Regulation No.431 of the Cabinet of Ministers Rules of Procedure of the Certification of Medical Practitioners

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THE ROLE OF LATVIAN MEDICAL ASSOCIATION IN
SERTIFICATION AND REGULATION PHYSICIANS
IEVINA ALKALATVIAN MEDICAL ASSOCIATIONVILNIUS
26 27 SEPTEMBER 2005
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Regulation No.431 of the Cabinet of
MinistersRules of Procedure of the Certification
of Medical Practitioners

• Certification award of certificates by
  evaluating and certifying with a certain degree
  of probability theoretical knowledge and
  professional skills of a medical practitioner in
  a primary speciality, sub-specialty, additional
  specialty or skills of a medical practitioner
  within relevant speciality to employ specific
  treatment or diagnostic method

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The Cabinet of Ministers of the Republic of
LatviaRiga, 23 December 1997 Regulation No.431

• Rules of Procedure of the Certification of
  Medical Practitioners
• Certification is granted in speciality according
  to the classification of specialities of medical
  practitioners listed on the Index of Professions
  in the Republic of Latvia and division of
  specialities of medical practitioners into
  primary specialties, sub-specialties and
  additional specialties by the Ministry of Health
  as well as within speciality in order to evaluate
  the skills of medical practitioner in application
  of specific treatment and diagnostic methods
• Re-certification is granted by the certification
  institution after reviewing the report of a
  certified person on his professional career and
  activities undertaken for raising his
  qualification during the validity of his
  certificate according to the requirements of the
  rules of the respective speciality

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Certification of Doctors 1990 Associations Certi
fication Commissions Rules of Specialities
Rules of Certification .
Lists of primary specialties, sub-specialties and
additional specialties, treatment and diagnostic
methods liable to certification
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The Ministry of Welfare of the Republic of Latvia
Riga, 13 March 1998 Ordinance No.63 Rules on
the Procedure for Approving the Rules
of Certification of Medical Practitioners
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The Ministry of Welfare of the Republic of Latvia
Riga, 13 March 1998 Ordinance No.63

• Certification institution shall ensure the
  accessibility of the services connected with the
  certification without limitation for all medical
  practitioners undergoing certification or
  re-certification according to the principle of
  the neutral third party involvement that is
  independent of health care provider and the
  provider of postgraduate training services,
  pursuant to the standard LVS EN 45013General
  Criteria of Personnel Certification
  Institutions, Regulation of the Cabinet of
  Ministers No.431 of 23.12.1997., and the
  procedures set forth in the present Rules.

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The Ministry of Welfare of the Republic of Latvia
Riga, 13 March 1998 Ordinance No.63

• Certification institution shall establish
  Certification Council with the term of office of
  2 years. The Certification Council shall be a
  collegiate body that co-ordinates and adopts
  decisions on the issues connected with
  certification and re-certification in the
  Certification institution.

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The Certification Institution shall perform the
following functions

• Coordinate the uniform evaluation procedure of
  theoretical knowledge and professional skills of
  medical practitioners in the Certification
  Institution
• Supervises the conformity of the operation of
  certification exam commissions to the
  requirements of the Regulation No.431 of the
  Cabinet of Ministers of 23.12.97., these rules
  and the decisions of the Certification Council.

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The Ministry of Welfare of the Republic of
LatviaRiga, 13 March 1998 Ordinance No.63

• Certification Council has the right by a
  reasoned decision to suspend the operation of a
  certification exam commission before the expiry
  of its term of office should the Certification
  Council find that the activity of the exam
  commission fails to conform to the requirements
  of Regulation of the Cabinet of Ministers of the
  Republic of Latvia No.431 of 23.12.97., these
  rules and the decisions of the Certification
  Council.

