ROMANIA MINISTRY OF HEALTH GENERAL HUMAN RESOURCES DIRECTORATE AND CERTIFICATION ROMANIA MINISTRY OF HEALTH GENERAL HUMAN RESOURCES DIRECTORATE AND CERTIFICATION Dr. Beatrice NIMEREANU Deputy General Manager

 The Romanian Catalogue of medical, pharmaceutical medical and dental care specialties for the healthcare network approved by the Minister of Health Order nr.1509/2008 provides 52 medical specialties for graduates of the medicine faculties, from which: -30 are clinical medical specialties; -14 are surgical specialties; - 8 are paraclinical specialties. The training length in the specialties is between 3 and 6 years depending on specialty. Training in the specialties listed for Romania, in Annex V DC/2005/36/CE, meets the minimum requirement of the EU rules. TRAINING IN SPECIALITY BY RESIDENCY

 Family Medicine Specialty which is the form of specific training in general medicine, stipulated by art. 28 of the DC/2005/36/EC is included in the group of clinical medical specialties. TRAINING IN SPECIALITY BY RESIDENCY

 The specialisation of doctors, dentists and pharmacists is obtained through residency training. This is the postgraduate education specific form of training for graduates of medecine, dentistry and pharmacy faculties, which provides the necessary training to obtain one of the specialties listed in the Romanian Catalogue of medical, pharmaceutical medical and dental specialties for the healthcare network.  The formal training by residency is an ongoing theoretical and practical process.  The number of resident students is approved annually by the joint order of the Minister of Health and of the Minister of Education, Research, Youth and Sports.  Ministry of Health organises the admission to residency by national contest which is held annually in the fourth quarter.

 The residency contest is organized on medicine, dentistry and pharmacy fields, based on a methodology approved by the Minister of Health.  Since October 2005 the residency contest session, for the medicine domain, the number places of residency training published to the contest is bigger than the number of the medical faculties students which graduates in the year when the contest is organized.  The resident quality gained through residency contest is confirmed by Minister of Health Order.  Residents sign an individual labour agreement for the period of residency in the chosen specialty with the training healthcare unit.

 Staff costs for residents is fully supported by the state budget for the entire period of residency training in the confirmed specialty stated by the law.  Residents are paid by the healthcare units with which they signed the individual employment contract, on based on attendance documentation regarding internships, issued by the training unit. TRAINING IN SPECIALITY BY RESIDENCY

The residency training takes place under the control of the Ministry of Health and Ministry of Education, Research, Youth and Sports in collaboration with the Romanian College of Physicians and the Romanian College of Dental Practicioners in Romania. Training in residency is decentralized, regional, organized in university centers which have accredited medicine, dentistry and pharmacy faculties, through postgraduate medical, dental and pharmaceutical education departments.

 For each specialty, residency training follows a national curriculum for training and a scale of maneuvers, procedures, diagnostic and therapeutic techniques compulsory and unique at national level.  The residency training program rules are approved by joint order of the Minister of Health and of the Minister of Education, Research, Youth and Sports.  Residency curricula is proposed by higher education institutions with accredited faculties of medicine, dentistry and pharmacy, analyzed by the advisory committees of the Ministry of Health and approved by joint order of the Minister of Health and the Minister of Education, Research, Youth and Sports after consultation with the Romanian College of Physicians, the Romanian Dental College and the Romanian College of Pharmacists.  The approved curricula is sent to all educational institutions and healthcare units accredited to conduct training in residency and fully implemented to all the residents which are in training, within the period provided for Romanian catalogue of medical, dental and pharmaceutical specialities.

 Higher education institutions with acreditated faculties of medicine, dentistry and pharmacy propose to the Ministry of Health the residency program coordinators, program directors and training managers which are university staff.  The nomination of the coordinators is made by joint order of the Minister of Health and Ministry of Education, Research, Youth and Sports.

 Residents perform specialized training in accredited public health units, including individual medical offices for family medicine and medical units of the ministries with their own health network.  Training units are nominated by the Ministry of Health, based on the proposals of medicine and pharmacy accredited universities and their training capacities.  Criteria and procedures for accreditation and re- accreditation of these units are approved by joint order of the Minister of Health and of the Minister of Education, Research, Youth and Sports.

