According to the regulatory framework in Ukraine, there is no provision for licensing of the professional activities of medical workers. A license may be issued for the conduct of economic activity in the field of medical practice exclusively to a business entity that is registered in accordance with the procedure established by law and meets the license conditions.

A new model of physician licensing.

It aims to be a transparent, clear, independent system that is as accessible as possible to the patient and will respond to the incompetence of doctors.

Differences in licensing of the medical profession and licensing of medical practice

	Licensing of the medical profession	Licensing of medical practice
What is the purpose of licensing?	Ensure proper qualification and ethics of doctors	to ensure that the individual entrepreneur or legal entity (health care institution) meets the organizational and personnel requirements, as well as has the appropriate material and technical support for them (their employees) to carry out medical practice
What rights does the license grant?	Work directly as a doctor (as an employee of a health care institution or an individual entrepreneur)	to carry out medical practice as a legal one. a person or an individual entrepreneur and act as a party to economic relations
Who will receive the license?	Any person who wishes to work as a doctor and meets the criteria	Legal entities and individual entrepreneurs
What are the consequences of license termination?	A person will lose the right to directly engage in medical practice as an employee or as an independent practitioner (loss of the right to a profession). For the first category – employees – their employer will be forced to hire another doctor with a valid license.	A legal entity or FOP will lose the right to carry out economic activities from medical practice, but their employees will be able to find employment with another employer and continue to work as doctors
What will govern licensing?	Law of Ukraine “On Professional Licensing of Doctors”	The Law of Ukraine “On Licensing Types of Economic Activity”.

The transition to the licensing system will take place in several stages.

• II half of 2018-2019 – development and adoption of the regulatory framework;
• 2020-2024 is a transition period during which doctors must pass an exam to obtain a license.
• Full transition to the licensing system.

It is important that doctors must pass the exam during the transition period in order not to lose the opportunity to practice.

Limited license

Full license

The doctor performs only those procedures duties provided for by the residency program. Practices under the supervision of an accompanying physician. Documents issued by a physician with a limited license are not valid without a duplicate signature of a physician with a full license. Does not extend. It is issued by the Ministry of Health after passing the “Step 3” exam. Get rid of the Licensing Board

The doctor independently makes decisions about procedures and methods of treatment. Practices independently. Documents do not require confirmation. Renewed every three years. Issued by the Ministry of Health after completion of residency. Excluded by the Licensing Board.

After successful completion of the medical residency, the doctor will receive a full license.

During the issuance of the license, the independent body will review the clinical residency document, as well as check whether the doctor has a diploma, criminal records, complaints about his activities during the medical residency, recommendations of the head of the clinical residency base, etc.

A full professional license will allow a doctor to practice medicine and hold relevant positions in health care facilities.

The license will be valid for 3 years. After it expires, the license will need to be renewed every next 3 years.

The license renewal procedure will take place online – the doctor will submit confirmation of compliance with the requirements for license renewal in electronic format.

The main requirement for the renewal of the license will be the presence of a sufficient number of BPR points. In addition to BPR scores, during license renewal, the Licensing Board will also check the history of medical practice and the doctor’s reputation (including the results of complaints against the doctor).

In the absence of problematic situations in practice and a sufficient number of BPR points, the doctor’s license will be renewed automatically.

An insufficient number of BPR points (including failure to collect the minimum number of BPR points during each year) will lead to the suspension of the license (until the required number of BPR points is collected). The doctor will not have the right to practice medicine. during the suspension of his license.

If the history of medical practice and the doctor’s reputation indicate the presence of problems and risks, the issue of extending the license will be decided by the Licensing Board.

According to the decision of the Licensing Council, the condition of extending the validity of the license may be the completion of special training or education.

 

Project/system of licensing of doctors in Ukraine

The law on licensing of doctors has not yet been adopted. However, the Ministry of Health submitted a draft of the Concept of Professional Licensing of Doctors in Ukraine to the Cabinet of Ministers. Let’s find out what changes in the work of doctors the medical reform will bring and what changes in the activities of medical workers have already taken place.

In order to improve the quality of medical services for the population, the Ministry of Health proposed to legislate the principles of access to the profession of a doctor. The essence of the changes is that a specialist will be allowed to work in his specialty if he:

• successfully completed his studies and passed the medical licensing procedure
• fulfilled the requirements of the NPR and extended the license

A doctor’s license is a document that proves that a specialist has the right to practice professionally.

Licensing of doctors is a procedure for obtaining access to the profession of a doctor.

Project of the Concept of Professional Licensing of Doctors

The public began discussing the project in June 2018. In 2019, the Ministry of Health organized a discussion on the licensing of doctors in Ukraine in the form of public consultations with medical workers throughout the country. The participants discussed the following topics:

• requirements for CPD (continuous professional development)
• principles of creation, functions and composition of the Licensing Council
• license extension/revocation procedure
• transitional period from certification to the licensing system of doctors in Ukraine (content, duration)
• quality control of medical care, personal responsibility of the doctor

 

The Licensing Board is a body that controls the process of issuing, confirming and revoking licenses for doctors. To understand which theses form the basis of the new bill, download and watch:

