– It takes a lot of time and effort to train a real doctor. Moreover, it is important here individual approach. This is especially true for obstetricians and gynecologists. It is difficult to prepare for this profession, because it is a very broad subject: there is normal physiology, pathology, and emergency sections of medicine, i.e. An obstetrician-gynecologist must also be a physiologist (meaning work on preventive direction), and a specialist in surgical branches of medicine and emergency assistance. After all, such a doctor is responsible for two lives - mother and child.
During the first 5 years of study at the institute, an obstetrician-gynecologist receives basic education, and specialization begins in the sixth year of study; This is the so-called subordination, its duration is 1 year. After graduation, the student becomes a doctor and can work independently, for example, in antenatal clinic. However, most doctors, after completing their subordination, continue their education in internship (1 year) and/or residency (2 years). A doctor is admitted to residency on a competitive basis based on the results of an exam. During this period of study, the aspiring doctor is assigned to a more experienced specialist, and he supervises his work. A young doctor leads patients and learns to operate, but under the guidance of his supervisor, and he does not have the right to sign his own signature (along with him medical documents it must be signed by the curator and/or head of the department). If a novice doctor is on duty, then if an emergency occurs difficult situation, in which his qualifications are insufficient, more experienced doctor will always help with advice - even while at home. So gradually the young doctor becomes a mature specialist. But life shows that this requires at least 10 years of practical experience. In addition, a doctor cannot be trained once and for a lifetime, since medicine is developing very quickly. In Europe, a midwife studies for 6 years, and an obstetrician-gynecologist has a 10-year education: 6 years basic course and 4 years of internship.
After residency, a doctor can also enter graduate school on a competitive basis. Its duration is 3 years. Postgraduate studies are aimed at training scientific personnel, there is less practical work, and most of the time is spent working on a dissertation. The graduate student also treats patients, but mainly on his own topic.
After graduation, the doctor is issued a certificate as an obstetrician-gynecologist, and every 5 years it is confirmed after free continuing education courses and a certification exam. In addition, a doctor can take paid courses and participate in paid seminars.
There is also a category system. The second category is assigned after 2-3 years of practical work, after 5-7 years the doctor has the right to receive the first category, and after 10 years of practical activity - the highest. To receive the highest category, a doctor must write a special paper. It indicates the knowledge and skills that he possesses; part of the work should be research. A doctor of the highest category working in a hospital must operate in full, have skills such as hysteroscopy, master laparoscopic techniques, and have some knowledge of ultrasound. A doctor of the highest category working in a antenatal clinic, of course, cannot operate, but he knows the whole spectrum gynecological diseases, knows issues related to family planning and prevention of abortion, substitution hormonal therapy etc.
Thus, it turns out that a doctor becomes a specialist – formally and actually – within 10 years after graduation. In Europe, there is no practice of dividing qualifications, but everyone knows that a doctor gains real experience within 10 years of work.
So, the path to becoming a doctor is very long: it usually consists of 8 years of study (institute + residency) and 10 years of work. Thus, if a woman has the opportunity to choose a doctor, then, in addition to the usual search method by asking her friends, she should focus on the doctor’s medical experience and place of work. The status of a candidate of medical sciences in some cases should not play a decisive role, since, as mentioned above, the period of postgraduate study often enriches the doctor’s experience in a purely narrow field of medicine.
– What about midwives? Is their preparation as serious?
– Midwives have a special status among other representatives of nursing staff. They are specially trained at the paramedic level 2 . If nurse fully complies with the doctor’s orders, then the midwife and paramedic have the right to act independently. A midwife graduates from a special paramedic school, the course of training lasts 4 years, and she has a fairly wide range of training. She not only cares for pregnant women and delivers babies, but in some cases also treats gynecological patients.
– Can everyone work as an obstetrician-gynecologist? Are there any medical restrictions?
– Absolute limitation – mental illness. Examinations of medical staff are carried out regularly, and if the doctor reveals contagious disease, such as syphilis, gonorrhea, it cannot work until it is cured, which should be monitored by repeated examination.
– What are there? gynecological departments and what would you advise a woman who is faced with choosing an institution providing gynecological care?
