Clinical residency is one of the parts higher education medical workers, a form of improvement professional qualities doctor, in which the formation of a medical worker as an independent specialist occurs. It is represented in medical universities, faculties of medicine of universities and institutes for advanced training of medical personnel in the territory Russian Federation and countries of the post-Soviet space.
In other words, residency is such a form self-study, in which the student gets the opportunity to develop his professional skills, expand his knowledge in the field of medical technologies, and also help the healthcare system in solving personnel problems.
This form of training(like, in fact, internship), exists at the official level and is enshrined in law in 1994 by order of the Ministry of Health of the Russian Federation. By law, medical specialists and specialists in the field of pharmaceutical activities, as well as pharmacists, are allowed to take it.
The duration of full-time study is two years, however, under some circumstances it can be extended and last more than five years, including seniority medical worker (according to the Regulations on Clinical Residency of 1993). Officially, residency is a job, and therefore the length of service labor activity calculated on general principles.
Features of residency training
Residency training in Russia is not a mandatory part of the education of a medical worker, therefore this stage of specialist training is a conscious choice of the physician. As in any educational institution, there is a certain form of knowledge control. It may vary depending on the requirements of a particular educational institution, however, it is most often carried out in the form of tests, exams and oral presentations.
Any person who has a diploma of higher medical education can enroll in residency: both citizens of the Russian Federation and foreign students who have the appropriate international document giving them the right to study abroad are allowed to study.
Training takes place according to an individual plan, which is developed for residents by the supervisor. Most often, the manager becomes a specialist with some work experience - a professor, candidate of sciences or doctor medical sciences. Individual plan work is approved by the head of the department.
What a residency is can be seen in the specialist training program. The classic resident set is:
- Lectures, seminars and practical classes;
- Lectures on related courses and disciplines of a narrow profile;
- Clinical rounds of patients followed by analysis of medical histories;
- Attending and speaking at meetings and conferences.
Residency training allows a medical worker to fill in the missing knowledge and prepare to work independently with patients under the supervision of a supervisor.
When entering a chosen educational institution, you should take into account the number budget places on the direction. In case of filling of budget places according to the competition, medical worker has the right to apply for training on a paid basis.
Dental Residency
In the dental department there is also its own residency. During this residency, dental students undergo in-depth training in dentistry and practice, and upon completion they receive certificates that give them the right to independently see patients in a dental clinic or open their own doctor’s office.
Is it possible to study abroad?
As noted earlier, residency is a form of education characteristic of the Russian Federation and the countries of the former Soviet Union, therefore, residency as such does not exist outside the CIS countries.
For those who want to undergo in-depth postgraduate training abroad, there is the opportunity to obtain the status of a medical assistant or take courses to confirm their specialization.
For example, in Italy, obtaining a specialization lasts from 2 to 6 years, and in Germany it is not possible to change the status of an assistant to the status of a doctor without passing an exam. This fully applies to doctors specializing in dentistry.
Fundamental differences between residency and internship
Many students often have questions about what is the difference between internship and residency, how long the training will take, and also where is the best place to enroll. So, in order to answer these questions, you need to understand what an internship is.
Internship is also One of the stages of training for specialists graduating from universities, however, is designed for accelerated completion. Young specialists who have completed six years of training and have a diploma of higher medical education are eligible to enter the internship.
Internship training time, in contrast to residency, is only one year, during which the intern, under the guidance of experienced doctors, is engaged in practical activities, however, does not accept independent decisions and is not responsible for its actions.
After completing the training, the intern is issued a certificate of completion of the course, which indicates the specialty acquired by the student. This certificate gives the young specialist the right to independent work in the field of medicine.
The difference between internship and residency is as follows:
- Since internship training lasts half as long, the student will be assigned the status of a doctor earlier;
- In an internship, training is more general, while a residency trains more specialized specialists;
- The studies have some differences in the areas of preparation;
- A former resident has the right to apply for the title of head, but an intern does not.
A little about nice bonuses
In addition to additional knowledge and in-depth study of the subject of their activity, residency training provides the student with some benefits and guarantees:
Overall benefits of residency, although it lasts longer than the internship, is to give the medical school graduate both more knowledge and practical experience for use in subsequent professional medical activities.
