Success in licensing examinations of doctors from outside the European Economic Area: experiences from Finland 1994-2009.

In the licensing process in Finland, of the doctors who have taken their medical degree outside the EU/EEA, a certificate of a language test in Finnish or Swedish is demanded. The Department of General Practice at the University of Tampere takes care of the licensing examinations, including two written medical knowledge tests and clinical skills assessment. The doctors have to prove that they can manage as primary care physicians. In this study, the aim was to investigate the performance of doctors in the licensing examinations. There were 746 doctors in all who had participated in the examinations during 1994-2009. Their success in the exams and numbers of attempts were studied in connection with demographic data. Over half of the participants had passed all three tests and about one-fifth of them had passed them on the first attempt. Gender was the only factor that was associated with good outcome, women being significantly better than men. The Finnish licensing system of non-EEA doctors is equal for all participants. Experienced general practitioners act as evaluators. The purpose is to make responsible assessments of the competency of the doctors, also taking into account the possibility that some doctors may continue to other EEA countries and start practice on the basis of the Finnish licensure.

Good pregnancy outcome despite intrahepatic cholestasis.

OBJECTIVE: Pregnant women complaining of itching are screened for intrahepatic cholestasis (ICP) by laboratory tests in primary healthcare. Cases of ICP are referred to specialist care. In Finland, ICP occurs in 1% of pregnancies. The aim was to study the outcome of deliveries. Design. Retrospective study of ICP pregnancies. Data were collected from the hospital discharge register, patient records, and the labour register. SETTING: The region of Tampere University Hospital in Finland. SUBJECTS: Altogether 687 ICP cases from 1969 to 1988 and two controls for each. Main outcome measures. ICP patients were compared with controls in terms of mother's age, pregnancy multiplicity, weeks of gestation at delivery, frequency of induction and Caesarean section, length of ward period, child's weight, Apgar scores, and stillbirth. RESULTS: For ICP patients, the risk for hospital stay of 10 days or more was eightfold (OR 8.41), for gestational weeks less than 37 at delivery sevenfold (OR 7.02), for induction threefold (OR 3.26), for baby's low weight at birth almost twofold (OR 1.86), and for Caesarean section one and a half fold (OR 1.47). The possibility of the incidence of multiple pregnancy was two and a half fold (OR 2.49, 95%). ICP was not associated with mother's age, the baby's risk of stillbirth, or low Apgar scores. CONCLUSION: ICP mothers are found and taken care of appropriately, and thus ICP is only a minor risk for mothers and their children.