Accreditation of medical workers. Continuing medical education

About the accreditation of medical workers and the new CME system Since 2016, big changes await Russian doctors: certification and training cycles every 5 years will become a thing of the past. Instead there will be accreditation and a new system of continuing medical education. What exactly will change for doctors, and how innovations will be introduced, said a member Coordination Council for the development of continuing medical and pharmaceutical education of the Russian Ministry of Health Zalim Balkizov. How will accreditation of doctors proceed from 2016? According to Federal Law No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation”, from January 1, 2016, certification medical workers will be replaced by accreditation. The accreditation certificate will be admission to medical and pharmaceutical activities. The first to receive it will be newly minted dentists and pharmacists – graduates of medical universities in 2016. And since 2017, accreditation awaits all other graduates. The procedure will include three stages: testing, competency assessment using simulation equipment, and solving clinical problems. Moreover, the tasks for the first stage are already known: on the websites of the Russian Ministry of Health ( www.rosminzdrav.ru) and the Methodological Center for Accreditation ( www.ffos.ru) 3500 tests have been published in dentistry and 3200 in pharmacy. These questions will be used to create individual sets of tasks for the exam, which can be “rehearsed” online. In preparation mode, the system will offer 60 tasks with four answer options and give you 90 minutes to solve them. Everything, but not right away Accreditation of doctors will be implemented in stages. So for now, you can still get a work permit “the old fashioned way.” Certificates will continue to be issued to specialists already working in the healthcare system until 2021, and they will be valid until 2026. Advanced training in a new way Another important reform of 2016 was the introduction of a new model of continuing medical education (CME). Doctors and nurses will now have to improve their qualifications not once every 5 years, but constantly. “The current practice, when a health worker improves his qualifications once every five years, has long been outdated,” Zalim Balkizov is sure. – With such a system of additional professional education (DPE), a doctor’s knowledge is updated more slowly than medicine itself. Science does not stand still: it is constantly being implemented modern methods treatment and diagnostics, new drugs are entering the market. And some familiar drugs, on the contrary, are going out of circulation because serious side effects, or the medicine has become useless. It is unlikely that a doctor will know all this, studying once every 5 years. Moreover, training cycles often come down to repeating what was learned in the 6th year of medical school.” How will it change additional education health workers? It is expected that the new model of continuing medical education will help streamline the “loose” system of continuing education. How will the new CME model be fundamentally different from the old one? Instead of 144 hours of advanced training once every 5 years, which fit into 4 weeks, doctors will have 250 hours of training over 5 years. Over the course of a year, a healthcare worker must accumulate at least 50 hours (or points) of educational activity. “You don’t have to get points at once,” explains Zalim Balkizov. – A doctor can complete short training cycles of 18 hours, attend a conference, study electronic educational modules remotely, etc. Where to improve knowledge - at conferences, simulation trainings, master classes or regular professional development cycles - the specialist decides for himself. But you can choose types of educational activities only from those approved by the Coordination Council of the Russian Ministry of Health for Continuing Education. There are already plenty of such materials on the site. edu.rosminzdrav.ru. Anyone entering the continuing medical education system will be required to register here. After this, you can create your own training plan, select electronic materials and activities, and monitor your accumulated points. “In 5 years, a health worker needs to score 250 points and confirm this with a report,” continues Zalim Balkizov. “Moreover, the majority of all points (from 70%) must be obtained in your specialty, and not in related ones.” Then a special commission will check the report. If there are no complaints, the physician will be allowed to be accredited. Those who pass it successfully will be able to continue working and accumulate points for the next promotion or confirmation of qualifications. No points – no accreditation? The CME system, as well as the accreditation of medical workers, will be implemented in stages. From 2016, continuing education will include those who this year will be accredited for the first time or last time will receive a certificate. From 2017 – the next “batch”. Every year, 120-150 thousand doctors will be included in the CME system, and in the end this will affect everyone. – Without a portfolio on the CME portal, no doctor will be allowed for initial or re-accreditation. Consequently, he will not be able to continue working,” Balkizov emphasizes. – My surgeon’s certificate is valid until 2017. Next year I will go through the certification cycle for the last time and immediately enter the CME system. If I accumulate 250 points by 2022, I will be able to undergo reaccreditation and gain the right to work as a surgeon. What if for some reason the specialist does not have time to score the coveted points? The expert of the Coordination Council is encouraging: “We will look for some way out. We will give additional time for the health worker to complete intensive courses and gain the missing points. This is what they do in most developed countries. We were guided by them when changing the system of continuous medical education. CME in Europe has long been implemented according to these principles: 250 hours over 5 years and at least 50 hours per year.” "Underwater rocks" new system True, in order to switch to European standards, Russian system Medical DPO needs to change a lot. The notorious 250 hours of training over 5 years is a completely new system for medical universities. Which means we need to change learning programs, coordinate them with the expert commission of the Ministry of Health. “The Ministry is currently working on new uniform training – 18 hours, i.e. just two days,” says Zalim Balkizov. – During this time, the doctor can attend a simulation course, seminar or master class, and study some of the educational materials at home. If you divide all 250 hours of training into such “segments,” employers will not need to let the doctor go for 4 whole weeks or look for a replacement specialist. This will be more convenient for managers, but health workers themselves may not like this system. After all, many regard professional development cycles as additional leave and don’t want to lose it.” However, the leaders themselves are still reluctant to let doctors go even to one-day conferences. This is confirmed by the first results of the CME pilot project, which started in Russia at the end of 2013 and will last until 2020. Within the framework of the project, 569 local therapists, doctors general practice and pediatricians from 15 regions of the country began to improve their qualifications in a new way. And then we ran into difficulties: the heads of medical institutions did not allow us to attend educational events. Thus, only three of the 20 Moscow doctors participating in the pilot project were able to attend the congress of the Union of Pediatricians. There is another problem: not all doctors have good computer and Internet skills. And without these skills, it will be difficult to join the CME system. About 30% of the pilot participants have already admitted that working with an electronic portfolio is difficult for them. “Participation in the pilot project prompted many specialists to learn how to work on the Internet,” comments Zalim Balkizov. – As a result, some doctors began to use the Internet more actively, some bought a laptop. People had a need to acquire such skills, and they mastered them. And as long as the doctor attends educational cycles once every 5 years, he doesn’t need the Internet.”

