Report. Designed by Oleg Galbur, local consultant in assistance of developing human resources strategy and actions plan of implementation

Report Concerning the comparative analysis of the classification and lists of the medical specialities in the EU and Republic of Moldova with concrete suggestions of improvement and fittings to the European Standards Designed by Oleg Galbur, local consultant in assistance of developing human resources strategy and actions plan of implementation Chisinau 2010

Contents 1.Introduction..... 3 2. Normative purview in force for training doctors and pharmacists in Republic of Moldova... 4 3. Basic training.. 4 4. Post-degree specialization... 5 5. Normative purview in force for training medical and pharmacy personnel of secodary education in the Republic of Moldova... 8 6. Normative purview concerning the professional health care training in the European Union....... 9 7. Basic forming in medicine..... 10 8. Basic titles of qualification in medicine... 10 9. Specialists training..... 11 10. Titles of qualification as a professional doctor. 12 11. Names of the professional medical formings and the minimum duration.14 12. Specific Forming in general medicine... 15 13. Titles of qualification in general medicine 15 14. Basic forming of a dentist... 17 15. Basic titles of qualification as a dentist. 18 16. The forming of a professional dentist 19 17. Titles of qualification as a professional dentist. 19 18. The forming of a pharmacist.. 20 19. The study program for pharmacists...... 20 20. Titles of qualification as a pharmacist... 21 21. The forming of the general medical assistant... 22 22. The study program for general medical assistants... 22 23. Titles of qualification as a general medical assistant... 23 24. The forming of a midwife.... 25 25. The study program for midwives... 25 26. Titles of qualification as a midwife.... 26 27. The lists of the specialists for post-degree training of the doctors in some EU countries...... 28 28. References.... 34 29.Appendix....... 35 2

Introduction The Report Concerning the comparative analysis of ranker and list of the medical specialties in the EU and Republic of Moldova with concrete suggestions of modifications and fittings to the European Standards was developed based of the following available sources of information: 1. Available information on the site of the European Commission (http://ec.europa.eu) 2. Official Journal of the European Union (http://eur-lex.europa.eu) 3. The Law of Education Nr.547-XIII from July 21, 1995 (Official Monitor of the Republic of Moldova nr. 62-63 from November 9, 1995) 4. The Law nr. 142 from 07.07.2005 Regarding the approval of the domain Lists for the professional forming and of the specialties for the forming of the cadres in the institutions of higher education, I cycle (The Official Monitor of the Republic of Moldova nr. 101-103, art 476 from July 29, 2005) 5. The specializations for the forming of the cadres in academic and post-academic institutions at the medical and pharmaceutic profiles, approved by the Ministry of Economy from December 27, 2000(The Official Monitor of the Republic of Moldova nr. 19-20/66 from february 22, 2001) 6. The Law Nr. 1070 from June 22, 2000 Regarding the approval of the specialties for the forming of the cadres in institutions of higher education and medium of specialty ( The Official Monitor of the Republic of Moldova nr. 094, art 676 from August 03, 2000) 7. The Minister of Public Health s Order in Romania, Nr. 1.509 from September 02, 2008(The Official Monitor of Romania nr. 538 from august 03, 2009). The report contains information concerning the normative effectual purview having reference to the professional forming of the doctors, pharmacists and other medical workers with medium studies in Republic of Moldova, after the event being analysed the effectual settlements at the corresponding compartment of the EU, ether in general or inside the member countries, and finally, there are presented recommendations of improvement and fittings of the national legislative and normative purviews according to the recommendations and the experience of the European community. 3

Normative purview in force for preparing doctors and pharmacists in Republic of Moldova Basic training The basic training of the doctors and pharmacists in Republic of Moldova is regulated by the following normative and legislative basic purviews (further there are exposed the most important aspects): I. Article 28(1). Medical and pharmaceutic Higher and post-graduating education (The Law of Education) (1) Medical and pharmaceutic education is realized through higher education of specialty and post-academic studies of residency. Higher education of specialty is organized as daily education, it takes 4-6 and corresponds to a number of 60 transferable study credits for each year of study. (3) Higher education of specialty ends with the taking of the graduating exams. The graduates which promoted the graduating exams are released the diploma of higher education in medicine and pharmacy. The owner of the diploma has the right to take part at the contest of admission for the post-academic studies of residency on specialization or at the attending of the master degree. II. The list of the specialties for the forming of the cadres in institutions of higher education at the area 7 of Health (Appendix nr. 2 of the Law nr. 142 from 07.07.2005 Regarding the approval of the domain Lists for the professional forming and of the specialties for the forming of the cadres in the institutions of higher education, I cycle The Code and the name of the fundamental domain of science, culture şi technic The Code and the name of the general domain of study The Code and the name of speciality /domain of the initial professional forming(higher education of specialty) Number of the study credites 7 Health 71 Medicine 711 General Medicine 360 712 Dentistry 300 713 Public Health Care 300 714 Pediatricians 360 721 Pharmacy 721 Pharmacy 300 4

