Quyết định 1854/QĐ-BYT 2015 Chuẩn năng lực cơ bản của Bác sĩ đa khoa
THE MINISTRY OF
HEALTH
——-
SOCIALIST
REPUBLIC OF VIETNAM
Independence – Freedom – Happiness
—————
No.: 1854/QD-BYT
Hanoi, May 18th,
2015
DECISION
ON
APPROVAL FOR DOCUMENT ABOUT COMPETENCE STANDARDS FOR GENERAL PRACTITIONERS
THE MINISTER OF HEALTH
Pursuant to the Decree No. 63/2012/ND-CP dated
August 31st 2012 by the Government defining the functions, tasks,
entitlements and organizational structure of the Ministry of Health;
At the request of Director of Administration of
Science Technology and Training,
DECIDES:
Article 1. Approval for the
Document “Competence standards for general practitioners” enclosed with this
Decision.
Article 2. Competence
standards for General practitioners means the competences a general practitioner
shall have when performing the medical examination and treatment in Vietnam.
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Article 4. The Chief of the
Ministry Office, Director of Administration of Science Technology and Training,
Directors of Departments, Directorate Generals of Directorates affiliated to
the Ministry of Health; Directors of the Departments of Health of provinces;
Directors of hospitals and institutes having hospital beds; Director of
educational institutes, Principals of universities providing training for
general practitioners and Heads of relevant units are responsible for
implementing this Decision./.
PP. THE
MINISTER
THE DEPUTY MINISTER
Le Quan Cuong
COMPETENCE STANDARDS FOR GENERAL PRACTITIONERS
Part one
GENERAL INTRODUCTION
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Medical doctors play an important role in medical
staff members who directly examine and treat illnesses. For many years,
Vietnamese medical system has faced a serious inadequacy of medical doctors.
Since 2000, due to the development of training institutions in both quantity
and scale, the number of medical doctors has obviously increased, at the same
time, the quality of medical doctors is not satisfactory, causing bad effect to
medical service quality, especially in grassroots-level medical facilities and
medical facilities in disadvantaged areas. This reality requires that training
institutions produce medical doctors reach the minimum competence standards.
By realization of the importance of this
requirement, the Ministry of Health directs the formulation of Competence
standards for General practitioners in Vietnam with the attendance of all the
relevant parties, including experts in training/recruitment, managers,
specialists and social organizations. During the formulation, Drafting Board
has made reference to competence standards for medical doctors in other
countries in ASEAN and around the world according to the reality in Vietnam.
Competence: is a range of attributes of a
particular person satisfying the requirements of an activity to perform the
activity well and efficiently.
Competence Standard: is the rank of levels
or capacity to satisfy the real requirements of work that is certified through
assessment and inspection according to professional competence standards.
Professional competence: is the conformity
between psychological – physiological attributes of a person and requirements
of his/her occupation. Each occupation has specific requirements; in general,
professional competence includes 3 components: specialist knowledge, skills and
professional attitudes.
Both competence and professional competence are not
innate. They are formed and developed continuously through hard study and work
and professional practice. During the professional practice, medical doctors
will have to study continuously to develop new competence appropriate to their
assignment.
2. Necessity for Competence
standards for General practitioners
The formulation and issuance of the Competence
standards for General practitioners are very importance due to the following
basic reasons:
2.1. Regarding the society:
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– Reduce and eliminate the supply of unqualified
medical service due to the incompetence.
2.2. Regarding training institutions:
– Form the basis for formulation of outcome
standards, determination of suitable training programs, methods and contents
for general practitioner training programs.
– Form the basis for students whose speciality is
general practitioner to strive and make self-assessment of professional
competence during the studying process and after graduation.
– Connect the training contents with the
socio-economy reality of Vietnam.
2.3. Regarding management facilities of general
practitioners:
– Determine the professional practice scope of
general practitioners.
– Determine the responsibilities and obligations of
a doctor and resolve the mistakes relating to general practitioners’ ethics or
practice.
– Form the basis for managers to draw up plans and
create opportunity for general practitioners to receive training to improve their
professional skills.
