The development of medical science, the ever-increasing amount of information, the deepening of differentiation and specialization medical care population make it necessary to regularly increase the level professional knowledge medical workers. After graduating from an educational institution, the professional development of a medical worker continues throughout life. The main task, according to the definition adopted by WHO back in 1980, is the continuous improvement of competence medical staff in daily work.
Continuing education is a process designed to help healthcare professionals adapt to changes in medical science and practice, as well as in healthcare management. Continuing medical education should provide additional knowledge at any stage of medical training. At the same time, the volume and degree of assimilated material depend primarily on the level of professional training of a specialist. It is on this basis that it is necessary to build continuous improvement at the state level; it is important to take into account the needs of society and the health system, which is especially important in a period of reform.
The ultimate goal of continuing medical education is continuous improvement quality of preventive and curative care.
Of paramount importance is continuous learning primary health care workers. According to WHO experts, lifelong education models should be reoriented in this way.
The former postgraduate system vocational education and certification of medical and pharmaceutical personnel was focused on narrow specialization. Today, the demands of healthcare practice dictate the need to revive the experience gained in the history of medical education in our country, to use the positive experience of educational institutions foreign countries on comprehensive training, retraining and advanced training of medical workers.
There is currently a large number of types of postgraduate training of doctors. All these training options are constantly being modified, improved, and undergo changes due to the fact that the system of postgraduate education is very dynamic and developing. The system of postgraduate professional education includes 7 educational institutions (academies and institutes) for the improvement of doctors and more than 40 faculties at medical universities. In addition, doctors receive postgraduate professional education at medical research institutes, scientific centers and associations, if the latter have a license to conduct educational activities. Additional vocational training workers with secondary medical and pharmaceutical education is represented by 41 advanced training schools.
The dynamics of changes in the number of students at institutes and faculties of postgraduate education was characterized by an increase in the number of students from 56,000 in 1975 to 141,000 in 1993, and the proportion of students who were trained on the basis of faculties for the improvement of doctors increased during this time from 17% to 43% . At the same time, according to a number of experts, it is advisable to change the current structure of educational institutions additional education, which includes both independent academies and institutes of postgraduate education, and a network of faculties for the improvement of doctors in medical universities. The future here belongs to the faculties of universities. This is evidenced by the recent trend towards an increase in the number of students at the faculties of advanced training of doctors and a certain decrease in their number in academies and institutes of postgraduate education.
The main documents regulating the procedure for postgraduate training of doctors are the “Regulations on the qualification exam for obtaining a specialist certificate”, approved by the Order of the Ministry of Health of the Russian Federation dated November 17, 1995 No. 318, and the Order of the Ministry of Health of the Russian Federation dated August 27, 1999 No. 337 “On the nomenclature of specialties in healthcare facilities Russian Federation". They provide for such innovations as mandatory certification of medical specialists, a new nomenclature of medical specialties, including 70 specialties, and the approval of an educational qualification for each specific medical specialty, i.e. the minimum level of postgraduate training required for the admission of a doctor to independent work in his chosen field of medicine.
In accordance with the current normative documents In Russia, medical and (or) pharmaceutical activities are allowed for persons who have received higher and (or) secondary vocational education and who have a specialist diploma and certificate. Diploma - a document on the level of education, specialty, training and qualifications issued by an educational institution of vocational education of various organizational and legal forms, which has a license for the right to conduct educational activities issued by government agency administration of education or, on his behalf, the local authority of education at the location educational institution based on the opinion of the expert committee.
After graduating from a medical university, a graduate must pass one of the following forms of training in the system of postgraduate professional education:
1) internship (1 year);
2) residency (2-3 years),
3) educational and professional program in the specialty (courses or cycles of improvement with the passing of a certification exam, 1-4 years);
4) postgraduate studies (3 years).
Graduates of medical schools undergo further training in the following order.
For most major medical specialties (about 25) and all dental specialties, the minimum level of postgraduate training is internship. In accordance with the “Regulations on internships”, this type of training should be carried out in large public medical institutions approved by local authorities health care management as bases for the training of interns in this specialty.