What types of accreditation are established and for whom? Where and in what order is it carried out? How are its results presented? How is the accreditation commission formed? What is accreditation of medical workers, and from what date is it possible? What should health workers whose specialist certificates have not yet expired? What document currently confirms the right to conduct medical activities?

One of the licensing requirements for an organization engaged in medical activities is specialists, which until January 1, 2016 was confirmed by a specialist certificate received by employees every five years. However, from January 1, 2016, the specialist certificate replaced the specialist accreditation certificate, which is also issued every five years. In this article we will tell you what accreditation is, who should undergo it and in what time frame, in what order it is carried out and by whom.

Accreditation deadlines.

Since January 2016, according to Art. 69 of the Federal Law of November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in Russian Federation"(hereinafter referred to as Law No. 323-FZ), the right to carry out medical activities in the Russian Federation is granted to persons who have received medical or other education in our country in accordance with federal state educational standards (FSES) and who have a certificate of accreditation of a specialist.

Persons who have a medical education but have not worked in their specialty for more than 5 years may also be admitted to medical practice, provided they have completed training in additional professional programs and accreditation.

In addition, by virtue of clause 2.1 of Art. 69 of Law No. 323-FZ, the following have the right to conduct medical (pharmaceutical) activities:

• pedagogical and scientific workers who have a specialist certificate or a certificate of accreditation of a specialist who carry out practical training students in accordance with Art. 82 of the Federal Law of December 29, 2012 No. 273-FZ “On Education in the Russian Federation” (hereinafter referred to as Law No. 273-FZ);
• scientific workers who have a specialist certificate or a specialist accreditation certificate, carrying out Scientific research in the field of health care.

At the same time, the rights, duties and responsibilities of health workers apply to teaching and research workers when carrying out medical activities.

For your information

Persons who have received medical or pharmaceutical education in foreign countries are allowed to carry out medical or pharmaceutical activities after recognition in the Russian Federation of education and (or) qualifications received in a foreign country in the manner established by the legislation on education, and passing the accreditation of a specialist, unless otherwise not provided for by international treaties of the Russian Federation.

Accreditation of a specialist in accordance with the same article. 69 of Law No. 323-FZ is a procedure for determining the compliance of a person who has received a medical, pharmaceutical or other education with the requirements for carrying out medical activities in a certain medical specialty or pharmaceutical activity.

The transition to the accreditation procedure for specialists is carried out in stages from January 1, 2016 to December 31, 2025 inclusive (Part 1.1 of Article 100 of Law No. 323-FZ).

The timing and stages of this transition and the categories of persons who have medical, pharmaceutical or other education and are subject to accreditation are approved by Order of the Ministry of Health of the Russian Federation dated February 25, 2016 No. 127n. Let's present them in the table on page .

Specialist certificates issued to medical and pharmaceutical workers before January 1, 2021 are valid until the expiration date specified therein. The form, conditions and procedure for issuing a specialist certificate are approved by Order of the Ministry of Health of the Russian Federation dated November 29, 2012 No. 982n.

Stage	Date after which education was completed	Education according to basic educational programs in accordance with the Federal State Educational Standard	Speciality
		Higher education	"Dentistry" "Pharmacy"
		Higher education	"Healthcare and Medical Sciences" (specialty level)
		Higher education	"Health and Medical Sciences" (residency level)
		Higher education	"Health and Medical Sciences" (bachelor's and master's levels)
		Secondary vocational education	"Health and Medical Sciences"
		Additional professional education under professional retraining programs
		Medical or pharmaceutical education obtained in foreign countries
		Other higher education
		Other persons who have not passed the specialist accreditation procedure at stages 1 – 3

Types of accreditation.

The regulations on the accreditation of specialists were approved by Order of the Ministry of Health of the Russian Federation dated July 2, 2016 No. 334n. This Regulation establishes the procedure for organizing and conducting accreditation and distinguishes its three types depending on the persons in respect of which it is carried out.