Post-diploma specialization The post-diploma training of the doctors and pharmacists(postgraduating training)in The Republic of Moldova is regulated by the following legislative and normative purview (here are taken out the most important aspects): I. Article 28 1. Medical and Pharmaceutic Higher and post academic Education (The Law of Education) (4) Post-academic studies of residency are organized by The Minister of Health, having the objective of the compulsory professional forming of the doctors and pharmacists on specialization, and is performed during 2-5. (7) The Graduates which had promoted the final exam are given the titles of b.a in the profile and in the followed specialization, also they are liberated diploma of License, which gives the right at the independent practical activity and at the continuance of the studies through clinic secondary or Ph.D. (8) Post-academic Studies of specialization in medicine are organized by the Minister of Health through clinic secondary and have a duration of 2. The studies end with the taking of the graduating exams and the receiving of a certificate of post-academic studies of specialization. II. The Specializations for the cadre preparring in Higher Education and Post-academic institutions at the medical and pharmaceutic profiles, approved by the Minister of Economy from December 27, 2000 (The Official Monitor of The Republic of Moldova nr. 19-20/66 from February 22, 2001) The Code and the name of the speciality The Code and the name of the specialization The Code and the name of the narrow specialization 1701 General Medicine 1701.01 Family Medicine 1701.02 internistical Medicine 1701.02.A Physiopneumology 1701.02.B Cardiology 1701.02.C Rheumatology 1701.02.D Gastroenterology 1701.02.E Nephrology 1701.02.F Endocrinology 1701.02.G Prophpatology 1701.02.H Allergology 1701.02.J Geriatry 1701.02.K Immunology 1701.02.L Functional Diagnostic Medicine 1701.02.M Dietetics 1701.02.N Sport Medicine 1701.02.P Physiotherapy 1701.03 Hematology 1701.03-A Pediatric Hematology 1701.03.B Transfusiology 1701.04 Psychiatry 1701.04.A Psychotherapy 1701.04.B Narcology 1701.04.C Pediatric Psychiatry 5

1701.04.D Medical Psihology 1701.04.E Legal Psychiatry 1701.05 Dermalvenerology 1701.04.F Sexopathology 1701.06 Infectious diseases 1701.05.A Cosmetology 1701.06.A Infectious diseases (children) 1701.07 Neurology 1701.07.A Medical genetics 1701.07.B Pediatric Neurology 1701.08 Nontraditional Medicine 1701.08.A Acupuncture 1701.08.B Phitotherapy 1701.08.C Homeopathy 1701.09 kinesitherapy 1701.09.A Manual therapy 1701.10 Surgery 1701.10.A Cardio-vascular surgery 1701.10.B Thoracic surgery 1701.10.C Plastic surgery, microsurgery 1701.10.D Oro-maxillo-facial surgery 1701.10.E Colorectal surgery 1701.10.F Combustiology 1701.11 Pediatric Surgery 1701.11.A Pediatric Combustiology 1701.11.B Pediatric Ortopedy - traumatology 1701.11.C Pediatric Urology 1701.11.D Pediatric Oncosurgery 1701.11.E Pediatric Anaesthesiology, reanimathology 1701.12 Obstetrics and gynecology 1701.13 Anaesthesiology, 1701.13.A Toxicology Reanimathology 1701.14 Ortophedics-traumatology 1701.14.A Ortophedics of prosthesis 1701.14.B Phisiatric Ortophedics 1701.15 Neurosurgery 1701.15.A Pediatric Neurosurgery 1701.16 Urology 1701.16.A Surgical Nephrology 1701.16.B Andrology 1701.17 Oncology 1701.17.A Surgical Oncology 1701.17.B Oncologic chemotherapy 1701.17.C Oncologic Ortophedics 1701.18 Ophthalmology 1701.18.A Pediatric Ophthalmology 1701.19 Otorhinolaryngology 1701.19.A Pediatric Otorhinolaryngology 1701.19.B Surdology 1701.20 Emergency Medicine 1701.21 Pediatricians 1701.21.A Neonatology 1701.21.B pediatric Pulmonology 1701.21.C Pediatric phisiatry 1701.21.D Pediatric Cardiology 1701.21.E Pediatric Rheumatology 1701.21.F Pediatric Nephrology 1701.21.H Pediatric Endocrinology 1701.22 Endoscopy 1701.22.A Diagnostic Endoscopy 1701.22.B Surgical Endoscopy 1701.23 MRI specialists/ Imagistics 1701.23.A Imagistic - sonography 1701.23.B Imagistic radiology 1701.23.C Imagistic nuclear medicine 1701.24 Morphopathology 1701.25 Laboratory medicine 1701.25.A Laboratory medicine in genetics 1701.25.B Sanitary chemistry 1701.26 Legal Medicine 1701.27 Hygiene and epidemiology 1701.27.A Epidemiology 1701.27.B Parasithology 1701.27.C Microbiology 1701.27.D Vimsology 1701.27.E Alimentary hygiene 1701.27.F Children and adults hygiene 1701.27.G Radiation hygiene 6

1701.27.1 Environment hygiene 1701.27.H labour hygiene 1701.27.K Disinfection 1701.28 Clinical Pharmacology 1702 Stomatology 1702.01 Stomatology 1702.01.A Surgical Stomatology 1702.01.B Dental Prosthetics 1702.01.C Pediatric Stomatology 1702.01.D Orthodontics 1703 Health Management 1703.01 Health Management 1751 Pharmacy 1751.01 Pharmacy 1751.01.A Clinical Pharmacy 1751.01.B Medicine Technology 1751.01.C Analytical Pharmacy 1751.01.D Pharmaceutical Management 1751.01.E Pharmacognosy As a result, nowadays, for the post-diploma specialization of the doctors and pharmacists in the Republic of Moldova there are 118 specializations in force, including: a) 31 specializations for the residency training, including 28 specializations for the graduates of the General Medicine faculty, 1 specialization for the graduates of Stomatology faculty, 1 specialization for Health Management faculty which there are no graduates at, and 1 specialization for the graduates of the Pharmacy faculty. b) 87 narrow specializations for the training through clinical secundary, including 68 clinical and paraclinical specializations for the training of the doctors, 10 specializations for the traning in the field of Preventive Medicine, 4 specializations for the training of the dentists and 5 specializations for the training of the pharmacists. Duration of the post-diploma training depending on the specialization was initially approved for 3 for residensy and 2 for clinical secundary through The Decision of the Government Nr. 502 from 15.07.1994 Concerning the improving and restructuring of the medical postgraduating education (The Official Monitor nr. 007 from 30.07.1994), as a result, through The concept of continuous graduating and post-graduating training of the cadres of doctors and pharmacists in the în Republic of Moldova, approved through the diction of the Ministry of Health nr. 48 from 26.06.2000 (Official Monitor nr. 005 from 18.01.2001) and in the residency postgraduating and clinical secundary Training Regulations of, approved by the Ministry of Health, which established the duration of 3 for internists specializatons, 4 for surgical specializations (5 for Neurosurgery)and 2 for clinical secondary training. 7