The duration of the internship is 11 months. The goal of internship training is to acquire in full the systematized theoretical knowledge and the necessary professional practical skills to perform work as a doctor. During the internship, interns pass two certifications at the specialized department of the university that supervises the training young specialist and at the end of their studies they have the right to pass a qualifying examination to obtain a certificate of a specialist in this specialty.
Specialist certificate - a document of a single sample, confirming the compliance of the specialist's training with state educational standards. The certificate indicates that a specialist has achieved a certain level of theoretical knowledge, practical skills and abilities sufficient for independent professional (medical or pharmaceutical) activities.
The certificate of a specialist is issued by state medical educational and research institutions that carry out postgraduate training of specialists.
At these institutions, examination qualification commissions are created, which conduct verification tests (examinations) of the certificate applicant.
To obtain a certificate, a specialist must submit the following documents to the examination committee:
1. Application.
2. A copy of the diploma of graduation from a medical or pharmaceutical educational institution (faculty).
3. A copy of the diploma or certificate of advanced training and specialty.
4. A copy of the researcher qualification diploma after completing the postgraduate course.
5. Copies of diplomas of a candidate (doctor) of medical (pharmaceutical) sciences and an academic title (senior researcher, associate professor, professor).
6. Copies of previously issued certificates.
7. Achievement list(extract from the work book).
Those who successfully pass the exam will receive a certificate..
To qualify independent work in the main specialty, an internship is a sufficient minimum level of postgraduate education. However, if a doctor wants to master one of the specialties that require in-depth training, then he must undergo a two-stage training: Stage I - internship (or clinical residency, postgraduate study) in the main specialty, Stage II - professional retraining (primary specialization), clinical residency or postgraduate study in the chosen specialty.
The sequence and correspondence of the basic and narrow specialties are strictly regulated: for example, in-depth training in the specialty "nephrology" must be preceded by training in an internship in the specialty "therapy"; primary specialization in the specialty "coloproctology" can be taken by doctors who have successfully completed the first stage of training in the specialty "surgery", etc. Graduates of dental faculties can be trained in narrow dental specialties (therapeutic, surgical, orthopedic or pediatric dentistry, orthodontics) only after receiving a certificate in the specialty "dentistry".
For most specialties requiring in-depth training, the minimum course of study at the second stage is professional retraining, i.e. primary specialization. The duration of such a course of study is at least 500 hours of study (depending on the specialty - from 3.5 to 6 months or more). professional retraining specialists have the right to conduct only state educational institutions that have a license to conduct postgraduate training in this specialty.
For some specialties (for example, cardiovascular surgery, maxillofacial surgery), the minimum level of training at the second stage of training is clinical residency, and therefore the duration of postgraduate training for these specialists is currently at least 3 years: 1 year in an internship in main specialty and 2 years in clinical residency in a narrow specialty. Since 2000, this sequence of postgraduate training in a number of specialties has been mandatory.
Doctors who have successfully completed the II stage of training are entitled to receive a second certificate in the specialty corresponding to the training profile at this stage. At the same time, each of the specialties included in the nomenclature requires a separate course of study. Simultaneous obtaining of certificates in several specialties (even close ones, for example, “endocrinology” and “diabetology”) is not provided for by the current regulatory documents.
The certificate of a specialist gives the doctor the right to work independently in his specialty. Once every five years, all doctors must complete medium-term cycles of thematic improvement (duration of at least 144 academic hours) and re-take an exam to confirm the certificate of a specialist in any licensed state university in the Russian Federation.
Issues of specialization and improvement are closely related to the certification and attestation of medical and pharmaceutical personnel. Certification of medical and pharmaceutical personnel was provided for by Art. 54 "Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens" and introduced in the industry by order of the Ministry of Health and Medical Industry of Russia No. 286 dated 12/19/94.