The issue of obtaining a full-fledged education is becoming increasingly relevant. After the federal standard for third generation education comes into force in the Russian Federation, the approach to training future doctors will change. Since January 2016, internships have been abolished for those who have chosen dentistry and pharmacy as their specialization, and since 2017 – for pediatric and medical and preventive faculties. The innovations apply to those who have entered a medical school since 2013. Let’s take a closer look at what such innovations bring to the training of doctors, and how they will train medical workers in Russia.
The essence of medical education reform
New state education standards state that graduates of medical universities must be absolutely ready to start working in the healthcare system. This is what explains the need to cancel internship training. Starting from September 2017, this form of higher professional training will be completely abolished.
In 2017, many doctors will start working without internship training
Let us remind you that until recently, even the local doctor of the clinic had to have a certificate confirming the completion of the internship and successful completion qualifying exam. Now, one diploma from a relevant university will be enough. According to the main provisions of the new approach to obtaining medical education, students of medical universities will master healing techniques on simulators or in hospitals and clinics assigned to the university.
The innovation assumes that students of pediatric and medical-prophylactic faculties will practice practical skills under the guidance of specialists from assigned medical institutions already in the fifth and sixth years of study. Dentists and pharmacists will undergo this practice as early as the fourth and fifth years of their education.
The main goal that can be achieved by abolishing internships is to solve the problem of the shortage of medical personnel in the so-called “primary practice”. Representatives of the Ministry of Health came to the conclusion that the problem will be solved if, in the near future, a graduate of a medical university who was admitted under a target quota, immediately after receiving the certificate of graduation from the educational institution, will have to work for three years in the therapeutic or pediatric department of a clinic.
It is assumed that the first place of work will be an institution located in the area from which the recruitment took place. “State employees” who studied on scholarships will have to return the money spent on them to the state after graduating from university. The system is reminiscent of the distribution practice that existed under the USSR and causes reasonable concern among students.
The young doctor will receive a job in the area from which the recruitment took place Not everyone dreams of going to the village for “working out”! Only after three years of medical practice as a therapist or pediatrician former student will receive the right to enter residency, where in two years of study he will be able to become a more specialized specialist. The question of completing residency remains relevant for those who plan to engage in surgery, transplantology, cardiology, neonatology and other specialties.
New in the accreditation procedure for health workers
Let us note that 2017 will bring another new thing for doctors: the certification procedure will be replaced by accreditation combined with state exams. It is assumed that this measure will improve the quality of education. Mandatory accreditation was introduced in 2011. According to adopted law, which regulates the field of health care, in 2016 the accreditation procedure comes into force - a procedure on the basis of which a doctor’s readiness to carry out professional activities is determined.
This examination will be required every five years. The Ministry of Health plans to create a general register of medical specialists, which will publish information about the level of education and advanced training of doctors. Thus, patients will be able to evaluate the professional skills and competence of existing doctors and independently choose their attending physician. It is worth noting that the Ministry of Health has not yet announced clear requirements for assessment criteria or rules for accreditation.
Presumably, this will include testing knowledge through testing, providing a portfolio and examination at the simulation center. Doctors who successfully pass the test will receive an “individual certificate of admission to specific types of medical care.” Accreditation of 2016 graduates will be carried out by specialized universities, and current doctors will undergo it over a five-year period in specially created centers.
The Ministry of Health plans to create a general register of health workers for patients Criticism of medical education reform
Many healthcare experts note that these innovations seem very dubious to them. The previously existing system of training medical specialists assumed that practical knowledge was acquired by interns, firstly, without distraction from the theoretical component of training, and secondly, under the strict guidance of accomplished practitioners who took upon themselves most responsibility. Some doctors even express the opinion that this measure is purely populist.
Of course, yesterday’s students, who will fill the vacancies of therapists and pediatricians, will eliminate queues at clinics (today in Russia the quota of local doctors, estimated at 40 thousand people, has not been filled). Doctors also fear that in this way the Ministry of Health will create artificial competition, because if a doctor’s place can easily be taken by a yesterday’s graduate, then it is more difficult to defend the right to a salary increase.
According to Alexander Kogan, doctor of medical sciences and oncologist, only internship provides an opportunity to prepare highly specialized medical practitioners. The abolition of this stage of training and its replacement with practice during training will lead to a reduction in the hours allocated to microbiology, biochemistry, physiology, so that future therapists will miss out on some important theoretical training. It is simply impossible for yesterday’s graduate to be ready for real work immediately after receiving the “crust.”