Normative purview in force for preparing medical and pharmacy personnel of secondary education in the Republic of Moldova Nowadays in the Republic of Moldova, medical and pharmaceutic secondary education is regulated by the following legislative and normative purviews in force: 1. The purviews of the Law of Education concerning the organization and the conducting of the secondary education, including the medical and the pharmaceutic one. 2. The Specialty classification for cadres training in higher and secondary educational institutions (The Law nr. 1070 from June 22, 2000) The Code and the name of the profile The Code and the name of the speciality 700 Medicine 1701 General Medicine 1702 Stomatology 1703 Public Health 1750 Pharmacy 1751 Pharmacy (At the specialities "General Medicine ", "Stomatology"and "Pharmacy" is permitted the training also in colleges of medicine, according to the specialities approved by the Ministry of Health ) 3. The Qualifications in the medical and pharmaceutic secondary education, approved through the order of the Ministry of Health nr. 62-p 4 from 30.06.2005. Profile The Code and the Qualification name of the speciality 1700 Medicine 1701 General Medicine Nurse Medical assiatant Midwife Medical assistant lab Assistant epidemologist hygienist 1702 Stomatology Dental technician 1750 Pharmacy 1751 Pharmacy Pharmacist lab As a result, the training of the medical and pharmaceutic personnel with secondary education nowadays takes place in 2 domains (Medicine and Pharmacy), at 3 specialities (General Medicine, Stomatology and Pharmacy), but the graduates can obtain one of the 8 qualifications (Nurse,medical assistant, midwife, medical assistant lab, assistant epidemiologist Hygienist, Dental technician and pharmacist lab). The admission at studies is taking place in base of gymnasial studies, secondary education and high school education, and the duration of the studies is approximately of 5 and 3. 8

Normative purview concerning the professional training in the direction of medicine in the European Union In the European Union (EU) the professional training of the doctors, dentists, pharmacists, nurses and midwives is regulated in Directive 2005/36/CE of the European Parliament and of the Counsil from September 7, 2005 concerning the approvement of the professional qualifications, which harmonize at the level of the EU the forming of the nominalized specialists in base of some minimum requirements set for the professional forming of these. At the same time, for special specializations it didn t manage to harmonize at the level of the EU, these remaining specific national specializations and a subject for discussion in continuance. a) doctors: This way, there were harmonized and unified the following forming principles: - the basic medical forming (art. 24, point 5.1.1 from App V) - The medical forming of a specialist (art. 25, points 5.1.2 and 5.1.3 from AppV) - The medical forming in general practice (art. 28, point 5.1.4 from App V) - The medical forming of the national specialist(art. 25, point 5.1.2 from App V, but not included in the point 5.1.3 of the same appendix). b) dentists: - The basic medical forming (study program, the qualification) (art. 34, points 5.3.1 and 5.3.2 from App V) - The medical forming on specializations (art. 35, point 5.3.3 from App V) c) pharmacists: the basic professional forming (study program, qualification) (art. 44, points 5.6.1 and 5.6.2 from App V) d) nurse: the study program and the name of the qualification (art. 31, points 5.2.1 and 5.2.2 from App V) e) midwife: the study program and the name of the qualification (art. 40, points 5.5.1 and 5.5.2 from App V) 9

Article 24 Basic forming in medicine (1) The Admission at the basic forming in medicine supposes the possession of a diploma or of a certificate which permies the access, as concerning the studies in cause, at the university. (2) The basic Forming in medicine totally includes at least six of study or 5500 hour of theoretical and practical instruction assured by an university or under an university s supervision. (3) The basic Forming in medicine offers the guarantee that the person in cause has obtained the following knowledges and proficiency: (a) coresponding knowledges about sciences on which the medicine is based on and a good comprehensiveness of the scientific methods, including the principles of measuring of the biological functions, the evaluation of the scientifically settled data and their analysis; (b) corresponding knowledges about the structure, the functions and the behaviour of the sick and healthy persons, also the relations between health condition and the social and physical surroundings of the human being; (c) corresponding knowledges about clinical disciplines and practices which offered a coerent image of the mintal and fizical affections, of the medicine from the perspective of profilaxy, diagnostic, therapy and human reproduction; (d) clinical experience useful in hospitals under the corresponding supervision. 5.1.1. Titles of basic qualifictions in medicine (App V) The country The Title of qualification The Organ that gives the title of qualification Belgium Diploma of doctor in medicine Czech Republic Danemarc Germany Diploma of graduating the program of General Medicine (Doctor in Medicine) Certificate of training confirmation in General Medicine 1. Certificate of state medical exam 2. The Testiminy about the training time as a nurse, in case that this fact was provided in conformity with the german law The competent Authorities 10

Estonia Diploma of Doctor Greece Licence in Medicine Spain Licence in Medicine and surgery France State Diploma of Doctor in medicine Ireland Primary Qualification The competent Organes Italy Diploma de licență în medicina și chirurgie Cyprus Certificate of doctor Medical Council Latvia Diploma of Doctor Lithuania Diploma of higher education with the qualification of Doctor Luxemburg State Diploma of doctor in Medicine, surgery State exam s Comission and births. Hungary The Grade of generalist Doctor Malta Title of Doctor in Medicine and Surgery Holland Certificate of confirming the medical training Austria Poland 1. Certificate of academic grade of Doctor in general Medicine 2.Diploma of special training of a generalist Doctor Studies in medicine with the title of "Doctor" Austriac medical association Portugal Grade in medicine Slovenia Diploma which gives the professional title of "Doctor in medicine" Slovakia Academic Title "Doctor in Medicine " Finland Licence in Medicine Swizerland Doctor in medicine United Kingdom Primary Qualification Bulgary Diploma of doctor Romania Licence in medicine The Competent Organs 11

