THE OPINION OF ACADEMIC STAFF REGARDING POSTGRADUATE TRAINING OF THE PUBLIC HEALTH SPECIALISTS

1. THE OPINION OF ACADEMIC STAFF REGARDING POSTGRADUATE TRAINING OF THE PUBLIC HEALTH SPECIALISTS Dr. Serghei Cebanu

2. The   public   health   training   is   of   great   importance   not   only   for   the   management  of  the  health  care  establishments,  but  also  for  the  management  of   the  growing  health  problem  of  the  population  as  well  as  the  development  of   new  public  health  policy.

3. Over   the   last   few   years   a   series   of   reforms   were   implemented   in   the   health  system.  However  the  high  level  of  morbidity  and  mortality  through  a   number  of  diseases  dictates  the  need  for  new  approaches  to  solving  the  public   health   problems.   It   is   necessary   to   develop   a   comprehensive   and   coordinated  appropriate  action  in  response  to  the  new  challenges  that  determine  the  health  state  of  population,  extending  the  area  of  action  of  the  specialists   from   the   Public   Health   Surveillance   State   Service.

4. Materials and methods To   evaluate   the   postgraduate   training   system   of  the  specialists  in  public  health,  the  development  and  approval  of  the  curricula  adjusted  to  the  requirements  of  the  National  Systemof Public   Health   and   international   educational   standards   it   was   developed   a   questionnaire   and   the   academic   staff   that   are   involved   in   the   training   of   the   future   public   health   specialists   were   surveyed. The   study   included   the   investigation   of   teachers   from   six   departments   of   the   State   University   of  Medicine and Pharmacy “NicolaeTestemitanu”, in total 46 persons

5. Results • 26,5%  have  a  teaching  experience  between  5­10  years,  35,6%- between 11­20   years,   11,1%-   between   21-­30,  11,1%- between   31­40   and   15,7% ­over  40  years. • The  investigated  teaching  staffs  know  three  international  languages:  English  –  57,8%,  French  –  53,3%  and  Italian  2,2%. • 66,7%  of  teachers  consider  the  teaching/development  conditions  offered   by  the  university  as  good,  6,7%  ­  very  good  and  26,6%  ­  satisfactory. • The  teaching  staff  is  involved  in  the  postgraduate  training  in  the  follow-­ ing   way:   60%   read   courses   to   residents,   53,3%   conduct   seminars,   44,4%   conduct   graduation   papers,   22,2%   coordinate   the   activity   in   the   Public   Health  Centers  and  22,  2%  do  not  participate  in  the  training  of  residents.

6. Most   teachers   also   work   in   the   practical   service.   Thus,   77,8%   of   the   teachers  are  involved  in  the  scientific- practical  activity  of  the  public  health   service.   The   mechanism   of   development   and   approval   of   the   residency   training   programs   included   the   participation   of   all   teachers   who   offered   their   suggestions   and   ideas   in   42,2%,   discussion   and   approval   within   the   department   meeting   in   64,4%,   discussion   and   approval   by   the   methodical   Council  of  discipline  in  35,6%,  discussion  and  approval  with  the  participation  of  specialists  from  the  practical  service  in  15,6%,  joint  discussion  with   graduates  in  4,4%.

7. Regarding   the   teachers’   opinion   about   the   system   of   the   postgraduate   training  of  the  specialists  in  public  health  in  accordance  with  the  Law  of   State   Surveillance   of   Public   Health   28,7%   of   them   consider   that   radical   reforms  are  needed  in  this  area,  22,2%  consider  that  the  university  graduates   have   an   insufficient   theoretical   background,   due   to   the   reduction   of   teaching   hours   in   some   subjects,   16%   have   no   opinion   regarding   the   training   of   the   specialists   in   public   health   and   they   mentioned   that   it   is   unclear  who  is  the  public  health  specialist  and  what  is  his  role,  only  17,8%   consider  the  system  as  being  appropriate.  The  other  44,4%  of  respondents   mentioned   about   the   insufficient   involvement   of   the   specialists   from   the   practical  activity..

8. The  postgraduate  education  is  a  mandatory  compartment  of  the  conception  of  continuing  training  of  physicians  and  pharmacists.  Residency  is  the   first   stage   of   training   of   the   physician-­specialist   within   the   postgraduate   system.  The  duration  of  the  residency  studies  in  public  health  is  2  years.   83,6%  of  teachers  think  that  this  is  a  sufficient  duration  for  allocated  for  the   formation   of   specialists   in   public   health,   9,7%   don’t   consider   it   sufficient   and  6,7%  have  other  opinions.

