A couple of days ago, an amendment to the health law was approved in parliament, which included a long-awaited internship opportunity for foreign doctors after the recognition of their education (diploma) in Slovakia. A similar procedure for the integration of foreign doctors has been operating in the Czech Republic for many years, and they are satisfied with it there. In our country, the internship could come into force from September 2019. It could be approved along with stratification, and although it only considered foreign doctors and not nurses or dentists, it was welcomed and supported by foreign medical professionals as a good opportunity to get to know the Slovak healthcare system and the right first step. But how has the Coronavirus changed the previous suggestion?
A time limitation was added to the approved text of the act stating that the change is effective "solely during a COVID-19 crisis situation" and the explanatory statement reads that "the trainee will not be allowed to continue to work after the removal of the crisis situation." Despite the fact that the law was passed, it seems rather one-sided and demotivating from the point of view of foreign doctors and other medical professionals, and I am afraid that it will not attract to Slovak medicine the reinforcement that the legislator was trying to attract. Below I will try to explain why.
Closed borders
Since we have closed borders until the state of emergency is lifted, it seems logical to me that only those doctors who are already in Slovakia can apply. They live here with their families and do not use their permits because of the long-standing bad system and especially the complete lack of a system of education as such, which I have been pointing out for a long time. According to my conservative estimate, there are now only about a hundred foreign doctors in Slovakia who meet the legal conditions under the new law: 39 doctors who applied for the spring exam, doctors who work as nurses, and those who live in Slovakia but do not practice, but managed to recognize his diploma before the crisis.
Spring exam for foreign doctors canceled
Foreign doctors, upon recognition of their diploma, must pass a professional examination to confirm their qualifications. The exam is held twice a year, in spring and autumn. This is a difficult professional exam in a foreign language for which they must prepare on their own for at least a year. This year, the exam was scheduled for March 19-20, and 39 doctors registered for it. A month after the deadline, the exam was canceled, and although they called it a postponement to the fall, the fact that the exam was not held at all in the spring of 2020 does not change. In addition, by rescheduling it, they have blocked even more candidates from enrolling in the exam as the official deadline for taking the fall exam is still February 18, 2020. The site still says that "we will announce the application process for additional applicants and the application deadline soon."
The proposed option of online testing for foreign doctors, by analogy with state online exams for medical school graduates, was not approved and only exacerbated the frustration of foreigners preparing for the exam. If they were allowed to demonstrate their knowledge in the exam, then some of them would not even need a scholarship.
Foreign doctors offered a helping hand during the crisis, but there was no response
On March 15, foreign doctors announced the "Let's unite and help Slovakia!" initiative, in which they offered their experience and willingness to help Slovakia as volunteers during COVID-19. Among them were not only doctors who know how to sign up for professional practice, but also other medical professionals, such as nurses, dentists or pharmacists, whom the law does not think about. An open letter to the Minister of Health was sent on 23 March and has yet to be answered.
The shortage of doctors is a long-standing problem, but there is also a shortage of nurses
The internship was finally approved, but, as I said, unfortunately, only during the crisis. We are now living through a time when many have realized not only the importance of medical personnel, but also their shortage. Therefore, we need high-quality, educated and experienced foreign doctors." The explanatory note states that "this proposal is based on proposals from hospital care providers, especially from regions with a shortage of medical workers." However, it does not mention that the proposals were received long before the crisis, no one wanted the internship to be limited to the coronavirus crisis, and in the country, in addition to doctors, there is a long-term shortage of nurses, who are 3 times more than doctors alone, namely 15,000. And this is not only in the regions.
Conclusion
Foreign medical workers can become an advantage of the Slovak healthcare system not only during the coronavirus outbreak. Slovakia has the potential to attract highly qualified foreign specialists and at least partially compensate for the shortage of personnel. Our country faces and will continue to face a shortage of personnel even after an increase in the number of medical students who can only come to practice after graduation and if they decide to stay in Slovakia. However, the adopted internship scheme for foreign doctors may not achieve the goal of increasing the number of medical staff in a crisis due to the interplay of several variables. In the end, perhaps one hundred foreign doctors may lose interest in the internship after repeated disappointments, such as ignoring their volunteer initiative or canceling the exam without the possibility of re-applying. Not to mention the ignoration of the lack of nurses, pharmacists, dentists, etc. But I believe that the crisis will soon be resolved and the internship will continue with minor changes that will be discussed with both practitioners and foreign medical professionals.