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2.5. Regarding the general practitioners:
Form the basis for the general practitioners to complete and improve themselves
to be granted practice certificates.
3. Basis for formulation of
Competence standards for General practitioners
Resolution No. 46-NQ/TW dated February 23rd
2005 by the Politburo.
Resolution of the 8th Conference of XIth
Central Executive Committee (Resolution No. 29-NQ/TW) on radical changes of
education and training.
– The Law on People’s Health Protection dated June
30th 1989.
– The Law on Medical examination and treatment No.
40/QH12 dated November 23th 2009.
– Professional standards for Scales of General
Practitioners according to the Decision No. 41/2005/QD-BNV, dated April 22nd
2005 by Ministry of Home Affairs.
– The agreement of mutual recognition framework in
medical practice between the ASEAN countries that Vietnam’s Government
concluded with ASEAN members on December 8th 2006.
4. Process
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The Competence standards for General practitioners
are formulated depending on the practical researches in Vietnam with reference
to international documents. The preparation can be summarized as follows:
– A Compilation board of Competence standards for
General practitioners is established including people who provide training,
manage or formulate medical policies, Vietnam Medical Association and experts
who are doctors.
– The Compilation board refers to the results of
the ministerial project on “Establishment of outcome standards for general
practitioners” made by Hanoi Medical University (2010-2013)
– The Compilation Board collects suggestions of
training institutions and posts them on websites of the Ministry of Health and
Administration of Science Technology and Training to collect more suggestions.
– Suggestions of general practitioner training
institutions, hospitals, Departments of Health and relevant Departments are
collected in writings or through seminars.
4.2. Procedures for approval by the Ministry of
Health
– The Minister of Health establishes a Specialist
Council to carry out appraisal of the Documents about Competence standards for
general practitioners. The Council discusses and carries out appraisal and
offer additional suggestions on contents and formula of documents. The
Compilation Board acquires the suggestions of the Council and completes the
documents.
– The Minister of Health signs the decision No. …
dated … issuing the Competence Standards for General Practitioners in
Vietnam.
5. Summary of Competence standards
for General practitioners
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Each field presents a basic function of a general
practitioner, including: Competence in professional practice; Competence in
application of medical knowledge; Competence in medical care and Competence in
communication and cooperation.
Each standard is a component of a field, containing
a task of the general practitioners.
Each criterion is a component of a standard. A
criterion may apply to multiple standards/fields.
Part two
COMPETENCE STANDARDS FOR
GENERAL PRACTITIONERS
FIELD 1: COMPETENCE IN
PROFESSIONAL PRACTICE
General practitioners shall have a professional
practicing manner according to moral and legal standards and shall respect the
variety of culture.
Standard 1. Perform medical practice
according to the social and cultural situation and actual conditions
1. Criterion 1. Respect the economic
conditions, customs, beliefs, religions and cultures of each
regions/individuals.
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3. Criterion 3. Show their enthusiasm for
their own choice of occupation by making commitment on compliance with the good
practice standards and maintain the standards of profession, ethics and culture
at the highest level.
4. Criterion 4. Approach patients and
healthcare issues of the community in a scientific, thorough, honest,
responsible, sympathetic, and altruistic way.
5. Criterion 5. Support the principle that
people from all backgrounds have the right to access to good-quality health
care service.
6. Criterion 6. Appreciate the cooperation
of modern medicine and traditional medicine.
7. Criterion 7. Uphold the role and image of
a doctor, value of a doctor to healthcare activities and to the society through
the competence in completing professional tasks and performing social
responsibilities with professional manners, wholesome lifestyle and good
communicative skills and behaviors.
Standard 2. Perform medical practice
according to professional ethical standards
8. Criterion 1. Take personal
responsibilities for the decision and intervention in the healthcare service
provided for patients or the community.
9. Criterion 2. Always give consider the
safety and interests of patients as the center. Identify the threats to safety
of patients in healthcare activities.
10. Criterion 3. Perform the medical
practice within the certificated professional scope, conformable to
occupational regulations and suitable with health conditions.
