https://doi.org/10.56079/20222/3

As a result of the reorientation in the health sector in Georgia, the foundation was laid for a new system of medical education, built on modern principles. A medical practice requires special and specific knowledge, which is mastered by a doctor as a result of many years of study and practice. The modernization of the medical education system included the implementation of the following measures: Adoption of regulatory norms for residency programs or postgraduate training in certain medical specialties, adoption of normative acts for accreditation and licensing of medical staff and medical institutions of higher and secondary education, and, most importantly, under the auspices of the World Bank, residency programs have been jointly prepared by specialists and foreign experts from the Ministry of Health.

    The Attestation and Accreditation Commission of Medical Educational Institutions established by the Ministry of Health of Georgia and the Ministry of Education started functioning in 1996. Certification of medical educational institutions becomes mandatory every 5 years. Unified criteria and rules for attestation-accreditation of higher medical institutions, regulations, and self-assessment questionnaires of higher medical institutions have been developed. The number of contingents to be admitted to each institution was determined by taking into account the potential of the pedagogical, material-technical, and clinical bases of the institution identified as a result of accreditation.

    The medical education reform envisaged the introduction of three levels of higher education: undergraduate higher education; postgraduate training or residency and continuing medical education.The Georgian State Medical Academy has been assigned the function of a basic institution in the field of personnel management in the field of postgraduate professional training (residency) and continuous medical education, training of doctors and secondary medical staff. In 1998, the certification process for doctors and pharmacists began.

    A Department of Medical Science and Education was set up to coordinate the state program to promote medical science and education. The Department has developed residency programs in Family Physician, Internal Medicine, Infectious Diseases, Intensive Care - Critical Care Medicine, Pediatrics, Neurology, Surgery, Traumatology-Orthopedics, Obstetrics-Gynecology, and Perinatal Medicine, General Medicine, and Radiology.

    Gradually switch to a healthcare and family physician-centered system for the first time. The family doctor has become the mainstay of the new health care system. A training program for family doctors was created and implemented on the basis of several polyclinics in Tbilisi.

     The increase in the role of nursing was significantly conditioned by the introduction of the position of Chief Nurse by the Ministry of Health. Georgian Nurses Association was established in 1996.The National Center for Health Management has begun work on developing new professional standards for nurses, increasing the rights and responsibilities of head and senior nurses in medical institutions, and expanding the field of nursing organization and management.

    To prepare the new type of head nurses, on the basis of the Continuing Medical Education Center, nursing skills, midwifery training, nursing-neonatologist training, general practice courses, and other continuing nursing education programs were implemented. Centers for continuous education of nurses have been established in different regions of Georgia."Leader Nurse" training course has been established within the framework of the Atlanta-Tbilisi Medical Partnership Program, which is led by the Nursing component of the Continuing Medical Education Center. The main purpose of the course was to prepare the main core on the basis of which new forms and methods of raising nurses' knowledge were to be introduced in the field in a short time.

    It is important that in order to develop high standards of nursing in Georgia, it became necessary to train specialists with higher nursing education. With the establishment of the nursing component of the Continuing Medical Education Center, a new system of retraining nurses was established in the country in a short period of time.

  The role of managers and administrators plays a very important role in the health care system. In this regard, one of the tasks of the World Bank project was to organize retraining courses in medical management, which began on a regular basis at the Center for Continuing Medical Education. Specially trained courses in health economics and management were conducted. At present, undergraduate and graduate programs in healthcare management are implemented in many higher education institutions in Georgia.

    However, the main difficulty in implementing the reforms was the scarce and incomplete state funding of continuing medical education. The health care system suffered from a chronic lack of funding, as the state often did not fulfill its promised obligations. Since 2003, the approach to the system of continuing medical education has changed, according to which the medical market should be based on self-regulation mechanisms, and medical personnel should be guided by the principles of self-development. As a result, since 2006, continuing medical education of medical personnel has ceased to be a prerequisite. Mechanisms for re-certification of doctors have also been abolished.

    Currently, continuing medical education in Georgia is voluntary. For comparison, in the overwhelming majority of European countries, participation in continuing medical education is mandatory. For example, in Austria, Germany, Italy, Switzerland, and Hungary, continuing medical education is compulsory for physicians, while in Norway it is compulsory for general practitioners.

     The country’s existing medical education system needs further reform in order to balance the new flow of doctors in the health sector and increase the role of nurses. Given that there is a direct relationship between patient safety, quality of medical care and continuing medical education, it is necessary to ensure compulsory continuing medical education based on the best international experience. Georgia is a European-oriented country, we are likely to soon become members of the European Union, and therefore, along with many other parameters, our medical education system must develop in accordance with the requirements of the European Union.

Keywords: Georgia, healthcare, medicine, reform, concept, medical education.

JEL Codes: H51, H75, I11, I18