Variations in regulations to control standards for training and licensing of physicians: a multi-country comparison
| Autor: | Shishi Wu, Sameen Siddiqi, Wafa Aftab, Nishant Chavan, Rumina Hasan, Afifah Rahman-Shepherd, Isha Sharma, Mishal S Khan, Zahra Zeinali, Sonia Rego |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Medicine (General)
Public Administration India Context (language use) Health administration 03 medical and health sciences R5-920 0302 clinical medicine Physicians Humans 030212 general & internal medicine Human resources Competence (human resources) Social policy Medical education Governance Education Medical business.industry 030503 health policy & services Research Public sector Public Health Environmental and Occupational Health Health services research Medical training Human resource management Medicine Clinical Competence Public aspects of medicine RA1-1270 0305 other medical science business |
| Zdroj: | Human Resources for Health Human Resources for Health, Vol 19, Iss 1, Pp 1-10 (2021) |
| ISSN: | 1478-4491 |
| Popis: | Background To strengthen health systems, the shortage of physicians globally needs to be addressed. However, efforts to increase the numbers of physicians must be balanced with controls on medical education imparted and the professionalism of doctors licensed to practise medicine. Methods We conducted a multi-country comparison of mandatory regulations and voluntary guidelines to control standards for medical education, clinical training, licensing and re-licensing of doctors. We purposively selected seven case-study countries with differing health systems and income levels: Canada, China, India, Iran, Pakistan, UK and USA. Using an analytical framework to assess regulations at four sequential stages of the medical education to relicensing pathway, we extracted information from: systematically collected scientific and grey literature and online news articles, websites of regulatory bodies in study countries, and standardised input from researchers and medical professionals familiar with rules in the study countries. Results The strictest controls we identified to reduce variations in medical training, licensing and re-licensing of doctors between different medical colleges, and across different regions within a country, include: medical education delivery restricted to public sector institutions; uniform, national examinations for medical college admission and licensing; and standardised national requirements for relicensing linked to demonstration of competence. However, countries analysed used different combinations of controls, balancing the strictness of controls across the four stages. Conclusions While there is no gold standard model for medical education and practise regulation, examining the combinations of controls used in different countries enables identification of innovations and regulatory approaches to address specific contextual challenges, such as decentralisation of regulations to sub-national bodies or privatisation of medical education. Looking at the full continuum from medical education to licensing is valuable to understand how countries balance the strictness of controls at different stages. Further research is needed to understand how regulating authorities, policy-makers and medical associations can find the right balance of standardisation and context-based flexibility to produce well-rounded physicians. |
| Databáze: | OpenAIRE |
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