1. Primary accreditation. Carried out in relation to persons who have completed mastering the basic educational programs:

• higher medical (pharmaceutical) education;
• secondary medical (pharmaceutical) education;
• other education.

2. Primary specialized accreditation. Carried out in relation to persons:

• those who have completed training programs for highly qualified personnel and additional professional programs;
• received education on the territory of a foreign state.

For your information

Primary specialized accreditation, for example, will have to be completed by persons who have received a higher medical education and completed a residency program. Let us recall that, by virtue of clause 4 of Art. 108 of Law No. 273-FZ, admission to internship was stopped from 01.09.2016.

3. Periodic accreditation. Conducted in relation to persons who have completed the development of professional educational programs of medical education and pharmaceutical education, ensuring continuous improvement of professional knowledge and skills throughout life, as well as constant increase professional level and expansion of qualifications.

Accreditation commissions.

Accreditation of specialists is carried out by a commission on the premises of educational and (or) scientific organizations implementing medical (pharmaceutical) education programs.

Accreditation commissions are formed by the Ministry of Health for the specialties for which accreditation is carried out, with the participation of professional non-profit organizations specified in Art. 76 of Law No. 323-FZ.

Persons included in the accreditation commission:

• must not have a conflict of interest or other personal interest in the accreditation of a specialist;
• must have a higher or secondary vocational education in a specialty corresponding to the specialty for which the accreditation commission is being formed, and work experience in the relevant specialty for at least 5 years (with the exception of the chairman of the commission).

The main form of activity of the accreditation commission is a meeting, following which a protocol is drawn up (Appendix 1 to the Regulations). The minutes are signed by all participants of the meeting immediately after its end.

The personal composition of the accreditation commission for each specialty in the field of healthcare is approved by order of the Ministry of Health.

In case of disagreement with the decision of the accreditation commission, a participant in the meeting has the right to demand that a special opinion be included in the minutes or to state it in writing in a statement addressed to the chairman of the commission. The minutes of the meetings of the accreditation commission are stapled into books and stored in the archives of educational and (or) scientific organizations for 6 years.

A commission meeting is held after each stage of accreditation of a specialist. The meeting is valid if all members of the commission who participated in this stage took part in it.

Accreditation procedure.

To undergo primary or initial specialized accreditation, a person who has expressed a desire to undergo it, personally submits the following documents to the accreditation commission:

• an application for admission to accreditation of a specialist, which also indicates information about the accredited person’s completion of an educational program of higher or secondary vocational education, as well as the specialty in which the accredited person intends to carry out medical or pharmaceutical activities (Appendix 2 to the Regulations);

To undergo periodic accreditation, the employee submits in person or sends by registered mail with notification to the accreditation commission the following documents:

• statement;
• a copy of an identity document;
• portfolio;
• a copy of the specialist’s certificate (if available) or specialist’s accreditation certificate (if available);
• copies of documents on higher education and qualifications (with attachments) or secondary education vocational education(with attachments) or an extract from the minutes of the meeting of the state examination commission;
• copy work book(in the presence of);
• a copy of the insurance certificate of compulsory pension insurance (if available).

A portfolio is a report for the last 5 years on the professional activities of the accredited person, including information about individual professional achievements, mastering advanced training programs that ensure continuous improvement of professional skills and expansion of qualifications. The portfolio is formed by the accredited person independently. The information indicated in it about the development of educational programs must be confirmed by relevant documents on education and (or) qualifications.

The documents submitted by the accredited person are recorded by the commission secretary in the document registration journal against receipt and within 7 calendar days from the date of registration it is submitted to the commission for consideration.

No later than 10 calendar days from the date of registration of documents, the commission holds a meeting and makes a decision on the admission of the accredited person to accreditation and on the timing of its implementation.

Primary and primary specialized accreditation include the following stages:

1. Testing. It is carried out using test tasks, completed automatically for each accredited person using information systems by randomly selecting 60 test items from the Unified Database of Assessment Tools, formed by the Methodological Center for Accreditation of Specialists. Accredited students are given 60 minutes to complete test tasks.

The test result is generated automatically. Based on the result, the commission evaluates the accredited person’s completion of this stage of accreditation as “passed” (with 70% or more correct answers) or “failed” (with 69% or less correct answers).

2. Assessment of practical skills (abilities) in simulated conditions. Can be carried out using simulation equipment (simulators and/or mannequins) and/or using standardized patients. The commission rates at least 5 practical tasks, which are also completed using information systems automatically from the Unified Database of Assessment Tools. You have 10 minutes to complete one task.

The members of the commission assess the correctness and consistency of completing the practical task by filling out evaluation sheets.

The result of completing practical tasks is also generated automatically, indicating the percentage of correctly completed practical actions, on the basis of which the commission evaluates the result of passing this stage, similar to the testing stage.

3. Solving situational problems. The accredited person answers 5 questions contained in each of 3 situational tasks. Task picking is carried out automatically. You have 60 minutes to prepare answers to questions.

The solution to the problems is assessed by 3 members of the commission. Based on the result of the decision, formed by the number of correct answers, the commission makes a decision “pass” (with 10 correct answers or more) or “fail” (with 9 correct answers or less).