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The Certification Exam Commission performs the
following functions

• Drafts and approves the examination programme and
  the questions for the theoretical part of an exam
  for the relevant speciality in conformity to the
  requirements of the Rules of that speciality.
• Informs the person undergoing certification about
  requirements of certification, examination
  programmes and questions as well as about
  evaluation system. It assesses reports on the
  previous professional activity and other
  documents submitted by the persons undergoing
  certification as stipulated in Articles 15-16 of
  the Regulation of the Cabinet of Ministers of the
  Republic of Latvia titled Rules of procedure for
  certification of medical practitioners of
  23.12.97.
• Ensures the availability of the requirements of
  certification, examination programmes and
  questions to the persons undergoing
  certification.

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• Certification Council functions pursuant its
  rules and determines
• Uniform procedure for the review of professional
  activities
• Uniform procedure for certification and
  recertification
• Constitutes and approves commissions of
  specialities and certification commissions as
  well as carries out the supervision of their
  activities to ensure the compliance of their
  activities with certification rules

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• Certification Commission for each speciality
  develops and with a special decision decides the
  following matters
• Rules for certification and re-certification
  procedure
• Examination programme in the form of multi-choice
  questions, including questions on emergency
  medicine programme
• Consults the Certification Board of Latvian
  Medical Association as to the content of the
  programme
• The scope of questions to be included in the
  programme that are in the field of competence of
  related specialities according to their
  speciality rules
• The criteria for control of professional
  activities

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Regulation No.431 of the Cabinet of
MinistersRules of Procedure of the Certification
of Medical Practitioners

• Certification exam may be taken by doctors,
  nurses, midwives, doctors assistants, laboratory
  technicians, dentist technicians, hygenists,
  physiotherapists and ergotherapists that after
  obtaining of an appropriate medical education
  have supplemented their knowledge in specialty
  and acquired skills during specified time period
  in accordance with a rules of relevant specialty
  as approved by the Ministry of Welfare.

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Procedure for taking Certification Examination

• Exam consists of filling out a multi-choice
  questionnaire. The physician taking an exam
  answers the questions, the minimum number being
  100, whereas the maximum number is 250.
• The physician undergoing certification is awarded
  certification diploma only if the proportion of
  correct answers reaches 75

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Updating the Rules of Operation of The Certification Council of the Latvian Medical Association Head specialists of the Ministry of Health or Directors of a specialised centres Sub-speciality may be represented by the representative of the primary speciality Certification Council of the Latvian Medical Association is entitled to delegate its representative to sessions of any certification commission of any association where he can participate with rights of a commission member
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The rights of a medical practitioner undergoing
certification

• Receive certification examination programme
• Receive the information on the rules of procedure
  of the examination
• Take a repeated certification exam after one year
  
• To be informed about the composition of the
  examination commission and to submit an
  opposition against the inclusion of individual
  members in the examination commission

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• FINANCIAL BASIS OF CERTIFICATION
• Certification is financed on the account of a
  physician undergoing certification
• Specialist Associations use the received money to
  finance
• Drafting of Certification and re-certification
  programme that is to be completed by 31.12.1994.,
  and drafting multi-choice questions for exams.
  The number of the questions shall be no more than
  3000, but not less than 2000 (in 1993-1994
  temporary questions were prepared depending on
  the number of persons undergoing certification)
• Prepares and distributes the multi-choice
  examination programme and eventual questions to
  physicians taking exam no later than 2 months
  before exam (since 31.06.1994.)