Article 25 The Forming of professional doctors (1) The Admission at the forming of the professional doctor supposes the graduating and validation of six of study in the cadre of the forming cycle mentioned at the article 24 during which the adequate knowledges of general medicine have improved. (2) The specialized Forming in medicine includes the theoretical and practical instruction, organized in an university, in an academic hospital or, depends on case, a health institution appointed with this purpuse by the competent authoryties or organs. The member states assures that the minimum periods of professional forming in medicine mentioned in app V point 5.1.3 not to be shorter than the periods provided at the same point. (3) The forming is put into effect on base of integral program, on specialized place, recognized by the competent authoryties. The Forming implies the participation at all the medical activities of the department in which the forming is being realized, including at the guard service, so that the professional in forming to dedicate to this practical and theoretical training all his professional activity, during the whole working week and during the whole year, after the prescribed by the competent authorities methods. In consequence, these jobs make the object of an adecvate remuneration. 5.1.2. Titles of qualification as a professional doctor (Appendix V) Country The Title of qualification The Organ that gives the title of the qualification Belgium The Title of professional Doctor The Ministry of Public Health Czech Republic Diploma of specialization The Ministry of Health Danemarc The Proof of permission to use The Agency of Health Protection the Title of specialist Germany Recognized Doctor The Medical State Association Estonia Certificate of specialist in the domain of study 12

Greece The Title of medical speciality Prefectures Spain The Title of specialist The Ministry of Education and Culture France 1.Certificate of special studies in Medicine 2. The Confirmation as a 1.Universities 2. The Council of the Doctor s Order professional doctor Ireland Certificate of professional doctor The competent Authorities Italy Diploma of professional doctor Cypre Latvia Lithuania Certificate of recognizing the speciality Certificate that confirms that the person has passed the exam of certification in speciality Certificate that confirms the given professional qualification The Medical Council The letonian medical Association Luxemburg Certificate of professional doctor The Ministry of Public Health Hungary Certificate professional The Organ Malta Certificate of professional doctor The Comitee of confirming the professionals Holland Professional Doctor The Comitee of registration Austria Diploma of professional The austriac medical Association Poland Diploma of receiving the The Medical Centre of qualification examination Portugal The Title of Professional The medical Order Slovenia Certificate of professional The Ministry of Health, Slovakia Diploma of specialization Finland The Grade of professional Swizerland The Proof of doctor s expertize The National Council United Kingdom Certificate of forming on speciality The Competent Authorities Bulgary Certificate of professional Romania Certificate of confirming the qualification The Ministry of Health 13

5.1.3. The names of the formărilor medicale specializate și durata minimă (Anexa V) n/o Qualification Durata minimă 1 Anestezy and intensive therapy 3 2 General surgery 5 3 Neurosurgery 5 4 Obstetrics-gynecology 4 5 Interior Medicine 5 6 Ophtalmology 3 7 Otorhinolaryngology 3 8 Pediatry 4 9 Pneumologie 4 10 Urology 5 11 Ortopedy 5 12 patologic anatomy 4 13 Neurology 4 14 Psychiatry 4 15 Radiology medical imagistics 4 16 Radiotherapy 4 17 Plastic surgery reconstructive 5 microsurgery 18 Lab Medicine 4 19 Microbiology - bacteriology 4 20 Biochemistry 4 21 Immunology 4 22 Thoracic surgery 5 23 Pediatric surgery 5 24 Vascular surgery 5 25 Gastroentherology 4 26 Cardiology 4 n/o Qualification Durata minimă 27 Rheumatology 4 28 General Hematology 3 29 Еndocrynology 3 30 Recuperation, phizical 3 medicine and balneology 31 Neuropsychiatry 5 32 Dermatovenerology 3 33 Radiology 4 34 Pediatric Psychiatry 4 35 Geriatry and gerontology 4 36 Nephrology 4 37 Infectious diseases 4 38 Public Health and management 4 39 pharmacology 4 40 Labour Medicine 4 41 Alergology 3 42 Nuclear Medicine 4 43 maxillo-facial surgery 5 (medicine) 44 Clinical Hematology 4 45 Stomatology 3 46 Dermatology 4 47 Venerology 4 48 Tropical Medicine 4 49 Gastrointestinal surgery 5 50 Emergency Medicine 5 51 Clinical Neurophiziology 4 52 oro-dental and maxillo-facial (med and stom) surgery 4 14

Article 28 The Specific Forming in general medicine (1) The Admission at the specific forming in general medicine supposes the graduating and the validation of six of study în the cadre of the cycle of forming provided at the article 24. (2) The specific Forming in general medicine which conducts to the obtaining of the titles of qualification released before January 1, 2006 has a duration of at least 2, on base of integral program. Concerning the titles of qualifications released after this date, the specific forming has a duration of at least three, on base of integral program. (3) The specific Forming in general medicine is realized on base of integral program, under the supervision of the authorities or of the competent organs. The training is more practical than theoretical. The practical Training is assured, on the one hand, on a period of at least six months, in an authorized hospital, which has adequate equipments and services and, on the other hand, in an authorized center in which the doctors offer primary medical assistance. 5.1.4. Titles of qualification in general medicine (App V) The The Act through which the title of The professional title country qualification is confirmed Belgium The Order of the Ministry for the approval of Generalist Doctor the General Practice Czech Diploma of specialization in General Doctor of General Practice Republic Medicine Danemarc The Permission to use the term of Generalist Doctor Professional in General Medicine Germany Certificate of specific forming in General Medicine Professional in General Medicine Estonia Diploma in the speciality of Family Medicine Family Doctor Greece Title of professional in General Medicine Specialized Doctor in General Medicine Spain Professional in Family and community Medicine Professional in Family and community Medicine 15

