ABSTRACT
BackgroundHealth professional licensing was introduced in Mongolia in 1999. Medical school graduates shouldpass the health professional licensing exam (HPLE) to be registered. It was informed that HPLEsuccess rate has been decreased for last few years among graduates who passed final theoreticexam (FTE). There has been no research conducted to explain the reasons of such trend. Thisresearch aims to conduct a comparative assessment of MSQs used for both HPLE and FTE.GoalTo analyze examination and test to identify the level of medical knowledge of students who graduateas medical doctor at “Ach” Medical University during 2011- 2015.Materials and MethodsThis is a cross sectional descriptive study. it employed a statistical analysis of 2950 MSQs (24version) that were used for the HPLE by the Health Development Center of the MOH (N=16)and FTE by the “Ach” Medical University (N=8) between 2011 and 2015. Test sheets of HPLE(N=728) and FTE (N=686) were assessed in order to identify a reliability of tests, difficulty index,discrimination index using QuickSCORE II program of the test reading machine with a mode of“Scantron ES-2010”.ResultsThe success rate was much higher in FTE than it in HPLE between 2011 and 2015. The successrate of HPLE decreased dramatically starting from 2013 (87%) to 2014 (4%) and 2015 (24%) whilethe same rate of FTE was stable and almost 100%.FTE’s reliability coefficient of 2011-2015 years meets requirement when it’s 0.92-0.96. HPLE’sreliability coefficient of 2013 and 2014 years don’t meet requirement.From all of the MCQs that has been used in FTE‘s 97% and in HPLE’s 80% are positive discriminationindex which means possible to identify medical school graduates knowledge.ConclusionOur findings confirmed that the success rates of HPLE among medical school graduates are beingquite low.Reliability coefficient of HPLE tests were less reliable (КР20=0.66-0.86) than FTE (КР20=0,92-0.96) and particularly tests for 2014 and 2015 were more difficult and were with high percentage ofnegative discrimination.Test score between HPLE and FTE of 2011-2015 is direct linear correlation.
ABSTRACT
Risk management practice and decision making are paramount for doctors to improving patient outcomes and managing the total cost of risk in our evolving healthcare landscape. In Mongolia there are no legal regulations about health professional’s liability insurance. The aim of the study is to provide relative information about the legal environment, systems and financing of liability insurancefor health professionals in selected foreign countries and Mongolia and to look at what policies and regulations could be applied to Mongolia.We carried out a policy study focused on health professionals’ liability insurance in four selectedcountries. We investigated health professionals’ liability insurance situation in Mongolia in the year of 2012-2014 byReviewing and analyzing the data related to health professionals liability insurance voluntary from the top six insurance companies’ by size and interviewing managerial level staff at these companies Studying court decisions related to health professionals’ errors to see how many health professionals could be prevented from court hearing Studying patients’ complaints against health professionals as filed with the Ministry of Health andSports to see how much risks are facing by health professionals.There are two main legal systems we discovered regarding resolution of health professionals’accountability for patient complaints: Court sentencing. Examples include Mongolia and the United States. Reimbursing the loss. Examples include Switzerland, Finland, New Zealand, Canada, Australia, England, and the Russian Federation. There are two insurance types for health professional’s liability: А. Compulsory B. Voluntary1 In USA, Canada and England, the liability insurance system for health care providers developed late in 19th and earlier in 20th century. Today, both private and nonprofit insurance entities in these countries insure health professionals and members of the health professionals’ association. England has rich experience of health professional’s liability insurance and the system is too large. Data fromthe England legal system shows that one case may take up to 4 years to receive a final decision. In order to determine health professionals’ fault with regard to claims, a health professionals’ liability damage assessor is needed who is well experienced and trained in healthcare law. Mostly not more than 30 percent of the claims are reimbursed. In Canada, statistical trends show claims against health professionals continue to increase. As a result, doctors prescribe additional laboratory tests and other additional investigations which increase health sector costs. In Russia in 2010 the health professional’s liability insurance law is approved and the implementationwill start January 2017. In Mongolia in 2012-2014, there were registered 373 complaints and errors against health professionals and 162 clients applied court complaints. During this period, 27 health professionals received court sentences. Health professionals liability insurance premium is calculated 0.8-3.5 percent of the insurance valuation. In 2012-2014 total 4377 health professionals insured voluntarily against professional liability.In most developed countries health professionals are protected from sentence to court. Averagecomplaints against health professionals have continued to increase steadily similarly in other countries.Therefore health professional’s professional risk is increasing. It shows that it is very important to improve the legal environment of the liability insurance system for Mongolian health professionals. of coronary atherosclerosis.