• The introduction of the system of professional licensing of doctors is one of the basic tools for the regulation of medical practice, which, in combination with the support for the development of medical education in Ukraine, will contribute to the improvement of the quality of medical care and the growth of the prestige of the medical profession in Ukrainian society.
• To obtain a license (access to the profession of a doctor), a candidate must pass a one-time exam. The license will be renewed automatically every three years. Personal educational portfolio and history of medical practice will be taken into account when confirming the license. In case of non-compliance with the requirements established by law or due to serious professional violations, the license may be suspended or canceled. Licenses will be issued by a single independent body with a special status – the Licensing Council .
• A doctor’s professional license can be full or limited. Limited licenses are issued to interns for training and obtaining initial specialization on the basis of internship. Full licenses are issued after completing the internship and passing the relevant exam

Why introduce professional licensing of doctors

The professional licensing of doctors in Ukraine is aimed at changing the system of training and improving the qualifications of doctors. Over time, this should improve the quality of medical services and the patient-doctor relationship. The Ministry of Health proposes to implement the concept by 2024. The duration of the transition period is 5 years. Thus, it is not yet necessary to talk about licensing the work of doctors in Ukraine in 2020.

Expected results of reforming the health care system:

• a new system of training, retraining of doctors
• clear and equal rules for admission to the profession/continuation of professional activity/deprivation of the right to professional activity
• high level of knowledge and professional skills of doctors
• personal responsibility of the doctor for providing medical care
• independence of doctors from the management of the medical institution
• increase in doctors’ income thanks to the new principle of financing the health care system “money follows the patient”
• growing confidence in doctors
• Ukrainian doctors will have the opportunity to integrate into the international medical community
• Ukraine recognizes licenses from the EU, USA, Israel, Canada, and Japan

Stages of implementation of the physician licensing procedure

No	Stage	Task	Features	Normative act
1	Implementation of CPD (continuous professional development)	introduce a unified qualification exam (EKI) for graduates of medical institutions	– EDKI — the only state qualification exam for applicants for the master’s degree of higher education in specialties “22 Health care” – EDKI consists of the following components: – integrated test exam “KROK” – international exam on the basics of medicine – professional English language exam – students who started studying in the master’s program from 2016, after passing all exams – in the third, sixth year, in internship – will become specialists with a professional license	Resolution of the CMU “On Approval of the Procedure for Conducting a Unified State Qualification Examination for Higher Education Degree Holders
		enter BPR of doctors	– the doctor must pass BPR – the doctor independently chooses educational activities in the field of formal, informal or informal education for training – BPR doctors are awarded points	Resolution of the CMU “On approval of the Regulation on the system of continuous professional development of specialists in the field of health care” dated March 28, 2018 No. 302
		to change the order of certification of doctors	– pre-certification interviews for certification will be cancelled – the doctor must independently choose where, how to study and what to study – BPR points will be taken into account during certification – the doctor must record the results of the BPR in the personal educational portfolio and submit it for consideration by the certification commission – from 02.01. at least 50 BPR points per year	order of the Ministry of Health “Some issues of continuous professional development of doctors” dated February 22, 2019 No. 446
2	Transition to the licensing system	to develop a draft of the Law of Ukraine “On Licensing of the Medical Profession in Ukraine”	– the license must be confirmed every three years – automatic renewal of a full license every three years if BPR points are available – personal educational portfolio and history of medical practice will be taken into account for the renewal of the doctor’s license – the license may be suspended or revoked – the doctor’s salary will depend on the number of patients, not on his category
		to create a Licensing Council	– powers – extension of the license for a new term and application of sanctions (revocation/suspension of the license) – members of the council are doctors selected in accordance with established criteria – clearly regulated procedures, published decisions
		to directly implement the licensing system of doctors in Ukraine	– to develop the tasks of the licensing exam for medical practitioners – to conduct examinations for medical practitioners for the transition to the licensing system – create an electronic portal for personal offices of licensed doctors – organize internships for doctors who have not passed the licensing exams – gradually eliminate the certification system NB! Doctors who do not pass the exam during the transition period will lose the right to practice

 

 

Types of licenses for doctors

Type of license	Features
limited	– such a license is issued by the Ministry of Health to a doctor during his residency after he passes the “Step 3” exam – gives the right to perform only the duties and procedures stipulated by the residency program – cannot be extended. The Licensing Council can deprive a specialist of this license NB! Documents issued by a doctor with a limited license are not valid without a duplicate signature of a doctor with a full license
Full	– is issued by the Ministry of Health to a doctor after completing residency – gives the doctor the right to practice independently, to make decisions about procedures and methods of treatment – subject to renewal every 3 years. Just as in the case of a limited license, the Licensing Board has the right to deprive a doctor of a full individual medical license.

 

Licensing procedure of doctors

Therefore, a doctor has the right to obtain a full license after completing residency. For this, an independent body:

• examines the document confirming residency,
• checks whether the doctor has a diploma, criminal record, complaints about his activities during residency, recommendations of the head of the clinical residency base.

As mentioned, the license must be renewed every three years. The procedure will take place online: the doctor submits documents in electronic form to confirm compliance with the requirements.

The main standards for licensing doctors:

• collection of a sufficient number of BPR points
• doctor’s reputation – no complaints

If the specialist does not collect the required number of BPR points, the license is suspended and the doctor is prohibited from practicing until the minimum number of BPR points is collected. If the doctor does not have the best reputation, the Licensing Board can decide to revoke his license or send him to training/internship.