Periodic accreditation includes the following stages:

1. Portfolio assessment. Based on the results of its assessment, the commission makes a decision on whether the accredited person passes this stage of accreditation “passed” or “failed”, based on the compliance of the level of qualifications and additional professional education with the requirements for professional activity in the specialty.

2. Testing.

Accreditation results.

An assessment of the result of each stage of accreditation, the commission’s decision to recognize the accredited person as having passed or failed accreditation, or a separate stage of accreditation is reflected in the minutes of the commission meeting and posted on the official website and information stands of the organization where accreditation was carried out within 2 working days from the date of signing the protocol.

The accredited person is recognized as:

• those who have passed accreditation - if each stage is assessed as “passed”. The decision to recognize the accredited person as having passed accreditation is reflected in the final minutes of the commission meeting, signed within 2 calendar days from the date of completion of the last stage of accreditation and within 5 calendar days from the date of its signing, sent by the secretary to the Ministry of Health;
• who did not pass the accreditation stage - if he did not appear to pass the stage or used communication means during accreditation or the result of passing the “failed” stage.

note

A person recognized as having passed or failed the accreditation of a specialist is given an extract from it containing the corresponding decision within 3 days from the date of signing the protocol.

Information about persons recognized as having passed specialist accreditation is entered by the commission secretary into the Federal Register of Medical Workers. And no later than 30 calendar days from the moment of signing the minutes of the meeting of the accreditation commission, the accredited are issued a certificate of accreditation of the specialist in the manner approved by Order of the Ministry of Health of the Russian Federation dated June 6, 2016 No. 352n.

note

The certificate of accreditation of a specialist is valid for 5 years from the date of signing the minutes of the meeting of the accreditation commission, containing the decision of the accreditation commission to recognize the person as accredited. The validity of the certificate is extended by 5 years if the specialist is recognized as having passed the next accreditation.

An accredited person who fails to pass any stage is given the right to pass it again based on an application. After failing to pass the stage 3 times, the accredited person is considered to have failed accreditation and the right to re-accreditation arises no earlier than 11 months from the date of recognition as such. Accredited, not accredited or its stage, has the right to file a complaint against the relevant decision of the commission to the appeal commission within 2 working days from the moment its results are posted for public access.

Decisions of the accreditation and appeal commissions can be appealed to the Ministry of Health.

The first stage of accreditation of specialists.

As noted, according to Order No. 127n, at the first stage in 2016, university graduates who completed the development of basic educational programs in the specialties “Dentistry” and “Pharmacy” were allowed to accredit specialists.

Since the accreditation system is still being implemented, some difficulties arise. And one of them concerns a document confirming the completion of accreditation - an accreditation certificate. Explanations on this issue are given in Letter of the Ministry of Health of the Russian Federation dated August 5, 2016 No. 16-5/10/2-4847.

The procedure for issuing a certificate of accreditation of a specialist, the form of a certificate of accreditation of a specialist and technical requirements for it are approved by Order of the Ministry of Health of the Russian Federation dated 06.06.2016 No. 352n.

Since at the time of accreditation by graduates of 2016, the certificate forms were at the production stage, those who did not receive the certificate must use an extract from the protocol of the accreditation commission as a document that is the basis for their admission to carry out medical activities.

Thus, specialists who successfully completed the primary accreditation procedure in the specialties “Dentistry” or “Pharmacy” in 2016, who have an extract from the protocol of the accreditation commission and who have not yet received a certificate of accreditation of a specialist, can carry out medical activities as “dentist” "or pharmaceutical activities in the positions of "pharmacist" and "pharmacist-technologist".

Summarizing the above, we note that all graduates of medical schools will undergo primary accreditation. Specialized accreditation is subject to specialists who have completed specialization (residency) and received a new qualification, and persons who have received education abroad. And after the expiration of the specialist’s certificate, periodic accreditation once every 5 years must also be carried out by all other doctors practicing in public or private medical institutions.

As for employers, they are not directly involved in accreditation. It is carried out by educational organizations based in medical universities that have the appropriate technical capabilities. And in connection with accreditation, the employer has two responsibilities: to track which of the medical specialists and medical students must undergo accreditation next year, so that when hired they have a certificate of accreditation; to control the validity of the certificates of its employees. Those health workers whose previous certificates expire this year must be included in continuing professional education programs and undergo the re-certification procedure, since certificates will be issued until 2021.

Decree of the Government of the Russian Federation dated April 16, 2012 No. 291 “On licensing of medical activities (except for the specified activities carried out medical organizations and other organizations included in the private healthcare system on the territory of the Skolkovo innovation center."

“On approval of the conditions and procedure for issuing a specialist certificate to medical and pharmaceutical workers, forms and technical requirements specialist certificate."

Order of the Ministry of Health of the Russian Federation dated December 31, 2013 No. 1159n “On approval of the Procedure for maintaining personalized records when carrying out medical activities of persons involved in the provision of medical services.”

“On approval of the procedure for issuing a certificate of accreditation of a specialist, the form of a certificate of accreditation of a specialist and technical requirements for it.”

