Le processus dit de Bologne est la conséquence de l’initiative prise en 1999 par 21 pays européens, de rendre plus homogène les formations universitaires en Europe. Son but est d’assurer la mobilité des professionnels en rendant comparables leurs diplômes issus de formations universitaires. Ce processus dit aussi LMD, pour Licence, Master, Doctorat est découpé en semestres validant chacun trente crédits universitaires. La licence est obtenue en trois ans, le Master en deux ans supplémentaires et le doctorat en trois ans. Ce processus a été adopté par l’Université et par la plupart des grandes écoles en France. En 2006 les Ministres de la Santé et de l’Enseignement Supérieur et de la Recherche ont initié cette réforme pour la formation des professions paramédicales. «L’universitarisation» de ces formations a permis de délivrer les équivalences universitaires correspondantes pour la plupart des métiers. Ce processus permet d’envisager la création de nouveaux métiers et compétences rendus nécessaires par le progrès médical, la démographie médicale et l’allongement de la durée de vie. Ces nouveaux besoins doivent être évalués qualitativement et quantitativement en amont, par spécialités et par région. Ces nouveaux métiers doivent être exercés au sein d’équipes soignantes multidisciplinaires sous responsabilité médicale.

In 1999, in Bologna, 21 European countries decided to standardize their graduate studies. The aim was to promote the mobility of professionals in organizing an integrated system for European diplomas. The new system (“Bologna process”) is called Bachelor-Master-PhD. The first degree is obtained in three years, the second after two more years and the PhD degree in three more years. Each year is divided into semesters. Every semester is validated by 30 European transfer credits. Universities and most high schools in France adopted this reform. In 2006 both the Minister of Health and that of Research and Education set up a working party to apply this reform to the paramedical professions. The list of training conditions for the 21 paramedical professions showed a high degree of heterogeneity in the content and regulation of the awardered diplomas. Highly varied public or private facilities are involved. Some curses had not been updated during the last twenty years.

The proposed reform is thus aimed at renewing the course content and at giving the diplomas a university label through conventions between the teaching structures and University. There are many challenges, including transfers of registration fees between the teaching structures and Universities. However, a need for “new” diplomas and formations is clear. There are a great many examples of specialist nurses in Europe such as clinician nurses in UK, but also nurses in dialysis, in chemotherapy, in renal transplantation coordination, in therapeutic education... Increase in the number of patients with chronic conditions, limitation of the number of physicians as well as emergence of inter professional collaborations will induce an increased need for these health professionals.

Several diplomas have now the equivalence of University degree: nurses, speech therapists, physiotherapists, dieticians...

The National Academy of Medicine thinks that the described above evolution of paramedical formation is a needed change. The University should have a key role in this reform. The newly emerging professions should be identified upstream by needs assessment for each specialty and each region and these new professionals should be under the responsibility of a medical doctor.