Circular No. 21/2020/TT-BYT guides the practice for issuing a professional practice certificate for general medical doctors.

CIRCULAR

Guidelines for practical training to issue a practice certificate for general medical examination and treatment

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Pursuant to the Law on Medical Examination and Treatment No. 40/2009/QH12;

Pursuant to the Decree No. 109/2016/NĐ-CP dated July 1, 2016 of the Government on issuing practice certificates for practitioners and operating permits for medical examination and treatment facilities;

Pursuant to the Decree No. 155/2018/NĐ-CP dated November 12, 2018 of the Government amending and supplementing certain regulations related to investment and business conditions within the scope of management of the Ministry of Health;

Pursuant to the Government's Decree No. 75/2017/NĐ-CP dated June 20, 2017 stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;

At the proposal of the Director of the Department of Medical Examination and Treatment;

The Minister of Health issues this Circular guiding practical training to issue a practice certificate for general medical examination and treatment for medical doctors.

Chapter 1

GENERAL PROVISIONS

Article 1. Scope of Regulation, Scope and Applicability

1. This Circular stipulates the content and organization of practical training for medical examination and treatment to issue a practice certificate for general medical examination and treatment for medical doctors, and responsibilities for implementation.

2. This Circular does not apply to dentists, traditional medicine doctors, preventive medicine doctors, other specialty doctors, or individuals with a bachelor's degree in medicine who have been trained according to the provisions of Clause 2 and 3, Article 5 of Circular No. 42/2018/TT-BYT dated December 26, 2018 issued by the Minister of Health. Practical training for these positions to issue a practice certificate will be carried out according to another Circular issued by the Minister of Health.

3. This Circular applies to agencies, organizations, and individuals related to practical training to issue a practice certificate for general medical examination and treatment for medical doctors.

Article 2. Principles of Practical Training

1. The content of practical training for medical doctors (holders of a medical doctor degree, general medical doctor degree, or a bachelor's degree in medicine who has been trained according to the provisions of Circular No. 42/2018/TT-BYT dated December 26, 2018 issued by the Minister of Health to be recognized as a medical doctor) must be consistent with the training program, occupational competency standards for general medical doctors, and the scope of professional activities of general medical doctors as prescribed in Circular No. 35/2019/TT-BYT dated December 30, 2019 issued by the Minister of Health (hereinafter referred to as Circular No. 35/2019/TT-BYT).

2. Practitioners (medical doctors) may perform medical examination and treatment techniques directly on patients under the supervision of the practical training instructor (the practical training instructor must meet the conditions specified in Clause 3, Article 16 of Decree No. 109/2016/NĐ-CP).

3. Practitioners must strictly follow the guidance of the practical training instructor. Practitioners must ensure that they complete all practical training content and ensure a total practical training period of 18 months. In cases where practical training must be suspended due to maternity leave, accidents, or other force majeure reasons, the practical training period can be accumulated but interrupted for no more than six months.

4. In cases where civil servants or employees are recruited by medical examination and treatment facilities to work in professional positions without a practice certificate for medical examination and treatment, such recruited individuals must also sign a practical training contract with the medical examination and treatment facility and be assigned a practical training instructor according to the provisions of this Circular.

5. Assignment of practical training instructors must ensure compatibility in terms of professional expertise and capability.

Chapter 2

CONTENT OF PRACTICAL TRAINING FOR MEDICAL EXAMINATION AND TREATMENT

Article 3. Construction and issuance of practical content

Based on the framework of practical content prescribed in Article 4 of this Circular, the practical guidance facility (general hospitals that have been granted permission to operate in accordance with the Law on Medical Examination and Treatment) shall construct and issue detailed practical content suitable for the capacity and conditions of each facility but must ensure the principles stipulated in Article 2 of this Circular.

Article 4. Framework of Practical Content and Duration of Practical Medical Examination and Treatment

1. The practical content of medical examination and treatment is based on the standard competency criteria for general practitioners issued by the Minister of Health under Decision No. 1854/QD-BYT dated May 18, 2015; knowledge and skills acquired at specialized medical schools for general practitioners and medical doctors, and within the scope of professional activities of general practitioners as prescribed in Clause 1 of Article 4 of Circular No. 35/2019/TT-BYT.