In connection with the publication of the Decree of the Ministry of Labor of the Russian Federation and the State Committee of the Russian Federation for Standardization, Metrology and Certification No. 21/9 dated 04.20.97 "On the development of a certification system for personnel in the Russian Federation", the Ministry of Health of Russia, together with the Ministry of Labor of the Russian Federation, resolves issues of improving and developing the system of certification of medical and pharmaceutical workers.
In accordance with Art. 63 of the Fundamentals of the Legislation of the Russian Federation on the Protection of the Health of Citizens, an inalienable right of medical and pharmaceutical workers is "obtaining qualification categories in accordance with the level of theoretical and practical training received."
For this purpose, the system of certification of specialists for the corresponding qualification category has been successfully functioning in the healthcare system of Russia for many years.
Certification doctors and paramedical workers is an important stage in improving the professional level of health workers and is aimed at increasing professional responsibility for the performance of their functional duties.
The organization of attestation work is considered as one of the mechanisms of state control over the placement and use of medical personnel, the level and quality of medical care to the population.
Certification is carried out at the request of a specialist and is voluntary.
To certification for the qualification category are allowed:
Persons with higher and secondary medical and pharmaceutical education and who have received the right to engage in medical and pharmaceutical activities in healthcare institutions, regardless of ownership;
Persons with a higher non-medical education, admitted in accordance with the established procedure to medical activities and holding medical and pharmacist positions in healthcare institutions;
Epidemiologists, biologists, zoologists, entomologists working in healthcare institutions in their respective positions (with the participation of specialists in these profiles in the work of the commission).
In accordance with the order of the Ministry of Health of the Russian Federation No. 314 dated August 9, 2001 “On the procedure for obtaining qualification categories”, the procedure for obtaining qualification categories by specialists, as well as the structure and main functions of attestation commissions, is determined.
Upon receipt of the qualification category are evaluated professional qualification competence, as well as the ability to perform job responsibilities according to the position. The qualification of a specialist is determined by three qualification categories: second, first and highest.
A specialist can receive a qualification category in specialties corresponding to both the main and combined positions. The qualification category is valid for five years from the date of issuance of the order on its assignment.
Specialists who have expressed a desire to obtain a qualification category, submit to the certification commission an application filled out certification sheet and a report on work for the last three years - for specialists with higher professional education and for the last year - for employees with secondary professional education, approved by the head of the organization in which the specialist works. Three months before the expiration of the qualification category, a specialist can submit an application to the certification commission to confirm the existing qualification category or obtain a higher one.
The specialist has the right:
Get a qualification in attestation commission.
Familiarize yourself with the documents submitted to him "to the attestation commission.
Obtain clarification from the manager writing, in case of refusal of the head to sign the report on the work.
Undergo professional development.
Apply with an application to the Central Attestation Commission or the body under which the Attestation Commission was created, in case of disagreement with the decision of the Attestation Commission.
In order to exercise the right to receive a qualification category, attestation commissions are created:
Central Attestation Commission - Ministry of Health of the Russian Federation.
Attestation commissions - health authorities of the constituent entities of the Russian Federation, centers of state sanitary and epidemiological surveillance in the constituent entities of the Russian Federation, Federal Office biomedical and extreme problems under the Ministry of Health of the Russian Federation.
Attestation commissions in healthcare institutions, scientific and educational medical institutions - by the Ministry of Health of the Russian Federation, other ministries and departments according to their subordination.
Certifying commission:
Determines the order, procedures and methods of work of the commission.
Involves independent experts to give opinions on reports on work.
Considers the submitted documents within two months from the date of their receipt (registration).
Makes decisions on the assignment, confirmation or withdrawal of qualification categories.
Issues a certificate of the established form and, if necessary, an extract from the order on obtaining a qualification category.
Conducts business.
Assessment of qualifications and recommendations for further vocational training specialist are accepted by voting in the presence of at least 2/3 of the number of members of the approved composition of the attestation commission. The results are determined by a majority vote of the members present.
The body under which the attestation commission is established, within one month, issues an order on the assignment of a qualification category, which is brought to the attention of the specialist and the head of the healthcare institution.
