EU-PHARE TWINNING PROJECT Mutual Recognition of Medical Professionals

EU-PHARE TWINNING PROJECT

Mutual Recognition of Medical Professionals

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Opleiding en Registratie

Domus Medica

The recognition of The recognition of medical professionals medical professionals

from other from other EU member statesEU member states

Dr Lourens R. Kooij MD PhDGeneral secretary HVRC

KNMG Postgraduate Training & Registration

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Recognition of medical Recognition of medical professionals from other EU professionals from other EU member states: member states:

a systematic a systematic approachapproachDr Lourens R. Kooij MD PhD

General secretary HVRCKNMG Postgraduate Training & Registration

April 2004

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Mutual recognition: what do Mutual recognition: what do we need to make the system we need to make the system workingworking??

•EU legislation

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•EU legislation: Directive 93/16/EEC

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EEC, EU, EEAEEC, EU, EEA

1957: founding EEC by B, NL, L, wD, F and I1973: + UK, IRL, DK1981: + GR1986: + SP, P1990: reunion of Germany1992: EEC + N, ICE, LST = EEA1993: EEC becomes EU1995: + FIN, A, S1999: treaty with CH 2004: + 10 new MS, including PL

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•EU legislation: Directive 93/16/EEC•competent authorities

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•EU legislation: Directive 93/16/EEC•competent authorities• trust

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•EU legislation: Directive 93/16/EEC•competent authorities• trust•a systematic approach

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Directive 93/16/EECDirective 93/16/EEC

•Mutual recognition of diplomas

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•Mutual recognition of diplomas

•Co-ordination of training programs

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•Mutual recognition of diplomas‘automatic’ recognition, based on

approved

diplomas and certificates, issued by the MS competent authorities

•Co-ordination of training programs

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•Mutual recognition of diplomas‘automatic’ recognition, based on

approved

diplomas and certificates, issued by the MS competent authorities

•Co-ordination of training programs minimum requirements

on contents and duration

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Mutual recognition Mutual recognition after 1 May 2004after 1 May 2004

POLAND

Other Member States

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Mutual recognition Mutual recognition

Member State

Member State

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Mutual recognition: Mutual recognition: betweenbetween MS and MS

Which EU diplomas have to be recognised by other MS competent authorities?•Three (or four) possibilities:

1. Study/specialisation after accession2. Acquired rights

a. Study before accessionb. Specialisation before

accession3. Third country qualifications

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Domus MedicaEU diplomas to be EU diplomas to be recognised by other recognised by other

MS MS 1. Study/specialisation after

accession:• diploma / certificate of a medical

study and/or a specialisation that started after the accession of the MS of origin

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MS MS 2. Acquired rights

a. medical study started before accession: diploma issued after a medical study that (does not meet the Directive and) started before the accession of the MS of origin, accompanied by a certificate from the competent authority in the MS of origin that the applicant worked as a medical doctor for at least 3 years in the last 5 years

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MS MS 2. Acquired rights

b. specialisation started before accession: diploma issued after a specialisation that (does not meet the Directive and) started before the accession of the MS of origin, accompanied by a certificate from the competent authority in the MS of origin that the applicant worked as a specialist at least twice the difference between the duration of the specialist training in the host MS and the MS of origin

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MS MS 3. Third country qualifications

• under article 42c Directive recognition in another MS, additional diplomas, training and professional experience within the EU have to be taken into account in requests to recognize third country qualifications

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Domus MedicaArt. 42c of Directive Art. 42c of Directive 93/16/EEC 93/16/EEC

•MS shall examine diplomas, certificates and other evidence of formal qualifications in the field covered by this Directive obtained by the holder outside the EU in cases where those diplomas, certificates etc have been recognised in another MS, as well as training undergone and/or professional experience gained in that other MS.

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Domus MedicaExample of a case study Example of a case study (1)(1)

A Dutch citizen (female, 37) who - after graduating as medical doctor in Belgium and postgraduate training for general practice (family medicine) in the UK – worked for more than 5 years in Bhutan, requests for recognition as a doctor and as a family physician in Poland.

•What would be your decision and why?

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Domus MedicaExample of a case study Example of a case study (2)(2)

A British citizen (male, 40), who - after graduating as medical doctor in the UK and specialisation as a paediatrician in the South-Africa – worked for 4 years in Germany, requests for recognition as a doctor and as a paediatrician in Poland.

•What would be your decision and why?

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It’s all about nationality!It’s all about nationality!