ABSTRACT
Background. Due to strengthening of understanding and scope for health service, in different countries of the World, there are wider range of medical specialized trainings newly emerged by quantity and quality. According to the researchers number of factors influence in choice of specialty among medical students and young professionals such as: age, gender, income status, judgement of vocation and prestige. Evaluation on understanding, choice and basic concepts of specialized training, among undergraduate medical stu¬dent and lack of information and research related to thi question lead to motivation and justification of this research. Goal. Goal of this research is to determine the understanding and choice of specialized postgraduate training among medical students. Objectives: 1. To determine the understanding of the basic and specialized vocational training among medical student 2. To determine the choice of the basic and specialized vocational training among medical student 3. To study choice of medical students on basic and specialized vocational training in relation to the needs of health sector. Material and methods. Research has been conducted among 157 medical students of HSUM who are at the 6th year and 74 medical students of Ach Medical institute and used cross-sectional study with quantitative and qualita¬tive descriptive methods. Statistic analysis has been done by SPSS-17 program. Results. 61 students or 26,4% of all participants had a sufficient knowledge about basic and specialized vocational training,where149 or 64,5% had a moderate knowledge, and 21 or 9,1% had an insufficient knowledge. Understanding of duration and fees of basic vocational training were higher than specialized training ( p<0.0001). Source of information of 118 or 51.1% of all participants were from schools and teachers, where 115 or 49.8% were from friends, but information gathered from doctors were more grounded than from other resources. Research shows 207 participants or 89.6% had decided on choice of basic vocational training and 24 participants or 10.4% had not decided yet. If we look into sectors, 53 participants or 25.6% have chosen internal medicine, 51 or 24.6% have chosen surgery, 33 or 15.9% have chosen obstetric and gynecology, 20or 9.6% have chosen ultrasound diagnostics. Among participants, 64.1% have chosen specialized vocational training, and 35.9% were no decision yet. Choice of basic vocational training was determined by gender: internal medicine ( p<0.001), obstetric and gynecol¬ogy (p<0.008), pediatric (p<0.041) were chosen by female students, and surgery(p<0.0001), orthopedic (p<0.007), were chosen by male students, But married students preliminary chosen fields like pediatrics ( p<0.040), imaging diagnostics (p<0.013). Speciality as a general practitioner or family doctor have been chosen by no ne of them. In our country medical specialists in obstetric and gynecology, pediatric, internal medicine, surgery, anaesthesiol¬ogy, intensive care and family medicine are highly in demand. For instance, there are 25 pediatric doctors, 30 anaesthesiologists, 40 gynecologists in need of due to the demand of the first and third maternal hospitals, National child and maternal health center and UB city Health department ( MOH, order 120). 71% of all participants have chosen by their own interest, 59.75% did not have any effort to seek imminent existing post and 67.1% did not know about job description and duties of chosen work. Conclusions: 1. More than half of all participants (64.5% ) have moderate knowledge on basic and specialized vocational train¬ing, and overoll understanding, fees, duration of basic vocational training are higher than of specialized training (p<0.0001). 2. 89.6% of all participants have chosen their basic training and major fields were internal medicine, surgery, ob¬stetric and gynecology, the preliminary choice depend on gender(p<0.001, p<0.0001, p<0.008). Also 64.1% of participants have chosen their specialized training direction 3. 71% of all participants have chosen by their own interest, 59.75% did not have any effort to seek imminent existing post and 67.1% did not know about job description and duties of chosen work.