When assigning a qualification category, it is recommended to follow the sequence of category assignment (second, first, highest).
In some cases, a specialist, taking into account his high theoretical and practical training in the chosen specialty, good performance in work, a higher qualification category can be assigned without established requirements to work experience.
Professionals with a doctoral degree medical sciences and employed in medical and preventive work in healthcare institutions, research and educational institutions, the highest qualification category in the relevant specialty is assigned in absentia on the basis of the presentation of the head of the institution where the doctor of science works.
Specialists who, based on the results of certification (re-certification), have been assigned a qualification category, are issued a certificate of the established form.
Recertification to confirm the existing qualification category is carried out every five years without fail.
In case of refusal of a specialist from the next recertification, the qualification category assigned earlier is lost from the moment of the expiration of the five-year term for its assignment.
In recent years, the interest of specialists in obtaining a qualification category has sharply increased. In order to improve the certification system for the assignment of qualification categories, for the first time, a nomenclature of specialties for nursing and pharmaceutical personnel and a list of correspondence of specialties to positions were developed and approved. Developed qualification characteristics and regulations on specialists in accordance with the nomenclature (for 26 specialties), which made it possible to streamline and unify the work of attestation commissions, establish firm regulations that contribute to rational use and placement of middle managers.
The qualification characteristics and positions of medical specialists are being reviewed. Currently, the nomenclature of medical specialties includes 70 specialties. Over the past decade, new specialties have been introduced: diabetology, general practice(family medicine), allergology and immunology, geriatrics, maxillofacial surgery, audiology - otorhinolaryngology, transfusiology, clinical pharmacology and pediatric oncology.
New learning programs, qualification characteristics of specialists are being developed, compliance with which should be a criterion for issuing appropriate certificates to doctors. To unify the certification examination procedure, a bank of test items for each specialty has been created.
Particular attention is paid to certification (certification) cycles for professionals with experience practical work and medical categories. These cycles last at least 2 months. are organized mainly in universities at the faculties of postgraduate professional education. They can be conducted in the form of intermittent full-time and part-time face-to-face cycles. Curricula should be drawn up taking into account the requirements for each qualification category. Representatives of health authorities and medical associations should take an active part in the attestation procedure.
Another important problem is re-certification - the certification of specialists with the highest certification category. For this group of doctors, criteria can be proposed confirming their active work to improve professional excellence: participation in congresses and conventions, publications, teaching and research work, etc. It is also possible to organize special three-four-week improvement cycles.
Certification is one of the mechanisms of state control over the quality of training of specialists, which is voluntary procedure and aims to stimulate the growth of staff qualifications.
Part attestation commission includes leading specialists of medical and preventive, research institutions, higher medical educational institutions, chief specialists of the health management body, representatives of professional medical associations.
The Ministry of Health of the Russian Federation, by its Order dated 09.08.2001, approved the Regulations defining the procedure for obtaining qualification categories by specialists working in the healthcare system of the Russian Federation. In accordance with this Regulation, when obtaining a qualification category, professional qualifications, competence, as well as the ability of a specialist to perform official duties in accordance with the position held are evaluated.
The qualification of a specialist is determined by three qualification categories: second, first and highest.
To certification are allowed specialists with work experience in the certified specialty:
for the assignment of the highest category - 10 years, of which 3 years in one place
To pass certification (re-certification) for a qualification category, a specialist submits the following documentation:
1. Application
2. Attestation sheet
3. Report on work for the last three years, approved by the head of the medical institution
Attestation procedure represents the passing by a specialist of a qualification exam for the assignment of a qualification category. The attestation exam can take place both in the form of testing and in the form of an interview and is conducted by examination boards in specialties. Practical skills are assessed based on the submission of a work report from the main place of work for the last 3 years.
Assessment of qualifications and recommendations for further professional training of a specialist are adopted by voting in the presence of at least 2/3 of the number of members of the approved composition of the certification commission. The results are determined by a majority of votes, and in case of equality of votes, the decision is considered adopted in favor of the specialist.
