Résumé
Le processus dit de Bologne est la conséquence de l’initiative prise en 1999 par 21 pays européens, de rendre plus homogène les formations universitaires en Europe. Son but est d’assurer la mobilité des professionnels en rendant comparables leurs diplômes issus de formations universitaires. Ce processus dit aussi LMD, pour licence, master, doctorat est découpé en semestres validant chacun trente crédits universitaires. La licence est obtenue en trois ans, le Master en deux ans supplémentaires et le doctorat en trois ans. Ce processus a été adopté par l’Université et par la plupart des grandes écoles en France. En 2006 les Ministres de la Santé et de l’Enseignement Supérieur et de la Recherche ont initié cette réforme pour la formation des professions paramédicales. « L’universitarisation » de ces formations a permis de délivrer les équivalences universitaires correspondantes pour la plupart des métiers. Ce processus permet d’envisager la création de nouveaux métiers et compétences rendus nécessaires par le progrès médical, la démographie médicale et l’allongement de la durée de vie. Ces nouveaux besoins doivent être évalués qualitativement et quantitativement en amont, par spécialités et par région. Ces nouveaux métiers doivent être exercés au sein d’équipes soignantes multidisciplinaires sous responsabilité médicale.
Summary
In 1999, in Bologna, 21 european countries decided to homogenize the teaching organization throughout Europe. This initiative was held to facilitate mobility and exchanges of professionals in organizing a correspondence system for European diplomas. The reform is called Bachelor-Master- PhD. The first degree is obtained in three years, the second after two more years and the PhD degree in three more years. Each year is divided in semesters. Every semester is validated by 30 European transfer credits. The whole system is called the “Bologna process”. Most of the universities in France and high schools have gone through this reform.
In 2006 both Minister of Health and Minister of Research and Education decided to organize a working group to apply this reform to the paramedical professions.
The inventory of formation of the 21 paramedical professions diplomas showed a high degree of heterogeneity in the content and legal form of the delivered diplomas. Multiple different structures, private or public are involved in this formation. Some of the content had never been updated since 20 years.
The proposed reform goal was to renew the content of the formation and to give the diplomas a university label through conventions of the teaching structures with University.
The difficulties are many, including transfer of the registration fees from the teaching structures and University.
However, a need for “new” diplomas and formations is clear. Examples of specialized nurses are multiple in Europe such as clinician nurses in UK, nurses specialized in dialysis, in chemotherapy , in renal transplantation coordination ,in therapeutic education…Increase number of patients with chronic diseases, limitation of the number of physicians as well as the emergence of inter professional collaborations will induce an increased need for health professionals.
Several diplomas have now their University equivalence: nurses, speech therapists, physiotherapists, dieticians…
The National Academy of Medicine thinks that the described evolution of paramedical formation is a necessity. The University should play a central role in this reform. The new emerging professions should be identified upstream by analyzing the needs by specialty and territory. The exercise of those new professional should be placed under the responsibility of a physician.
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Bull. Acad. Natle Méd., 2015, 199, n° 4-5, 705-715, séance du 7 avril 2015