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12. Criterion 5. Strictly comply with the
ethical principles in medical researches
Standard 3. Perform medical practice
according to the regulations of laws
13. Criterion 1. Perform medical practice
according to the legislation of Vietnam and relevant International Agreements
to which Vietnam is a party.
14. Criterion 2. Comply with the
regulations, principles and communication culture at workplace.
15. Criterion 3. Report the violations
against the regulations in speciality and practice to competent agencies and
take personal responsibilities for such report.
16. Criterion 4. Apply the approaching methods
depending on the legality and ethics in the use of medical care sources.
Standard 4. Study continuously for personal
development and for occupational capacity
17. Criterion 1. Make self-assessment and
use the feedback about their work systematically, regularly and scientifically.
Determine the actual requirements of work, their targets, expectation for
occupational development and their own strong points and weak points.
18. Criterion 2. Draw up plans and
participate in the study and development of their occupation using supportive
sources that are suitable, effective and creative.
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20. Criterion 4. Have ability to use English
and/or other languages in study, research and occupational development.
21. Criterion 5. Have ability to collect,
assess and use Vietnamese and foreign medical information that is valuable and reliable
in the provision of health care service.
22. Criterion 6. Approach the archives and
restore the clinical information in medical records (in printed paper or
digital files), libraries and online sources of information in appropriate,
sufficient and accurate way ensuring the privacy and legality.
FIELD 2: COMPETENCE IN
APPLICATION OF MEDICAL KNOWLEDGE
General practitioners shall have ability to
apply the knowledge about basic science and basic medicine, pathology and
social and medical studies as the rationale for identifying, explaining and
resolving the problems and transmit to individuals, groups of individuals and
community about health conditions.
Standard 5. Apply the knowledge about basic
science, basic medicine and pathology in medical practice
23. Criterion 1. Have the ability to give
explanation about structure, functions and normal development in physical and
spiritual conditions of human through development period in the interaction
with natural and social environment.
24. Criterion 2. Have ability to give
explanation about the interaction between structure and functions of human’s
body, between the organs in normal conditions and about pathological signs and
structure of symptoms and syndromes, the anticipating factors of abnormal signs
and pathological at different ages.
25. Criterion 3. Have ability to give
explanation about basic principles, indications, contraindications, procedures,
weakness of procedures, techniques for physical examination and testing serving
the diagnosis of common diseases.
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27. Criterion 5. Have ability to give
explanation about the principles and solutions for common health problems and
some conditions requiring emergency treatment including treatment with drugs,
surgeries, physical therapies, medical nutrition therapies, psychological therapies,
traditional medicine and additional and replacement therapies…
28. Criterion 6. Have ability to assess the
effectiveness of medical intervention.
Standard 6. Apply the public medical
principles/methods in medical services
29. Criterion 1. Have ability to present the
principles and models of organizational systems, functions of Vietnamese
medical network and relationship between medical sector and relevant sectors.
30. Criterion 2. Have ability to present the
basic principles on medicine management and main contents of national programs
in the field of medicine.
31. Criterion 3. Have ability to analyze the
concepts and basic principles of epidemiology, main medical indices, risks and
relationship between the risks and the diseases/the epidemics.
32. Criterion 4. Have ability to give
explanation about the principles and apply such principles to grade 1, 2, 3
providing plans; personal providing strategy, providing accessing depending on
the community and providing accessing depending on the risk in disease
prevention and health improvement.
33. Criterion 5. Have ability to give
explanation about the risk of environment pollution and its affect to people’s
health; principles for prevention and fighting against environment pollution.
34. Criterion 6. Have ability to give
explanation about the risk of occupational diseases and prevention and fighting
against occupational diseases.
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General practitioners shall have ability to
resolve a normal demand for medical care safely, promptly, economically and
effectively depending on scientific evidence and conformable to the real
conditions.
Standard 7. Give diagnoses and decisions on
resolution depending on the evidence with attendance of the patients, their
family and relevant medical officers according to the real conditions.
35. Criteria 1. Have ability to make
diagnosis serving the determination/separation of common diseases and have
ability to classify international diseases – ICD10.
36. Criteria 2. Have ability to solve the
normal emergency cases and discover serious things that threaten human life to
promptly intervene.
