Bill 33-21 amending and supplementing law 131-13 on the practice of medicine in Morocco has been controversial since its adoption by the Council of Government on May 27, 2021. A project that aims to facilitate access for doctors foreigners in Morocco in order to fill the huge shortage of medical personnel and support the social protection project initiated by King Mohammed VI.
But professionals from both the private and public sectors, through their unions, see this bill as a ” fiasco“, Thus denouncing the lack of consultation for its development, especially since it will allow foreign doctors to practice the profession in Morocco without restrictive conditions.
To better understand this file, MoroccoLatestNews met with the President of the National Council of the Order of Physicians, Dr. Boubekri Mohammadin.
MoroccoLatestNews: Why this controversy around PL 33-21 relating to the practice of medicine in Morocco?
Dr. Boubekri Mohammadin. : First, I would like to point out that there are two bills. There is the PL concerning foreign doctors which was filed on January 10, 2019 by the Ministry of Health. After sending this project to the CNOM, the order held a meeting with the director of litigation and the director of hospitals within the Ministry of Health on December 27, 2019.
In this PL which was presented to us, there were 4 articles to modify of law 131-13, in particular the obligation of three years’ experience for the foreign doctor wishing to practice in Morocco and the obligation of the equivalence of diplomas.
Subsequently, the CNOM held its General Assembly on January 10 and 11, 2020 where we adopted almost all the modifications of the PL which was presented to us by requiring the experience of 3 years, the equivalence and the reciprocity of Moroccan doctors. with foreign doctors as well as the revision of the Moroccan health map.
In the bill 33-21 which was adopted by the CG, we found other articles which were not mentioned in the PL of 2019. These articles exempt foreign doctors from any condition of access to the market Moroccan. That is to say the condition of 3 years’ experience, the condition of equivalence of diplomas and the condition of the quality of diplomas.
The controversy that has been created comes after CNOM’s concerns for the health of Moroccans. Why ? Because in all the countries of the world, there is a commission that checks the scientific quality of the diplomas presented by foreign doctors to make sure.
To do this, this commission carries out a theoretical examination for these foreign doctors, a practical knowledge examination and a linguistic examination to find out the level of the language spoken in the country where he is going to practice his profession. These are simple requirements.
What will a health card be used for?
For the CNOM, we are aware of the shortage of doctors that exists in Morocco. But we will have to know where this shortage is according to the regions, the specialties and the sectors. We will have to know how many foreign doctors will settle in remote regions where there is a shortage of doctors or how many foreign doctors will settle in the public sector and how many in the private sector.
If we eliminate all the conditions of access to the Moroccan market to accept foreign doctors and without imposing the condition of regionalization, that will be catastrophic for the sector. All the foreign doctors will settle in Casablanca and Rabat and this bill will be a fiasco.
For us, it is absolutely necessary to review the health map and the needs of each region according to each specialty. But so far, no study has been carried out by the Ministry of Health to know the needs of each region and each sector.
It should be noted that there are three categories of foreign doctors. There is category A which we call competent doctors or senior doctors. With this category we will have to require an experience of 5 years and a requirement for them to teach their practices and their know-how to Moroccan faculties, CHUs and hospitals. This is category A whose skills are known to all.
Then there is category B. These are Moroccan doctors residing abroad. For this category, and according to law 131-13, there is a limited duration of the exercise of the profession in Morocco of 30 days accumulated per year. (Chapter IV: Exercise of the profession of medicine by non-resident physicians: Article 31: Notwithstanding the provisions of Chapter III of this title and the legislation relating to the entry and stay of foreigners in the Kingdom of Morocco, Irregular emigration and immigration, non-resident doctors in Morocco may be authorized to practice exceptionally in the following cases for a period the total of which does not exceed 30 days per year ). At the level of the CNOM, we are not against increasing the duration of this period to 3 months without any registration to the order.
Then there is category C. It is the new foreign doctors who do not have much experience. A period of 3 years of experience is required, an examination of know-how on the theoretical level, linguistic practice. If these young doctors do not have the experience of 3 years, they must practice in an approved establishment (CHU or regional hospital or hospital of foundation like Sheikh Zayed) under the control of the pairs (Moroccan doctors who train them). All this to preserve the health of Moroccan citizens.
What do you think of the amendments proposed by the CSNMSP, SNMG, SNMSL and ANCP?
For us, and so that foreign doctors practice in Morocco, whether in remote areas or in the center, especially for novice foreign doctors, they must absolutely practice in approved institutions to control their competence.
Because, if we refer to the royal discourse which demands the overhaul of the health system and for a real investment in the health system, these foreign doctors must practice in the public and private sector. For us, these associations must change their recommendations regarding seniority and practice in the sector.
Isn’t it better to motivate national skills, future doctors or Moroccan doctors living abroad to fill this shortage instead of calling on foreign doctors?
In the recommendations of the general assembly of the councils of the CNOM addressed to the Minister of Health and during the meeting with the Minister, the motivation of the Moroccan doctor was demanded so that he does not immigrate abroad and thus be able to stop this hemorrhage.
We also asked for the motivation of doctors in the public sector so that they do not give up their post or the support that must be provided to retired Moroccan doctors for their installation in the private sector with fiscal and financial motivations …
For Moroccan doctors abroad a recommendation was delivered for the abolition of the duration of one month and spread it to 3 months by also removing the registration to the Order of Physicians in Morocco, given the requirement of register in one order and not two.
How do you think the shortage of doctors can be remedied and the health system reformed?
We must create a health map to know the needs and the offer of care. We must review the national pricing within the national health insurance agency (ANAM) and especially think about a real motivation of professionals. And finally, change the governance of this health system.