On the issue of certification of Saint Petersburg healthcare system specialists (history, analysis and current trends; certifi cation of doctors in the specialty “Healthcare organization and public health”)
HEALTHCARE ORGANIZATION
Abstract
Introduction. In order to improve the quality of medical and preventive care in the healthcare system the Government of the Russian Federation is taking certain steps aimed both at improving the level of professional training of medical personnel and at increasing incentives for advanced training of medical professionals. Admission of doctors to practical work is possible only after they have successfully fulfilled the mandatory accreditation procedure; a system of continuing medical education has been implemented. At the same time, a voluntary system for assessing the qualifications of both doctors and nursing staff has been introduced — certification for obtaining a qualification category regulated by the Ministry of Health. Aim — to analyze the expert activity on the certification of specialists with higher medical education in the historical aspect and its current state; to make a thorough study of the certification of doctors in the specialty “Healthcare organization and public health” for 2024 in order to develop recommendations for improving certification activities in the urban health care system organizations. Materials and methods. In order to study the formation and development of the legislative framework for certification of medical workers, the laws and orders of the Ministry of Health of the Russian Federation reflecting the organization of the certification of doctors in the XXI century were analyzed. The work of 31 attestation commissions of the St. Petersburg Health Committee was analyzed, in which 16213 doctors were certified, including 541 doctors specializing in health organization and public health (“HP HO”) for 5 years. Moreover, all the attestation cases (134) of healthcare organizers for 2024 have been studied and analyzed. Results and discussions. The history of certification of medical workers in Russia goes back for more than 65 years. Using the example of the work of the attestation commission in the specialty “HP HO” for 2024, the main trends of this procedure have been identified. Such characteristics of certified specialists as their position, place of work, gender, age, work experience in an organizational specialty, academic degree, and others are considered. Special attention was paid to the issues of professional development and test results. Thus, higher scores (90 and above) were obtained by the heads of medical institutions and organizations with proper training in their specialty (residency, academic degree), who regularly upgrade their qualifications according to the “classical program” (144 hours) in medical universities and research centers. The expert activity of the reviewer was analyzed based on the reports of the attested persons alongside the analysis of comments. The structure and work of the expert commission on the specialty “HP HO” are highlighted in detail. Of all those certified in this specialty in 2024, 10.4% were assigned the II qualification category, 23.1% of the I category, and 66.5% of the highest category. Along with solving a number of organizational problems of the certification procedure for doctors (Medical Information and Analytical Center electronic information systems have been installed to optimize the conditions for submitting documents by doctors, as well as to improve the effectiveness of expert groups), the problems of involving medical professionals in the certification procedure remain being insufficiently solved. Conclusion. Certification of medical personnel is one of the ways of state control over the quality of specialist training. Attestation is not considered to be a substitute for the accreditation procedure, which is a mandatory element of admission to professional activity. A qualification category is a practical assessment of a specialist’s performance and level of qualification. Among the problems of certification, a group of organizational problems should be highlighted, the quality of training and advanced training of doctors, encouraging medical professionals to participate in certification in order to improve the level of medical and preventive care in general, and other issues outlined in the article.
References
1. Коленникова О.А. Причины дисфункции института аттестации медицинских специалистов. Народонаселение. 2023;26(3):158–169. https://doi.org/10.19181/population.2023.26.3.13. EDN: SYDKII.
2. Постановление ЦК КПСС и Совета Министров СССР от 14.01.1960 г. № 58 «О мерах по дальнейшему улучшению медицинского обслуживания и охраны здоровья населения СССР». В кн.: Решения партии и правительства по хозяйственным вопросам. В 5 т. Сборник докладов за 50 лет. Т. 4. 1953–1961 гг. М.: Политиздат; 1968. С. 634–645.
3. Постановление ЦК КПСС, Совета Министров СССР и ВЦСПС от 15 июля 1964 г. № 620 «О повышении заработной платы работников просвещения, здравоохранения, жилищно-коммунального хозяйства, торговли и общественного питания, и других отраслей народного хозяйства, непосредственно обслуживающих население». В кн.: Решения партии и правительства по хозяйственным вопросам. В 5 т. Сборник докладов за 50 лет. Т. 5. 1962–1965 гг. М.: Политиздат; 1968. С. 479–483.
4. Мишарин В.М., Кочубей А.В. Пилотный опрос врачей о системе присвоения квалификационных категорий. Медицина экстремальных ситуаций. 2023;25(3):146–150. https://doi.org/10.47183/mes.2023.035.
5. Алексеева Н.Ю., Гайдаров Г.М., Пчела Л.П., Макаров С.В. Социологическое исследование эффективности внедрения новой системы оплаты труда в учреждениях здравоохранения. Сибирский медицинский журнал. 2010;(2):86–90.
6. Шишкин С.В., Темницкий А.Л. Роль аттестации медицинских работников в повышении трудовой мотивации. Вопросы государственного и муниципального управления. 2019;(2):141–167.
7. Коленникова О.А., Токсанбаева М.С. Факторы дисфункции институтов оценки квалификации медицинских специалистов. Здравоохранение Российской Федерации. 2021;65(5):467–476. https://doi.org/10.47470/0044-197X-2021-65-5-467-476.
8. Фанта И.В., Шустова Т.И. Итоги аттестации врачей-оториноларингологов лечебно-профилактических учреждений Санкт-Петербурга. Российская оториноларингология. 2018;93(2):123–130. https://doi.org/10.18692/1810-4800-2018-2-123-130.



