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Degrees and their impact on the patient... on both sides of the Berlin Wall

Imagine that you are a patient and you come to see a doctor who does not have a MUDr. in front of his name, but a special designation Doctor Svitlana Krasná. What are your thoughts running through your head? Would you trust such a specialist? Maybe she has an accent and she is obviously a foreigner... Do you wonder what kind of person she is? Maybe she doesn't even have a college degree, unless she is a doctor of medicine? What does she allow herself to do when she asks me personal questions related to my health... and at the same time ordering me to observe quarantine, quit smoking or prescribing medications I don't want to take, maybe she doesn't know what medications are available in Slovakia?

This is the Slovak truth and reality. A doctor who graduated from a university outside of Slovakia cannot use the medical title of MUDr. or the dental title of MDDr. even if he has gone through the whole complicated process of education recognition in Slovakia, what we among ourselves call the Berlin Wall, which has not yet fallen in our country. This status quo makes it difficult to get the job done, sometimes even too much so. The use of an academic degree on the basis of a decision on the recognition of an educational document issued for the purpose of exercising a regulated profession (or for academic purposes) is governed by § 56(2) and (5) of Act No. 422/2015 Coll. on the Recognition of Educational Documents and the Recognition of Professional Qualifications, according to which:

"(2) An individual who has fulfilled the conditions for exercising a regulated profession in the Slovak Republic shall use the academic degree and its abbreviation awarded to him/her in accordance with the national law of a member state or a third state, in the language of that state".

And since our Dr. Svetlana Krasná graduated from a university in Ukraine, which does not confer any degree, she is not entitled to use the academic title in the acronym M.D., and it does not matter that she has highly valued experience in the field, confirmed by time, by patients, and by colleagues in the field. In Anglo-Saxon countries, physicians are given the title M.D. or D.M. (Medical Doctor or Doctor of Medicine) written after their name, but this title evokes similarly negative feelings from patients and colleagues, even if the specialist graduated from a school recognized in the professional community in, say, Canada. The Slovak Medical Chamber communicates with such members by simply changing the M.D. to Doctor.
Cooperation with colleagues

Doctors collaborate with each other, writing notes, discharge reports, and meeting in wards where they use name badges on their work clothes. Meeting a colleague like Dr. Svetlana Krasna can surprise even colleagues. If, for example, such a physician refers her patient to a cardiac surgeon with a signature without an M.D., and the note suggests that the patient be seen by a specialist, it can indeed cause an unpleasant reaction of distrust among colleagues, in which the patient may be somewhere in the middle. But, in my opinion, it is not the intercollegial relationship that we patients should be concerned about, but the treatment and service we come for, without any assumptions about the quality of the specialist with whom we come into contact. Let me remind you that the Slovak Medical Chamber keeps a register of 979 doctors from abroad, and not only each of them faces this problem, but also hundreds of their patients, residents of Slovakia.

How can this be done?

Recently we have been talking a lot about integration and inclusion. The pandemic has fully exposed the lack of capacity and access to basic health needs of the Slovak population. Slovakia lags far behind in basic health indicators, and the Recovery Plan is designed to help improve this situation. According to the current legislation, an academic degree is obtained upon successful completion of a higher education institution and is awarded exclusively by the respective higher education institution (in the Slovak Republic or abroad) in which the education was completed. In the Slovak Republic there is no legal regulation authorizing the Ministry of Education, Science, Research and Sport, the Centre for the Recognition of Educational Documents of the Slovak Republic, to award academic degrees to graduates of a foreign institution of higher education. However, we have Act No. 422/2015 Coll. on the recognition of educational documents and the recognition of professional qualifications, which, although amended on New Year's Eve 2021 due to a justified complaint from Brussels, needs further adjustment in terms of the recognition of degrees from third countries, not only from the EU. Indeed, the Berlin Wall of recognition of medical professional qualifications could have collapsed by now in accordance with the interests of citizens - patients...

Perhaps this could take the form of a decree from the Ministry of Education, Science, Research and Sport, as is done in Decree No. 16/2016 Coll. which establishes professional organizations whose members practice regulated professions with the right to use professional titles and regulated professions with educational coordination. I don't know what the form should be, but I do know that the use of medical academic titles is necessary for the successful exercise of one's license and for patient trust.

Foreign doctors, after 3 years of working in the state in which they have received recognition of their qualifications, can already apply for a change of EU member state as a place of practice based on the European directive, and this is an automatic process. Therefore, it is time to raise the recognition of professional qualifications to the level at which medical academic degrees can be used, which will put doctors from different countries on the same level as their colleagues who graduated from university in Slovakia.

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