France Ireland Italy State Diploma of Doctor in medicine (with the specification of the specific forming in General Medicine) Certificate of special qualificotion in General Medicine Confirmation of specific forming in General Trained Doctor in General Medicine Professional in Medicine Doctor in General Medicine General Medicine Cyprus Title in General Medicine Doctor in General Medicine Latvia Certificate of Family Doctor Family Doctor (General Practice) Lithuania Certificate of Family Doctor Family doctor Hungary Certificate professional Doctor Professional Doctor Malta Certificate of Family Doctor Family doctor Holland Certificate of registration in the Register of accredited practicers Professional Doctor in General Practice Austria Certificate of General Practice Professional of General Practice Poland Diploma in the domain of Family Medicine Professional in Family Medicine Portugal Supplement at the probation diploma of Generalist Doctor general practice Slovenia Certificate of finalization of the forming of Family doctor speciality in Family Medicine ( general practice) Slovakia Diploma of specialization in the domain of Doctor of General Practice General Medicine Finland Certificate of medical education in Primary Doctor of General Practice medical assistance Switzerland Proofs of competence of generalist doctor Generalist Doctor given by the National Council United Certificate of experience in General Practice Doctor of General Practice Kingdom Bulgary Certificate of general practice/ Family Medicine Romania Certificate of specilization Family doctor Doctor of General Practice / Family doctor 16

Article 34 Basic forming of a dentist (1) The Admission at the basic forming of a dentist supposes the possession of a diploma or of a certificate which allows the access, for the corresponding studies, at the universities or at the higher education institutions of a recognized level as being equal to a member state. (2) The basic Forming of a dentist totally consists of at least five of theoretical and practical training based on integral program, including at least the provided program in the app V point 5.3.1 and performed in an university, in a higher educational institution at the recognized level as being equal or under the supervission of an university. The basic Forming of a dentist confers the necessary competences for all the preventive activities, diagnose and treatment concerning the anomalies and the diseases of the teeth, mouth, maxillares and of the related tissues. 5.3.1. Study Program for the dentists (App V) A. Basic Material B.Medical-biological material and general-medical material C.Odonto-stomatological material specific 1. Chemistry 1. Anatomy 1. dental prosthetics 2. Phisics 2. Embriology 2. Stomatological Materials 3. Biology 3. Histology, including cytology 3. Conservative Stomatology 4. Phisiology 4. Preventive Stomatology 5. Biochemistry (or phisiological 5. Anestezy and sedation in stomatology chemistry) 6.Pathological anatomy 6. Special Surgery 7. General Pathology 7. Special Pathology 8. Pharmacology 8. Odonto-stomatological Clinical practice 9. Microbiology 10.Pedodontics 10. Hygiene 11.Orthodontics 11. Peventive medicine and 12. periodontitis epidemiology 12. Radiology 13. Dental radiology 13. Phiziotherapy 14. Dental Occlusion and maxillar function 14. General Surgery 15. Social aspects of the dental practice. 15. Internal Medicine, 17

including pediatry 16. Otorhynolaryngology 17.Dermathovenerology 18.General Psychology - psychopathology -neuropathology 19. Anesthesy 5.3.2. Titles of basic qualification as a dentist (App V) Country The proof of qualification Organul care eliberează dovada calificării Belgium Licence Diploma in dental sciences Universităţi, Juriul didactic calificat Czech Diploma of graduating the Dentist Republic program of Stomatology (Doctor) Danemarc Proof of dental exam Dentist The professional title Licence in dental sciences Germany Certificate of examination in the domain of Stomatology Competent authorities Dentist Estonia Diploma in stomatological Dentist sciences Greece Diploma in Stomatology and Dentist dental surgery Spain The Title of Licence in Stomatology Licence in Stomatology France State Diploma of a Doctor in Dental Surgeon dental surgery Ireland Bachelor in Dental sciences Bachelor in dental surgery Licence in dental surgery Universities Colleges Dentist Dental Practicer Dental Surgeon Italy Licence in Stomatology and Odontologist dental implants Cypre Certificate of registration of a Dental Council Dentist Dentist Latvia Diplomas mutually recognized Dentist Lithuania Diploma of dental qualification Dentist Luxemburg State Diploma of doctor in dental The Comission of Medic dentist medicine State Exam Hungary Doctor in dental medicine Dentist Malta Licence in dental surgery Dental Surgeon Holland Certificate of dental exam Dentist Austria The notification of giving the academic title of Doctor in Stomatology Dentist 18

Portugal Course Letter with dental grade Dentist Slovenia Diploma with professional title of Doctor in Dental Medicine Doctor in dental Medicine Slovakia Diploma of giving the academic Dentist title of Doctor in dental medicine Finland Licence in Stomatology Dentist Switzerland Dental Grade Stomatologist United Kingdom Bachelor in dental surgery Licence in dental surgery Royal College Dentist Dental Practicer Dental Surgeon Bulgaria Certificate in dental medicine Stomatologist / Romania Certificate in Stomatology The Ministry of Health dentist Stomatologist / dentist Article 35 The forming of a professional dentist (1) The admission to the forming of a professional dentist supposes the graduation and validation of five of teoretical and practical training in the cadre of the forming provided at the article 34 or the possession of the documents provided at the articles 23 and 37. (2) The Forming of a professional dentist includes the theoretical and practical training in an university centre, in an attendance centre, of education and of research or, in a health institution authorized with this purpose by the competent authorities or organs. The Forming of a professional dentist is realized o base of integral program, on a period of at least three and under the supervission of the competent authorities or organs. The Forming implies the personal participation of the professional dentist nominated at the activity and responsability of the corresponding institution. 5.3.3. Titles of qualification as a professional dentist (App V) Orthodontist Oral/ dental surgery 19

