Medical education reform: changes for students and doctors

Under the Constitution of Ukraine, in accordance with the Law of Ukraine ‘On the Fundamental Principles of the Ukrainian Health Legislation’ and the Civil Code of Ukraine, all patients in Ukraine are entitled to quality healthcare and have all of the following rights:

1. the right to preventive healthcare;

2. the right to have access to health care services;

3. the right to give consent to or refuse medical procedure; 

4. the right to freedom of healthcare choice, in particular:

• the freedom to choose doctors;
• the freedom to choose healthcare treatment;
• the freedom to choose a healthcare provider / facility;
• the freedom to change doctors;
• the right to treatment abroad in case there is no possibility to provide the necessary care or treatment in any of the healthcare facilities or institutions in Ukraine;

5. the right to medical privacy;

6. the right to quality medical care;

7. the right to safe medical care;

8. the right to innovative medical care, in particular:

• the right to a medical and biological experimentation;
• the right to assisted reproductive technology;
• the right to donation;
• the right to therapeutic cloning;
• the right to sex reassignment surgery (sex change);

9. the right to be informed promptly of potential suffering and pain;

10. the right to be treated as an individual with unique needs and preferences;

11. the right to appeal against unlawful decisions and actions of medical staff, healthcare facilities and institutions;

12. the right to claim compensation for the damage caused to health;

13. the right to life and respect for human dignity in healthcare settings;

14. the right to protection from any form of discrimination in health care.

Every patient in Ukraine has all of the following responsibilities and obligations stipulated in the provisions of the Law of Ukraine ‘On Fundamental Principles of the Ukrainian Health Legislation’:

1. to take care of one's own health and the health of one's children, as well as to not endanger other patients' health;
2. to undergo preventive health check-ups and to be vaccinated according to the recommended schedule;
3. to take necessary measures to provide first aid and emergency assistance to other citizens in any life- or health-threatening situation;
4. every patient shall follow treatment schemes and doctor’s recommendations, as well as respect and observe the internal legal rules of the healthcare facility and the institutional order;
5. In an emergency, where there is an obvious, immediate and real threat to life, every patient shall receive the necessary medical care or treatment without prior consent or a medical decision made by his/her legal representatives.

Sound academic background is one of the key prerequisites for healthcare improvement in Ukraine. In general, educational opportunities must reflect the real needs of the population and doctors’ work remuneration must meet the healthcare quality level.

On March 28, 2018, the Cabinet of Ministers of Ukraine approved several resolutions providing for the first steps in implementation of medical education reform. For example, Master’s students of medical schools and institutions in Ukraine will have to pass the Unified State Qualification Exam in the specialty. An international monitoring and evaluation of the quality of higher medical education will be conducted in 2018, and the new approach to continuing medical education and professional development of healthcare workers will be introduced.

MoH of Ukraine develops a new system of continuing professional development for healthcare workers

On March 28, 2018, the Cabinet of Ministers of Ukraine adopted Resolution "On Approval of the Regulation on the System of Continuing Professional Development of Healthcare Workers", which lays the legal and organizational groundwork for the system of continuing medical education and professional development.

Continuing professional development is the process by which health professionals keep updated to meet the needs of patients, the healthcare service, and their own professional development. It includes the continuous acquisition of new knowledge, skills, and attitudes to enable competent practice. Therefore, continuing professional development is a process of lifelong learning in practice.

The quality of life and the health of people directly depend on quality of medical services and performance of healthcare professionals. This is very important, because life and health are recognized as the fundamental social values both in Ukraine and in other countries of the world. This is why many countries regulate the status and continuing education/professional development programs for healthcare workers at all stages.

The new system of continuing medical education and professional development will ensure proper control over certification of healthcare specialists and will improve the quality of medical services provided to the Ukrainian citizens.

MoH of Ukraine introduces the Unified State Qualification Exam

On March 28, 2018, the government passed the Resolution of the Cabinet of Ministers of Ukraine "On Approval of the Unified State Qualification Exam Procedure for the Master’s degree students of the Healthcare departments".

The Ministry of Health of Ukraine introduces effective mechanisms for certification of healthcare graduates. Moreover, for the first time since Ukraine’s independence, the MoH has developed an integrated approach to examinations in medical education.

The Unified State Qualification Exam will consist of the following components:

• the integrated exam ‘KROK’;
• the objective structured practical (clinical) examination (OSPE or OSCE);
• the International Foundations of Medicine exam (IFOM);
• the English language proficiency test.

The introduction of the Unified State Qualification Exam will not only contribute to higher quality of medical education, but also to improved healthcare in Ukraine.

International monitoring and evaluation of the quality of medical education in Ukraine is planned to be conducted in 2018

On March 28, 2018, the Cabinet of Ministers of Ukraine adopted Resolution "On some Aspects of the 2018 International Monitoring and Evaluation of the Quality of the Ukrainian Higher Medical Education", which stipulates that all Ukrainian higher education institutions that train doctors, regardless of their subordination and ownership form, will participate in the international monitoring and evaluation of the quality of medical education.

The Ministry of Health of Ukraine introduces transformational changes in the medical education system in Ukraine, but the MoH team needs objective information about the current quality of medical education, especially in comparison with the situation in other countries of the world, in order to identify key issues in this field and form an efficient state policy.

International comparative studies, like widely-used TIMSS, PIRLS, PISA, CIVIC, ICILS, constitute the key method for obtaining such information.

The International Foundations of Medicine (IFOM) exam will serve the basis for international monitoring and evaluation of the quality of medical education in Ukraine, which is scheduled to be conducted in 2018. IFOM is one of the main exams for medical students in many countries of the world, as it provides comparative data on educational achievements and acquired knowledge, as well as establishes an international quality standard for medical education.

Medical education in Ukraine requires radical reform to start producing high quality results. This is why we need new academic programs and exams for healthcare professions, which are not currently used in Ukraine, but are already the norm in the international practice. Such qualitative changes in medical education will improve the overall image of medicine and healthcare in the country.