Internship 2021-2022 - will it

Modern students still have a glimmer of hope that the abolished internship will be returned, but this will not happen in 2021-2022, therefore, for further training in the chosen specialty, the medical student will have to enroll in residency.

Such an education system implies a modern health care reform, after which, according to its authors, the quality of the provision of medical services in medical institutions and the degree of professionalism of workers in the field of medicine should increase.

For the first time, internship at the dental and pharmaceutical faculties was abolished - this happened in 2016, the same innovations in 2017 affected the medical and pediatric faculties, and in 2018 all medical specialists.

And what will be the effectiveness of this method in solving the problem of the shortage of qualified workers in rural areas, it will become clear when the first results of the modern reform of Russian healthcare are announced in a few years.

A new approach to assessing knowledge

If no changes were made to the previously operating educational system, then, having successfully completed the internship in 2020, the student could receive a certificate that would actually allow him to perform direct duties (subsequently, every 5 years he would have to confirm his qualifications in order to have the right to work in hospitals and clinics). But instead of certification, a young specialist will now have to undergo accreditation, without which he will not be able to start work and receive admission to patients.

Accreditation is the receipt of a certain number of points, which are awarded for:

  • participation in various medical events (conferences, seminars, trainings, etc.);
  • publication of articles and scientific papers in periodicals, books, etc .;
  • the use of complex regimens in the treatment of serious diseases, etc.

It is assumed that this knowledge assessment methodology will be launched from 2021. But there are still many questions that relate to the procedure for conducting accreditation (who will pay for accommodation and travel to the place of its holding, whether it will be possible to reduce the time of patient admission so that there is an opportunity to participate in scientific research or seminars, etc.) and methodology scoring. However, the Ministry explains that in the near future all these issues will be carefully analyzed and worked out, and the cancellation of the internship will take place as gently as possible and without any consequences.

Conditions for admission to residency

In fact, internship and residency in 2019-2020. have much in common, given that after completing such training, the future physician will be able to receive a narrow specialization and permission to work with patients. But, if you believe the innovations that were initiated by the Ministry as part of the reform, it will be very difficult to enter the residency, especially if the task is to take a budgetary place. And if a physician decides to abandon this stage of training, then he will be able to work only as a therapist, which will significantly reduce his professional opportunities.

The residency exam will consist of several parts:

  • Testing, which includes 60 questions (on general medical knowledge). It takes only 1 hour to complete it, and during this time it is necessary to correctly answer at least 70% of the questions.
  • Getting a point for the current experience. Due to the fact that doctors will be awarded more points for work in rural areas, this should stimulate them to move “to the outback” and after graduating from the university for at least several years to work in village clinics (before entering the residency).
  • Additional points will also be awarded for honors and for receiving the Presidential Scholarship. Consequently, students who study on a contract will not have much of a chance to accumulate enough points (especially if they did not work in rural areas) to continue their studies.

After calculating the number of points received, a decision is made on the admission of the applicant to residency.

Cons of medical education reform

The main disadvantage for young doctors is that residency becomes the only chance for a novice doctor to follow the call of the heart and work by vocation. Yes, it should be agreed that, on the one hand, the reform can help in attracting doctors to work in rural FAPs, but, on the other hand, the adopted education standard is still very imperfect and fraught with many disadvantages:

The total degree of doctors' qualifications will significantly decrease, because some of the medical workers will devote time to part-time jobs, because getting an education in residency is not a cheap pleasure, but somehow you need to pay for it.

Mentors and teachers will lose the incentive to improve the level of their knowledge and skills, and the students themselves speak about this - many medical practitioners are careless about their professional duties and throw off the work with documents instead of training them.

The so-called paysites - students who study on a paid basis - do not need to rely on the accrual of bonuses in the form of points. They are also not awarded for scientific research, although, as the teachers themselves say, it is scientific work that shows the level of students' current knowledge in the best possible way.

Of course, it is highly probable that the proportion of students who did not enroll in residency will exceed the proportion of students enrolled in residency. In theory, only accommodating students with an excellent diploma and medical experience can hope for a coveted place in residency and obtaining a narrow specialization. However, it will be possible to speak about the results and effectiveness of the proposed reform several years later and after the publicity of the first results of its work.

What was the reason for the termination of the internship?

Many medical professionals are concerned about the pertinent questions about whether they have time for practice - working with patients, if they constantly have to travel to conferences, seminars and other events, in addition, they now need to write articles or publish a book about their scientific research. But, as the government health authorities assure, the process of completing the internship and accreditation of doctors will be well organized and the work schedule of doctors will not be affected.

And the internship should be canceled due to the fact that recently there has been a significant shortage of specialists in the initial element of the provision of medical services (polyclinic, outpatient clinic) and this problem most of all affects the medical centers located in the rural area. And the cancellation of the internship leads to the fact that university graduates in the medical direction are sent to work in rural outpatient clinics or in a polyclinic, and this will help reduce the number of open vacancies.

In addition, to come to such a conclusion of government bodies, the opinion of professional teachers of medical universities, who claim that they manage to produce specialists capable of independent work in medical practice immediately after the end of the educational period, forced them to come to this conclusion.

But, there are also specialists who reject the opinions of their colleagues. Because they believe that the increase in practical training in the educational procedure leads to a reduction in theoretical education, which is the need for obtaining in-depth skills in the specialty. Moreover, in their opinion, phantoms and simulators will never be able to replace the situation with a living soul - a person.Since each person, according to a different psychological calculation, accepts medical manipulation and treatment procedure, and it is necessary to treat a patient taking into account his psychological state and emotions. And doctors get this practical experience only in internship.

But, for now, the law remains in force and now doctors need to be accredited in order to start medical practice.

Only time can tell what results can be expected from an innovation in the medical education system.

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