Everyone is worried about the question: will yesterday’s students cope with real work? The pediatrician also supports this opinion. highest category Svetlana Novichikhina, who has a PhD in Medical Sciences. She believes that in the future this innovation will lead to a reduction in the number of specialized specialists. Her conclusions are based on a simple calculation: a student studies at a medical university for six years, after which he works for three years in a clinic’s therapy setting. By the time it is possible to enter residency, the physician will be 27 years old.
It is likely that by this age many will have time to start a family and children. Let’s say that as a therapist, a doctor earns 20 thousand rubles, and during residency training he will be able to receive about 2 thousand stipends, and within 2-5 years. It is quite natural that family people They are unlikely to be able to afford it. So there will be enough therapists, but you may lose good surgeons, orthopedists or gynecologists.
Despite the fact that the reform of the healthcare system in Russia is still being discussed, and officials have not yet given any specifics, the picture is quite clear regarding the issue of providing the industry with young specialists. Graduates of medical universities in 2016 will see a lot of innovations regarding internship, residency and accreditation. And now in more detail about each of them.
Accreditation
In 2016, a program to introduce a system for confirming the accreditation of physicians began work. Graduates will be the pioneers on this path. They will be the first to go to simulation centers, where they will be able to practice the skills they acquired at universities. About 70 such nodes have already been opened in the country, equipped with everything necessary for tests. The main equipment is mannequins and computers with appropriate programs.
Both doctors and nursing staff will be able to confirm their qualifications in such institutions. In the future, all doctors will have to periodically renew their accreditation. They will be forced to study the protocols required for each specialty, and thus keep up with the times and follow all the trends that exist in modern medicine.
Doctors will have to confirm their qualifications by passing tests!
According to the plan of the Ministry of Health, in two years (i.e. until 2018) all health workers will have to undergo this procedure and confirm your professional suitability. Also, each doctor will be able to expand the scope of his professional activity. Officials say practicing in a specialty for which a doctor does not have permission will be strictly prohibited.
However, after completing training and receiving the appropriate accreditation, the doctor will be able to begin working in a new specialty. To confirm his professional suitability, the doctor will have to master clinical protocols for the relevant specialization. The Ministry is already developing them: in total, 1.5 thousand such protocols need to be created!
Starting from the new year, graduates of medical universities in some specialties will be able to go to work immediately after receiving their diploma, bypassing years of internship, which was mandatory before. In this way, the state wants to solve the problem of the influx of new personnel into medical institutions. Of course, young doctors will be supervised by their experienced senior colleagues.
But graduates will be able to gain practical experience in “field” conditions – helping real patients. With one caveat - you can only go to work in a clinic or central regional hospital. Pediatricians, dentists, general practitioners, hygienists, epidemiologists and pharmacists can count on employment immediately after graduating from medical school. The rest will still learn according to the old rules.
From 2016, young doctors will begin to work without undergoing an internship New in residency
Officials also have some plans regarding residency training. Thus, according to current proposals, residency training should be limited to two years. But, before entering residency, a young specialist must work for some time in a medical institution (for now we're talking about about three years).
Only after this will it be possible to submit documents for further studies. In general, they plan to do residency special form postgraduate education. It is here that the doctor will be able to acquire a narrow specialization - for example, study cardiac surgery or neurology. It's just general scheme, which will be improved over time.
Well, for those students who would like to immediately move on to specialization, they can develop a separate plan. Perhaps this right will be given to young specialists who have worked scientific activity in the chosen field - for example, participated in international conferences, published scientific works etc.
The opportunity to receive a full-fledged education is of concern to both students of medical universities and those who are just preparing to enter medical school. And therefore, one question is extremely relevant for future doctors: will there be an internship in 2016-2017 or not?
Internship in 2017
According to state educational standards, a graduate of a higher educational institution with a medical profile must be fully prepared to work in the healthcare sector. Therefore, such a form of education as internship is completely abolished.
So, everyone who entered universities from 2013 and later, asking the question “will internships be canceled in 2017?”, should know:
On September 1, 2016, internships for pharmaceutical and dental specialties are canceled; On September 1, 2017, internships for pediatric and therapeutic specialties are canceled.