Article 44 The Forming of a pharmacist (1) The Admission at the forming of a pharmacist supposes the possession of a diploma or of a certificate which permits the access, for the corresponding studies, at the universities or at the higher educational institutions of a recognized level as being equal to a member state. (2) The Titles of qualifications as pharmacist testifiesa forming for a perioad of five, from which at least : (a) four of theoretical and practical training at daily courses in an university, in a higher educational institution of a recognized level as being equal or under the supervision of an university; (b) six months of probation in an open to the public pharmacy or in a hospital, under the supervision of the farmaceutic service of the corresponding hospital. 5.6.1. The Study Program for the pharmacists (App V) - Biology of the plants and animals - Physics - General and inorganic Chemistry - Organic chemistry - Analytic chemistry - Pharmaceutic chemistry, including the analysis of the medicines - General and Applied Biochemistry (medical) - Anatomy and physiology; medical terminology - Microbiology - Pharmacology and pharmacotherapy - Pharmaceutic technology - Toxicology - Pharmacognosy - Legislation and, conforming the case, deontology. 20

5.6.2. Titles of qualifications as a pharmacist (App V) The country The proof of Qualification The Organ that confirms the qualification Belgium Diploma of Pharmacist Czech Diploma of graduating in Pharmacy (Master Republic Degree) Danemarc Proof of graduating the pharmaceutic Danish school of Pharmacy studies Germany State Document concerning the evaluation Competent authorities in the pharmaceutic domain Estonia Diploma of Pharmacist Greece Permission for the practicing of the Prefecture pharmaceutic profession Spain Licence in Pharmacy France State Diploma of Pharmacist State Diploma of Doctor in Pharmacy Ireland Certificate of registered Pharmacist Italy Diploma or certificate of competence for practicing as pharmacist, obtained through State Exams Cyprus Certificate of registation as a Pharmacist Pharmacy Council Letonia Diploma of Pharmacist Lithuania Diploma of higher education with the qualification of Pharmacist Luxemburg State Diploma in the domain of Pharmacy State Commission of examination Ministry of National Education Hungary Diploma of pharmacist graduate (Master in Pharmacy) Malta Licence in Pharmacy Holland Certificate concerning the succesful taking of the exam in Pharmacy Austria State Diploma in Pharmacy Federal Ministry of Health Portugal Academic Course Letter (Carta) in pharmaceutic science Slovenia Diploma of Master in Pharmacy Slovakia Academic Grade Master in Pharmacy Finland Commission for the exam of Provisor Switzerland Exam of Pharmacist United Certificate of Pharmacist chimist Kingdom Bulgaria Diploma of Pharmacist Romania Diploma of Licence in Pharmacy 21

Article 31 The Forming of nurse (1) the Admission at the forming of the nurse supposes a general educational forming of 10, confirmed by a diploma, a certificate or another title of qualification released by the competent authorities or organs of a member state or by a certificate that confirms the promotion of an exam of admission, of equal level, at an assistants school. (2) The Forming of a nurse is displayed on base of integral progam and includes at least the program provided in the app V point 5.2.1. (3) The Forming of a nurse consists of at least three of study or 4600 hours of theoretical and clinical training, the period of theoretical training representing at least one third, but the clinical training one- at least half of the minimum period of forming. The member states can give partial exceptions to the persons which benefited such a forming in the cadre of another formings of at least equal level. 5.2.1. The Study Program for the nurses (App V) A. Theoretical training - Sanitary education. (a) Nursery: - Pharmacology - Orientations and deontology (c) Social Sciences: - General Principles of health and nursery - Sociology - Principles of nursering in material of : - Psychology - General Medicine and medical specialities; - Principles of administration - General Surgery and surgical specialities; - Teaching Principles - Puericulture and pediatrics; - Social and sanitary Legislation - Hygiene and the nursing of the mother and the - Judicial Aspects of the profession new-born child; - Mental Health and psychiatry; B. Clinical training - The nursing of the adults and geriatry. Nursering in material of: (b) Fundamental Sciences: - General medicine and medical specialities; - Anatomy and physiology - General surgery and surgical specialities 22

- Pathology - Nursering of the children and pediatry; - Bacterhyology, virusology and parasitology - Hygiene and the nursering of the mother and of the new-born child ; - Biophysics, biochemistry and radiology - Mintal health and psychiatry; - Dietetics - Nursering of the adults and geriatry; - Hygiene: - Home nursering - Prophilaxy; 5.2.2. The Titles of qualification as a nurse (App V) The country Belgium Czech Republic Danemarc Germany Titles of qualifications Certificate of Nursing and of Hospital Nurse Diploma of Nurse Diploma of graduating in the domain of study General Nursing Diploma of Nurse (Nursing) The testimony concerning the state exam in Nursing The Organ which gives the title of qualification Educational Institutions Didactic qualified Jury Professional scool The Certificate which accompanies the title of qualification Hospital nurse Generalist Nurse Generalist Medical assistant The Ministry of Education Medical Assistant (Nursing) State Comitee of audition Nurse in health and nursing Estonia Diploma in the speciality Medical Schools nurse assistance Greece Nursing Educational Institutions Asistent medical Spain Diploma with the title of Diploma of Nurse Nursing France State Diploma of The Ministry of Health Nursemaid nursemaid Ireland Certificate of registered generalist Nurse Nurse Council Registered generalist Nurse Italy Diploma of professional nursemaid State Recognized Schools Professional nursemaid Cypre Diploma of Nursing General Scool of Nursing Registered Nurse Latvia Diploma in medical nurse Lituania assistance Diploma of higher education (assistant) Diploma of non-academic studies (nursing) Colleges Assistant/nurse of general practice 23