37. Criteria 3. Make suitable designation
and analyze the results collected from the methods, procedures for clinical and
subclinical physical examination and functional exploration.
38. Criterion 4. Provide information
relating to health conditions and illness for patients, their family and their
colleagues to make them peace of mind and agree to cooperate before and during
the physical examination and treatment.
39. Criterion 5. Assess the role and select
the treating methods like internal medicine, surgery, physical therapy,
psychotherapy, medical nutrition therapies, radiotherapy, etc. depending on
scientific evidences.
40. Criterion 6. Apply new knowledge,
methods, techniques and technologies in diagnosis and treatment according to
the reality.
41. Criterion 7. Give decision on care for
patients, use the available evidences thoroughly, clearly with discussion and
agreement with the patients and their family to avoid mistakes when making
decision.
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43. Criterion 9. Formulate plans, provide
total treatment for patients and diseases.
44. Criterion 10. Comply with the technical
procedures and clinical skills according to the regulations of the Ministry of
Health towards general practitioners conformable to the regulations,
organization and resources at workplace.
45. Criterion 11. Supervise often to
discover and handle promptly the accidents during the care and treatment.
46. Criterion 12. Discover the cases in
which diseases exceed the professional capacity and transmit patients to the
right place, right line and right time.
47. Criterion 13. Support patients in terms
of psychology, constitution, social spirit; handle the symptoms until there is
a definite diagnosis and provide specific treatment.
Standard 8. Apply the knowledge and
methodology in terms of behaviors, psychology and society in medical care
practice
48. Criterion 1. Have ability to analyze the
psychological processes of patients both in normal conditions and when the
disease occurs. Have ability to determine the impact of psychology, economy and
society on patients when decide the treating methods.
49. Criterion 2. Have ability to apply the
principles and psychological methods to create the agreement and cooperation of
patients and their family with the diagnosis and treatment decision.
50. Criterion 3. Have ability to determine
management method appropriate to patients having psychological problems.
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51. Criterion 1. Make prescriptions
according to the regulations, safe, reasonable, lawful, with reliable scientific
evidences and after discussing with patients or their family and their
colleagues.
52. Criterion 2. Comply with the basic
principles in use of antibiotics on patients, avoiding the drug resistance.
53. Criterion 3. Discover and provide first
aid for the signs of drug allergy.
Standard 10. Medical care for pregnant women
54. Criterion 1. Provide antenatal care and
gestation management. Take care of pregnant women and discover the risks during
the gestation, labor and postpartum.
55. Criterion 2. Have ability to determine
the signs of labor predict the labor condition and carry out normal delivers.
56. Criterion 3. Provide first aid for
obstetric and postnatal accidents.
Standard 11. Be enthusiastic in providing
medical care in recovery, first aid and care
57. Criterion 1. Assess sufficiently,
classify and make handling decision promptly, suitably and predictively for
cases that threat human lives and/or not threat human lives but require an
urgent treatment.
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59. Criterion 3. Provide patients and their
family with guidance on predicting the conditions of diseases.
60. Criterion 4. Cooperate effectively with
members of groups providing care in first aid and emergency aid.
Standard 12. Prolonged care and palliative
care for patients with chronic or incurable diseases
61. Criterion 1. Improve the living quality
of patients, decrease the physical and spiritual pains, helping patients to
maintain an independent life. Always consider the personal characteristics and
characteristics of the diseases that affect the ability and psychological –
physiological attributes of the patients.
62. Criterion 2. Use appropriate drugs,
auxiliary equipment and social services and transport vehicles.
63. Criterion 3. Mobilize and encourage the
participant of the patients and their family, their friends and other members
in prolonged care or palliative care.
Standard 13. Pain control
64. Criterion 1. Select and carry out the
basic analgesic technique according to the treatment regimen in a suitable way.
65. Criterion 2. Have ability to perform the
analgesic principles with drugs, physical therapies and psychology therapies.
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Standard 14. Traditional medicine and
treating methods without use of drugs in treatment, prevention and recovery
from a number of common diseases
67. Criterion 1. Provide treatment,
prevention and recovery from a number of common diseases by combining
traditional medicine and modern medicine in reasonable and scientific way.
