3,000 junior doctors for France's medical deserts: who pays for the care?

According to Le Monde, around 3,000 "docteurs juniors" (junior doctors: final-year general medicine students deployed on the ground) are being posted across the territory. Some 80% of them have been assigned to areas where access to care is seriously lacking. Over a year-long placement, they will handle consultations, treatment and the follow-up of chronic illnesses, all while remaining under the responsibility of a supervising senior doctor, the praticien maître de stage.

Everything that follows is our reading, not an established fact. The dispatch says nothing, at this stage, about these young doctors' pay, their hours, or the burden this places on the supervising doctors. We will not invent it. What we know is enough to ask the question: when a system lacks hands, who supplies them?

Caring is social reproduction work: the labour that keeps people going, day after day, so they can go to work, raise their children and grow old. When the supply of care dwindles, this work does not vanish. It shifts. It falls back on families, and most often on women: the one who takes the elderly mother forty kilometres to her appointment, who takes half a day off unpaid for a single consultation, who monitors the fever because there is no slot to be had. Medical deserts are also kitchens where someone is doing the nursing.

The deployment of junior doctors therefore looks like a public patch. The state is drawing on the most available and cheapest workforce, students at the end of their training, to fill gaps dug by decades of numerus clausus (the cap on medical school places), ward closures and a poorly distributed private practice. Young carers are both trained and used: a convenient status, because a great deal can be asked of them in the name of learning. The real measure will be in the payslip and in working hours, two things we will need to examine closely.

There is also the supervising doctor, often already overstretched, who now takes on supervision too. Mentoring is work; is it recognised, is it compensated? The dispatch does not say.

It would be petty to deny that patients, at last, are finding a doctor. Yet a year-long placement does not make a practice that lasts: at the end of the year, the junior doctors will leave, and the deserts will remain unless something is done to establish posts, salaries and teams on a lasting basis. Healthcare unions have long insisted that fighting for working conditions is the first response to the shortage, not the last.

Care is not a surplus to be handed out when budget is left over. It is the foundation on which everything else rests. As long as it is held up on young, precarious or family shoulders, someone will pay the bill, and it will not be those who decided on the savings.