doctors”. Rotarians do not receive meritorious practice, and cannot undertake independent medical work. Guidance is absolutely essential in this initial phase as a doctor, and something that all doctors on rotation receive. The fact that waiting staff do medical work without systematic guidance cannot possibly be the best offer for patients. Two hundred thousand Norwegians are without a GP, and we need at least 200 GPs to meet the urgent need. Many of the new graduates are ready for the task, but they have to put in 18 months of rotation training. The background figures show that around a hundred of those who are rejected in each half-yearly round want a job in the primary health care service when they have finished their rotation training. There is also reason to ask how much the government actually saves by keeping newly qualified doctors on hold. The medical degree is among Norway’s most expensive, and the Ministry of Education calculated in 2014 that Norway invested close to 3 million in the education of a doctor. Nevertheless, one in four with a Norwegian medical exam did not get a job this spring. It was even worse for medical students with education from other EU countries, where almost half were without an offer of a rotation place. Some are still missing a rotation as the last part of their education even after 4–5 application rounds. Oslo Economics has calculated that the rotating queue has a cost of 125 million each year. This cannot possibly be good social economics. Denmark trains twice as many doctors as Norway. Nevertheless, they have an arrangement where all candidates are guaranteed so-called basic clinical education (KBU, equivalent rotation) after completing the exam. When the Danes get it right, it’s hard to see why we can’t do the same. Norwegian medical students with an education from Denmark must complete the Danish KBU in order to have the education approved. Nevertheless, they must take the rotation again to be able to work in Norway. These are thus overqualified for a rotation place. A Norwegian medical student with six years of study, passed exams and full Danish rotation service should be well enough qualified to work in Norway. We train too few doctors in Norway. Almost half of Norwegian medical students study abroad, most at English-language universities in Eastern Europe. A public committee, the Grimstad Committee, has made recommendations for the future education of doctors. Therefore, the committee proposes that Norway should increase by 440 study places by 2027 so that at least eight out of ten are educated in Norway. Thirty new study places will come next year, which is a small step in that direction. We are therefore increasing the number of study places, but that does little good when the bottleneck in the system is just as tight. The government’s unexpected budget cuts pull up the ladder for the next step: Education positions. When fully motivated students still end up queuing to get rotation service, a comprehensive strategy to get more doctors into work is missing. Ingvild Kjerkol was generous with her criticism of her predecessor Bent Høie, and she promised more rotation places. But that was before she became health minister. Now it seems that the ambitions are being adjusted down in line with increasing power.
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Let in newly qualified doctors, Kjerkol. It’s urgent! – Speech