 For each of the specialties provided by the Romanian Catalogue for medical, dental and pharmaceutical specialties for healthcare network, the Ministry of Health specialized commissions, with the Romanian Medical College and the Romanian Dental College and the Romanian College of Pharmacists, as the case develops resident job description, nature and general content and mandatory requirements, which include the rights, obligations and limits of its competence.

Residency Training involves the resident’s participation in all the specific activities of the domain of specialization, including guards, carried out in clinics accredited university or medical units where residents made ​​ their training for the entire working days and, respectively, of the years in residency training. Depending to the resident specialty, the resident takes effectively part to the activities and responsibilities of clinics, wards, laboratories, individual medical offices for family medicine, dental offices and pharmacies under the direct supervision of the coordinators from the accredited institutions and healthcare units. Theoretical and practical activities of residents, represented by the scale of manoeuvres, procedures, diagnostic and therapeutic techniques are recorded in two documents called “The Resident’s Card” and the “Resident Monitoring File”.

Resident doctors can perform activities in the field of confirmed specialty in the limits of competence according to the skills level of the training year. Exceeding the limits of jurisdiction is sanctioned by law. The limits of competence are established by the Ministry of Health in collaboration with the Romanian College of Doctors according to the training curriculum and based on the of the specialty committees recommendation and approved by Minister of Health Order. Starting with the third year of residency training, the resident doctors may be included in the duty line performed in specialty in which they were confirmed, except the first duty line and outside normal working hours. Resident’s work in duty line is carried out under direct supervision of the duty holder. Starting with the fourth year of residency training, resident doctors may be included in the first duty line performed in the training specialty outside normal working hours, within the limits of competence and under the supervision of a specialist doctor. The work performed by resident in duty line outside the mandatory working hours is paid according to the law.

 No resident can not be simultaneously resident in several specialties. Resident quality shall cease: a) at the end of the residency training program and it is certified by the coordinator and residency program director in “The Resident’s Card” and the “Resident Monitoring File”; b) during training, for any cases by law of ending of the individual employment contract; c) express waiver to the Ministry of Health; d) in case of incompatibility; e) other cases provided by law.

 The incompatibility means the situation when a resident, during its training, promotes another residency contest.  Resident who is in a situation of incompatibility is obliged to inform the Ministry of Health about this situation, in writing, within 15 days after its occurrence;  Within 15 days after the deadline, referred residents must opt for training in one specialty. If the resident in a state of incompatibility expresses no choice, and the state of incompatibility still exists, it is considered by law to give up to the previously acquired resident status incompatibility appearance, this being established by the Ministry of Health. During training in residency, resident physicians do not have access to other forms of human medical specialty postgraduate education.

  The next stage after the finishing of the residency training is the exam for obtaining the title of specialist, which includes a written and practical tests which are specific for every specialty.  The specialist exam is organized by the Ministry of Health in accredited medical university centers where the training has been carried out, and is held with a comission of university staff proposed by the Medicine and Pharmacy accredited University, with the advice of the mentioned professional organisation and approved by the Minisrtry of Health order.

 After passing the exam, the title of specialist is confirmed by Minister of health order and is attested by certificate of specialist, delivered by the Ministry of Health.  The exam can be performed within a maximum of 5 years after completion of training program. After passing the exam, the title of specialist is confirmed by Minister of health order and is attested by certificate of specialist, delivered by the Ministry of Health.

 The specialist exam methodology is approved by the Minister of Health and Ministry of Education, Research, Youth and Sport.

The Ministry of Health has under evidence an approximately number of 14,000 of resident doctors trained in the specialties listed by the Romanian Catalogue of medical, dental and pharmaceutical specialties. The training residents data management is conducted by the Management Department for the training of doctors, dentists and pharmacists, through residency and second specialisation of the General Directorate for Human Resources and Certification.

Thank you for your attention. Beatrice NIMEREANU Deputy General Manager