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Katerina Venovska MSPH, FM Spec. MD

3-4 September 2012 IV Biannual Conference Gothenburg on the Future of Primary Health Care in Europe IV: "Crossing Borders in Primary Care“.

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Katerina Venovska MSPH, FM Spec. MD

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  1. 3-4 September 2012 IV Biannual Conference Gothenburg on the Future of Primary Health Care in Europe IV: "Crossing Borders in Primary Care“ The importance of international experience, capacity building activities and consistent environment and leadership for a critical policy decision and successful process of Family Medicine specialization and reeducation initiation in Macedonia KaterinaVenovska MSPH, FM Spec. MD Republic of Macedonia

  2. PROJECT COORDINATION UNITMinistry of Health of Republic of Macedonia Health Sector Management Project (HSMP) - Loan by the WB (2004 – 2010) Provided financial & technical support and consistent environment & leadership Component 1: Health Policy Formulation & Component 3: Service Delivery Improvement Coordinator: Katerina Venovska, MSPH, FM Spec. MD Republic of Macedonia

  3. HEALTH SECTOR MANAGEMENT PROJECT Health Strategy Development Process • International Health Policy Consultant engaged (2005) • Health Strategy Working Group established (2005) • Health Situation analyses & needs assessment carried out • Broad discussion & negotiations with stakeholders • Transparent process involving profession and the public • International experience reflected (WHO, WB...) • Health Strategy 2020 developed & enforced by the Government (2006) Republic of Macedonia

  4. FAMILY MEDICINE (FM) IMPLEMENTATION Training & International Experience - Strategic Planning SOUTHEMPTON CONFERENCE - 2008Future of Primary Care in Europe II Visit to St Mary’s Surgery HARVDARD SCHOOL OF PUBLIC HEALTH - 2008 Strengthening Human Resources in Health Republic of Macedonia

  5. FAMILY MEDICINE IMPLEMENTATION Public Relations & Communication (PRC) support • Adequate communication of Health Reform goals & activities • Increased cooperation with journalists (opponents to FM) • Public Relations Working Group established within HSMP • Technical support to PRC activities provided (2007) • PRC Strategy developed (2008) • Study Tour of Journalists in Netherlands organized (2009) • Joint PRC on FM implementation with main stakeholders Republic of Macedonia

  6. JOURNALIST STUDY VISIT TO NETHERLAND (2009) Ministry of Health, Welfare and Sport – Den Haag Domus Medicus - Utrecht Family Practice - Den Haag NIVEL Republic of Macedonia

  7. FAMILY MEDICINE IMPLEMENTATION FM Strategy Development & Implementation • Technical support & cooperation with Slovenian Family Medicine Department (Medical Faculty - Ljubljana) - HSMP • Family Medicine Working Group established within HSMP • FM Strategy and Implementation Plan developed (2009) • Memorandum of Cooperation in FM implementation signed (Ministry of Health & Medical Faculty Skopje) - May 2009 • 16 FM Educators / Mentors (skilled CME educators) were engaged through HSMP and trained (2009/2010) • FM Educational Board nominated at Skopje Medical Faculty Republic of Macedonia

  8. FAMILY MEDICINE IMPLEMENTATION FM Capacity Building Activities • Training of Core group of 24 FM Educators (2009, Ohrid) • 6 day training curricula developed • 50 FM Educators trained - Prilep Educational Centre (2010) • Visit to FM Educators practices • FM Continuous Medical Education program initiated • Close cooperation with Association of GP/FD in Macedonia • Training of additional groups of FM educators (2010-2011) • Study visits to Slovenia (Ljubljana & Bled) (2009-2010) Republic of Macedonia

  9. FAMILY MEDICINE CAPACITY BUILDING Training of FM educators – Cooperation with Slovenian FM Department Professors Training of additional groups of FM Educators by the Core Group of FM Educators Republic of Macedonia

  10. FAMILY MEDICINE CAPACITY BUILDING Debriefing of FM Educators after the training Group of Certified FM Educators and teachers Republic of Macedonia

  11. FAMILY MEDICINE IMPLEMENTATION FM Department establishment at the Medical Faculty • Family Medicine Educational Board operational • FM specialization curricula revised and teaching program developed • Family Medicine Specialization initiated (October 2009) • First year of study - financial support provided to first 10 trainees • Educational Centers in Veles, Gostivar & Strumica visited to plan their use for FM purposes • Family Medicine Educational Centre in Skopje established & fully equipped with HSMP support (2010) Republic of Macedonia