– Gynecological departments are divided into two categories: those working on emergency basis and those that are hospitalized on a planned basis. But any gynecological department is a surgical department, so they carry out surgical operations. Women are hospitalized in gynecological departments with a variety of problems: infertility, inflammatory processes, with endometriosis, with complications after abortions, IUDs (intrauterine contraception), etc. are also installed and removed there. In other words, such a department has no specialization. Only in some hospitals (in Moscow this is gynecological hospital No. 5) there are several specialized departments: department of early pregnancy (spontaneous abortion at early stages, abortions), department conservative methods and the operations department. But such a narrow specialization of departments is rare. Most gynecological departments are part of multidisciplinary hospitals. Obstetrics and gynecology clinics are called obstetrics and gynecology departments or centers at medical educational institutions. These are departmental clinics, where the head of the department is subordinate to the professor, who organizes the life of the department in such a way as to optimally ensure the learning process for students.
In clinics, the training process is carried out in parallel with the process of treating patients. If a medical institution is not called a clinic, but it has a department of obstetrics and gynecology, then this means that they are simply adjacent on the same territory. In such an institution, the head of the department reports not to the professor, but to the city health department. The departments there are in a subordinate position and do not decide anything independently. The life of the departments is geared only to treatment.
If a woman has a choice of which institution - clinical or city hospital– seek help, then, without a doubt, you should prefer a clinic. Firstly, the clinics have a double staff (training staff + treatment staff). Secondly, the clinic’s staff are doctors who, in their work with patients, rely not only on their practical skills and experience, but also on the latest scientific developments.
– What criteria should be used to choose a place for childbirth?
– As in the rest of the world, it is better to choose the maternity ward of a multidisciplinary hospital or hospital. In my opinion, you shouldn’t choose a separate maternity hospital, because it’s good there as long as the birth is going well... In Moscow there are only 7 maternity institutions merged with multidisciplinary hospitals. This combination, in my opinion, is absolutely justified. Because if you urgently need doctors who are not gynecologists, for example, a blood transfusion specialist or a vascular surgeon, they will only be able to help promptly if they are in the same hospital. This does not mean that they replace obstetricians, just that doctors of different specializations work together, complementing each other. In a separate maternity hospital there are no such specialists.
– How officially do midwives conduct home births?
– By law, any medical personnel, including midwives and doctors, cannot provide routine care. medical care pregnant women outside medical institutions. A particular woman retains the right to invite a midwife or doctor to her home, but this is done unofficially. But if a complication occurs during childbirth, the medical staff present at the birth will incur criminal liability, because according to the law it is impossible to provide obstetric care at home. Although in Moscow a project of such an option for obstetric care is ready for implementation, when from maternity hospital A special team consisting of a doctor, midwife and anesthesiologist goes to the woman’s home.
A doctor’s qualifications are determined during certification procedures and make it possible to identify the level of correspondence between theoretical knowledge and practical skills qualification characteristics relevant specialty. Certification for assignment of a category is carried out on the initiative of the medical worker, she is a good incentive for him professional growth. Subsequently, the established category gives the doctor the right to provide medical services, defined for a given specialty, affects the size wages, increases the prestige of the doctor, contributes to his further advancement in the profession.
Qualification categories and procedure for obtaining them
The qualification of a doctor can be assigned for a main or combined position and is determined in accordance with the requirements for the second, first and highest categories.During the certification procedures, the employee must undergo professional retraining (courses and internships in leading medical institutions), then personally attend the meeting of the certification commission, where the assessment of his work is carried out certification report about the work done, testing and interview. When assigning a category, the education and experience of the doctor in the certified position are also taken into account, which must meet the requirements:
The second category is 3 years of experience, higher and secondary vocational education;
- first category – experience of 7 years if you have a higher education and 5 years if you have a secondary vocational education;
- highest category - experience of 10 years if you have a higher education and 7 years if you have a secondary vocational education.
Category validity period
The validity period of the assigned qualification category is 5 years from the date of signing the order. If it is impossible to be certified after 5 years ( maternity leave, temporary disability) its validity period can be extended only if the certification commission agrees with a petition to extend the category, signed by the chief physician of the institution where the doctor works.It is the responsibility of any medical practitioner to improve their knowledge and skills. Certification is considered one of the methods of training, which has its own requirements and characteristics, based on the results of which specialists are assigned the appropriate category. Each category of doctors occupies a certain level in the hierarchy of the medical field.
