New standards approved to reform national system of medical training in Russia. Eugene Gerden reports.
The Russian government has approved new standards for the training of doctors and health care workers in the country, in an attempt to bring their skills level to the highest Western standards and to raise the prestige of the profession of a medical worker in the country, according to recent statements of Veronika Skvortsova, the Russian Minister of Health1.
The development of the new standards became part of the existing state project, known as “New Personnel for Modern Healthcare in Russia”. The main goal is providing skilled health care workers and doctors throughout the country.
According to the latest report of the Russian Ministry of Health, as of January 1, 2019, the total number of health care workers in Russia was 2,162,000 people. At the same time, the ratio of practitioners and medical personnel continues to decline, being currently estimated at 1:2 in Russia. This is significantly lower than Russia’s target indicators in this field of 1:3 and the average EU figures of 1:4.
In its report the Ministry also discussed the current shortage of nurses in Russia, which is equivalent to 270,000 people, and a shortage of doctors of 40,000. The most complex situation is currently observed in the case of anesthesiology-resuscitation, neonatology, and oncology.
At the same time another problem is associated with the current skill level of Russian practitioners and medical workers, many of whom (especially those living in the vast Russian province) continue to use outdated Soviet practices in their work.
Still, according to Skvortsova, there is a possibility that such a situation will change in the coming years thanks to the adoption of new training standards in the industry and tightening of state control for the domestic healthcare industry in regard to personnel training.
As part of the new standards, a new system for assessing skill levels of health care workers in Russia has been approved.
The new system includes the introduction of a practice of primary accreditation for university graduates as well as periodical assessment for accreditation that will be conducted once every five years and will be applied to practitioners and other health care workers.
The goal is to provide the industry with qualified specialists through the introduction of a new procedure for admitting specialists to professional activities - accreditation of specialists - and introducing a system of continuing professional education for doctors using interactive educational modules.
The priority project will create a system of continuing medical education for specialists and move to a fundamentally new mechanism for admission to professional activity - accreditation, which should significantly increase the level of professional competence of medical workers and provide the industry with qualified specialists.
This year 60% of doctors will receive continuous additional professional education using interactive educational modules and by 2025 - 99% of doctors will receive.
By the end of 2019, 64 updated educational standards for training highly qualified personnel for residency programs will be developed taking into account the requirements of professional standards. In 2017, 1,000 interactive educational modules were developed and included in the system of continuing medical education, in 2019 such modules should be at least 3,000, and in 2025 - 5,000.
According to state plans, by 2020, about 25% of practitioners, working in the domestic healthcare industry, should receive admission to professional activities by the new accreditation procedure, while by 2025 their number will grow to 100%. In order to implement these plans, the Russian Ministry of Health plans to establish 114 accreditation and simulation centers that will be located throughout Russia. In the initial stage, their openings will be in the largest cities of the country, Moscow and St. Petersburg to begin to train the most providers and will spread throughout the country.
To this end, in 2018, 97 accreditation and simulation centers are operational, in 2019 - 105 centers should be operational and the plan is for 114 Center in 2025.
Finally, at the beginning of the current year a new federal web-server, which is solely dedicated for continuing medical education has been officially launched in Russia. Thanks to the new web-server2, medical workers in Russia can choose for themselves the necessary courses of both distance and full-time education, along with internships at leading research institutes and clinics in the country.
So far, the latest state initiatives in the field of medical training have been welcomed by some leading Russian practitioners, along with some leading experts in the field of medical training and education. Still, most of them believe this should be just the beginning, while much work should be done to improve the current system with training of medical personnel.
Sergey Shishkin, head of the Center for Health Economics of the Higher School of Economics, one of Russia’s most prestigious universities, comments:
“The continuous training of medical personnel in Russia, which has been lobbying by the state since 2016 is a good initiative for the industry. The amount of knowledge, which is necessary for practitioners and other healthcare professionals for successful work, is constantly growing. However, it is impossible to significantly improve vocational training without changing the quality of education at the university level. The main problem in this case is that students are often studying under outdated programs and experience a lack of access to some modern Western technologies. Another problem is associated with the ongoing sanctions’ pressure on Russia.”
According to him, the system of continuous training should completely replace the outdated postgraduate courses that have ceased to meet the requirements of modern, high-tech and rapidly growing medicine.
The same position is shared by Lyudmila Kozlova, a Deputy Chair of the Committee on Social Policy of the Council of Federation, (the upper house of the Russian Parliament), who said the level of quality of both medical training and education, provided by universities in Russia has significantly declined in recent years.
According to Kozlova, among the major reasons for this is the low level of remuneration of the teaching staff of the majority of domestic medical and pharmaceutical universities3, the lack of social guarantees for teachers, poor technical equipment of local training facilities and the lack of a clinical base.
The situation is complicated by a high level of workload of teachers of medical universities, which is currently estimated at 900 hours per year, along with a high level of bureaucracy and excessive paper work.
About the Author:
Eugene Gerden, a former senior analyst of the Ministry of Health Russia, who currently works as an international free-lance writer, specializing on covering topics in the field of global health care and medical training.
- All medical workers in Russia must undergo accreditation by 2021» – Izvestia business paper, Feb, 19 2018 https://iz.ru/709746/kirill-poliakov-valeriia-nodelman-roman-kretcul-elina-khetagurova/vse-medrabotniki-proidut-akkreditatciiu-do-2021-goda
- Priority Project "New Personnel for Modern Healthcare" –the authorities of the Krasnoyarsk region», March, 9 2019. http://www.krskstate.ru/project/projects/fedproj/zdrav/medhr
- About Kozlova Lyudmila Vyacheslavovna», , Russian Success, 04-8-2018 https://ruspekh.ru/people/item/kozlova-lyudmila-vyacheslavovna
Originally published in Issue 2, 2019 of MT Magazine.