Main changes
What will change with the cancellation of internships in 2017? What should future graduates expect? About...
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The scheme of education in medical universities in Russia has changed radically. Due to the cancellation of internships, many are afraid that dropouts will come to clinics. The introduction of new medical standards divided doctors into two classes.
Since 2016, future local pediatricians and therapists begin studying under a shortened program, which involves six years of training. Potential surgeons, cardiologists and other medical specialists will have to spend 8 to 11 years studying.
As it was
Previously, all doctors studied for seven to eight years. It took six years to study at medical school, and then either an internship for a year or a two-year residency. Moreover, in some specialties it was necessary to go through both of these steps. However, for many medical specialists, one internship or residency to choose from was enough.
An intern and a resident are considered something like students in a medical institution, since they are not on the staff and do not receive salaries. They are essentially doing...
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For future graduates and applicants to medical universities, the issue of obtaining a full-fledged education is becoming increasingly relevant. After the federal standard for third generation education comes into force in the Russian Federation, the approach to training future doctors will change. Since January 2016, internships have been abolished for those who have chosen dentistry and pharmacy as their specialization, and since 2017 – for pediatric and medical and preventive faculties. The innovations apply to those who have entered a medical school since 2013. Let’s take a closer look at what such innovations bring to the training of doctors, and how they will train medical workers in Russia.
The essence of medical education reform
New state education standards state that graduates of medical universities must be absolutely ready to start working in the healthcare system. This is what explains the need to cancel internship training. Beginning with...
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Internship in 2017, or more precisely, the question of whether it will be canceled or not, is one of the topics discussed among students and applicants to medical schools. educational institutions, and who want to receive a complete and decent, and, most importantly, high-quality and highly professional education.
Do you need an internship?
Currently, there are state standards and parameters that are prescribed by law, according to which a graduate of a higher educational institution with a medical profile and orientation is fully prepared to work in the healthcare system. And what does it mean? And the fact is that precisely thanks to this approach to the education system, the internship system can be simplified or even abolished as unnecessary and incapacitating. This issue is especially acute and relevant among those students who entered universities in 2013 and later. It should be noted that some transformations and actions in this direction have already been made last year, 2016. Like this...
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For applicants to most medical universities, as well as for many graduates of these same institutions, the question of obtaining a full-fledged and in-demand education is becoming increasingly relevant and pressing. Only after it comes into force federal standard relative training of the third generation, in Russia the approach to training future doctors will radically change. For example, from January 2016, internship is abolished for those who decide to choose a future specialization in dentistry and pharmacy. Since 2017, a similar outcome will affect those wishing to receive specialization in the faculties of treatment and prevention and pediatrics. First of all, those applicants who entered their studies in 2013 will be eligible for the 2017 innovations.
To understand whether internship will be canceled in 2017 and what innovations we should expect in this area, it is worth discussing this issue in more detail.
The essence of the 2017 reform regarding medical education
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Our expert is the rector of the Nizhny Novgorod State medical academy, Professor Boris Evgenievich Shakhov.
One diploma is enough
Elena Shitova, AiF. Health. Drug Review": Boris Evgenievich, what fundamental difference new educational standard?
Boris Shakhov: Unlike the previous standard, our graduates, after receiving their diplomas, will have the right to independently work as doctors. Previously, they had to first obtain a certificate, which required completion of an internship and/or residency.
– The internship is cancelled, what will happen to the residency?
– Residency remains, its duration in all specialties of training will be 2 years. It will become a type of postgraduate education for those who want to acquire a narrow specialty, for example, to work as a cardiac surgeon, neurologist, etc.
– Where and who can a newly minted specialist with a diploma from a medical university work for?
– Graduates of medical universities will receive...
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How the standard of medical education has changed, why internship is being abolished and what will replace it, where and who can a young specialist work immediately after graduating from medical school, what are the advantages of university clinics, and why accreditation of doctors is being introduced - the rector of the First Moscow State Medical University spoke about this in an interview with MedNews named after I.M. Sechenov Petr Glybochko.
“First of all, practical training”
– Pyotr Vitalievich, why did you need to change the standard of medical education? What are the features of the new doctor training programs?
The introduction of the new educational standard of the third generation (FSES-3) since 2011 was due to the requirements modern market labor, international trends in the development of higher education and Russia’s accession to the Bologna process. The main features of Federal State Educational Standard-3 are a competency-based approach, a level training system (bachelor's and master's degrees), expansion of academic freedoms at universities and the introduction...
