katerina venovska msph, fm spec. md

The importance of international experience, capacity building activities and consistent

environment and leadership for a critical policy decision and successful process of Family

Medicine specialization and reeducation initiation in Macedonia

Katerina VenovskaMSPH, FM Spec. MD

3-4 September 2012 IV Biannual Conference Gothenburg on the Future of Primary Health Care in Europe IV:"Crossing Borders in Primary Care“

21/04/23 Republic of Macedonia 1

PROJECT COORDINATION UNITMinistry of Health of Republic of Macedonia

Health Sector Management Project (HSMP) - Loan by the WB (2004 – 2010)

Provided financial & technical support and consistent environment & leadership

Component 1: Health Policy Formulation & Component 3: Service Delivery Improvement

Coordinator: Katerina Venovska, MSPH, FM Spec. MD21/04/23 Republic of Macedonia 2

HEALTH SECTOR MANAGEMENT PROJECT Health Strategy Development Process

• International Health Policy Consultant engaged (2005)

• Health Strategy Working Group established (2005)

• Health Situation analyses & needs assessment carried out

• Broad discussion & negotiations with stakeholders

• Transparent process involving profession and the public

• International experience reflected (WHO, WB...)

• Health Strategy 2020 developed & enforced by the Government (2006)


FAMILY MEDICINE (FM) IMPLEMENTATION Training & International Experience - Strategic

Planning

HARVDARD SCHOOL OF PUBLIC HEALTH - 2008

Strengthening Human Resources in Health

SOUTHEMPTON CONFERENCE - 2008

Future of Primary Care in Europe II

Visit to St Mary’s Surgery


FAMILY MEDICINE IMPLEMENTATION Public Relations & Communication (PRC) support

• Adequate communication of Health Reform goals & activities

• Increased cooperation with journalists (opponents to FM)

• Public Relations Working Group established within HSMP

• Technical support to PRC activities provided (2007)

• PRC Strategy developed (2008)

• Study Tour of Journalists in Netherlands organized (2009)

• Joint PRC on FM implementation with main stakeholders


JOURNALIST STUDY VISIT TO NETHERLAND (2009)

Ministry of Health, Welfare and Sport – Den Haag

Domus Medicus - Utrecht

Family Practice - Den Haag NIVEL


FAMILY MEDICINE IMPLEMENTATION FM Strategy Development & Implementation

• Technical support & cooperation with Slovenian Family Medicine Department (Medical Faculty - Ljubljana) - HSMP

• Family Medicine Working Group established within HSMP

• FM Strategy and Implementation Plan developed (2009)

• Memorandum of Cooperation in FM implementation signed (Ministry of Health & Medical Faculty Skopje) - May 2009

• 16 FM Educators / Mentors (skilled CME educators) were engaged through HSMP and trained (2009/2010)

• FM Educational Board nominated at Skopje Medical Faculty


FAMILY MEDICINE IMPLEMENTATION FM Capacity Building Activities

• Training of Core group of 24 FM Educators (2009, Ohrid)

• 6 day training curricula developed

• 50 FM Educators trained - Prilep Educational Centre (2010)

• Visit to FM Educators practices

• FM Continuous Medical Education program initiated

• Close cooperation with Association of GP/FD in Macedonia

• Training of additional groups of FM educators (2010-2011)

• Study visits to Slovenia (Ljubljana & Bled) (2009-2010)


FAMILY MEDICINE CAPACITY BUILDING


Training of FM educators – Cooperation with Slovenian FM Department Professors

Training of additional groups of FM Educators by the Core Group of FM Educators

FAMILY MEDICINE CAPACITY BUILDING


Debriefing of FM Educators after the training

Group of Certified FM Educators and teachers

FAMILY MEDICINE IMPLEMENTATION FM Department establishment at the Medical

Faculty

• Family Medicine Educational Board operational

• FM specialization curricula revised and teaching program developed

• Family Medicine Specialization initiated (October 2009)

• First year of study - financial support provided to first 10 trainees

• Educational Centers in Veles, Gostivar & Strumica visited to plan their use for FM purposes

• Family Medicine Educational Centre in Skopje established & fully equipped with HSMP support (2010)


