These are the proposals of Professor Le Ngoc Thanh - Principal of the University of Medicine and Pharmacy, Vietnam National University, Chairman of the Council of Professors of Medicine, Chairman of the Vietnam Association of Cardiovascular and Thoracic Surgery, revolving around the issue of medical training management.
Lack of "arbitration" to establish a resident doctor's degree
In the context of the debate over recognizing the degree in training for resident doctors, specialties that have lasted for many years, the lack of consensus between the Ministry of Health and the Ministry of Education and Training continues to cause thousands of young doctors to fall into the vicious cycle of overlapping regulations. This is a group of students trained according to the highest clinical practice standards of the Vietnamese medical system, but there is no "arbiter" to establish a unified framework and standards for the degree.
According to Professor Le Ngoc Thanh's analysis, the content of the BSNT training program includes all the content of the master's program, major 1, in addition, the practice time is much deeper and more difficult than the master's program, major 1.
"A point that needs to be resolved immediately is that doctors and nurses must pay their salaries during their study period (in my opinion, the Government's funding is provided to universities or hospitals that train doctors and nurses in an annual manner) and other allowances, not having to pay tuition fees as at present.
Because they are doctors, not students or trainees and health workers work according to prescribed standards such as hospital permanent residence, on-duty and high-intensity work..." - Professor Thanh analyzed.
"Regarding the training program for specialties 1, specialties 2 are specialized training, meaning that doctors have chosen and worked in one major and are sent for specialized training in that major with 2 simple levels of major 1 and 2 (the French system is specialties and specialized specialties) managed by the Ministry of Health, the training content for major 1 is similar to the Master's program, the only difference is that they do not do graduate theses.
As for doctors in specialty 2, the training program content is similar to the Doctoral training program (graduation from specialty 2 has a layout like a doctoral thesis), the other point is some auxiliary subjects, topics, mandatory scientific articles, etc. because training of doctors in the second specialty mainly focuses on skills" - Professor Thanh said.
The Professor said that the core point is that there is no referee for this issue, because currently the two Ministries of Education and Training and the Ministry of Health have not found a common voice. Everyone is right, but does not follow international practices, said Professor Thanh frankly.
Professor Le Ngoc Thanh said that Vietnam needs to immediately refer to and apply (without research) medical training models like developed countries. He said that the models in France and Japan are suitable for Vietnam.
Solutions for the vicious cycle of overlapping regulations
On the important point, Professor Thanh said that the Government needs to preside over and convene the Ministries of Health, the Ministry of Education and Training, the Ministry of Home Affairs, the Ministry of Finance, the Ministry of Justice, etc. to discuss and propose the most unified and reasonable policies.
"We must consider the medical industry as a special training industry because the subjects are human. Long training time. I was assigned to be in France, it took doctors 9 years to practice general medicine; in Japan, it took doctors 8 years, it took 12-14 years to become doctors specializing in neurosurgical surgery, cardiovascular surgery, cardiovascular intervention...
Thus, to integrate and be recognized as a degree, at least our medical training time must be equivalent and after 6 years, there must be a national exam to select doctors who continue to study general medicine (2-3 years) or specialties (4-6 years) like in developed countries today.
In addition, there should be a treatment policy equivalent to the study time. Consider boarding training, major 1, major 2 as a national training program, specifically managed by the Ministry of Health, with appropriate treatment.
If they need to be granted master's and doctoral degrees, they only need to study additional programs that are not yet available and protect their theses and theses according to the regulations of universities. It is necessary to abolish the regulation on applied master's and master's research in the medical industry. commonly called a master's because in the practice of medicine and pharmacy, the master's degree is still practiced in hospitals, still participates in research and publications - the word "application" here should be applied to other majors and the medical industry that have specialized training programs" - Professor Le Ngoc Thanh said.
Professor Le Ngoc Thanh's recommendations show that the issue of medical degrees is not only about training techniques or academic differences, but more deeply, the story of industry management thinking. When the medical industry is not truly considered a special training field, when the inter-Ministry mechanism still lacks a unified focal point, all efforts to standardize are still just stopped at debate.
His call for the Government to take the lead, shaping a training model according to international practices - along with appropriate treatment policies - is considered the most feasible direction to remove the current bottleneck. This is also the time when Vietnam needs a strong policy, so that the future team of doctors will be trained according to standards and recognized as worthy of the efforts and time they have spent.
Legally, there is a clear foundation for training in resident doctors (Decision 19/2006/BYT) and the training in resident and specialist "conversion" or "conversion" to a master's or doctorate program that has been regulated for a long time (association document 30/2003).
However, despite the regulations, the implementation and recognition of degrees and management responsibilities between the Ministry of Health and the Ministry of Education and Training is still a "bottleneck" that Professor Thanh pointed out - especially when the old regulations may not be completely consistent with the reality of modern medical training and not completely "according to international practice".
Therefore, Professor Thanh suggested that there should be adjustments to inter-Ministryary policies and management mechanisms, as well as treatment mechanisms - to make the inpatient/specialty training framework more transparent, fair and sustainable.
According to Decision 19/2006/QD-BYT promulgating the Regulations on inpatient doctor training issued by the Minister of Health, inpatient is a specially designed form of training, and is "recommended" for a master's degree.
Joint Circular of the Ministry of Education and Training - Ministry of Health No. 30/2003/TTLT-BGDDT-BYT dated July 1, 2003 guiding the conversion between degrees and postgraduate training levels in the health sector has allowed "conversion" from a resident doctor to a master's degree if completing the subjects that are still lacking and defending the thesis; allowing specialty I to convert to a master's degree if the student completes the subjects that are still lacking and defending the thesis.
Circular 30/200 also stipulates the conversion between major II and doctoral: "People with a level II degree want to convert to get a doctorate... complete the practice and graduation exam parts ... and defend the doctoral thesis".
However, recently in report No. 2028 sent to National Assembly delegates, explaining and accepting opinions on the draft Law on Higher Education (amended), the Ministry of Education and Training said that, in its academic and professional nature, the CKI and CKII inpatient doctor programs are "training - practice", aiming to accumulate professional practice capacity and recognize specialties.
The output standard is not an academic training program to award master's and doctoral degrees, but aims to train specialized practice skills in a medical specialty.
