Staff reserve: mentors will supervise young doctors in hospitals
Graduates of medical schools, after passing the initial accreditation, will work for three years under the guidance of a mentor. Such amendments to the federal laws "On the Basics of Public Health protection in Russia" and "On Education in Russia" were approved by the Cabinet of Ministers on August 26. The press service of the Ministry of Health explained to Izvestia that the specialist performing the mentor's function would receive a salary supplement, but did not specify its amount. The measure is designed to solve the problem of personnel shortages in medicine and help save jobs for employees of pre-retirement and retirement age, who are well suited to the role of mentors, according to the experts interviewed. For more information, see the Izvestia article.
Why mentoring in medical organizations is necessary
Within three years after graduation from medical schools, all young doctors and pharmacists who start working in public hospitals and polyclinics will be supervised by mentors. Such a bill, developed by the Ministry of Health, was approved by the Cabinet of Ministers.
"It is extremely important for a medical professional to gain practical work experience that meets state quality standards immediately after graduation," the explanatory note to the documents says. "The industry employs highly qualified specialists who will provide the young person with the necessary support in the first three years of independent professional activity, help him consolidate and improve his acquired practical skills."
Data is provided confirming the personnel shortage in the industry: in 2023, the shortage amounted to 29 thousand doctors and 63 thousand average medical workers.
The amendments are aimed at providing the healthcare system with qualified specialists, Vladimir Gruzdev, Chairman of the Board of the Russian Bar Association, told Izvestia.
—Every year, about 35% of graduates who studied at the expense of the budget for the main programs of higher medical education, and 40% of graduates who completed secondary professional medical education programs do not subsequently work in medical organizations that are part of the state or municipal healthcare system," he said.
At the same time, the idea of mentoring for the Russian healthcare system is not new — back in 2020, the Ministry of Health developed recommendations on such a process in medical organizations: but then it was about the mentoring process for a period of six months to a year. If necessary, the process was proposed to be extended to two years. The regions also issued separate recommendations: in 2012, the Ministry of Health of the Ulyanovsk Region, in 2015, the Health Committee of the Volgograd Region, and in 2017, the Ministry of Health of the Moscow Region. One of the objectives of the Healthcare Development Strategy in the Russian Federation until 2025 was the development of mentoring in this area.
"The goals of mentoring are to assist young professionals in their professional development, acquisition of professional knowledge and skills in performing official duties, adaptation in a team, as well as education of discipline and corporate culture," the recommendations of the Russian Ministry of Health said. — Not only the young employee is interested in early adaptation, but also the entire organization, because the arrival of inexperienced specialists reduces the effectiveness of the entire team, the entire organization."
The current amendments, which were approved by the Cabinet of Ministers, should make this process of working with young specialists mandatory and uniform throughout the country. In particular, the mentoring period is set at three years for each graduate. The process will begin after the young specialists have passed the primary accreditation procedure for checking their compliance with their position. But if, for some reason, they did not "gain" three years of work with mentors and stopped working at a medical institution, then, returning to the profession, they will need to be accredited again, and then get the mentoring time to the required three years.
How will mentoring work?
In the response of the press service of the Ministry of Health to the request of Izvestia, it is specified that the graduate will be able to independently choose the region of stay and place of work. It is also noted that the draft law provides for strengthening the measures of responsibility of a person who has concluded a contract on targeted training. In case of violation of its provisions, he will have to pay to the budget the amount spent on training a specialist, including support measures, as well as a fine in the amount of two times the amount of compensation.
As a rule, the Ministry of Health of the regions or specific medical organizations act as the customer, the press service of the Ministry of Health added.
"Persons who perform the functions of a mentor will receive a salary supplement," they said.
The state healthcare system has already implemented a mentoring system in all key areas, the press service of the Ministry of Health emphasized.
"A project has been implemented to test mentoring models in 2021-2023, in which 14 regions, 246 medical organizations and 509 paramedic and obstetric centers participated," the response to a request from Izvestia says.
The ministry recalled that the federal law "On Amendments to the Labor Code of Russia" has been adopted, which introduces the concept of "mentoring in the field of work" and defines the procedure for additional payment for the performance of mentor functions.
After the bill is passed, the Ministry of Health will develop and approve a provision on mentoring in healthcare. The agency will also issue conclusions on the maximum value of the control figures for admission to the residency program.
"This will ensure the quality of training in the context of all organizations engaged in educational activities, specialties of training in residency programs, depending on the current and projected needs of the healthcare system," the press service of the Ministry of Health noted.
How the amendments are evaluated
The introduction of mandatory mentoring for graduates of medical universities is necessary, says Nikolay Prokhorenko, an expert in the field of public health. According to him, this measure is important in the training of qualified young specialists.
"In recent years, the number of hours devoted to training doctors has decreased significantly," he stressed. — Mentoring should solve this problem. After all, there are specialties where the correct implementation of various procedures is extremely important. Without the supervision of a mentor, only graduate doctors can harm the patient's health.
The amendments will allow not only to solve the program of personnel shortage in healthcare, but also to keep jobs for older professionals, Nikolay Prokhorenko added.
"Doctors of pre—retirement and retirement age can be excellent mentors," he stressed.
Older academics always have something to share. They can help young specialists to establish the correct diagnosis faster, agreed Levan Ozashvili, a healthcare organizer and therapist.
"It is also possible and necessary to give the right to senior officials — heads of departments, deputy chief physicians and chief physicians — to engage in mentoring," he added.
Fedot Tumusov, First Deputy chairman of the State Duma Health Committee, is confident that the introduction of the institute of mentoring will help solve the personnel shortage and accelerate the professional growth of young specialists.
The key advantage of the draft law for young medical professionals is a guaranteed place of employment and, most importantly, in the public health system, said Alexander Kolsanov, Rector of Samara State Medical University.
"It is here that medical professionals receive all the opportunities for self—improvement, exchange of experience and best practices, and continuous professional development," he added. — This includes, for example, working with a wide variety of clinical cases, developing independent decision-making skills, interacting with colleagues from different centers, and supporting federal specialized institutions in the Ministry of Health system.
Recently, some specialists have been choosing "fashionable" medical specialties and going into training for two years, and the system requires, first of all, saturation of the primary level, so there is a need for changes, said Oleg Yanushevich, rector of the Russian University of Medicine.
"This initiative will saturate the primary network and change the structure of staff training at the residency stage," he stressed.
Targeted training is an effective mechanism that can help eliminate the shortage of personnel in medical institutions, agreed Andrey Eremin, Rector of Saratov State Medical University.
— Now, upon graduation, a student chooses to pay a fine, since its amount is not comparable to the cost of 5-6 years of study. The current fines can be called an interest—free installment plan, which was provided by the state for the student's education," he added.
The number of students under one mentor, according to Nikolay Prokhorenko, will depend on how it will be arranged, that is, students will be assigned one at a time or in groups and depending on their specialty.
— For example, when teaching students in therapeutic specialties, one mentor can organize students into groups of five to six people and supervise their activities. And if we talk about surgical students, it's best for one mentor to lead no more than three people," explained Nikolay Prokhorenko.
The expert noted that the established period of three years of work with a mentor may be long for young therapists, for whom a period of one and a half years would be sufficient, but not enough for surgeons, for whom a period of supervision over three years would be optimal.
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