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27 August 2014
To obtain a medical licence in Austria, physicians have to complete practical medical training after graduating from university. Currently, this medical training is held at hospitals and takes three years for general practitioners and six years for consulting physicians. The training concept has been discussed for years because trainee doctors are not trained properly as intended by the law, but rather are used to perform administrative tasks or tasks that could be performed by nursing staff. After years of negotiations, the stakeholders in healthcare (ie, state, provinces, social security institutions and the Chamber of Physicians) have agreed on a new model for post-graduate training.
The draft amendment to the Physicians Act(1) was circulated by the Ministry of Health on July 24 2014. The amendment will be adopted by Parliament in autumn and will enter into force on January 1 2015.
The reform emphasises the obligation to complete nine months of basic training after the completion of medical studies in order to acquire basic clinical competences in the fields of internal medicine, surgery and emergency medicine, as well as the 15 most common diseases (eg, cardiovascular diseases, depression, cerebrovascular diseases, Alzheimer disease, dementia and diabetes) in general hospitals.
The basic training (which will be performed at hospitals) will qualify trainee doctors to recognise emergencies and take immediate measures to treat patients with available means until better means of help are available. After acquisition of these basic competences, trainees can decide whether to qualify as a general practitioner or a consulting physician. After completing basic training, the trainer will provide the trainee with a training schedule for the complete training course. This training schedule will enable the trainee and trainer to improve the predictability of the rest of the training course and to monitor the trainee's progress.
General practitioner training
Locations similar to those already provided for consulting physician training will be established for general practitioner training. The first stage of practical training will be completed at a general hospital or an outpatient clinic and will take 27 months. Following this, trainees must train with a resident doctor at a teaching practice for six months. The duration of this second stage at a teaching practice will increase to nine months in seven years and to 12 months in another five years. The total duration of the training thus increases gradually from 42 months to 45 months and finally to 48 months. In addition to training at a teaching practice, trainees may also work as employed doctors in a hospital. The Chamber of Physicians sought the gradual extension of the second stage at the teaching practice in order to improve both the service that patients receive from resident doctors and the quality of education that trainee doctors receive. The new scheme will be evaluated after seven years. The evaluation term corresponds to the duration of two training courses so that there is sufficient data available for evaluation of the new scheme. The intention of this new training concept is to improve the appreciation of general practitioners and to improve the attractiveness of the profession.
Consulting physician training
Consulting physician training will be split into a basic programme for a specialised field and a subsequent in-depth programme focusing on the specialised field. Through this modular focus, it will be possible to provide in-depth training for many specialisations.
The specialist basic training will last for at least 15 months and the in-depth training will last for at least another 27 months. For each specialised field, trainees will be able to select at least two and at most three modules out of a maximum of six available modules. In addition, a similar scientific module for all fields of specialisation will be available.
The amendment further provides that contrary to the status quo, only specific departments within hospitals, headed by a qualified physician who is present during the majority of the training, will be approved as training facilities. The presence requirement will ensure that the department head can fulfil his or her training duties. Further, the draft provides that general hospitals must employ one trainee general practitioner per 15 systemised beds in order to make sufficient training locations available.
Although the amendment has not yet been adopted by the government, hospital heads and departments have already been instructed to prepare for the implementation of the new training scheme.
The draft amendment was broadly welcomed, as it is a significant step towards the professionalisation of the practical training of medical graduates seeking to obtain medical licences. The new system should allow trainee doctors to develop better practical competences for treating future patients. Further, it is hoped that the training in teaching practices will provide trainees with insight into their profession and ensure that they are not exploited as cheap doctors' receptionists.
For further information on this topic please contact Rainer Herzig at Preslmayr Attorneys at Law by telephone (+43 1 533 16 95), fax (+43 1 535 56 86) or email (firstname.lastname@example.org). The Preslmayr Attorneys at Law website can be accessed at www.preslmayr.at.
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