Reform of the first year of medical studies and diversification of student profiles in France: an unmet need?

Abstract

Abstract Objectives: To determine whether the reform of the first year of medical studies implemented in September 2020 in France met its objective of diversifying the profiles of students admitted to second year at the faculty of medicine at the University of Tours. Methods: Single-centered, retrospective study, covering students who passed the first year of medical studies between 2018 and 2022. Student profiles originating from three different entry gateways (PACES, PASS and L.AS) to the second year of medical studies were compared. Results: 1479 students over five promotions were included. The ratio of students who had obtained a scientific baccalaureate was 98.8% in the reform year compared to 99.2% in average to the previous years. For students in the reform year, 43.4% passed their high school diploma with highest honors compared to 57.9% in average the previous years while 11.8% obtained their high school diploma with a standard pass, compared to 2.2 % in average the previous years (p < 0.001). These differences were related to increased student intake via a standard pass in L.AS (44.8% to 8.5% in PACES and 1.5% in PASS) (p < 0.001). In terms of geographical origin, the ratio of students domiciled in the territory of the faculty of medicine was one in two students from PACESand PASS (average: 50.5%) compared to one in three from L.AS(33.9%) (p = 0.023). The proportion of students with at least one or both parents from the white-collar and knowledge professional category was higher in PASS (1 parent: 72.8% compared to 57.2% in PACES and 48.2% in L.AS (p = 0.002); 2 parents: 34.6% compared to 26.2% in PACES and 17.9% in L.AS (p = 0.051)). Conclusions: Students with a scientific background and who obtained highest honors in their high school diploma, remain the standard in PACESand PASS. Diversification of student profiles was achieved only within the L.AS gateway, which represented only a minority of students (17%) of total second year admissions. Student profile diversification was therefore a partially achieved objective and follow up studies of future promotions is needed to assess the medium and long-term impact of the reform. Particular attention should be paid to the future of these students who have different profiles between L.ASand PASS to determine whether these changes will have any impact in the quality of healthcare for the French population.