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By September 2017, medical schools will say goodbye to internships. Who will treat us from the flu in 2017?
This is, perhaps, the question that should be asked by those who fell ill this year or happily avoided infection.
The fact is that 2016 and 2017 are a time of great change for medical students, and therefore for all of us. From September of this year, internships for dentists and pharmacists are canceled, and from September 2017 – for pediatricians and therapists (Federal Law No. 323 of November 21, 2011 “On the fundamentals of protecting the health of citizens in the Russian Federation”).
The internship is twelve months of practical training. Previously, specialists were not allowed into practical healthcare without completing a one-year postgraduate education course. Now, in order to go to work in a clinic, it will be enough to obtain a university diploma.
Only if a young doctor dreams of becoming a surgeon or, say, a cardiologist, will he need to complete...
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Graduates of higher medical educational institutions are required to undergo primary postgraduate training - residency. With its help, future doctors are able to develop independent skills and achieve a certain level of mastery in such a difficult task as providing emergency care. medical care to the population.
Residency 2017 includes not only testing medical specialties, but also conducts a qualifying stage based on passing exams. Resident education is considered expensive, since the cost per year is comparable to paying in advance for 2-3 courses at a medical institution.
Reform education is underway by leaps and bounds and is being implemented not only in high school– new educational standards have reached the system of higher educational institutions. New changes this time affected medical educational institutions.
Starting from 2016, internships are canceled in Russian medical universities. This is due to the transition to a federal state educational standard(hereinafter referred to as GEF) of the third generation. But what does this mean for ordinary people? Experts in the field argue that this approach to training future doctors may have a negative impact on the level of training of healers in white coats.
Physicians' knowledge may decline
Scientists analyzed the level of knowledge of graduates of medical universities and noted that this moment, even before the coming changes, it is very weak. It turns out that now, having barely received a diploma, newly minted medical workers, instead of undergoing an internship, are required to start working in medical institutions in full.
Experts also note that a graduate education may not be enough to work in clinics. Many people are concerned about whether yesterday's medical students will be able to provide quality care. That is why the new training standard provides for enhanced practical training of future doctors, including on special medical simulators. And after receiving a diploma, every doctor is simply obliged to undergo additional training every five years and expand their knowledge.
Nobody canceled residency
However, residency remains. That is, a student, upon graduating from university, works as a doctor for some time, gains practical experience, and then enters residency in his field. So far the figure is three years. Nothing is written in the documents, but this particular period has already been discussed verbally several times. This is exactly the amount of time a doctor will need to complete the “young fighter course” in primary care (whether it be an outpatient appointment or other work in a clinic).
Then, if the doctor has a desire, he will be able to enter residency. At the same time, they also decided to increase the deadlines for the latter. Depending on the specialty, postgraduate training will range from one to five years.
Personnel problem solved
As the members of the coordinating council say, cancellation of internship in 2016 will provide an almost complete solution to the problem regarding the shortage of personnel in the field of medicine. The third generation Federal State Educational Standard will completely change the nature of training medical students. From the theoretical segment, the emphasis will be shifted towards practice. Young specialists with their wealth of knowledge and a fresh point of view on many medical issues will pour into the country's clinics. In addition, health workers will be required to undergo accreditation as medical specialists.
New medical models
New teaching models are being implemented everywhere both in secondary schools and in higher education. educational institutions. As a result of the abolition of internships in 2016, the training scheme in medical institutions in Russia may completely change.
The updated educational standard requires the abolition of internships, depending on the number of important reasons, one of which is the lack of doctors at outpatient clinics in municipal clinics. The scientific plans of the new medical model include increasing the level of knowledge of medical students by placing emphasis on practical training and professional disciplines. Under the supervision of teachers, young specialists will work with patients, gaining the necessary practical experience.
Once every five years, a doctor must undergo a refresher course, which consists of attending lectures at a university for two to four months. This method acquiring knowledge is not optimal, therefore it is planned to introduce a foreign system, which includes attending trainings and master classes of leading specialists, active participation in seminars, scientific conferences etc. Thus, continuous training is carried out, the doctor constantly improves his level of knowledge, and this is the key to his successful development.
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