Russian Government to Reform National System of Medical Training

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.

Lecture for students of the The First Pavlov State Medical University of St. Petersburg, one of Russia’s oldest and most prestigious medical universities. Image credit: press-service of the University.

The development of the new standards becamepart of the existing state project, known as “New Personnel for ModernHealthcare in Russia”. The main goal is providing skilled health care workersand doctors throughout the country.

According to the latest report of theRussian Ministry of Health, as of January 1, 2019, the total number of healthcare workers in Russia was 2,162,000 people. At the same time, the ratio ofpractitioners and medical personnel continues to decline, being currentlyestimated at 1:2 in Russia. This is significantly lower than Russia’s targetindicators in this field of 1:3 and the average EU figures of 1:4.

In its report the Ministry also discussedthe current shortage of nurses in Russia, which is equivalent to 270,000people, and a shortage of doctors of 40,000. The most complex situation iscurrently observed in the case of anesthesiology-resuscitation, neonatology,and oncology.

At the same time another problem isassociated with the current skill level of Russian practitioners and medicalworkers, many of whom (especially those living in the vast Russian province)continue to use outdated Soviet practices in their work.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 apossibility that such a situation will change in the coming years thanks to theadoption of new training standards in the industry and tightening of statecontrol for the domestic healthcare industry in regard to personnel training.

Veronika Skvortsova, Russia's Minister of Health, who is the main initiator of the reforming of the Russian national system of medical training. Image credit: Russian Ministry of Health.

As part of the new standards, a new systemfor assessing skill levels of health care workers in Russia has been approved.

The new system includes the introduction ofa practice of primary accreditation for university graduates as well asperiodical assessment for accreditation that will be conducted once every fiveyears and will be applied to practitioners and other health care workers.

The goal is to provide the industry withqualified specialists through the introduction of a new procedure for admittingspecialists to professional activities - accreditation of specialists - andintroducing a system of continuing professional education for doctors usinginteractive educational modules.

The priority project will create a systemof continuing medical education for specialists and move to a fundamentally newmechanism for admission to professional activity - accreditation, which shouldsignificantly increase the level of professional competence of medical workersand provide the industry with qualified specialists.

This year 60% of doctors will receivecontinuous additional professional education using interactive educationalmodules and by 2025 - 99% of doctors will receive.

By the end of 2019, 64 updated educationalstandards for training highly qualified personnel for residency programs willbe developed taking into account the requirements of professional standards. In2017, 1,000 interactive educational modules were developed and included in thesystem of continuing medical education, in 2019 such modules should be at least3,000, and in 2025 - 5,000.

According to state plans, by 2020, about25% of practitioners, working in the domestic healthcare industry, shouldreceive admission to professional activities by the new accreditationprocedure, while by 2025 their number will grow to 100%. In order to implementthese plans, the Russian Ministry of Health plans to establish 114accreditation and simulation centers that will be located throughout Russia. Inthe 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 spreadthroughout the country.

To this end, in 2018, 97 accreditation andsimulation centers are operational, in 2019 - 105 centers should be operationaland the plan is for 114 Center in 2025.

Doctors from the Solnechogorsk regional hospital can use the new federal web-server for continuing medical education. Image credit: Solnechogorsk regional hospital.

Finally, at the beginning of the currentyear a new federal web-server, which is solely dedicated for continuing medicaleducation has been officially launched in Russia. Thanks to the newweb-server2, medical workers in Russia can choose for themselves the necessarycourses of both distance and full-time education, along with internships atleading research institutes and clinics in the country.

Sofar, the latest state initiatives in the field of medical training have beenwelcomed by some leading Russian practitioners, along with some leading expertsin the field of medical training and education. Still, most of them believethis should be just the beginning, while much work should be done to improvethe current system with training of medical personnel.

Sergey Shishkin, head of the Center forHealth Economics of the Higher School of Economics, one of Russia’s mostprestigious universities, comments:

“The continuous training of medicalpersonnel in Russia, which has been lobbying by the state since 2016 is a goodinitiative for the industry. The amount of knowledge, which is necessary forpractitioners and other healthcare professionals for successful work, isconstantly growing. However, it is impossible to significantly improvevocational training without changing the quality of education at the universitylevel. The main problem in this case is that students are often studying underoutdated programs and experience a lack of access to some modern Westerntechnologies. Another problem is associated with the ongoing sanctions’pressure on Russia.”

According to him, the system of continuoustraining should completely replace the outdated postgraduate courses that haveceased to meet the requirements of modern, high-tech and rapidly growingmedicine.

The same position is shared by LyudmilaKozlova, a Deputy Chair of the Committee on Social Policy of the Council ofFederation, (the upper house of the Russian Parliament), who said the level ofquality of both medical training and education, provided by universities inRussia has significantly declined in recent years.

According to Kozlova, among the majorreasons for this is the low level of remuneration of the teaching staff of themajority of domestic medical and pharmaceutical universities3, the lack ofsocial guarantees for teachers, poor technical equipment of local trainingfacilities 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.

Aboutthe Author:

Eugene Gerden, a former senior analyst ofthe Ministry of Health Russia, who currently works as an internationalfree-lance writer, specializing on covering topics in the field of globalhealth care and medical training.

References

1. 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
2. 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
3. About Kozlova Lyudmila Vyacheslavovna», , Russian Success, 04-8-2018

https://ruspekh.ru/people/item/kozlova-lyudmila-vyacheslavovna

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Originally published in  Issue 2, 2019 of MT Magazine.