The decision of the attestation commission is drawn up in a protocol, which is signed by the chairman, secretary and members of the commission who took part in the meeting. Then, the body under which the attestation commission is established, within one month, issues an order on the assignment of a qualification category, which is brought to the attention of the specialist and the head of the healthcare institution.
Recertification to confirm the existing category is carried out every 5 years. In case of refusal of a specialist from the next recertification, the previously assigned qualification category is lost from the moment of the expiration of the five-year period for its assignment.
Certification- a mandatory procedure for all categories of medical workers, since a specialist certificate is required to engage in professional (medical and pharmaceutical) activities.
Specialist Certificate- This is a document of a single sample, confirming the compliance of the training of a specialist with state educational standards. The result of obtaining a specialist certificate is the admission of a specialist to the implementation of professional medical activities. Persons who do not have a certificate can only work as trainees under the supervision of a certified specialist.
Personnel certification is carried out qualification commissions, which are created at state universities and scientific research institutes of a medical profile, as well as at professional medical associations.
Certification procedure is the process of passing a qualifying examination to obtain a specialist certificate. The qualification exam is conducted by examination commissions in specialties approved by the Ministry of Health of the Russian Federation.
To pass the qualifying exam, the medical worker provides the following documents:
1. Application
2. Copy of medical school diploma
3. Copies of state documents on the passage of various forms of postgraduate or additional professional education
4. Copies of previously issued certificates
5. Copy of work book
Exam includes three parts: test control, determination of practical skills, final interview.
To the qualification exam for a specialist certificate are allowed medical workers:
1. Of the inexperienced professional activity - persons who have completed internship, residency, postgraduate studies in clinical disciplines
2. Of those with experience- specialists who have improved their qualifications in cycles of improvement in their specialty in licensed institutions over the past 5 years or who have completed doctoral studies in a clinical discipline.
Regulation labor relations in healthcare. The procedure for hiring, dismissal from work, transfer to another job.
CERTIFICATION OF AVERAGE MEDICAL WORKERS.
The organization of attestation work is one of the mechanisms of state control over the placement and use of medical personnel, the level and quality of the provision of medical and preventive care to the population.
The legal significance of attestation for a particular employee lies in the fact that, based on its results, a qualification category is assigned, on which the amount of remuneration depends. The regulation on the procedure for obtaining qualification categories by specialists working in the healthcare system of the Russian Federation was approved by order of the Ministry of Health of the Russian Federation of August 9, 2001. This document applies to both specialists with higher and secondary professional medical education working in the healthcare system.
Persons with higher medical and pharmaceutical education and who have received the right to engage in relevant activities, as well as epidemiologists, biologists, zoologists, entomologists working in healthcare institutions in relevant positions, are allowed to be certified for the qualification category. Secondary medical and pharmaceutical workers are also subject to certification.
Attestation is carried out by attestation commissions created under the health authorities of the constituent entities of the Russian Federation, health care institutions, education, and scientific institutions. The structure and composition of the attestation commissions are determined by the body under which they are created. The main form of testing the theoretical knowledge and practical skills of a specialist is a certification exam conducted using test tasks.
The qualification category assigned to medical workers is valid for 5 years from the date of issuance of the order on its assignment. Three months before the expiration of the qualification category, an employee can apply to the certification commission with an application to confirm the category he already has or receive a higher one. Certification of specialists is carried out at the expense of the institution in which the specialist works, professional associations, and scientific societies. It is also possible to carry out attestation at the expense of the person being certified.
Qualification of specialists is carried out in 3 qualification categories: second, first and highest. When assigning each of them, the certification committee is guided by the following criteria:
The order of assignment of categories (second - first - highest);
Work experience in the specialty (for the second - at least 3 years; for the first - at least 5 years; for the highest - at least 7 years);
Work experience in this medical institution - at least 3 years;
Fulfillment of relevant qualification requirements for a specialist.