2. The total duration of practical medical examination and treatment is 18 months, allocated according to each specialty as follows:

a) Duration of internal medicine specialty practice including emergency resuscitation: 5 months;

b) Duration of surgery specialty practice: 3 months;

c) Duration of obstetrics and gynecology specialty practice: 3 months;

d) Duration of pediatrics specialty practice: 4 months;

e) Duration of practice of certain techniques from other specialties (otolaryngology, stomatology, ophthalmology, dermatology, rehabilitation, traditional medicine, and other techniques as specified in Circular No. 35/2019/TT-BYT): 3 months.

Chapter 3

ORGANIZATION OF PRACTICAL MEDICAL EXAMINATION AND TREATMENT

1. Annually, based on the needs of those requiring guidance in practice and the capacity to accept practitioners, the practical guidance facility must develop a Guidance Practice Plan.

2. The Guidance Practice Plan includes the number of practitioners that the facility can accept in a year; the number and list of guidance practitioners; cooperation guidance contracts (if any). In cases where the practical guidance facility does not have all the required specialties as stipulated in Article 4 of this Circular, the facility may enter into cooperation contracts with other practical guidance facilities that have those specialties.

3. The practical guidance facility must submit its annual Guidance Practice Plan to the Ministry of Health or the Provincial Health Department before January 31, according to the management hierarchy, for consolidation, monitoring, and management of guidance practice activities. At the same time, the practical guidance facility must publicly post the plan on its website.

4. The Ministry of Health and Provincial Health Departments must consolidate the Guidance Practice Plans of practical guidance facilities under their jurisdiction, and publish the information on the Ministry of Health's official website and the Provincial Health Department's website.

Article 6. Acceptance of Practitioners and Signing of Practical Training Contracts for Medical Examination and Treatment

1. The training institutions must accept practitioners according to the publicly announced practical training plan. In case of non-acceptance, they must provide a written response to the practitioner, clearly stating the reasons.

2. The training institution shall sign a practical training contract for medical examination and treatment with the practitioner in accordance with Clause 1, Article 16 of Decree No. 109/2016/NĐ-CP.

Article 7. Assignment of Training Supervisors

1. The head of the training institution must assign training supervisors to practitioners in accordance with Clause 2, Article 16 of Decree No. 109/2016/NĐ-CP.

2. Where multiple training supervisors are assigned to one practitioner, the scope of supervision and specific training times for each supervisor must be clearly defined.

3. Where the training institution has a cooperation agreement on practical training with another institution, the head of that other institution must assign specific training supervisors in writing according to each specialty.

Article 8. Monitoring, Management, Evaluation of the Practical Training Process, and Confirmation of the Practical Training Process

1. The training institution must designate functional units to monitor, supervise, and manage the practical training activities of the institution.

2. The direct training supervisor evaluates and comments on the practical training process of the practitioner according to the contents specified in the Practical Training Evaluation and Comment Form attached to this Circular. Such evaluation and comment must be conducted immediately after the practitioner completes each practical activity. The supervisor who guides a particular content must comment on that content.

3. Based on the Practical Training Evaluation and Comment Form, the head of the medical examination and treatment institution issues a Certificate of Practical Training Process to the practitioner according to Model 02 stipulated in Appendix I of Decree No. 109/2016/NĐ-CP.

Article 9. Costs of Practical Training

1. Training institutions determine the practical training costs based on the principle of accurately and fully calculating costs for practical training, ensuring revenue covers expenses; accounting, income and expenditure, settlement, and finalization must comply with legal regulations.

2. The training institution must publicly announce the costs of practical training on its electronic information website.

3. The training institution must inform those requiring practical training about the costs of practical training and clearly state them in the Practical Training Contract for Medical Examination and Treatment according to Model 02 stipulated in Appendix V of Decree No. 109/2016/NĐ-CP.