68. Criterion 2. Guide patients to apply
treating methods without use of drugs in treatment, prevention and health
improvement.
Standard 15. Participate in infection control
69. Criterion 1. Comply with the procedures
for prevention, isolation and control of bacterial contamination.
70. Criterion 2. Have ability to determine
the main bacterial contamination and common biological pathogens that require
medical care.
71. Criterion 3. Have ability to determine
transmission routes starting from hospital to decide the suitable handling
measures.
Standard 16. Provide propagation, education
and mobilization for health improvement and preventive healthcare
72. Criterion 1. Determine the demands and
contents of healthcare guidance/education to provide for individuals, family
and groups of community.
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74. Criterion 3. Use the forthcoming
multimedia (telephone, email, Internet, book, newspaper, TV recording…)
assisting the transmission of information through the skills in presentation,
writing report/scientific articles effectively and suitably.
Standard 17. Death management
75. Criterion 1. Confirm the death.
76. Criterion 2. Notify the deaths of
patients to their family.
FIELD 4: COMPETENCE IN
COMMUNICATION AND COOPERATION
General practitioners shall have ability to
communicate effectively with patients and their family, their colleagues and
the community.
Standard 18. Have ability to create a
friendly, cooperative and trustful relationship with patients, their family and
the community
77. Criterion 1. Spend time listening,
sharing, discussing and solving the anxieties and worries of patients and their
family.
78. Criterion 2. Have knowledge about
demands, psychological, physiological and sociocultural factors that affect the
patients.
…
…
…
TVPL
Pro
để sử dụng được đầy đủ các tiện ích gia tăng liên quan đến nội dung TCVN.
Mọi chi tiết xin liên hệ: ĐT:
(028) 3930 3279
DĐ:
0906 22 99 66
Bạn phải đăng nhập hoặc đăng ký Thành Viênđể sử dụng được đầy đủ các tiện ích gia tăng liên quan đến nội dung TCVN.Mọi chi tiết xin liên hệ:
80. Criterion 4. Guide, encourage and
discuss with the patients, their family and other occupational organizations to
participate in giving decision and solving healthcare issue through discussion.
Standard 19. Cooperate effectively with
colleague and partners
81. Criterion 1. Be honest, polite, caring,
discussion-based, respect the patients and avoid conflict.
82. Criterion 2. Have ability to determine
the role and relationship of members in care provider groups; organize and
manage the provision of care for patients, ensuring the healthcare is
continuous, safe, economic and effective.
83. Criterion 3. Listen and share exactly
and effectively the necessary information about patients through discussion via
speech, writing, mail without infringement of privacy principle.
84. Criterion 4. Discuss often with
colleagues to discover the cases exceeding capacity, ensuring the safety of
patients.
85. Criterion 5. Comply with the medical
consultation principle and carry out the decisions of medical consultation.
Standard 20. Effective communication
86. Criterion 1. Have a good voiced and
unvoiced communication with patients, their family and their colleagues.
…
…
…
TVPL
Pro
để sử dụng được đầy đủ các tiện ích gia tăng liên quan đến nội dung TCVN.
Mọi chi tiết xin liên hệ: ĐT:
(028) 3930 3279
DĐ:
0906 22 99 66
Bạn phải đăng nhập hoặc đăng ký Thành Viênđể sử dụng được đầy đủ các tiện ích gia tăng liên quan đến nội dung TCVN.Mọi chi tiết xin liên hệ:
88. Criterion 3. Communicate effectively in
cases patients have communicating obstacles such as the old, children, people
having difficulties in listening, looking and speaking, ethnic minority people.
89. Criterion 4. Communicate effectively with
people regardless of ages, genders, sociocultural characteristics in Vietnamese
or the common language in the workplace.
90. Criterion 5. Have ability to communicate
with patients who are irritable, vulnerable and patients who suffer violence,
help patients and their family have psychological preparation before provide
them with information about the deterioration of the diseases, honestly admit
the lack of information and mistakes (if any).
