7 November 2016. The statements made by today’s medical students from the Canton of St.Gallen are clear: 90% of them rate the attractiveness of a Master’s degree course in St.Gallen as high, 55% would even be prepared to prefer a Master’s course in St.Gallen to their current university location. According to the project assignment issued by the government a year ago, the project group had to examine three possible variants of implementing a medical degree course in St.Gallen. The group recommends that primarily, the cooperation model with the University of Zurich and Zurich University Hospital should be pursued as the quickest way towards the realisation of a medical Master’s degree course in St.Gallen.

The government also prioritises the cooperation model, which is intended to have a special St.Gallen profile with an attractive curriculum and a particular focus on primary out-patient and in-patient care. The next step will be to calibrate the St.Gallen ideas about this course with possible partners. Basic work with regard to cooperation agreements has already been completed with the University of Zurich and Zurich University Hospital; additional agreements will have to be concluded in the course of the next project stage, always subject to the consent provided by the cantons involved.

From the starting point to recommendations

The lack of specialists is manifesting itself particularly strongly in the health sector. The tendency of the existing shortage of qualified medical personnel to increase even more also has structural reasons. Whereas Germany trains 12.2 medical doctors per 100,000 inhabitants, the Netherlands 14.4 and Denmark even 18.4 medical doctors, Switzerland merely trains 10.6. In addition, the neighbouring countries have continually improved their own medical doctors’ working conditions and income in order to stop them emigrating to Switzerland. The fact that there is no facility for medical training in Eastern Switzerland markedly aggravates the situation for our region.

The project report suggests that the Canton of St.Gallen should set up a medical training facility in cooperation with a partner, primarily with the Canton of Zurich, and that it should initiate the requisite political process. Cooperation between the Universities of Zurich and St.Gallen and Zurich University Hospital and St.Gallen Cantonal Hospital plus the regional hospitals and primary care providers would allow for a quick start of the St.Gallen Medical Master. From the St.Gallen perspective, this course should focus on primary medical care, interprofessional cooperation and medical subjects examined by the University of St.Gallen such as health care management, health economics and governance in the health system.

Besides these policy recommendations, the authors of the report also put forward further proposals for the alleviation of the shortage of doctors, such as advanced courses in medical care or taking measures to reduce the number of people leaving the profession.

Implementation stage initiated

The government hopes that the cooperation project will receive some impetus from the application for participation in the start-up funding for additional medical student places submitted to the Swiss University Conference (SHK). The decision about the projects that will be considered will be made by the SHK in February 2017. For this purpose it issued the project assignation for the “Joint Medical Master St.Gallen” in early November. It will cover the preparatory stage of the cooperation model between 2017 and 2020. In this period of time, all the prerequisites should be put in place to enable approx. 40 students to take their Joint Medical Master’s course in St.Gallen from Autumn Semester 2020.

After the conclusion of the first project stage, the leadership will pass from the Health Department to the Education Department, which in close cooperation with the Health Department will tackle any further work at once. In a first step, the benchmarks will have to be defined which will be relevant to the future medical students’ decision to enrol for the degree course in St.Gallen. In this preparatory work, the University of St.Gallen (HSG) will take on an important role. It is planned that a St.Gallen Medical School will be established at the HSG. The institute will be responsible for the coordination and organisation of the range of courses, the supervision of students, the provision of the infrastructure and the award of lectureships.

In cooperation with the St.Gallen Cantonal Hospital (KSSG), the Eastern Swiss Children’s Hospital and other institutions, the Health Department will ensure that the medical knowledge and the existing know-how in the field of teaching at existing medical faculties will be incorporated by the faculty members into the development of the curriculum and the teaching and learning structures. The new Master’s programme is intended to focus on primary medical care, interprofessional medical care, as well as health management and governance. What is explicitly not the object of this project is the adaptation of the Cantonal Hospital’s status to a university hospital – the St.Gallen Cantonal Hospital will play its role as an academic teaching hospital.

Both the government and the University of St.Gallen and the KSSG are convinced that they will be able to create a modern and pedagogically innovative course in the Joint Medical Master.

Project costs

The estimated costs of CHF 2.19m for known expenditure that will be incurred through the work carried out by the project organisation, and the the preparatory and implementation work in 2017 have been included in next year’s budget. For the following years, the Education Department in consultation with the project organisation and, on a centrally cantonal level, with the Health Department will make the necessary budget requests. The expected project costs for 2018 and 2019, as well as the expenditure for 2020, have already been taken into consideration in the 2018-2020 Tasks and Finance Plan. As a project of a great financial scope, the project is also mentioned in the 2018-2020 TFP Dispatch.

Bild: Photocase / lemminge