A time limitation was added to the approved text of the act stating that the change is effective "solely during a COVID-19 crisis situation" and the explanatory statement reads that "the trainee will not be allowed to continue to work after the removal of the crisis situation." Despite the fact that the law was passed, it seems rather one-sided and demotivating from the point of view of foreign doctors and other medical professionals, and I am afraid that it will not attract to Slovak medicine the reinforcement that the legislator was trying to attract. Below I will try to explain why.
Closed borders
Since we have closed borders until the state of emergency is lifted, it seems logical to me that only those doctors who are already in Slovakia can apply. They live here with their families and do not use their permits because of the long-standing bad system and especially the complete lack of a system of education as such, which I have been pointing out for a long time. According to my conservative estimate, there are now only about a hundred foreign doctors in Slovakia who meet the legal conditions under the new law: 39 doctors who applied for the spring exam, doctors who work as nurses, and those who live in Slovakia but do not practice, but managed to recognize his diploma before the crisis.
Spring exam for foreign doctors canceled
Foreign doctors, upon recognition of their diploma, must pass a professional examination to confirm their qualifications. The exam is held twice a year, in spring and autumn. This is a difficult professional exam in a foreign language for which they must prepare on their own for at least a year. This year, the exam was scheduled for March 19-20, and 39 doctors registered for it. A month after the deadline, the exam was canceled, and although they called it a postponement to the fall, the fact that the exam was not held at all in the spring of 2020 does not change. In addition, by rescheduling it, they have blocked even more candidates from enrolling in the exam as the official deadline for taking the fall exam is still February 18, 2020. The site still says that "we will announce the application process for additional applicants and the application deadline soon."
The proposed option of online testing for foreign doctors, by analogy with state online exams for medical school graduates, was not approved and only exacerbated the frustration of foreigners preparing for the exam. If they were allowed to demonstrate their knowledge in the exam, then some of them would not even need a scholarship.
Foreign doctors offered a helping hand during the crisis, but there was no response
On March 15, foreign doctors announced the "Let's unite and help Slovakia!" initiative, in which they offered their experience and willingness to help Slovakia as volunteers during COVID-19. Among them were not only doctors who know how to sign up for professional practice, but also other medical professionals, such as nurses, dentists or pharmacists, whom the law does not think about. An open letter to the Minister of Health was sent on 23 March and has yet to be answered.
The shortage of doctors is a long-standing problem, but there is also a shortage of nurses
The internship was finally approved, but, as I said, unfortunately, only during the crisis. We are now living through a time when many have realized not only the importance of medical personnel, but also their shortage. Therefore, we need high-quality, educated and experienced foreign doctors." The explanatory note states that "this proposal is based on proposals from hospital care providers, especially from regions with a shortage of medical workers." However, it does not mention that the proposals were received long before the crisis, no one wanted the internship to be limited to the coronavirus crisis, and in the country, in addition to doctors, there is a long-term shortage of nurses, who are 3 times more than doctors alone, namely 15,000. And this is not only in the regions.
Conclusion
Foreign medical workers can become an advantage of the Slovak healthcare system not only during the coronavirus outbreak. Slovakia has the potential to attract highly qualified foreign specialists and at least partially compensate for the shortage of personnel. Our country faces and will continue to face a shortage of personnel even after an increase in the number of medical students who can only come to practice after graduation and if they decide to stay in Slovakia. However, the adopted internship scheme for foreign doctors may not achieve the goal of increasing the number of medical staff in a crisis due to the interplay of several variables. In the end, perhaps one hundred foreign doctors may lose interest in the internship after repeated disappointments, such as ignoring their volunteer initiative or canceling the exam without the possibility of re-applying. Not to mention the ignoration of the lack of nurses, pharmacists, dentists, etc. But I believe that the crisis will soon be resolved and the internship will continue with minor changes that will be discussed with both practitioners and foreign medical professionals.
Current articles by Alona Kurotova are also available at dennikn.sk