Luxemburg State Diploma of nursemaid State Diploma of hospital nursemaid Hungary Certificate of Assistant / Nurse Malta Master Diploma of nursemaid studies Holland Austria Poland Portugal Slovenia Slovakia 1. Diploma in medical assistance 2. Diploma of Nurse (National Vocational Nurse) 3. Diploma Nurse (profesional superior Nurse) 4. Diploma of professional medical assistant 5. Diploma of superior professional medical assistant Diploma of medical assistant Diploma with the title of Master in Medical Assistance Diploma of General Nursing Course Diploma in Nursing Diploma which gives the professional title of medical assistant Academic grade of Master in Nursing Ministry of national education, of the professional forming and sport / College Special Council for the examining the assistants Specialized schools Higher educational Institutions Scools of Nursing College Medical school Nursemaid Assistant / Nurse Registered Nurse Nurse / medical assistant Certified Nurse/ medical assistant Medical assistant Nurse Medical assistant nurse Finland Diploma of nursemaid Medical School Nurse Switzerland Certificate of Nursing Academic College Nurse United Kingdom Bulgaria Romania Declaration of registration as general Nurse in the Register kept by the Central Council of the United Kingdom for nursemaids and midwives Diploma of medical assistant Diploma of medical assistant Competent organs Educational institutions Acreditated institutions Registered Nurse General registered Nurse Medical assistant Nurse 24

Article 40 The Forming of the midwife (1) The Forming of the midwife totally consists of at least one of the following formings: (a) a specific forming of midwife, based on integral program, of at least three of theoretical and practical training (type I), including at least the program provided in app V point 5.5.1; (b) a specific forming of a midwife, besed on integral program, of at least 28 months (type II), including at least the program provided in app V point 5.5.1, which did not attend the object of an equal forming of a nurse. (2) The Access to the forming of the midwife makes the object of one of the following conditions: (a) the graduating of at least the first 10 of the secondary educational forming for the type I or (b) the possession of a title of qualification as a nurse provided in app V point 5.2.2, for the type II. 5.5.1. The study Program for midwives (App V) A. The theoretical and technic training (a) Basic Materials - Sexual Education and family planification - Fundamental notions of anatomy and physiology - Juridical protection of the mother and the child - Fundamental notions of pathology (b) Materials specific for the activities of the midwives - Fundamental notions of bacteriology, virusology - Anatomy and physiology and parazithology - Fundamental notions of biophysics, biochemistry - Embriology and the growth of the fetus and radiology - Pediatry,in special concerning the new-born child - Pregnancy, birth and puerperality - Hygiene, sanitary education, preventive medicine, Early diagnostics - Gynecological and obstetrical pathology - Nutrition and dietetics, in special concrning the - Preparing for birth and maternity, including the women, New-born children and infants psychological aspects -Fundamental notions of sociology and problems of - Preparing for birth (including the knowledge and social medicine usage of the technic equipment of obstetrics) - Fundamental notions of pharmacology - Analgesy, anestezy and resuscitation 25

- Psychology - Physiology and the pathology of the new-born child - Pedagogy - Nursing and supravision of the new-born child - Medical and social legislation and medical - Psychological and social factors organization - Deontology and professional legislation B. Practical and clinical training - The Consulting of the pregnant women, including at least 100 prenatal examinations. - The Supervision and the nursering of at least 40 pacients. - The Assisting of the students at least at 40 births; in case they can t reach this number as a result of the dificiency of the pregnant women, it can be reduced to minimum 30, with the condition that the student will actively participate in another 20 births. - The Assisting at the births with pelvic presentation. In case that this thing is impossible, as a result of the insufficient number of births with pelvic presentation, the training is done through simulation. - The Practicing of ephysiotomy and the initiation in suture. The Initiation will include the theoretical training and clinical exercises. The Practice of the suture includes the suture of the ephysiotomy and of the simple disruptions by the perineum, which can be immitated in case it is absolutely necessary. - The Supervision and the nursing of 40 women, which are going to give birth or which already gave birth, having risking pregnancy. - The Suprervision and the nursing, including the examination, of at least 100 of healthy pacients newborn children. - The observing and the nursering of the new-born child necessiting speciale nursery, including those of premature birth, of those born after the date, as well as of the underweight or ill. - The nursing of the women which present gynecological and obstetrical pathologies. - The Initiating in the medical and surgical nursery. The Initiation will include the theoretical training and clinical exercises. 5.5.2. Titles of qualification as a midwife (App V) Country The proof of qualification The Organ that gives the qualification The professional Title Belgium Diploma of midwife Educational Institutions Midwife Czech Republic Diploma of graduating the medical assistance, program in the doman of Midwife study (licence) Diploma of graduating in the qualified domain of study of a Midwife (certificate specialist) Profesionale schools Danemarc Diploma of Midwife Midwives School from Danemarc Germany Estonia The testimony concerning the state exam as a Midwife, medical obstetrics assistant Diploma in the profession of Midwife State Comitetul for Audition Medical schools Midwife /birth assistant Midwife Midwife / Obstetrics assistant Midwife 26

