The National Medical Chamber is dissatisfied with the quality of retraining for surgeons, anesthesiologists and resuscitators

The National Chamber of Medicine is dissatisfied with the quality of retraining for surgeons, anesthesiologists and resuscitators. Doctors of other specialties were allowed to retrain in these areas at the end of 2022 due to staff shortages. According to the chamber, due to the lack of proper controls, some centers began to engage in “diploma trading” without actual training. The Ministry of Health does not agree with the claims: the department reminds that all such organizations must have a license for educational activities, which means they meet the strict requirements of the regulator. The ministry adds that all graduates undergo an accreditation commission with the participation of public organizations.

Let us recall that in December 2022, the Russian government simplified the mechanism for retraining doctors with specializations in general medicine, pediatrics and clinical medicine to become anesthesiologists-resuscitators, orthopedic traumatologists and surgeons. Resolution No. 2351 allows doctors to be admitted to a new job after 504 hours of retraining (for those who have completed clinical residency) or 1296 hours (after internship training). The Federation of Anesthesiologists and Resuscitators of Russia explained this decision by a lack of personnel. The Ministry of Health also said that this “will help reduce the staff shortage.” According to the department, the country lacks about 25-26 thousand doctors and about 50 thousand specialists with secondary medical education.

The National Chamber of Medicine (NCM) recently discussed the implications of this ruling. A member of the board of the Association of Doctors of the Belgorod Region, surgeon Sergei Nikolaev, said that the quality of such training raises strong doubts “primarily due to the acquired manual skills.” In addition, he does not understand who retrains doctors and how. Mr. Nikolaev recalled that the Russian Ministry of Health has not yet determined the professional requirements for educational organizations applying for clinical residency training in these specialties as part of professional retraining. Draft orders with training and retraining programs were previously posted on the regulation portal, but have not yet been approved. Meanwhile, “a lot of cases” are known, the surgeon emphasized, when such training is carried out in absentia, remotely – and almost always for a fee.

A diploma of professional retraining has ceased to have the status of a state document, Mr. Nikolaev said; to issue it to an institution, only a license for educational activities is sufficient. “Cases of outright selling of documents have emerged. So, for example, a diploma of professional retraining in surgery in the amount of 1296 hours can be purchased for 35 thousand rubles,” the press service of the National Medical Chamber quotes Sergei Nikolaev.

Vice-President of the NMP Natalya Aksenova believes that the situation will be difficult to change without amendments to the federal law “On Education”. After all, licenses for educational activities are issued by regional authorities, and the mechanism of professional and public accreditation of educational programs is optional. Advisor to the President of the Union of NMP Vladimir Plyakin added that the National Medical Chamber has an agreement with the Ministry of Health, which contains a clause on professional and public accreditation of educational programs. However, this point, according to him, “is not being implemented to the proper extent.”

The President of the Association of Medical Workers of the Republic of Tatarstan, Irina Pitulova, proposed conducting professional retraining only in government institutions. But the president of the National Association of Non-Governmental Medical Organizations, former assistant to the Minister of Health of the Russian Federation, Ilya Shilkrot, believes that the issue is not the form of ownership, but the organization’s responsibility for trained personnel. According to him, it is necessary to make systemic decisions: “For example, so that at the end of the residency there is a commission not only from representatives of the educational organization, but also from public organizations and the employer. And so that during the residency training process there is also public control – what people learn, whether they go to classes or just receive documents.”

The chief oncologist of the Russian Ministry of Health, Andrei Kaprin, noted that a clinical resident receives a stipend of 15 thousand rubles for several years of training: “It is necessary to establish a decent stipend, which must be supported by a social package, otherwise the problem cannot be solved.”

As a result, the National Medical Chamber intends to write a letter to the Ministry of Health with a request to explain the reasons for the delay in draft orders on additional postgraduate training. She will also send a request about the possibilities of monitoring commercial educational institutions.

The Ministry of Health stated that the Russian Medical Academy of Continuing Professional Education has developed draft exemplary professional retraining programs. They provide for different periods of study depending on the basic training of doctors (504 hours for surgical specialists, 864 hours for other specialists who have completed internship or residency training, and 1296 hours for specialty graduates who have undergone primary specialist accreditation). They also establish requirements for organizations involved in retraining. In addition to a license to carry out educational activities in additional professional programs, they must have a license to carry out educational activities in the corresponding residency program. This ensures the availability of the necessary material, technical and personnel support for educational activities and the quality of training, the Ministry of Health emphasized.

“In addition, doctors who have completed this training are subject to a mandatory requirement to undergo specialist accreditation. It is carried out by accreditation commissions, which include representatives of practical healthcare and professional non-profit organizations,” the Ministry of Health reported.

Natalia Kostarnova