Institution of certification of medical workers: the reasons for dysfunction

Abstract

Institutions of qualification assessment in the field of medicine are designed for improving the level of qualification of medical specialists, and as a result for providing quality medical care. One of them is certification of medical workers for the qualification category. Certification was introduced into the Soviet healthcare system, but in recent years, the interest of doctors in obtaining the category has significantly weakened. This actualizes clarification of the causes of the situation. The article makes a retrospective analysis involving a wide range of sources of the regulatory and statistical information and presents an assessment of the factors of this phenomenon by medical specialists themselves, obtained during their questionnaire survey in organizations of Moscow. The obtained results showed that the dysfunction of the certification institute was caused by a complex of internal and external factors. First of all, there was a failure in the mechanism of material incentives, directly related to the general system of remuneration in the public sector of the economy. Due to the work overload, the conditions for preparing for certification activities have deteriorated significantly, the interest of managers in having workers of the category has decreased, and the prestige of the category itself, especially among young cadres, has fallen. Therefore, without taking special measures, the institute of certification for the qualification category is threatened with deinstitutionalization. The key areas of the necessary changes are revision of the operating mode with reservation of the required time for additional professional training, as well as organizational combination of the certification and accreditation examination procedures. The restoration of the effectiveness of material incentives for the category can be expected with the introduction of a new wage system in the public sector of medicine, but the start of its testing has been postponed again until 2025.