Greece Diploma of Midwife Educational institutions Midwife Spain France The Title of obstetrical nursery (midwife) Diploma of obstetrical gynecologic Nursing Diploma in the profession of Midwife Ministry of Education and Culture State Obstetrical assistant Midwife Ireland Certificate of Midwife The Council of the Midwife Midwives Italy Diploma of Midwife Schools approved by the Midwife state Cyprus Diploma in Obstetrics Nursing school Registered Midwife Letonia Diploma of Midwife Nursing schools Midwife Lithuania 1. Diploma of higher education, with the qualification of prifessional Midwife 2. Diploma of higher education ( non-academic studies) with the qualification of professional midwives College Midwife Luxemburg Diploma of Midwife Ministry of education Midwife Hungary Certificate of Midwife School / College Midwife Malta Diploma of master in studies of Midwife Holland Diploma of Midwife Ministry of Health, Wellfare and Sport, Acreditated institutions Midwife Midwife Austria Diploma of midwife College / school Midwife Portugal Diploma of speciality in medical Assistance of maternal health and obstetrics Nursing schools Health schools Medical assistant of maternal health and obstetrics Slovenia Diploma which gives the qualification of Qualified Midwife, College Qualified Midwife Slovakia Finland Academic Grade of "Bachelor of Midwives " Diploma licence in the domain of study of a Midwife Midwives Master degree in social Sciences and Health Medical school Nursing Institutions of health Midwife Midwife Switzerland Midwives,College Midwife United Declaration of registration as a Different organs Midwife Kingdom Midwife Bulgaria Diploma of Midwife Colleges Midwife Romania Diploma of Midwife Medical schools Midwife 27

The classification of the specialities for the postdiploma training of the doctors in some countries of the EU Italy 46 qualifications Maxillo -faccial surgery Farmacology Hygiene and preventive medicine Surgery of the digestive apparatus The diseases of the respiratory apparatus Ortopedy and traumatology Neuropsychiatry Physical medicine and reabilitation Gastroentherology Cardiology Vascular surgery Pediatrical surgery Clinical pathology Urology Doctor of general medicine Geriatry Dermatology and venerology Pediatry Odonthostomatology Radiodiagnostics Ophtalmology Neurosurgery Ematology Psycchiatry Infantile Neuropsychiatry Radiology Allergologia ed immunologia clinica Basic medical training of Italy Labor Medicine Plastic and reconstructive surgery Anestesy and rianimation Rheumatology Nephrology Endocrynology and infectious diseases Microbiology and virology Patological anathomy Tropical medicine Infectious diseases Toracic surgery; Cardiosurgery Clinical biochemistry Radiotherapy Internal medicine Ginecology and obstetrics General surgery Nucleare medicine Neurology Portugal - 42 qualifications Clínical general assistant Plastic and recontructive surgery Gynecology and obstetrics Internal medicine Imuno-allergology Physiatry or physical medicine and the reabilitation Radiotherapy Ophtalmology do trabalho medicine Anestesiology Nuclear medicine Psychiatry Basic medical training Pedopsychiatry Dermatovenerology Endocrynology Vascular surgery Pediatry 28

Infecciologia Radiodiagnostics Otorhynolaryngology Neurosurgery Imuno-hemotherapy Neurology Clinical hematology Nephrology Pediátrical surgery Urology Gasterenterology maxillo-facial surgery Estonia 31 qualifications Reabilitation and physiatry Toracic surgery Gastroenterology Labor medicine Pulmonology Rheumatology Psychiatry Ortopedy Infetious diseases Dermatovenerology Gynecology General surgery Hematology Pathology Endocrynology General surgery Rheumathology Ortopedy Tropical medicine Stomatology Clínical pathology Pneumology Pathological medicine Cardiology Públic health Radiology Cardiotorácic surgery Radiology Pediatry Cardiovascular surgery Plastic and reconstructive surgery Otorhynolaryngology Neurosurgery Doctor of general medicine Nephrology Cardiology Oncology Anestesiology Neurology Uroloogia Ophtalmology Internal medicine pediatrical surgery 29

Latvia 37 qualifications Gastroenterology Vascular surgery Theraphistical radiology Physiopneumonoloy Allergology Pediatrical psychiatry Gynecology Cardiology Imunology Microbiology Diagnostical radiology Neurosurgery surgery Psychiatry Infectious diseases Endocrynology Plastic surgery Traumatology and ortopedy Nefrology Thoracic surgery Ophtalmology Professional diseases Dermatology and venerology Internal medicine Anesteziology and reanimatoloy Hematology Oro-maxillo-facial surgery Toracic surgery Urology Pediatry Rheumatology Physical Reabilitology physical medical reabilitation Pediatrical surgery Otolaryngology Neurology Pathology Family medicine (general practice) Lithuania 36 qualifications Physical medicine and reabilitation Vascular syrgery Rheumatology Psychiatry Ortopedy and traumatology Labor medicine Lab medicine Endocrynology Pulmonology Toracic surgery Radiology Urology Pediatry Surgery Dermatovenerology Pediatric surgery Psychiatry of the child and of the adult Otorhynolaryngology 30

Internal diseases Hematology Cardiology Family medicine Inphectology Geriatry Plastic and reconstructive surgery Gynecology Gastroenterology Malta - 42 qualifications General medicine Dermatoloġy Clinical and therapeutic pharmacology Ġeriatry Vascular surgery Microbioloġy Ġeneral surgery Rheumatoloġy Uroloġy Rhespiratory medicine Pediatry Otorhynolaryngology Psychjatry Ortopedical surgery Basic medical training - Malta Occupational medicine Infectious diseases Dermato-venerology Cardio Toraċic surgery Immunology Oncology and Radiotherapy Slovenia 33 qualifications Family medicine Pathology Maxillo-facial surgery Nephrology Oncology and radiotherapy Ophtalmology Neurosurgery Anestesiology and reanimatology Alergology and clinical immunology Neurology Public health Pediatrical surgery Chymical Pathology Ophtalmology Neurosurgery Istopathology Cardiology Family Mediċine Neurology Gastroentherology Endocrinology and Diabets Plastical surgery Radiology Maxillo-facial surgery Nuclear medicine Accidental and emergency Mediċine Hematology Nephrology Clinical Neurophysiology Internal medicine Anesthesy and intensive therapy Urology 31