Goal and tasks
Participation in the certification process is voluntary. In the process, the specialist’s personal worth, level of knowledge, practical skills, suitability for the position held, and professionalism are assessed.
Certification of doctors for a category carries with it a certain interest:
- It's prestigious. Allows you to borrow more high position allows you to draw management's attention to yourself. Quite often, the categories of doctors are indicated on signs at the entrance to their office.
- In some cases, the highest category allows you to reduce moral or physical responsibility to the patient’s relatives. Like, if such a person could not solve the problem, then it is difficult to think what would have happened if a less experienced doctor had been in his place.
- Material side. Medical categories of doctors and promotion through the levels of the medical hierarchy allow for an increase in the basic salary.
Types of certifications
The legislation distinguishes several types of certification activities:
- assignment of the title “specialist” after determining theoretical and practical skills;
- qualification category of doctors (obtaining);
- category confirmation.
Determining the level of knowledge for the designation of a “specialist” is a mandatory step before appointment to the position of a doctor. Conducted by special commissions in postgraduate education institutions. The following candidates will be considered:
- after internship, master's degree, residency, postgraduate study, if there is no diploma "doctor-specialist";
- those who have not worked for more than 3 years in a narrow specialty;
- those who did not undergo certification in a timely manner to obtain qualifications;
- persons who are denied the opportunity to receive the second category for objective reasons.
Each doctor has the right to receive a category in several specialties at the same time, if they are related. The main requirement is work experience in the required specialization. The category of general practitioner is an exception.
Basic rules and requirements
There are second, first and highest category doctors. There is a rule of consistency in receiving, but there are exceptions. The requirements are discussed in the table.
| Qualification category of doctors | Outdated requirements | Requirements for current orders |
| Second | 5 years of practicing experience or more | At least 3 years of practical experience in the specialty |
| Submitting a work report | Personal appearance, including participation in an interview, testing | |
| First | Department Head or Leadership level required | At least 7 years of practical experience in the specialty |
| Upon receipt - appearance, confirmation occurs in absentia | ||
| Higher | Manager position required | More than 10 years of practicing experience in the specialty |
| Personal appearance in any case | Personal appearance, including participation in report evaluation, interview, testing |
Validity periods
According to the old orders, there were certain circumstances that were classified as social benefits and made it possible to extend the period of the current qualification. These included:
- pregnancy and child care under 3 years of age;
- a month after dismissal due to reduction;
- business trip;
- state of temporary disability.
On this moment benefits are not valid. Certifying commission may decide to extend the validity period at the request of the chief physician of the medical institution. If a doctor refuses to appear for the commission, his category is automatically removed after a five-year period from the date of assignment.
Documentation
A report on the work done over the past few years, approved by the chief physician of the healthcare facility and the personnel department where the certified person works, is also filled out. Copies of education documents are also sent to the commission, work book and assignment of current qualifications.
Attestation report
The introduction includes information about the identity of the doctor and the medical institution where he holds a position. The characteristics of the department, its equipment and staff structure, and the performance indicators of the department in the form of statistical data are described.
The main part consists of the following points:
- characteristics of the population undergoing treatment in the department;
- possibility of carrying out diagnostic measures;
- carried out therapeutic work with the specified results for specialized diseases;
- deaths over the past 3 years and their analysis;
- implementation of innovations.
The conclusion of the report consists of a summary of the results, indications possible problems and examples of their solutions, opportunities for improvement. If published materials are available, a copy is attached. Indicated and studied over the past few years.
Points for promotion
Each specialist receives points that are used in making decisions about qualifications. They are awarded for attending conferences, including international congresses, lecturing to colleagues or average medical personnel, distance learning with obtaining a final certificate, training courses.
Additional points are awarded for the following achievements:
- publishing of textbooks, manuals, monographs;
- publication of an article;
- obtaining a patent for an invention;
- presentation at symposiums with a report;
- speaking in institutions and the media;
- obtaining a title;
- defense of the thesis;
- awards by public authorities.