In general, the range of application of Directive 93/16/EEC is limited to applicants who have:

•MS nationality•MS diplomas and/or certificates

Case studiesCase studies 1 2 3 4 …

Nationality

Medical study

Specialisation

Experience

Recognition as MD/spec.?

Remarks

Case studiesCase studies 1

Nationality EU

Medical study

EU

Specialisation

0

Experience 0

Recognition as MD/spec?

Remarks


Nationality EU

Medical study

EU

Specialisation

0

Experience 0

Recognition as MD/sp?

+/0

Remarks

Case studiesCase studies 1 2

Nationality EU EU

Medical study

EU EU

Specialisation

0 EU

Experience 0 0


+/0

Remarks


Nationality EU EU

Medical study

EU EU

Specialisation

0 EU

Experience 0 0


+/0 +/+

Remarks

Case studiesCase studies 1 2 3

Nationality EU EU EU

Medical study

EU EU EU

Specialisation

0 EU EU

Experience 0 0 EU


+/0 +/+

Remarks



Medical study

EU EU EU

Specialisation

0 EU EU

Experience 0 0 EU


+/0 +/+ +/+

Remarks

Case studiesCase studies 1 2 3 4

Nationality EU EU EU EU

Medical study

EU EU EU EU

Specialisation

0 EU EU EU

Experience 0 0 EU ThC


+/0 +/+ +/+

Remarks



Medical study

EU EU EU EU

Specialisation

0 EU EU EU

Experience 0 0 EU ThC


+/0 +/+ +/+ +/+

Remarks

Case studiesCase studies 1 2 3 4 5

Nationality EU EU EU EU EU

Medical study

EU EU EU EU EU

Specialisation

0 EU EU EU ThC

Experience 0 0 EU ThC 0


+/0 +/+ +/+ +/+

Remarks



Medical study

EU EU EU EU EU

Specialisation

0 EU EU EU ThC



+/0 +/+ +/+ +/+ +/?

Remarks



Medical study

EU EU EU EU EU

Specialisation

0 EU EU EU ThC



+/0 +/+ +/+ +/+ +/?

Remarks / nat law


Nationality EU

Medical study

EU

Specialisation

ThC

Experience ThC


Remarks


Nationality EU

Medical study

EU

Specialisation

ThC

Experience ThC


+/?

Remarks


Nationality EU

Medical study

EU

Specialisation

ThC

Experience ThC


+/?

Remarks / nat law


Nationality EU EU

Medical study

EU EU

Specialisation

ThC ThC

Experience ThC EU


+/?

Remarks / nat law


Nationality EU EU

Medical study

EU EU

Specialisation

ThC ThC

Experience ThC EU


+/?

+/?

Remarks / nat law


Nationality EU EU

Medical study

EU EU

Specialisation

ThC ThC

Experience ThC EU


+/?

+/?

Remarks / nat law

/ EU 42c



Medical study

EU EU ThC

Specialisation

ThC ThC 0

Experience ThC EU 0


+/?

+/?

Remarks / nat law

/ EU 42c



Medical study

EU EU ThC

Specialisation

ThC ThC 0

Experience ThC EU 0


+/?

+/? ?/0

Remarks / nat law

/ EU 42c



Medical study

EU EU ThC

Specialisation

ThC ThC 0

Experience ThC EU 0


+/?

+/? ?/0

Remarks / nat law

/ EU42c

nat law



Medical study

EU EU ThC ThC

Specialisation

ThC ThC 0 EU

Experience ThC EU 0 0


+/?

+/? ?/0 ?/?

Remarks / nat law

/ EU42c

nat law



Medical study

EU EU ThC ThC

Specialisation

ThC ThC 0 EU



+/?

+/? ?/0 ?/?

Remarks / nat law

/ EU 42c

nat law

EU 42c



Medical study

EU EU ThC ThC ThC

Specialisation

ThC ThC 0 EU EU

Experience ThC EU 0 0 EU


+/?

+/? ?/0 ?/?

Remarks / nat law

/ EU 42c

nat Law

EU 42c



Medical study

EU EU ThC ThC ThC

Specialisation

ThC ThC 0 EU EU



+/?

+/? ?/0 ?/? ?/?

Remarks / nat law

/ EU 42c

nat law

EU 42c



Medical study

EU EU ThC ThC ThC

Specialisation

ThC ThC 0 EU EU



+/?

+/? ?/0 ?/? ?/?