E.A. Stolyarova, head of the legal department of the State Budgetary Institution “GP No. 3 DZM”, Moscow
On June 27, 2016, the Regulations on the accreditation of specialists, approved by Order of the Ministry of Health of Russia dated June 2, 2016 No. 334n, came into force. Federal law dated November 21, 2011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” it is determined that the right to carry out medical and pharmaceutical activities in the Russian Federation will have persons who have received medical or other education in the Russian Federation in accordance with federal state educational standards and having a certificate of accreditation of a specialist.

Keywords: accreditation of specialists, medical education, medical activities
Keywords: accreditation professionals, medical education, medical activities

The current Accreditation Regulations establish the procedure for organizing and conducting accreditation of a specialist, that is, the procedure for determining the compliance of a person who has received a medical, pharmaceutical or other education with the requirements for carrying out medical activities in a certain medical specialty or pharmaceutical activity.

Accreditation of a specialist is carried out by the accreditation commission of the Ministry of Health of the Russian Federation upon completion of a person’s completion of professional educational programs of medical education or pharmaceutical education at least once every five years, taking into account the order of the Ministry of Health of the Russian Federation dated February 25, 2016 No. 127n “On approval of the terms and stages of accreditation specialists, as well as categories of persons with medical, pharmaceutical or other education and specialists subject to accreditation" in relation to:

• persons who have completed the basic educational programs of higher medical education, higher pharmaceutical education, secondary medical education, secondary pharmaceutical education, and other education, in accordance with federal state educational standards ( primary accreditation);
• persons who have completed training programs for highly qualified personnel and additional professional programs (professional retraining), as well as persons who received education in the territory of a foreign state ( primary specialized accreditation);
• persons who have completed the development of professional educational programs of medical education and pharmaceutical education, ensuring continuous improvement of professional knowledge and skills throughout life, as well as continuous improvement of professional level and expansion of qualifications ( periodic accreditation).

Accreditation 2016-2026

The accreditation procedure itself is being implemented in stages. In 2016, persons who complete the basic educational programs of higher medical and pharmaceutical education in the specialties “Dentistry” and “Pharmacy” in 2016 will be admitted to medical practice through the accreditation procedure. The remaining categories of persons in 2016 are allowed to engage in medical activities through the certification procedure in accordance with Order of the Ministry of Health of Russia dated November 29, 2012 No. 982n “On approval of the conditions and procedure for issuing a specialist certificate to medical and pharmaceutical workers, the form and technical requirements of a specialist certificate.”

Accreditation applies to all medical and pharmaceutical workers. But this year, only graduates of pharmaceutical and dental faculties will go through the new system of admission to professional activities - primary accreditation. The main advantage of third generation standards is that they are practice-oriented. Thanks to this, graduates will immediately be admitted to the accreditation procedure, receive individual access to specific areas of activity and will be able to work in certain positions.

From 2017, graduates of the faculties of general medicine and pediatrics, as well as medical and preventive specialists, will be allowed to work through the accreditation system. Further, from 2018, primary specialized accreditation will be introduced for residency graduates and doctors who receive new specialties as part of additional professional education. Starting from 2021, periodic accreditation will be introduced for all other specialists who were not included in the first three stages. Thus, by 2026, all medical professionals must be accredited.

Initially, it was intended that the accreditation procedure would be handed over to professional communities. However, professional standards have not yet been fully adopted, the professional community itself as a whole has not been fully organized, therefore the regulatory function of the Russian Ministry of Health is legislatively provided for.

For the purpose of methodological support of the accreditation procedure on the basis of the First Moscow State medical university them. THEM. Sechenov, the Methodological Center for Accreditation of Specialists was created. The main task of the center is to launch the preparation of assessment funds in collaboration with other medical universities in Russia as early as 2016. The National Pharmaceutical Chamber and the Dental Association of Russia took part in the development of assessment tools, Russian universities. To date, materials have been prepared, including specifications of assessment tools, funds of test tasks, situational tasks (mini-cases), and assessment rubrics. The assessment tools underwent textual and content examination, based on the results of which the content and form of the tasks were corrected, followed by their testing on a specific sample. Graduates will undergo accreditation at the sites of their universities.

Thus, the accreditation procedure includes three stages of assessing a person’s qualifications:

• testing;
• solving situational problems;
• assessment of practical skills (abilities) in simulated conditions.

The interval between stages is 1-2 days. The criterion for moving from one stage to another is “passed” or “failed”. A “passing score” at each stage - the first and second - is at least 70 percent of completed tasks and practical manipulations. If the accredited person does not pass one of the stages, then three new attempts will be given to pass the stage.

First stage. The peculiarity of this stage is that special software, based on a comparison of professional and educational standards, generates an individual version of test tasks for each accredited person, taking into account the specifications of the assessment tool. In 60 minutes, using electronic access (via a proximity card or login and password), you need to complete 60 test tasks. All this is formed at the Federal Methodological Center First Moscow State Medical University named after I.M. Sechenov and is transferred to universities that carry out accreditation.

Second phase- testing of skills in simulated conditions according to the principle of an objective structured clinical examination. This is necessary to assess the graduate’s preparation for independent activity, understanding whether he has enough competencies to begin medical practice. The graduate is asked to go through a chain of five simulation stations, where he will have to apply one or another practical skill. Each station has clearly stated times, electronic monitoring, a situation bank and standardized checklists. One of the stations - rendering emergency care patients.