Composition of the commission
The commission consists of a committee, whose work takes place during breaks between meetings, and a narrowly focused expert group, which directly conducts certification of a specialist (exam, testing). Both the committee and the expert group consist of persons holding the following positions:
- The chairman, who oversees the work and divides responsibilities between the members of the commission.
- The deputy chairman performs the functions of the chairman in full in his absence.
- The secretary is responsible for registering incoming documents, preparing materials for the work of the commission, and recording decisions.
- The deputy secretary replaces the secretary and performs his duties during absence.
Each expert group includes specialists from related specialties. For example, the category of dentist and its receipt/confirmation requires being in the group of a periodontist, orthodontist, pediatric dentist, or therapist.
Order of the meeting
Certification is scheduled no later than three months from the date of receipt of data about the specialist by the committee. If the data does not match the requirements for the latter, the documentation will be refused (no later than 2 weeks from the date of receipt). The secretary of the committee agrees with the chairman of the expert group of the required specialization on the date of the examination.
Members of the expert group review the certification documents for the category, completing a review for each of them, displaying the following data:
- level of practical skills of a specialist;
- participation in social projects related to the medical field;
- availability of published materials;
- self-education of the certified person;
- compliance of knowledge and skills with the declared category of doctors.
The examination must take place within two weeks from the date of receipt of the report. The result of the review is an indicator of the possible outcome of the certification. The secretary informs the specialist of the date of the meeting, which includes an interview and testing. More than 70% of correct answers allow you to consider the test passed. The interview takes place by questioning the person being certified according to theory and practice, the knowledge of which must correspond to the requested qualification.
The meeting is accompanied by the preparation of a protocol, which is signed by the members of the expert group and the chairman. The final decision is noted on the qualification sheet. A specialist receives the right to retake the exam only after a year. Within 7 days, the certified person receives a document confirming the promotion, reduction or refusal to assign a category.
Extreme measures
Administration medical institution may send a request to the commission so that the doctor is dequalified or promoted ahead of schedule. In this case, documents are sent to justify the decision. The commission considers the issue in the presence of a specialist. Failure to appear without a valid reason allows a decision to be made in his absence.
Protest
From the day the decision is made, the doctor or medical institution can appeal the result to month period. To do this, it is necessary to fill out an application specifying the reasons for disagreement and send it to the commission under the Ministry of Health.
0.1. The document comes into force from the moment of approval.
0.2. Document developer: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
0.3. The document has been approved: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _.
0.4. Periodic verification of this document is carried out at intervals not exceeding 3 years.
1. General Provisions
1.1. The position "Obstetrician-gynecologist of the 1st qualification category" belongs to the category "Professionals".
1.2. Qualification requirements- complete higher education (specialist, master's degree) in the field of training "Medicine", specialty "General Medicine". Specialization in the specialty "Obstetrics and Gynecology" (internship, specialization courses). Advanced training (advanced courses, internships, pre-certification cycles, etc.). Availability of a medical specialist certificate and a certificate of assignment (confirmation) of the 1st qualification category in this specialty. Work experience in the specialty for more than 7 years.
1.3. Knows and applies in practice:
- current legislation on health care and regulatory documents regulating the activities of governing bodies and health care institutions, the fundamentals of law in medicine, the organization of obstetric and gynecological care;
- rights, duties and responsibilities of an obstetrician-gynecologist;
- performance indicators of obstetric and gynecological institutions and departments;
- work of medical advisory and medical and social expert commissions;
- modern classification gynecological diseases;
- topographic anatomy, normal and pathological physiology woman's body;
- physiology and pathology of pregnancy, childbirth and postpartum period;
- basics of hematopoiesis and hemostasis, water-electrolyte metabolism and acid-base balance of blood, immunology and pharmacology;
- general and special methods examinations that are used in obstetrics and gynecology;
- modern methods prevention, diagnosis, treatment, rehabilitation and medical examination of obstetric and gynecological diseases, prevention unwanted pregnancy;
- modern methods of childbirth;
- prevention of miscarriage and post-term pregnancy, resuscitation, intensive care newborns;
- modern techniques for performing obstetric and emergency procedures gynecological operations and manipulations, as well as resuscitation;
- principles of preoperative preparation of patients and postoperative monitoring of them;
- identification, monitoring, treatment of pregnancy complications and postpartum rehabilitation;
- rules of asepsis and antiseptics;
- basics of pharmacotherapeutic methods used in obstetrics and gynecology;
- basics of prevention and timely diagnosis malignant neoplasms;
- clinic, causes, diagnosis, treatment methods infectious diseases And " acute abdomen"in gynecology, acquired immunodeficiency syndrome (AIDS), sexually transmitted diseases, etc.;
- issues of sexopathology;
- basics of endocrinology, urology, surgery, gynecological oncology;
- basic methods of physiotherapy and physical therapy, used in obstetrics and gynecology;
- design rules medical documentation;
- modern literature on the specialty and methods of its generalization.