  12. FAMILY MEDICINE IMPLEMENTATION FM Specialization Initiation FAMILY MEDICINE SPECIALIZATION LAUNCH - October 2009 Medical Faculty Skopje & MOH/PCU (Vice-Dean, Dean, MOH/PCU FM Coordinator, Medical Faculty FM Coordinator) MEMORANDUM OF COOPERATION (FM) SIGNED - May 2009 Ministry of Health & Medical Faculty Skopje (Deputy Minister, Minister, & the Dean) Republic of Macedonia

  13. FAMILY MEDICINE EDUCATIONAL CENTER – SKOPJEReconstruction, Equipping & Launch Family Medicine Educational Centre - Skopje Launch - 2010 Family Medicine Educational Centre - Skopje Launch - 2010 Acceptance of renovated & fully equipped premises Ministry of Health / PCU Republic of Macedonia

  14. FAMILY MEDICINE EDUCATIONAL CENTER International Experience & Cooperation • Memorandum for Cooperation in the field of FM between Medical Faculty Skopje & Ljubljana signed (2010) • Study visit to Slovenia & maintaining close cooperation with the GP/FM Associations & FM University Departments in Croatia, Montenegro, Slovenia, Serbia, Bulgaria, Turkey… • Study visit to Nijmegen University, FM Department, Netherland and relevant institutions & Family Doctors • Study visit to Imperial College, London, United Kingdom • Bilateral Cooperation in FM between Macedonia & Turkey • Contact established with FM Association in Canada • Cooperation with Austrian FM University Dep. (CME Course) Republic of Macedonia

  15. FM INTERNATIONAL EXPERIENCE & COOPERATION Study visit to Imperial College, London, UK Study visit to Bled, Slovenia Republic of Macedonia

  16. FM INTERNATIONAL EXPERIENCE & COOPERATION Study visit to Nijmegen, Netherland Study visit to Domus Medicus, Utrecht, Netherland Republic of Macedonia

  17. FM INTERNATIONAL EXPERIENCE & COOPERATION Study visit to Family Practice near Nijmegen, Netherland Republic of Macedonia

  18. FM INTERNATIONAL EXPERIENCE & COOPERATIONBilateral Cooperation in FM with MOH / Turkey Republic of Macedonia

  19. IMPROVED COLLABORATION IN FM IMPLEMENTATION Established & maintained good cooperation between the key players: Ministry of Health, Health Insurance Fund, Medical Faculty Skopje, Slovenian FM Department experts Macedonian Doctors Chamber Association of GP/FM Doctors in Macedonia Republic of Macedonia

  20. FAMILY MEDICINE EDUCATIONAL CENTER Retraining of GPs to become FM Specialists • FM retraining curricula & teaching program developed • Bylaw for Specializations referring to FM Specialization & Retraining of doctors working in GP practices adopted • Specialization & Retraining Fees agreed between MOH, Medical Faculty Skopje & the Macedonian Doctors Chamber • Web Site for FM specialization & FM activities created & regularly updated • Second Group of FM specialization started in October 2010 • Retraining of GPs in FM Specialists started in February 2011 in Prilep and Skopje FM Educational Centers Republic of Macedonia

  21. SKOPJE FAMILY MEDICINE EDUCATIONAL CENTER Retraining of General Practitioners to FM Specialists Established Teacher exchange program with Ljubljana FM University Department based on the signed Agreement for Cooperation Regular Training Sessions in the FM Educational Center Within FM Retraining activities Republic of Macedonia

  22. TRAINING OF MEDICAL FACULTY PROFESSORS Family Medicine Specialist Exam – Examiners Preparation • Appropriate FM Specialist Exam materials and program were developed • The Medical Faculty nominated professors from various related fields to take part in the team of examiners for the FM Specialist Exam • Orientation Training for the professors for the implementation of FM Specialist Exam was carried out by the Slovenian FM University Department Professors • The first FM Specialist Exam was organized in May 2011 and managed by the Ljubljana University FM Department Professors in collaboration with trained Skopje Medical Faculty Professors • First 24 FM Specialists in Macedonia certified in May 2011 • Since then number of FM Specialists is growing - over 50 (2012) Republic of Macedonia

  23. TRAINING OF MEDICAL FACULTY PROFESSORS Family Medicine Specialist Exam – Examiners Preparation Republic of Macedonia

  24. FIRST GROUP OF FAMILY MEDICINE SPECIALISTS Certified by Slovenian Professors & Medical Faculty SkopjeMay 2011 Republic of Macedonia

  25. THANK YOU Republic of Macedonia

  26. ANY QUESTIONS? Republic of Macedonia

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