9. As   possible   ways   of   postgraduate   formation   of   specialists   in   public   health,   60,9%   of   teachers   mentioned   the   training   of   specialists   in   separate   domains,   34,8%   ­   training   of   specialists   in   one   domain  -­   Public   Health   which   would   include   Hygiene,   Epidemiology,   Public  Health,  Health  Promotion,  etc.  and  4,3%  have  other  opinions.

10. 51,1%  of   teachers   don’t   consider   necessary   to   includenew subjectsin the  curricula, 41,3%  suggested  to  include  some  new  subjects,  and  7,6%  did   not  answer  to  the  question. Among   the   new   proposed   subjects   there   are:   Modules   of   legislation;  Economy,   Psychology,   Health   Promotion,   Public   Health   Management,   Communication   in   Public   Health,   Biostatistics,   Health   Services   Management,  Social  Marketing,  Financial  Management,  Economics  and  Planning,   Decentralization  and  Development,  Project  Management,  Hospital  Management,   Psychology   Reconciliation,   Evidence-­based   medicine,   Occupational   medicine,  Hygienic  Laboratory,  Environmental  Medicine,  Risk  Assessment,   Nutrition,  Children  and  Mother  Health,  Epidemiology  of  noncommunicable diseases,  etc.

11. 71,7%  of  teachers  considered  necessary  the  modification  of  the  syllabus   by  introducing  new  themes,  17,4%  did  not consider  it  necessary  and  10,9%   did  not  answer  the  question. We   found   that   the   surveyed  teachers  know  the  provisions  of  the  Bologna  process  and  regarding the implementation  terms  of  the  provisions  of  the  Bologna  process  in  the  training  of  the  specialists  in  Public  Health,  23,9%  considered  that  they  can  be  implemented,  62,2%  considered  that  these  provisions  can  be  partially   implemented  and  13,9%  did  not  answer  the  question.

12. 43,5%  of  the  teaching  staff  consider  it  necessary  to  adjust  the  system  of   training   of   the   specialists   in  Public   Health   from   the   Republic   of   Moldova   to  the  one  from  the  European  Union,  other  47,8%  consider  necessary  only   some  changes  and  8,7%  don’t  consider  it  necessary.

13. 54,3%  of  respondents  declared  that  they  didn’t  encounter  any  obstacles  for  an  efficient  organization  of  the  postgraduate  training,  28,3%  encounter   some  obstacles  and  17,4%  did  not  answer  the  question. Among  those  obstacles  are  the  lack  of  adequate  space  for  training,  especially   the   laboratory,   lack   of   equipment,   limitedpossibilitiesfor research,   centralism  in  decision  making,  poor  technical-material  basis,  irresponsible  attitude  of  medical  practitioners.

14. Other  opinions  on  the  postgraduate  training  of   specialists  in  Public Health: • The  segmentation  of  the  required  specialties  in  the  postgraduate  training  in  the  V-­VI  year  of  study. • The  systematization  of  the  functional  obligations  (job  description)  of  the  specialists  in  Public  Health,  restructuring  the  postgraduate  training. • It  is  necessary  to  redefine  the  concept  of  Public  Health  for  a  better  understanding  of  it. • To   provide   more   practical   training   for   residents   in   the   Municipal   and  Districts  Centers  of  Public  Health,  Public  Medical  Institutions,  etc. • Unification  of  training  programs. • To  specify  the  concrete  notion  of  the  specialist  in  Public Health. • To  study  the  international  practice  regarding  the  Public  Health  specialists  training.

15. To  assess  the  role  of  specialists  in  Public  Health  depending  on  the  new  economic  conditions. • To   introduce   a   new   residency   for   the   Public   Health   and   Management  specialty. • Training  of  specialists  in  only  one  domain  –  Public  Health. • To  conduct  a  study  on  the  training  needs  of  specialists  in  Public  Health   and  adopt  the  program  according  to  the  demand. • The   distribution   of   the   training   hours   on   subjects   in   order   to   acquire   a   sufficient  number  for  the  assimilation  of  the  material  and  not  according   to  other  criteria. • To strengthenthe  interrelationships   and   responsibilities   of   the   university  employees  and  those  from  the  Public  Health  Centers  involved  in  the   postgraduate   training.

16. Conclusions With  the  advancement  of  the  Health  care  reform  in  Republic  of  Moldova   the   role   of   the   Public   Health   training   became   crucial   in   terms   of   training   the  public  health  leaders  capable  of  formulating  and  implementing  adequate   Public  Health  policies.   Today  we  need  to  improve  the  system  of  the  postgraduate  training  of  specialists   in   Public   Health   by   changing   the   curricula,   introducing   new   modules, implementing mobility  programs   for   residents,   conductingtraining courses  for  teachers,  strengthening  the  technical­material framework  of  the   departments  involved  in  the  training  of  specialists.

17. Thank you for your attention!