1.4. Appointed to a position and dismissed from a position by order of the organization (enterprise/institution).
1.5. Reports directly to _ _ _ _ _ _ _ _ _ _ .
1.6. Supervises the work of _ _ _ _ _ _ _ _ _ _ .
1.7. During absence, he is replaced by a person appointed in accordance with the established procedure, who acquires the corresponding rights and is responsible for the proper performance of the duties assigned to him.
2. Characteristics of work, tasks and job responsibilities
2.1. It is guided by the current legislation of Ukraine on health care and regulations that determine the activities of governing bodies and health care institutions, the organization of obstetric and gynecological care to the population.
2.2. Provides pregnancy diagnostics, monitoring of pregnant women, obstetric care, early detection complications of pregnancy and childbirth, treatment and supervision of women in labor; organizes and conducts clinical examination of gynecological patients.
2.3. Applies modern methods of prevention, treatment and rehabilitation within his specialty; masters all methods of outpatient and inpatient treatment, full scope surgical interventions, including hysterectomy, ligation of the hypochondrial arteries, microsurgical and plastic surgeries.
2.4. Provides emergency and emergency medical care to obstetric and gynecological patients.
2.5. Monitors adverse reactions/effects of medications.
2.6. Provides consultations on referrals from doctors of other specialties, including at home.
2.7. Conducts work ability assessments.
2.8. Plans work and analyzes its results.
2.9. Maintains medical documentation.
2.10. Adheres to the principles of medical deontology.
2.11. Promotes legal protection women in accordance with current legislation.
2.12. Supervises the work of nursing staff.
2.13. Takes an active part in disseminating medical knowledge among the population and conducting mass preventive examinations.
2.14. Constantly improves his professional level.
2.15. Knows, understands and applies current regulations relating to his activities.
2.16. Knows and complies with the requirements of regulations on labor protection and environment, complies with the standards, methods and techniques of safe work performance.
3. Rights
An obstetrician-gynecologist of the first qualification category has the right to:
3.1. Take action to prevent and correct any violations or non-compliances.
3.2. Receive all social guarantees provided for by law.
3.3. Request assistance in fulfilling your job responsibilities and exercise of rights.
3.4. Require the creation of organizational and technical conditions necessary for the performance of official duties and the provision of the necessary equipment and inventory.
3.5. Get acquainted with draft documents relating to its activities.
3.6. Request and receive documents, materials and information necessary to fulfill their job duties and management orders.
3.7. Improve your professional qualifications.
3.8. Report all violations and inconsistencies identified in the course of its activities and make proposals for their elimination.
3.9. Familiarize yourself with the documents defining the rights and responsibilities of the position held, and the criteria for assessing the quality of performance of official duties.
4. Responsibility
An obstetrician-gynecologist of the first qualification category is responsible for:
4.1. Failure to fulfill or untimely fulfillment of the requirements set forth herein job description obligations and (or) non-use of granted rights.
4.2. Failure to comply with internal labor regulations, labor protection, safety regulations, industrial sanitation and fire protection.
4.3. Disclosure of information about an organization (enterprise/institution) related to a trade secret.
4.4. Failure to comply or improper fulfillment of internal requirements regulatory documents organization (enterprise/institution) and legal orders of management.
4.5. Offenses committed in the course of their activities, within the limits established by the current administrative, criminal and civil legislation.
4.6. Causing material damage to an organization (enterprise/institution) within the limits established by current administrative, criminal and civil legislation.
4.7. Illegal use of granted official powers, as well as their use for personal purposes.
