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THE OPINION OF ACADEMIC STAFF REGARDING POSTGRADUATE TRAINING OF THE PUBLIC HEALTH SPECIALISTS. Dr. Serghei Cebanu.
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THE OPINION OF ACADEMIC STAFF REGARDING POSTGRADUATE TRAINING OF THE PUBLIC HEALTH SPECIALISTS Dr. Serghei Cebanu
The public health training is of great importance not only for the management of the health care establishments, but also for the management of the growing health problem of the population as well as the development of new public health policy.
Over the last few years a series of reforms were implemented in the health system. However the high level of morbidity and mortality through a number of diseases dictates the need for new approaches to solving the public health problems. It is necessary to develop a comprehensive and coordinated appropriate action in response to the new challenges that determine the health state of population, extending the area of action of the specialists from the Public Health Surveillance State Service.
Materials and methods To evaluate the postgraduate training system of the specialists in public health, the development and approval of the curricula adjusted to the requirements of the National Systemof Public Health and international educational standards it was developed a questionnaire and the academic staff that are involved in the training of the future public health specialists were surveyed. The study included the investigation of teachers from six departments of the State University of Medicine and Pharmacy “NicolaeTestemitanu”, in total 46 persons
Results • 26,5% have a teaching experience between 510 years, 35,6%- between 1120 years, 11,1%- between 21-30, 11,1%- between 3140 and 15,7% over 40 years. • The investigated teaching staffs know three international languages: English – 57,8%, French – 53,3% and Italian 2,2%. • 66,7% of teachers consider the teaching/development conditions offered by the university as good, 6,7% very good and 26,6% satisfactory. • The teaching staff is involved in the postgraduate training in the follow- ing way: 60% read courses to residents, 53,3% conduct seminars, 44,4% conduct graduation papers, 22,2% coordinate the activity in the Public Health Centers and 22, 2% do not participate in the training of residents.
Most teachers also work in the practical service. Thus, 77,8% of the teachers are involved in the scientific- practical activity of the public health service. The mechanism of development and approval of the residency training programs included the participation of all teachers who offered their suggestions and ideas in 42,2%, discussion and approval within the department meeting in 64,4%, discussion and approval by the methodical Council of discipline in 35,6%, discussion and approval with the participation of specialists from the practical service in 15,6%, joint discussion with graduates in 4,4%.
Regarding the teachers’ opinion about the system of the postgraduate training of the specialists in public health in accordance with the Law of State Surveillance of Public Health 28,7% of them consider that radical reforms are needed in this area, 22,2% consider that the university graduates have an insufficient theoretical background, due to the reduction of teaching hours in some subjects, 16% have no opinion regarding the training of the specialists in public health and they mentioned that it is unclear who is the public health specialist and what is his role, only 17,8% consider the system as being appropriate. The other 44,4% of respondents mentioned about the insufficient involvement of the specialists from the practical activity..
The postgraduate education is a mandatory compartment of the conception of continuing training of physicians and pharmacists. Residency is the first stage of training of the physician-specialist within the postgraduate system. The duration of the residency studies in public health is 2 years. 83,6% of teachers think that this is a sufficient duration for allocated for the formation of specialists in public health, 9,7% don’t consider it sufficient and 6,7% have other opinions.
As possible ways of postgraduate formation of specialists in public health, 60,9% of teachers mentioned the training of specialists in separate domains, 34,8% training of specialists in one domain - Public Health which would include Hygiene, Epidemiology, Public Health, Health Promotion, etc. and 4,3% have other opinions.
51,1% of teachers don’t consider necessary to includenew subjectsin the curricula, 41,3% suggested to include some new subjects, and 7,6% did not answer to the question. Among the new proposed subjects there are: Modules of legislation; Economy, Psychology, Health Promotion, Public Health Management, Communication in Public Health, Biostatistics, Health Services Management, Social Marketing, Financial Management, Economics and Planning, Decentralization and Development, Project Management, Hospital Management, Psychology Reconciliation, Evidence-based medicine, Occupational medicine, Hygienic Laboratory, Environmental Medicine, Risk Assessment, Nutrition, Children and Mother Health, Epidemiology of noncommunicable diseases, etc.
71,7% of teachers considered necessary the modification of the syllabus by introducing new themes, 17,4% did not consider it necessary and 10,9% did not answer the question. We found that the surveyed teachers know the provisions of the Bologna process and regarding the implementation terms of the provisions of the Bologna process in the training of the specialists in Public Health, 23,9% considered that they can be implemented, 62,2% considered that these provisions can be partially implemented and 13,9% did not answer the question.
43,5% of the teaching staff consider it necessary to adjust the system of training of the specialists in Public Health from the Republic of Moldova to the one from the European Union, other 47,8% consider necessary only some changes and 8,7% don’t consider it necessary.
54,3% of respondents declared that they didn’t encounter any obstacles for an efficient organization of the postgraduate training, 28,3% encounter some obstacles and 17,4% did not answer the question. Among those obstacles are the lack of adequate space for training, especially the laboratory, lack of equipment, limitedpossibilitiesfor research, centralism in decision making, poor technical-material basis, irresponsible attitude of medical practitioners.
Other opinions on the postgraduate training of specialists in Public Health: • The segmentation of the required specialties in the postgraduate training in the V-VI year of study. • The systematization of the functional obligations (job description) of the specialists in Public Health, restructuring the postgraduate training. • It is necessary to redefine the concept of Public Health for a better understanding of it. • To provide more practical training for residents in the Municipal and Districts Centers of Public Health, Public Medical Institutions, etc. • Unification of training programs. • To specify the concrete notion of the specialist in Public Health. • To study the international practice regarding the Public Health specialists training.
To assess the role of specialists in Public Health depending on the new economic conditions. • To introduce a new residency for the Public Health and Management specialty. • Training of specialists in only one domain – Public Health. • To conduct a study on the training needs of specialists in Public Health and adopt the program according to the demand. • The distribution of the training hours on subjects in order to acquire a sufficient number for the assimilation of the material and not according to other criteria. • To strengthenthe interrelationships and responsibilities of the university employees and those from the Public Health Centers involved in the postgraduate training.
Conclusions With the advancement of the Health care reform in Republic of Moldova the role of the Public Health training became crucial in terms of training the public health leaders capable of formulating and implementing adequate Public Health policies. Today we need to improve the system of the postgraduate training of specialists in Public Health by changing the curricula, introducing new modules, implementing mobility programs for residents, conductingtraining courses for teachers, strengthening the technicalmaterial framework of the departments involved in the training of specialists.