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The Certification Council have adopted specialty
definitions and criteria enabling a drawing up
of a classification of specialties

• Primary specialty an area of medicine in which
  a medical practitioner has acquired a
  professional medical postgraduate training the
  length of which is specified in a rules of
  specialty and cannot be shorter than 3 years
• Criteria for primary specialty this is a wide
  area of medicine in which a medical practitioner
  acquires a professional medical (postgraduate)
  training pursuing the plan of education either of
  a type of residentship training or courses that
  is specified in the rules of specialty and the
  length of which cannot be shorter than 3 years

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The Certification Council have adopted specialty
definitions and criteria enabling a drawing up
of a classification of specialties

• Sub-specialty narrower area of the primary
  specialty for mastering of which (specialization)
  previous primary specialty is required
• Criteria for Sub-specialty this is a narrower
  area of the primary specialty that can be
  mastered by a medical practitioner only upon the
  completion of the residentship training programme
  (or training cycle) and for which a plan of
  residentship education programme (or of
  postgraduate training) is specified as defined in
  the rules of the relevant subspecialty and
  according to which the length of education period
  cannot be shorter than 2 years

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The Certification Council have adopted specialty
definitions and criteria enabling a drawing up
of a classification of specialties

• Supplementary specialty - narrower area of the
  primary specialty that is a shared competence of
  two or more primary specialties and for mastering
  of which (specialization) previous training in
  one of the relevant primary specialties
• Criteria for supplementary specialty this is a
  narrower area of several primary specialties that
  can be mastered by a medical practitioner only
  after completion of residentship training
  programme (or training cycle) of some primary
  specialty (that is connected with this
  supplementary specialty) and has a defined plan
  of residentship training (or postgraduate
  education plan) that is specified in a rules of
  relevanat supplementary specialty and whose
  length of training cannot be shorter than 2
  years.

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Latvian Medical AssociationStructures and forms
of co-operation involved in the process of
postgraduate education

• Structures
• Professional Associations I
• Commissions and Councils II

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Latvian Medical AssociationStructures and forms
of co-operation involved in the process of
postgraduate education

• Structures
• Professional Associations I
• Commissions and Councils II

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Professional Associations I

• Without cooperation partners

• With cooperation partners
• Latvia University
• Riga Stradina University, Department of
  Postgraduate Education
• Riga International School of Economics and
  Business Administration
• State Agency of Medicines
• Health Statistics and Medical Technologies State
  Agency
• Major Latvian Hospitals etc.

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Commissions and Councils II

• Certification Council

• Commission of doctors with teaching rights
• Selection of
  doctors for award
• of teaching rights
  is done
• according to the
  criteria set by
• the Latvian Medical
  Association
• Selection and
  assessment of
• facilities
  available for training
• of resident doctors

• Complaints Commission

• Professional Court

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Forms of Action and Cooperation for LMA I

• In international context
• UEMS cooperation commenced
• Organization of professional congresses,
  conferences and postgraduate training courses
• Cooperation with international professional
  associations
• Cooperation with the WHO
• World Congress of Latvian Physicians

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Forms of Action and Cooperation for LMA II

• On a national level
• Congresses of physicians, conferences and
  seminars for different specialties
• In cooperation with Pharmaceutical companies
• Seminars
• Conferences
• Residentship education

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Not only Residentship, but also Retraining of
Doctors from Other Related Specialities

• Emergency Medicine doctor
• Family doctor ( GP )
• The goal is the execution of state procurement
  for the implementation of the Master Plan and
  maintenance of human resources.

