Health care delivery system in France: effects on surgical education

Surgical education in France has changed in recent years. It had to conform to the transformation of surgery into a more scientific discipline, to European Community regulations, and to increasing costs of health care. It is now organized on a national scale and is based on anonymous selection. The main objective is to train general surgeons who only afterward become specialized in various surgical specialties. The aim is to make them able to adapt to the changes that will transform surgery in the near future. In France the obligatory social insurance system, called Social Security, reimburses most medical expenses for 99% of the population. Patients can be reimbursed in a similar way whether they seek treatment in a private or a public institution. However, the system has to face major and presently unsolved problems due to the rapidly increasing cost of health care.