Third stage- This is a solution to situational problems. Here important role allocated to the accreditation commission. An individual version of three situational problems is formed, each problem has five questions, and a commission of three people hears the graduate’s answer. At the third stage, commission members fill out evaluation sheets.

Evaluation of the result of passing each stage of accreditation of a specialist, the decision of the accreditation commission to recognize an accredited specialist as having passed or failed accreditation or a separate stage of accreditation of a specialist are reflected in the minutes of the meeting of the accreditation commission, signed on the day the specialist’s accreditation stage is completed, and are posted on the official website in the information and telecommunications network "Internet" and information stands.

If the accreditation is unsuccessful overall, the attempt can be repeated after 11 months. The accreditation commission of each university works for a year.

Accreditation of medical workers will become permanent form medical education with the introduction of admission to certain types of medical care based on clinical protocols.

On the official website of the Ministry of Health of Russia and the Methodological Center for Accreditation, a database of tests in the specialties “Dentistry” and “Pharmacy” is publicly available, of which during the first stage of accreditation software A set of test tasks will be completed automatically through random selection. These questions will be used to create individual sets of tasks for the exam - it can be “rehearsed” online. In preparation mode, the system will offer 60 tasks with four answer options and give you 90 minutes to solve them.

The Ministry of Health allocates three types of accreditation that operate in the system of continuing medical education:

• primary;
• specialized;
• repeated.

All graduates today medical specialties pass primary accreditation– this exam is essentially admission to the profession. This step is required for the level of secondary medical education, for specialty, master's and bachelor's degrees.

Specialized accreditation specialists with medical education is necessary only for those doctors who have completed residency training or have undergone professional retraining in order to master a new area of ​​work. Also, employees who received education abroad must undergo this accreditation procedure.

Re-accreditation The examination of medical workers is periodic and is carried out to confirm the qualifications of specialists. All health workers will undergo it in full from 2021. In addition, re-accreditation of healthcare professionals is integrated into the CME system.

During the 5 years before accreditation, health workers accumulate at least 150 hours of training. Previously, the Ministry of Health proposed determining the amount of points that a health worker needs to gain, however, this mechanism is not fixed at the legislative level. The Ministry of Health promises that those doctors who have already begun to gain points will not lose them.

Documents for accreditation

• 1. Application for admission to accreditation of a specialist.
  
• 2. A copy of an identity document.
  
• 3. A report on the professional activities of the accredited specialist over the past five years (portfolio) - for periodic accreditation.
  
• 4. A copy of the specialist’s certificate or specialist’s accreditation certificate, if such documents are available.
  
• 5. Copies of documents on higher education and qualifications (with attachments) or on secondary vocational education (with attachments) or an extract from the minutes of the meeting of the state examination commission.
  
• 6. A copy of the work record, if available.
  
• 7. A copy of the insurance certificate of compulsory pension insurance. For foreigners and non-citizens - if available.

What tasks are included in accreditation?

The accreditation exam includes three successive stages:

• Solving test tasks
• Assessing specialist skills using a simulator
• Situational tasks

Let's look at these steps in more detail for all three types of accreditation, since they are the same for each of them.

Accreditation test: features of passing

• 1. Test tasks for each test are generated by automatically selecting 60 tasks from a unified database of assessment tools. This base is formed by the Methodological Accreditation Center at the University named after. Sechenov.
• 2. The specialist must answer the test questions in 60 minutes. But health workers with visual impairments have the right to perform test tasks 120 minutes. This is one of the additions to the basic accreditation regulations.
• 3. Each test contains 4 answer options, including only one correct answer.
• 4. Answers are scored automatically, as a percentage of correct answers from total number test assignments. The test is passed if the health worker correctly answers 70% or more of the questions, and fails if the correct answers are 69% or less.

Assessing a doctor's knowledge using simulators

Passing the simulator is a task that is included in the primary and primary specialized accreditation. On this moment At least 5 practical skills and abilities of doctors are assessed, and one skill is assessed for medical workers with secondary education. The assignments are formed by the methodological accreditation center. The assessment is carried out either in a simulation center or with the help of trained statisticians. One doctor is given 10 minutes to complete one task, and nursing staff - 30 minutes. To evaluate the results, the commission members use score sheets. The result of completing practical tasks is generated automatically as a percentage of correctly completed practical tasks from the total number of practical actions. Passed - 70% or more correct answers, failed - 69% or less.

Solving situational problems

This task is only for primary and primary specialized accreditation of doctors and pharmacists. The nursing staff does not solve such problems. A set of tasks for the test subject is generated automatically by selecting the required number of tasks from the database. The doctor must prepare and issue a response within 60 minutes. Number of tasks – 3, each task contains 5 practical issues. The decision is assessed by members of the commission, at least 3 people. They simultaneously listen to the doctor’s answer and evaluate its correctness. This will take no more than 30 minutes. Then the results are calculated. In order to successfully pass this stage, the doctor must answer 10 or more questions correctly. 9 or fewer correct answers – the stage is not passed.