Remarks / nat law

/ EU 42c

nat law

EU 42c

EU 42c


Nationality EU

Medical study

ThC

Specialisation

EU

Experience ThC


Remarks

Case Case studiesstudies

11

Nationality EU

Medical study

ThC

Specialisation

EU

Experience ThC


?/?

Remarks


Nationality EU

Medical study

ThC

Specialisation

EU

Experience ThC


?/?

Remarks EU 42c


Nationality EU EU

Medical study

ThC ThC

Specialisation

EU ThC

Experience ThC EU


?/?

Remarks EU 42c


Nationality EU EU

Medical study

ThC ThC

Specialisation

EU ThC

Experience ThC EU


?/? ?/?

Remarks EU 42c


Nationality EU EU

Medical study

ThC ThC

Specialisation

EU ThC

Experience ThC EU


?/? ?/?

Remarks EU 42c

EU 42c


Nationality EU EU ThC

Medical study

ThC ThC EU

Specialisation

EU ThC 0

Experience ThC EU 0


?/? ?/?

Remarks EU 42c

EU 42c



Medical study

ThC ThC EU

Specialisation

EU ThC 0

Experience ThC EU 0


?/? ?/? ?/0

Remarks EU 42c

EU 42c



Medical study

ThC ThC EU

Specialisation

EU ThC 0

Experience ThC EU 0


?/? ?/? ?/0

Remarks EU 42c

EU 42c

nat law


Nationality EU EU ThC ThC

Medical study

ThC ThC EU EU

Specialisation

EU ThC 0 EU



?/? ?/? ?/0

Remarks EU 42c

EU 42c

nat law



Medical study

ThC ThC EU EU

Specialisation

EU ThC 0 EU



?/? ?/? ?/0 ?/?

Remarks EU 42c

EU 42c

nat law



Medical study

ThC ThC EU EU

Specialisation

EU ThC 0 EU



?/? ?/? ?/0 ?/?

Remarks EU 42c

EU 42c

nat law

nat law


Nationality EU EU ThC ThC ThC

Medical study

ThC ThC EU EU EU

Specialisation

EU ThC 0 EU EU



?/? ?/? ?/0 ?/?

Remarks EU 42c

EU 42c

nat law

nat law



Medical study

ThC ThC EU EU EU

Specialisation

EU ThC 0 EU EU



?/? ?/? ?/0 ?/? ?/?

Remarks EU 42c

EU 42c

nat law

nat law



Medical study

ThC ThC EU EU EU

Specialisation

EU ThC 0 EU EU



?/? ?/? ?/0 ?/? ?/?

Remarks EU 42c

EU 42c

nat law

nat law

nat law

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Is it as simple as that? Is it as simple as that?

.

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•yes, it is

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•yes, it is•but there are other things:

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•yes, it is•but there are other things:

for example:

what to do when an immigrating specialist has a specialisation that does not exist in the host MS?

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Domus MedicaWhat to do when a What to do when a specialisation does not specialisation does not exist in the host MS? exist in the host MS?

• art 8 of the Directive determines that in this case the host MS has to try to ‘fit him/her in’ in a specialisation that does exist in the host MS

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• by examining the (contents and duration of the) specialist training that has been followed, the professional experience and CME

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• by examining the (contents and duration of the) specialist training that has been followed, the professional experience and CME

• and deciding on the additional training that is necessary to recognize this specialist in a specialisation that does exist in the host MS

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Domus MedicaIs it necessary to develop Is it necessary to develop curricula for this kind of curricula for this kind of situation? situation?

.

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• that is a possibility you have to consider when you expect to have to deal with this type of question on a regular basis and you think you need ‘ready-made’ solutions

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• that is a possibility you have to consider when you expect to have to deal with this type of question on a regular basis and you think you need ‘ready-made’ solutions

• this type of problem however is quite rare and every situation is different: in the NL we decided to design ‘tailor-made’ solutions, often based on assessment during practising under supervision

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‘‘Exceptive clauses’ Exceptive clauses’

.

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•art. 42c- in other MS recognized third country

qualifications

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qualifications

•art. 8- differences in specialisations between MS

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qualifications


•art. 9- acquired rights in other (existing) MS

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qualifications


•art. 9- acquired rights in other (existing) MS

•art. 9a (new!)- acquired rights in other (new) MS

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Closing remarks Closing remarks

•It is not always easy•but mostly it is not difficult either•some requests are complicated•look carefully at diplomas/certificates•trust competent authorities in other MS•and have faith in your own competence

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EU-PHARE TWINNING PROJECT Mutual Recognition of Medical Professionals