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Regulation No.315 of the Cabinet of Ministers of 23 July 2002 Minimum requirements for educational programmes for obtaining professional qualification of medical doctors Regulation sets out the basic requirements for educational programmes for obtaining a professional qualification of medical doctor in the Republic of Latvia in order for it to be recognised abroad. For mastering residentship programme full-time training is required.
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Courses of Action of the Certification Council Draft the rules of evaluation of theoretical knowledge and professional skills during certification and re-certification for all specialities that would conform to uniform basic criteria Revive the co-operation with the Ministry of Health, including co-operation through the Consultative Council of Head Specialists and special centres Include in the activities of the Certification Council all the delegated functions of the Latvian Medical Association that are concerned with the recognition of the professional qualification in doctors profession Update the rules of procedure of the Certification Council integrating all accumulated information and Europe opinion
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Doctors Specialities and Number of Sertificated
Doctors (01.09.2005)
No Code Primary Speciality Code Sub-speciality
1. P01 Internist 903 A011 Cardiologist 231
A012 Rheumatologist 27
A013 Phthysiopulmonologist 180
A014 Endocrinologist 82
A015 Nephrologist 41
A016 Gastroenterologist 44
2. P02 Family doctor (general practitioner) 1397
3. P03 Surgeon 78
4. P04 Neurosugreon 48
5. P05 Thorasic Surgeon 20
6. P06 Heart Surgeon 15
7. P07 Vascular Surgeon 18
8. P08 Urologist 59
9. P09 Plastic Surgeon 21
10. P10 Transplantologist 7
11. P11 Outpatient Surgeon -
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Doctors Specialities and Number of Sertificated
Doctors (01.09.2005)
No Code Primary Speciality Code Sub-speciality
12. P12 Paediatric Surgeon 54
13. P13 Traumatologist/Orthopaedic Surgeon 173
14. P14 Gynaecologist/Obstetrician 492 A141 Paediatric Gynaecologist -
15. P15 Paediatrician 913 A151 Neonatologist 106
A152 Paediatric Infectologist 34
A153 Paediatric Cardiologist 9
A154 Paediatric Rheumatologist 10
A155 Paediatric Pneumonologist 18
A156 Paediatric Endocrinilogist 4
A157 Paediatric Neprologist -
A158 Paediatric Gastroenterologist 8
A159 Paediatric Haematho-oncologist 5
A1510 Paediatric Allergologist 11
16. P16 Oncologist 73 A161 Oncologist chemiotherapist 16
A162 Oncologic Surgeon 25
A163 Oncologic Gynaecologist 15
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Doctors Specialities and Number of Sertificated
Doctors (01.09.2005)
No Code Primary Speciality Code Sub-speciality
17. P17 Haemothologist 21
18. P18 Anaesthesologist, reanimathologist 404
19. P19 Psychiatrist 359
20. P20 Neurologist 282
21 P21 Paediatric Neurologist 47
22 P22 Ophthalmologist 253
23 P23 Othorhinolaryngologist 185 A231 Phoniatrist -
A232 Paediatric Audologist -
24 P24 Infectologist 64
25 P25 Dentist 1563 A251 Orthodontist 15
A252 Paradonstist -
A253 Paediatric Dentist 11
A254 Dental Prothesist 6
26. P26 Mouth, Face and Jaw Surgeon 37
27. P27 Dermathologist, venerologist 155
28. P28 Narcologist 101
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Doctors Specialities and Number of Sertificated
Doctors ( 01.09.2005)
No Code Primary Speciality Code Sub-speciality
29. P29 Laboratory Doctor 194 A291 Parasithologist -
A292 Microbiologist 69
A293 Cytologist -
30. P30 Hygenist 68
31. P31 Radiology therapist 27
32 P32 Radiology diagnostician 269
33. P33 Pathologist 48
34 P34 Forensic Doctor 31
35 P35 Occupational Health Doctor 399
36 P36 Sports Doctor 48
37. P37 Rehabilitologist 62 A371 Doctor of Physical Rehabilitation 7
38. P38 Doctor of Physical Medicine 75
39. P39 Emergency Medicine Doctors 179
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Doctors Specialities and Number of Sertificated
Doctors (01.09.2005)
No Code Primary Speciality Code Sub-speciality
