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I.3.7 The role of medical education
The demography of health professionals can be regulated through the entry to medical
schools with the use of “numerus clausus”. According to OECD statistics, there are
differences across countries over medical school enrolment. Some countries exercise
some form of control over medical school intakes (OECD, 2008). These controls take the
form of a “numerus clausus” 71 (see Table 5). In fact, countries have modified these caps
at different times. France, Denmark, Italy, Germany and Netherlands, Portugal and more
recently Belgium have adopted a numerous clausus system. Other countries, such as
Ireland, leave some discretion.
Countries with a higher graduation rate for instance such as Denmark, Austria, Greece,
and Ireland, more liberal policy have adopted a relaxed student intake policy (OECD,
2009). Portugal has the lowest graduation rate among OECD countries. Denmark and
Italy have graduation rates above the OECD average (OECD, 2008). There is also
variation regarding the duration of medical studies.
Regarding ECE countries, for instance, Romania has not restrictions on the entry of
medical schools (numerus clausus). Each university decides for itself the number of
students to be admitted to study medicine, depending on the available funding (Vladescu
et al., 2008). In Estonia, due to an oversupply of doctors, the national government
decided to reduce the number of students admitted from 200 per year in the 1980s to 70
in 1995. Nevertheless, since 2004, the government has increase the admission level to
140 per year (Koppel et al., 2008)
A high proportion of the international immigration consists of students. In fact, students
mobility is some kind of temporal immigration, though in many cases becomes
permanent. The OECD estimated that around three million of students in higher
education are enrolled outside the country of citizenship. The exact number of students
outside is difficult to estimate. Data on international student flows can be collected from
the OECD. Australia, France, Germany, UK, and United States receive more than 50% of
all foreign students worldwide. In particular, the USA received almost 19% of all foreign
students worldwide, followed by UK (10%), Germany (7), France (7) and Australia (7).
Also, significant numbers of foreign students were enrolled in Canada (6%), Spain 82%),
71 It is a policy instrument which countries have used by changing the cap at different times.
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