In the column below, the author, a Tunisian doctor practicing in France, attempts to explain why doctors are leaving Tunisia en masse to exercise their talent abroad, particularly in Europe, and offers solutions to this phenomenon. which is fast becoming one of the main public health problems in Tunisia.
I would like to remove the ambiguity on what public opinion thinks following the results of the EVC*: it should be known that a majority of Tunisian doctors leave the country because they are forced to do so. Either because they have been harassed morally or professionally, or because they cannot earn a living to meet the basic needs of their family, or because they work in hospitals where it is impossible to practice medicine correctly. , or because of insecurity in hospitals.
The causes of departure
For these causes of departure, I give you concrete examples. Necessary conditions are not guaranteed. Like the presence of a well-maintained elevator so as not to lose your life there. Or the safety of not being beaten to death in the emergency room. You should know that during an audit, 200 female doctors declared that they had been the victim of a physical attack at least once in Tunisian hospitals.
Professional harassment is when an intern is forced to be on call every other day for a year to avoid problems with his hierarchy.
Remuneration is when an associate professor, who graduated 20 years ago, cannot afford to buy a house or an apartment for his family.
And yet, despite all these drawbacks, 50% of these doctors plan to return to Tunisia if the necessary conditions are met. The major condition remains the authorization to work on Tunisian territory.
Let’s take the example of Dr. AB, who went to Belgium to specialize in robotic surgery, which does not exist in Tunisia. To master this surgical technique, he needs at least 10 years. During this period, Tunisian law prohibited him from practicing medicine in Tunisia by prohibiting double registration with the National Council of the Order of Physicians (CNOM). Dr. AB wants to work two weeks in Belgium to realize his dream and two weeks in the regional hospital of his governorate in Tunisia, but given the law, he cannot ensure this shared work.
A real state problem
So let’s sum up the problem: we are faced with a massive departure of Tunisian doctors, who are forced to leave for the reasons mentioned, exposing the country to a real state problem.
How to find a solution to this problem?
The solution is simple and we offer it to decision-makers:
– activate the CNOM to establish partnerships with the CNOMs of the countries where the majority of Tunisian doctors leave;
– establish drastic rules as soon as possible in public hospitals to ensure the safety of caregivers;
– carry out a national audit of health structures which will conclude with a report detailing all the problems;
– create the legal framework that will allow the practice of medicine in Tunisia for doctors who have left: this will allow, firstly, to guarantee a profit in foreign currency for the country, secondly, to share the expertise acquired abroad with young people Tunisian doctors in training, and finally to fight against the shortage of doctors and medical deserts.
* Anesthesiologist Resuscitator.
** The knowledge verification tests (EVC) constitute the first step in the procedure for authorization to practice (PAE) for doctors with diplomas from outside the European Union. Every year, many Tunisian doctors pass these tests and apply for authorizations to practice which open the way for them to emigrate. And this feeds the scourge of the brain drain from which Tunisia suffers today.