New format of situational tasks

Recently, upcoming changes in solving situational problems were announced. This new system is currently being tested, and there were even plans at the end of 2018 that some of the specialties would undergo accreditation with new tasks.

Features of the new format of situational tasks:

• multiple cases, navigation according to task conditions has been changed; using images to visualize task conditions (eg skin);
• 12 tasks of a multiple case are arranged sequentially in 4 blocks - laboratory and instrumental examination, diagnosis, treatment and variable part;
• the doctor doesn't see next tasks without answering the current question (possible hints are excluded). In addition, the system controls the number of responses (it does not allow further responses if less or more than a specified number of responses are selected);
• chapter laboratory research:
• when selecting the correct answers, the system provides prepared results of laboratory tests and issues an appropriate message;
• Prepared results of instrumental studies are similarly provided.

The question of diagnosis is the key issue in the multiple case. If you select the wrong answer, the system will display a warning message and provide information about the correct diagnosis. After completing the answers to all tasks, the system will conduct an assessment and display its result: for example, you answered 9 out of 12 questions correctly, and then it will give you the opportunity to look at the correct answers to each question from 4 sections and their rationale.

If the justification provides a link to a source, the system makes it possible to look at this source with highlighting the corresponding places in the document ( For example, clinical guidelines to provide medical care sick with illness......). Now new format problem solving is tested in two specialties - pediatrics and therapy.

Evaluation of accreditation results

If the assessment for each stage is “passed”, then accreditation is considered passed. The decision on this is reflected in the minutes of the meeting of the special commission; it is signed within two calendar days from the date of completion of the last stage of accreditation. The final protocol is sent to the Ministry of Health of the Russian Federation by the executive secretary of the accreditation commission within 5 calendar days from the date of signing. Meetings of the accreditation commission are held after each stage of accreditation. Based on the results of each meeting, a protocol is drawn up, that is, the number of protocols for one accreditation procedure corresponds to the number of its stage. In the case of primary specialized accreditation - 3 stages, 3 protocols. The executive secretary of the commission enters information about persons recognized as having passed accreditation into the Federal Register of Medical Workers.

When accreditation is not passed

An accredited person is recognized as having failed the stage of medical accreditation if he:

• did not appear to undergo the specialist accreditation stage;
• received a “failed” grade;
• violated the requirements prohibiting the possession and use of communication devices.

If this happens, you must submit an application to the accreditation commission within a week, indicating the stage that was not passed.

The commission will review this application and decide whether the specialist can go through the stage again. If you fail to pass the accreditation stage three times, the commission will recognize the specialist as having failed accreditation. You can go through the procedure again a month from the date the accredited person was recognized as having failed accreditation.

What is the appeal procedure

The appeal procedure is also provided for in the accreditation regulations.

• An accredited person who has not passed accreditation in full or a separate stage thereof has the right to file a complaint against the relevant decision to the appeal commission.
• This must be done within 2 working days from the moment the results of passing the medical accreditation stage are posted on the official website and information stands of the accrediting organization.
• To consider complaints, the chairman of the commission forms an appeal commission. At the same time, members of the appeal commission do not have the right to consider complaints regarding decisions that they themselves made.

The Appeals Commission considers the complaint within 5 working days from the date of its filing (clause 57) and makes one of two decisions:

• satisfy the complaint and cancel the decision of the AC against which the complaint was filed;
• refuse to satisfy the complaint and leave the decision of the AC without change.

The appeal commission notifies the accredited person who filed the complaint about its decision on the day the complaint is considered. If the commission’s decision is annulled, then the accredited person has the right to continue going through the specialist accreditation procedure starting from the stage that he did not pass. If the complaint is rejected, the accredited person has the right to appeal the decisions of the accreditation and appeal commissions to the Ministry of Health.

How many times can health workers retake the accreditation exam?

If a health worker fails to pass the accreditation test successfully the first time, he has the right to retake the test.

The regulations allow you to go through the accreditation stage three times in a row. After the third attempt, the commission recognizes him as “not having passed the accreditation of a specialist.”

If a health worker does not agree with the decision, he has the right to file a complaint with the appeal commission against the decision of the accreditation commission. This must be done within two working days.

The complaint will be considered within five days (order of the Ministry of Health dated April 26, 2018 No. 192n<О внесении изменений в Положение об аккредитации специалистов...>).

Attention! the information on the site does not constitute a medical diagnosis or a guide to action and is intended for informational purposes only.

Since ancient times, the state has been trying to make medicine much better and more reliable. In connection with ongoing projects, fundamentals are developed annually that help improve not only the service, but also the qualifications of specialists.

About the program

According to a legislative act approved in 2011, medical activities Only persons who have received public education in accordance with the new standards can practice. The future doctor needs not only to earn a certificate of completion of higher education educational institution, but also to undergo accreditation of doctors and have a certificate confirming this. Without the above documents, a person does not have the right to start work.

Obtaining a document for activities came into force on January 1, 2016. All innovations are planned to be introduced not immediately, but over 5 years. During this time, a list of medical institutions that meet the necessary standards will be compiled.