FAMILY MEDICINE IMPLEMENTATION FM Specialization Initiation


MEMORANDUM OF COOPERATION (FM) SIGNED - May 2009

Ministry of Health & Medical Faculty Skopje

(Deputy Minister, Minister, & the Dean)

FAMILY MEDICINE SPECIALIZATION LAUNCH - October 2009

Medical Faculty Skopje & MOH/PCU(Vice-Dean, Dean, MOH/PCU FM Coordinator, Medical Faculty FM

Coordinator)

FAMILY MEDICINE EDUCATIONAL CENTER – SKOPJEReconstruction, Equipping & Launch


Acceptance of renovated & fully equipped premises

Ministry of Health / PCU

Family Medicine Educational Centre - Skopje Launch - 2010

Family Medicine Educational Centre - Skopje Launch - 2010

FAMILY MEDICINE EDUCATIONAL CENTER International Experience & Cooperation

• Memorandum for Cooperation in the field of FM between Medical Faculty Skopje & Ljubljana signed (2010)

• Study visit to Slovenia & maintaining close cooperation with the GP/FM Associations & FM University Departments in Croatia, Montenegro, Slovenia, Serbia, Bulgaria, Turkey…

• Study visit to Nijmegen University, FM Department, Netherland and relevant institutions & Family Doctors

• Study visit to Imperial College, London, United Kingdom

• Bilateral Cooperation in FM between Macedonia & Turkey

• Contact established with FM Association in Canada

• Cooperation with Austrian FM University Dep. (CME Course)

21/04/23) Republic of Macedonia 14

FM INTERNATIONAL EXPERIENCE & COOPERATION


Study visit to Imperial College, London, UK

Study visit to Bled, Slovenia



Study visit to Domus Medicus, Utrecht, Netherland

Study visit to Nijmegen, Netherland



Study visit to Family Practice near Nijmegen, Netherland

FM INTERNATIONAL EXPERIENCE & COOPERATIONBilateral Cooperation in FM with MOH / Turkey


IMPROVED COLLABORATION IN FM IMPLEMENTATION


Established & maintained good cooperation between the key players:

Ministry of Health, Health Insurance Fund, Medical Faculty Skopje,

Slovenian FM Department expertsMacedonian Doctors Chamber

Association of GP/FM Doctors in Macedonia

FAMILY MEDICINE EDUCATIONAL CENTER Retraining of GPs to become FM Specialists

• FM retraining curricula & teaching program developed

• Bylaw for Specializations referring to FM Specialization & Retraining of doctors working in GP practices adopted

• Specialization & Retraining Fees agreed between MOH, Medical Faculty Skopje & the Macedonian Doctors Chamber

• Web Site for FM specialization & FM activities created & regularly updated

• Second Group of FM specialization started in October 2010

• Retraining of GPs in FM Specialists started in February 2011 in Prilep and Skopje FM Educational Centers


SKOPJE FAMILY MEDICINE EDUCATIONAL CENTER Retraining of General Practitioners to FM Specialists


Regular Training Sessions in the FM Educational Center

Within FM Retraining activities

Established Teacher exchange program

with Ljubljana FM University Department based on the

signed Agreement for Cooperation

TRAINING OF MEDICAL FACULTY PROFESSORS Family Medicine Specialist Exam – Examiners

Preparation

• Appropriate FM Specialist Exam materials and program were developed

• The Medical Faculty nominated professors from various related fields to take part in the team of examiners for the FM Specialist Exam

• Orientation Training for the professors for the implementation of FM Specialist Exam was carried out by the Slovenian FM University Department Professors

• The first FM Specialist Exam was organized in May 2011 and managed by the Ljubljana University FM Department Professors in collaboration with trained Skopje Medical Faculty Professors

• First 24 FM Specialists in Macedonia certified in May 2011

• Since then number of FM Specialists is growing - over 50 (2012)


TRAINING OF MEDICAL FACULTY PROFESSORS Family Medicine Specialist Exam – Examiners Preparation


FIRST GROUP OF FAMILY MEDICINE SPECIALISTS Certified by Slovenian Professors & Medical Faculty Skopje

May 2011


THANK YOU


ANY QUESTIONS?


katerina venovska msph, fm spec. md

Documents

fm educational board

health situation analyses

prc strategy

hsmpfamily medicine

implementation plan

hsmpfm strategy

skopje medical faculty

prc activities