40. P40 Disaster Medicine Doctor -
41. P41 Health Care doctor 5
42. P42 Psychotherapist 39
43. P43 Epidemiologist 66
44. P44 Genetic 18
45. P45 Transfusiologist 84
46. P46 Health Care Manager 208
S 1- 46 9562 S 1- 46 9562 S 1- 46 9562 S 1- 46 9562 974 974 974
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Doctors Specialities and Number of Sertificated
Doctors
(01.09.2005)
No Code Supplementary speciality
47. PP01 Alergologist 24
48. PP02 Hepatologist 18
49. PP03 Immunologist 19
50. PP04 Homeopath 117
51 PP05 Cosmethologist 33
52. PP06 Dietician 21
53. PP07 Acupuncture Doctor 144
54. PP08 Military Medicine Doctor -
55. PP09 Doctor of Occupational Health 31
56. PP10 Prosthetic Orthopaedist -
57. PP11 Sexologist, sexopathologist 44
58. PP12 Child Psychiatrist 46
59. PP13 Expert 154
60. PP14 Intensive Care Doctor -
61. PP15 Hypnotherapist 29
62. PP16 Algologist -
63. PP17 Osteopath 7
64. PP18 Flebologist 13
S47-64 700 S47-64 700 S47-64 700 S47-64 700
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Diagn. and Treat. Methods and Nr. of Sertificated
Doctors
Nr. Code Method
1. M01 Iridodiagnostics 3
2. M02 Electroacupuncture diagnostics according Voller method 22
3. M03 Electroacupuncture and electroacupuncture therapy 10
4. M04 Auriculoacupuncture 21
5. M05 Laser acupuncture 8
6. M06 Medical bioesthesia 7
7. M07 Nonverbal hypnosis 2
8. M08 Qi-Gong 5
9. M09 Su-Jok 17
10. M10 Bioresonance therapy 5
11. M12 Hyperbaric oxygenation -
12. M16 Laser therapy 27
13. M17 Gastrointestinal endoscopy 60
14. M18 Medical chlamydiology 12
15. M19 Electrocardiography 77
16. M20 Exercise testing with ECG 72
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Diagn. and Treat. Methods and Nr. of Sertificated
Doctors
Nr. Code Method
17. M21 Echocardiography 55
18. M22 Manual diagnostics and manual therapy 29
19. M23 Electroencephalography 22
20. M24 Neuro-ultrasonography 26
21. M33 Ultrasonography of superficial abdominal blood vessels 89
22. M34 Ultrasonography in gynaecology and obstetrics 125
23. M35 Electro cardio stimulation and invasive correction of arrhythmias 8
24. M36 Counter pulsation with intra aortal balloon and ancillary circulation methods -
25. M37 Electro physiological diagnostics 1
26. M39 Ultrasound Dopplerography of vessels 19
27. M40 Angioplasty of peripheral vessels 1
28. M43 Plasmopheresis -
29. M45 Treatment, prevention and diagnostics of fungal diseases 13
30. M46 Methods for analysis of presence of alcohol, narcotics and psychotropic substances -
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Diagnostic and Treatment Methods and Number of
Sertificated Doctors
Nr. Code Method
31. M48 Percuatneous coronary angioplasty for treatment purposes 7
32. M49 Diagnostic catheterisation of heart and major vessels, incl. coronary angiography 13
33. M50 Ostheopathy -
34. M51 Ostheorephlexotherapy 17
35. M52 Bronchoscopy 11
36. M53 Electromyography 7
37. M54 Neurosonography of children and infants 26
38. M55 Neurological Diagnostics according Vojt method -
S1 38 817 S1 38 817 S1 38 817 S1 38 817
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Courses of Action of the Certification Council Draft the rules of evaluation of theoretical knowledge and professional skills during certification and re-certification for all specialities that would conform to uniform basic criteria Revive the co-operation with the Ministry of Health, including co-operation through the Consultative Council of Head Specialists and special centres Include in the activities of the Certification Council all the delegated functions of the Latvian Medical Association that are concerned with the recognition of the professional qualification in doctors profession Update the rules of procedure of the Certification Council integrating all accumulated information and Europe opinion
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WE DO HOPE WE ARE NOT PUTTING TOO MUCH TROUBLE TO
LATVIAN DOCTORS BECOMING MORE BELIEVE IN GOD THAN
POPE
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Thank you for your attention!