The main difference in the accreditation of doctors since 2016 is that upon receipt of a certain certificate, doctors have the right to practice their activities for 5 years. But doctors and students who have just decided to devote their practice to work are required to undergo mandatory accreditation. In addition, the difference lies in the fact that the doctor constantly needs to improve his own working skills throughout his entire career. labor activity. Experienced specialists pass all standards according to established deadlines and forms.

How is it carried out?

Accreditation of doctors with secondary and higher education in the field of pharmacy and medicine is a procedure that determines the level of their professionalism. The state reform, which came into force in 2016, is aimed at consistently improving services in this area and modernizing the entire system in general.

This procedure is carried out after completion of educational programs, and then once every 5 years. The order of passage is determined by the national, expert-methodological and district centers, which pursue the following goals:

• formation of a personnel structure of the healthcare system that can provide high-quality medical services;
• obtaining correct information about the level of competence of healthcare workers.

Accreditation of doctors, whose tasks are very multifaceted, evaluates not only professional knowledge, but also the presence of a portfolio, their competence in the conditions of a special simulation and certification center.

Kinds

1. Primary - carried out directly by the educational system itself, after a person has completed residency and a full cycle of professional training.
2. Competency-based - taken after receiving a new qualification.
3. Periodic - introduced in 2021 after the specialist performs auxiliary vocational education.

The accreditation system for doctors includes several forms of knowledge assessment:

• testing (an individual list of questions is prepared using a single database);
• solving situational problems;
• tests on simulators (this test is intended only for those who receive practical knowledge).

Who should pass?

The first to be included in this process are university graduates. Those of them who did not get into residency or did not pass the entrance tests can start working in initial level local therapist. But for this purpose, specialists must have primary accreditation of doctors in their hands.

Residency graduates know how to pass it, since more serious tests are intended for them, namely specialized exams that they need to pass in order to gain access to more serious work and be able to call themselves a specialist.

After the expiration of the certificate, all doctors who operate in private or public medical institutions must undergo such a check once every 5 years. Those people who received their education abroad will not be able to avoid the exam either. Regardless of whether they have a valid document to practice, they must visit a physician accreditation center in the Russian Federation.

Who conducts the inspection?

This issue is dealt with by a specially prepared commission, which consists of people different sectors healthcare systems. It also includes non-profit organizations executive bodies in the field of health care, who carry out medical and pharmacological activities, and representatives of a scientific organization that creates educational programs.

Naturally, the members of the commission cannot be random. Required condition for everyone there is no conflict of interest or other self-interest, since they must award points for the accreditation of doctors when checking specialists, and they must also have a secondary or higher education in their specialty and at least 5 years of work experience.

Where is it held?

To obtain accreditation, the ministry created a Methodological Center. However, you can take the test only in the premises of scientific or educational organizations, whose technical supply allows this to be carried out. During the inspection, video and audio recordings are required. It is also prohibited to have any means of communication with you at the time of the exam. This is done in order to reliably track the knowledge of future specialists.

Documentation

Registration of doctors for accreditation must follow all the rules. To do this, a graduate or specialist hand-submits a set of copies of documents to obtain permission.

1. Primary:

• application for admission;
• identification;
• documents confirming higher or secondary vocational education, information about qualifications and an extract from the report of the meeting of the state examination commission.

2. Periodic:

• application for admission to accreditation;
• identification;
• portfolio for the last 5 years, which will clearly present professional activity accredited: it includes information about individual achievements, information about the development of a professional development program;
• specialist certificate or accreditation certificate;
• documents on higher or secondary vocational education, as well as an extract from the minutes of the meeting of the national commission from the exam;
• employment history;
• certificate of compulsory pension insurance.

Everyone knows how to get accredited doctors future doctor, but he must certainly understand that within 10 calendar days from the date of submission and registration of documents, the commission meets to make a decision on the admission of the accredited person and on the timing of the examination.

Compliance with international standards

The Russian Federation actively joined in 2003 and forms a single standard higher education on the territory of Europe. After 6 years, all universities implemented a transition to a two-level education scheme, namely the graduation of masters and bachelors.

The agreement in Bologna has now made state educational systems collated and convertible.

A doctor who has graduated from an educational institution and received the appropriate accreditation can easily practice in any country without additional confirmation of his qualifications.

Features of the event

Primary accreditation of doctors is carried out by specialized universities of the Ministry system Russian healthcare. This procedure will take place as their certificates begin to expire and after their qualifications have been confirmed. At this stage, both license and accreditation are acceptable for carrying out professional activities.

Authorized district centers will be responsible for testing, and some of the universities of the Ministry of Health will become the platform for their promotion. Observations and expert advice are provided to ensure independence and impartiality.

Over time, accreditation will develop into continuous system medical education with the formation of a personal certificate of admission to established types of medical assistance.

After passing all preparatory stages will not be held responsible for the patient's health medical institution, and the doctor himself, just like all over the world.

Accreditation of dentists

The first scientific and educational cluster has been created in Russia, in the system of which all dental graduates will receive certificates at the very beginning of the implementation path. At the time of the event, the audience in which the exam is taking place will be monitored; it is also prohibited to bring mobile devices to it.

To test knowledge, the ministry has developed computer programs with personalized answers to the stated questions. Therefore, Russian dentistry has been meeting all declared regulations and European standards since 2016.