Factors of dysfunction of institutes for assessing the qualifications of medical specialists

Abstract

Introduction. The ongoing transformations of institutes for assessing the qualifications of medical specialists lead to ambiguous consequences, including the phenomena of their dysfunction. The aim of the study is to systematize the factors influencing the formation of the dysfunctions on the examples of the institute for accreditation of medical specialists and their certification for a qualification category. Material and methods. The concepts of continuing education and continuing professional development, formulated under the auspices of the United Nations, served as the theoretical basis of the study. They were the basis for the analysis of the factors causing deviations from these processes, that is, the dysfunction of the institutes for assessing the qualifications of medical professionals. The information of two sociological surveys of medical specialists employed in the system of the Moscow Healthcare Department was used, namely, a sample questionnaire survey and a survey by the method of expert interviews. Results. The factors of dysfunction of the institute of accreditation of medical specialists were identified on the basis of an analysis of the practice of continuing medical education (CME), introduced as an integral element of the transition from the institute of certification to the institute of accreditation. The main attention is paid to the shortcomings of the CME, which cause the dysfunctions of this institute. It is revealed that they are caused by an insufficiently debugged organization of the CME. The study of the work of the institute of certification for a qualification category showed that its main function, namely, ensuring permanent professional development above the accreditation level, has significantly weakened. This is confirmed by the statistics of a decrease in specialists undergoing both primary and secondary certification. One of the main factors is a violation of the incentives for professional growth. Discussion. The problems of dysfunction of qualification assessment institutes are mainly because the coordination of their elements is not sufficiently observed in the work of these institutes. Within the framework of the accreditation institute, this is reflected in the fact that the distribution of responsibilities between all the subjects of the CME is poorly coordinated. And in the work of the institute of certification for a qualification category, its fundamental differences from the institute of accreditation are erased, mainly due to symbolic surcharges for the type and attempts to replace them with incentive payments common to both institutes. Conclusion. The factors of dysfunction of the institutes for assessing the qualifications of medical specialists are systematized into main and concretized (as forms of manifestation of the main factors). The necessity of joint responsibility of the subjects of the CME for its quality, adequate to ensure the basic level of qualification, and strengthening the financial and career incentives for professional growth above the basic level, is substantiated.