Chapter 4

RESPONSIBILITIES FOR IMPLEMENTATION

Article 10. Responsibilities of Practitioners

1. Adhere to the internal rules and regulations of the training institution.

2. Comply with professional regulations and rules of the training institution and follow the guidance of the training supervisor.

3. Ensure patient safety during the practical training process and maintain confidentiality regarding patient information and medical examination and treatment institutions during the practical training process.

4. Fulfill the obligations stated in the Practical Training Contract for Medical Examination and Treatment. Pay all practical training costs for medical examination and treatment as agreed upon in the Practical Training Contract with the training institution.

5. Practitioners may not sign prescriptions or sign in patient treatment records. They may not perform procedures or techniques without permission from the training supervisor.

Article 11. Responsibilities of the Practical Training Instructor

1. Adhere to the practical training guidance assignment from the head of the practical training facility.

2. In cases where the instructor's expertise is exceeded or for legitimate reasons, the practical training instructor may refuse to provide guidance and must report this to the head of the practical training facility.

3. Ensure patient safety during the practical training process. Bear responsibility when the trainee causes a professional error during practice that affects the patient's health due to the instructor's fault.

4. Monitor, evaluate, and comment on the results of the trainee's practical work according to the assigned content and be responsible for the content of their comments.

Article 12. Responsibilities of the Practical Training Facility

1. Develop the practical training content of the facility and establish a Practical Training Plan.

2. Organize practical training activities according to the practical training content and the Practical Training Plan of the facility.

3. The practical training facility shall issue a Certificate confirming the practical training period for those who have completed the training period based on the evaluation of the practical training instructor as stipulated in Clause 4 of Article 11 of this Circular.

4. Report annually on the practical training activities of the practical training facility:

a) Practical training facilities under the Ministry of Health, and practical training facilities under other ministries and sectors (except the Ministry of National Defense) shall report on the practical training situation to the Ministry of Health (Department of Medical Examination and Treatment).

b) Practical training facilities under the People's Committee of Health, and private hospitals shall send reports to the People's Committee of Health where the practical training facility is located.

Chapter 5

IMPLEMENTING PROVISIONS

Article 13. Effective Date

1. This Circular takes effect from January 15, 2021.

2. Repeal the provision: "In the case of a general physician, they shall register for practical training in one of the four specialties of internal medicine, surgery, obstetrics and gynecology, or pediatrics, or register for practical training in one of the systems of internal-pediatric or surgical-obstetric. If practicing according to a system, the total practical training time is 18 months, with at least 9 consecutive months in each specialty within the system" as stipulated in Article 15 of Circular No. 41/2011/TT-BYT.

Article 14. Transitional Provisions

1. Physicians currently undergoing practical training for medical examination and treatment before the effective date of this Circular shall continue to follow the provisions of Article 15 of Circular No. 41/2011/TT-BYT.

2. For general physicians wishing to obtain a professional practice certificate with a scope of activity being either internal medicine, surgery, obstetrics and gynecology, or pediatrics, they shall register for practical training in one of these four specialties for a period of 18 months as prescribed by laws on medical examination and treatment.

Article 15. Reference Provisions

In cases where referenced documents in this Circular are replaced or amended, the replaced or amended documents shall apply.

Article 16. Implementation Organization

1. The Ministry of Health assigns the Department of Medical Examination and Treatment to direct, guide, inspect, supervise, and urge the implementation of this Circular. The Department of Science, Technology and Training, various Departments, the Office of the Ministry, the Inspectorate of the Ministry, and the Departments and General Departments under the Ministry of Health shall cooperate in implementing practical training work within their respective areas of responsibility.

2. The Director of the People's Committee of Health, the Heads of health agencies under ministries and sectors shall be responsible for organizing the implementation of this Circular within their respective jurisdictions. During the implementation of this Circular, if there are difficulties or obstacles, it is requested that relevant agencies, organizations, and individuals report to the Ministry of Health (Department of Medical Examination and Treatment) for consideration and resolution.

During the implementation of this Circular, if there are difficulties or obstacles, it is requested that relevant agencies, organizations, and individuals report to the Ministry of Health (Department of Medical Examination and Treatment) for consideration and resolution./.