Implementing EU Acquis, Procedures and Challenges in Lithuania

Dr. Jonas Bartlingas

Head of Health Care Resources Management Division

Ministry of Health, LITHUANIA

Mutual Recognition of Qualifications for Medical

Professions

Five months of crossing Internal Market borders by health care professionals

Polish-Dutch Twinning Project

22nd September 2004, WARSAW

Implementation of EU Acquis into Lithuanian law

• Republic of Lithuania implemented all obligations and transferred requirements of sector-based directives to Lithuania laws and legal acts:

There were added/changed acts

There were admitted acts on recognition EU diploma

Implementation of EU Acquis into Lithuanian law

• Give great support:

– European Commission and their experts

– EU-Institution Building Twinning Programme (Project

number: LT 2002.0601/Ref.Number: LT02/IB-SO-01 Employment and Social Policy, Free Movement of Workers)

– Health ministry of Netherlands

– Health ministry of Germany

– Competent authorities of North Rhine–Westphalia (Germany), Sweden, Ireland, Norway, Netherlands

Implementation of EU Acquis into Lithuanian law

• Improvement of programs on doctors, dentists, nurses, midwives, pharmacists professions training:

• Most alteration was in training of doctors specialists

HARMONIZATION OF COORDINATION DIRECIVES: HARMONIZATION OF COORDINATION DIRECIVES: RESTRUCTURING OF DOCTORS’ RESTRUCTURING OF DOCTORS’ TRAININGTRAINING

Tertiary residency:1-2 years /

Sub-specialized clinical training in Gastroenterology,

Gastroenterological surgery etc.

Secondary residency:2-4 years /

Family (general practice) medicine orspecialized clinical training in Internal

medicine, General surgery, Pediatrics etc.

Primary residency:1 year /

General clinical training

Basic medical education6 years (education from 1952)

University level

Residency3-5 years /

Specialized clinical training in different specialties

Specific training in Family medicine3 years

Internship:1 year /

General clinical training

Basic medical education6 years

University level

Will be included

HARMONIZATION OF COORDINATION DIRECIVES: HARMONIZATION OF COORDINATION DIRECIVES: RESTRUCTURING OF DOCTORS’ RESTRUCTURING OF DOCTORS’ TRAININGTRAINING

Surgery• Abdominal surgery

• Vascular surgery;

• Neurosurgery;

• Thoracic surgery;

• Cardio-surgery;

• Urology;

• Vascular surgery;

• Plastic surgery

• Oro-maxillofacial surgery;

Internal medicine• Allergology and clinical immunology

• Occupational medicine;

• Dermatovenerology;

• Endocrinology;

• Gastroenterology;

• Geriatrics;

• Hematology;

• Infectious diseases;

• Cardiology;

• Clinical toxicology;

• Nephrology;

• Onco-radiotherapy;

• Pulmonology;

• Rheumatology

• Training programs of dentists, pharmacists, nurses, midwives were revised according to experts recommendations on requirements of directives:

– Dentist’s professional title “stomatologas” to “odontologas”

– Theoretical course in college study program of nurse is separated from practical training

– Restart training of midwives after secondary education, also have 18 months training after graduated nurse

Implementation of EU Acquis into Lithuanian law

Recognition of EEA qualifications

• The Ministry of Health is the competent authority in the Republic of Lithuania in relation to Community directives concerning health care specialists: doctors, dentists, nurses, midwives

• The Pharmacy Department under the Ministry of Health is the competent authority in the Republic of Lithuania in relation to Community directives concerning pharmacists

Recognition of EEA qualifications

In Lithuania the registration and licensing is one procedure which is done by one institution (under supervision of the Government): Doctors and they specialization – the State Health Care

Accreditation Agency under the Ministry of Health

Dentists and they specialization – Chamber of Odontology

Nurses, midwives – Ministry of Health

Pharmacists – Ministry of Health

Recognition of EEA qualifications

Applicant

Licensing institution

Competent authority

Documents: An application Proof of identity Proof of qualification Proof of Physical and

mental health Certificate of good

standing Proof of previous diploma

or certificate, which gives the right to exercise the profession

State fee

License

Approximately 2 weeks

Maximum 3 months

Recognition of EEA qualifications (including third country qualifications recognized

in other EEA countries)

Language requirement

No specific level of language skills is required to obtain license. It is the responsibility of the employer to assess that the specialists meet the requirements of the national acts that every specialist must practice in his field carefully and conscientiously. To comply with this provision, specialists are required to be capable of responsible communication with patients, relatives, other staff, licensing institution, etc.

After Accession: Certification of nationally acquired professional qualifications

Till 1950 study in medicine – 5 year, diploma, 1952 - 1992 – 6 year study

From 1991 study program “comply” with directive 93/16/EEC, only one diploma

From 1993 diploma with certificate accompanying qualification - “profesinės kvalifikacijos pažymėjimas” of “medicinos gydytojas” (1994)

1993 General practice (family medicine)

Dates of conformity in specialized medicine differ according the specialization:

1994 Anesthesiology and reanimation, Ophthalmology, Otorhinolaryngology

1995 Gynecology-obstetrics

2005 Orthopaedics and traumatology, Physical medicine and rehabilitation, Clinical laboratory, Pathology

2006 Psychiatry, Radiology, Child and adolescent psychiatry

Dates of conformity Medicine

After Accession: Certification of nationally acquired professional qualifications

Internal medicine from 2007:

2006 Allergology and clinical immunology, Occupational medicine, Dermatovenerology, Endocrinology, Gastroenterology, Geriatrics, Hematology, Infectious diseases, Cardiology, Nephrology, Neurology, Pulmonology, Onco-radiotherapy, Rheumatology

Or all diplomas in above mentioned specializations after qualified in internal medicine (program 2 years)

General surgery from 2005

2005 Neurosurgery, Urology, Abdominal surgery, Vascular surgery, Thoracic surgery, Children surgery, Plastic surgery from 2005

Or all diplomas in above mentioned specializations after qualified in general surgery (program 2 years)

Dates of conformity

After Accession: Certification of nationally acquired professional qualifications

Nurses– University diploma

– College diploma from 2003

Midwives– College diploma from 2007 without nurse diploma

– College diploma from 2005 with college nurse diploma

Dates of conformity

After Accession: Certification of nationally acquired professional qualifications

Dentists

– University diploma, 5 year study

– Comply with directive from 1991

– From 1993 diploma with certificate accompanying qualification - “profesinės kvalifikacijos pažymėjimas” of “bendrosios praktikos gydytojas stomatologas” (1994)

Specialization in dentistry

- from 2004 year are comply with directive

Dates of conformity

After Accession: Certification of nationally acquired professional qualifications

Acquired rights: the certificates issued

Certificate of good standing – about issued licence and its validity

Certificate in accordance with Community Directive:

Compliance to training standards laid down in Directive

Acquire rights if not comply with training standards

Acquire rights if study began before 1990-03-11

After Accession: Certification of nationally acquired professional

qualifications

Upsurge in migration

In period May 1st – 31st August were issued certificates for 179 doctors, dentists, nurses, pharmacists:

123 doctors

28 dentists

20 nurses

8 pharmacists

70 of them left Lithuania before 1st May

Thank you !