Health care professional education in Estonia and national health care regulations- impact of the EU enlargement Pille Saar Ministry of Social Affairs of Estonia

MAIN TOPICS  National legislation system  curricula's and specialties for doctors and nurses  recognition of professional qualification

LEGISTLATION, NATIONAL SYSTEM Registration  All health care professionals (doctors, dentists, nurses, midwives) must apply for registration in the Health Care Board since 2001 An activity licence is required for:  the provision of emergency medical care;  the provision of specialised medical care;  the independent provision of nursing. Activity licences shall be valid for five years as of issue thereof. Registration + Activity Licence = gives physicians right to provide health services

PROFESSIONAL EXPERIENCE  The health care professionals must undergo additional training related to their profession to the extent of at least 60 hours each year.  The top managers and the health care professionals working as heads of structural units must regularly undergo management training for at least 40 hours per year in addition to professional training.

CURRICULUM Duration of the basic training  Doctors6 years, 240 CR  Dentists5 years, 200 CR  Pharmacists5 years, 200 CR  Nurses3,5 years, 140 CR  Midwives4,5 years, 180 CR The new curriculum witch is accordance of EU requirements  Doctors1997  Dentists1997 Pharmacists1997  Nurses1996  Midwives1997

POSTGRADUATE SPECIALIST MEDICAL TRAINING  33 Medical specialty  2 dental specialty Residency means professional training of three to five years for the acquisition of the profession of specialist doctor; Since 1995, the Postgraduate specialist medical training is accordance of EU requirements. The residency training of medical specialists is currently performed according to 40 different programmes including 3 programmes for specialization in dentistry. The duration of residency is 3 till 5 years according to speciality.

NURSING Definition of nursing Nursing means out-patient or in-patient health care services which are provided by nurses together with family physicians, specialists or dentists, or independently. List of nursing specialties  16 nursing specialties Independent provision of nursing Companies or sole proprietors which hold corresponding activity licenses may provide nursing independently. The nursing care services provided independently  school health services ( 13 activity licenses has been issued)  home nursing care services (58 activity licenses has been issued)

ESTONIAN NURSING DEVELOPMENT PLAN FOR 2015 At the 2002 the Estonian Nurses Association worked out “Estonian Nurses Development Plan for 2015” Contains  the principles of panning the need of nurses in the health care system and for the primary health care sector  list of services which nurses may provide independently  requirements for competence of nurses  the principles of additional training

FUTURE STEPS IN NURSING Decrease the nurses specialities to 4  Primary health care nursing  Clinical nursing  Intensive care nursing  Mental health nursing New specializations and curriculas for specialist nurses  Project with cooperation on EU Structural Funds  Curricula for 40 CP  Starting from January 2006

COMPETENT AUTHORITY The Health Care Board is government agency, which started operations on 1 st of January 2002 under the Jurisdiction of the Ministry of Social Affairs, according to the Health Services Organisation Act The responsibilities of HCB are:  registration of health care workers  recognition of foreign diplomas in Estonia  issuing of activity licence  also issues the appropriated Certificates to Estonian doctors who wish to work in Member States.

COMPETENT AUTHORITY REGISTRATION AND RECOGNITION responsible institution HCB Apply for  persons who have obtained their qualifications in Estonia  persons who have obtained their qualification in one of the member states of the European Union, European Economic Area or Switzerland  persons who have obtained their qualification in other foreign countries.

COMPETENT AUTHORITY Types of certificates issued: content of training acquired rights right to practise good standing Contacts: Competent Authority – Health Care Board Coordination of professional recognition – Ministry of Social Affairs Ministry of Education www. Tervishoiuamet.ee www:sm.ee

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