Certification is carried out, as a rule, at the location of the commission, but its off-site meetings are also possible. The Commission is obliged to consider the submitted certification materials for the assignment of a qualification category within 3 months from the date of their receipt. Pregnant women and mothers who have children under 3 years of age and are on leave to care for them are exempted from the next recertification. The deadline for their recertification in these cases is postponed.
Professional competence and qualification of a specialist are determined by the results of the certification exam using test items. At the end of the exam, the attestation commission, by a majority of votes, decides on assigning a qualification category to a specialist. In case of equality of votes, the decision is made in favor of the person being certified. Specialists who have successfully passed the exam are assigned the appropriate qualification category and issued a certificate of the established form, certified by the seal of the institution or health authority under which the certification commission was created. Attestation materials are stored in the attestation commission for 5 years. In case of refusal of a specialist from the next recertification, the previously assigned qualification category is lost from the moment the 5-year period for its assignment expires.
— it is a right, not a duty. Why such certification is needed and how it is carried out, we will tell in our article.
Certification is not advanced training
Right to exercise medical activity in our country have persons with a special education and a certificate of accreditation.
IMPORTANT! Until 2016, instead of an accreditation certificate, a specialist certificate was required. Since accreditation is gradual, the issuance of such certificates will continue until 2021 and they will be valid until the end of the period for which they were issued (paragraph 1,Clause 1, Part 1, Part 2, Art. 100Law of November 21, 2011 No. 323-FZ).
Since in the hands of doctors the most precious thing a person has is his health, the state is trying to carefully control the qualifications of medical personnel. So, it is mandatory for them to constantly improve their skills. It must be carried out at least once every 5 years throughout the entire labor activity specialist. This is always training in educational or scientific organizations, followed by an exam and the issuance of a special document - a certificate.
Unlike mandatory advanced training, certification for a category is purely voluntary. It affects not so much the professional as the material side of the work of a physician (the presence of a category, among other things, makes it possible to receive higher remuneration). Although certification also assesses the level of knowledge and skills of a specialist and there is a final exam.
ABOUT material incentives in medical organizations read the article .
Certification of medical workers in 2017: legal framework
Certification of medical workers V 2017 year, as well as in 2016, is regulated by a special NLA - Order of the Ministry of Health of Russia dated April 23, 2013 No. 240n, which determines the procedure and procedure for obtaining categories.
This procedure is the same for persons with higher and secondary education. Wherein:
- specialists with higher medical and pharmaceutical education are certified according to the nomenclature of specialties from the order of the Ministry of Health of Russia dated 07.10.2015 No. 700n;
- specialists with secondary medical education - according to the nomenclature from the order of the Ministry of Health and Social Development of Russia dated April 16, 2008 No. 176n;
- specialists with other higher vocational education - according to positions according to the nomenclature approved by order of the Ministry of Health of Russia dated December 20, 2012 No. 1183n.
IMPORTANT! "Attestation" order No. 240n came into force on 08/04/2013. Categories assigned before this date continue to be valid for the entire period for which they were assigned.
There are 3 qualification categories in total:
- second;
- first;
- higher.
For each of them, by order No. 240n, the requirements for experience, knowledge and skills of a medical specialist are fixed.
General rules for the certification of doctors and mid-level health workers
Certification of medical workers conducted by an expert group of a special attestation commission. The exam itself includes 3 stages:
- Expert evaluation of the report on professional activity specialist. Such a report is submitted by the applicant in the package of documents required for certification, and is preliminarily evaluated by the commission with a conclusion.
- Testing. Completion of 70% of the total volume of test tasks is considered successful.
- Interview on theory and practice.
The final result of the exam / certification will be the decision of the commission to assign a category or refuse it. In case of disagreement, the decision can be appealed to the state authority or organization that created the commission. It takes exactly one year.
Results
Certification of medical workers for the category is an exam that evaluates the theoretical knowledge and practical skills of a physician necessary in his work. Unlike mandatory advanced training, attestation is voluntary. Its presence gives the specialist certain advantages, including material ones.
Find out about the duration of the working week for medical professionals from the article .
