Future competence requirements in doctor s work

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1 Future competence requirements in doctor s work Sami Heistaro MD PhD MBA Head of Education Finnish Medical Association Helsinki, 21 September 2017

2 Sami Heistaro Education MD, Univ Helsinki, 1998 PhD, Univ Helsinki, 2002 Specialist in Public Health Medicine, 2004 MBA, HSE, 2008 Positions KTL (THL) Post Doc Australia , USA 2007 Part-time clinical work Pharmaceutical Industry Private Health Care Sector FMA Nov 2014 present Positions of trust in many organisations (e.g. LKS, HYY, NLY, FMA >20 years) Local politics, City of Helsinki 2000-

3 About the FMA (est. in 1910) Tasks: Advance the medical profession Unite doctors as a professional community Safeguard doctors interests Promote health and the best interests of the patient Defend humanity and ethical values in Finland and internationally Appr. 92% of physicians living in Finland are members of the FMA members, of whom medical students (in 2017)

4 The FMA promotes medical education at all levels Basic medical education: the FMA works in close collaboration with the five medical faculties (Helsinki, Turku, Oulu, Tampere and Kuopio) to ensure the quality of education Specialist workforce planning Internet-based tool My speciality to help young doctors in the choice of speciality CME/CPD: Recommendation for minimum of 10 days annually for every doctor Leadership training for specialist doctors Special competences: 32 areas, 2709 competences awarded; competence in medical education the most popular (242)

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6 Suomen Lääkäriliitto Finnish Medical Association Lääkärit Suomessa Physicians in Finland 6 Tilastotietoja lääkäreistä ja terveydenhuollosta 2016 Statistics on physicians and the health care system 2016

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8 New medical students in QUALITY OF EDUCATION?

9 Educational methods Source: FMA Student Survey 2014 Ryhmäopetus Luento-opetus Small groups Lectures Itsenäinen opiskelu Verkko-opiskelu Potilaiden kohtaaminen ja tutkiminen ohjattuna Potilaiden kohtaaminen ja tutkiminen itsenäisesti Kliinisten toimenpiteiden tekeminen ohjatusti Kliinisten toimenpiteiden tekeminen itsenäisesti Minor clinical operations, self- 0 % 20 % 40 % 60 % 80 % 100 % guided Toivon vähemmän Määrä on sopiva Toivon enemmän En osaa sanoa Patients, guided Patients, self-guided Minor clinical operations, guided

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12 Are you planning to come and work in Finland after your graduation? (n=214) yes no does not know yet kyllä ei en osaa vielä sanoa Sweden / Ruotsi 29% 5% 66% Estonia / Viro 81% 19% Latvia 84% 16% Other / Muut 71% 5% 24% Total / Yhteensä 62% 3% 35% 0 % 10 % 20 % 30 % 40 % 50 % 60 % 70 % 80 % 90 % 100 % Source: FMA Student Survey 2016

13 PHYSICIAN 2013 Survey among doctors under 70 years of age

14 Would you still aim to be a doctor if you were about to start your studies now? 2008 Kyllä 90 % Kyllä 83 % Kyllä 78 % Kyllä 75 % Kyllä 75 % Kyllä 78 % Jos nyt olisit aloittamassa opintojasi, ryhtyisitkö lääkäriksi? Lääkäri 2013

15 How does your basic medical education correspond to your actual work as a doctor (in 2013)? (respondents graduated in ) Very/Quite Well Average Quite/Very Poor Melko tai erittäin hyvin Kohtalaisesti Melko tai erittäin huonosti Helsinki (n = 257) 39 % 42 % 19 % Turku (n = 222) 46 % 37 % 17 % Oulu (n = 203) 33 % 44 % 23 % Kuopio (n = 204) 47 % 41 % 12 % Tampere (n = 195) 48 % 36 % 16 % 0 % 20 % 40 % 60 % 80 % 100 % Vuosina valmistuneiden lääkärien näkemys peruskoulutuksen ja nykyisen työn vastaavuudesta koulutusyksikön mukaan (%) Lääkäri 2013

16 How much training did you receive for the following duties during your basic medical education? ( far too little or too little ) Hallinnollinen työ Oman työn kehittäminen Sosiaaliset kysymykset Management Developing own work Social Affairs Eettiset kysymykset Preventio Ethical questions Prevention Sairaalalääkärin työ % Hospital Work Missä määrin sait peruskoulutuksessasi opetusta seuraaviin tehtäviin? Vuosina valmistuneiden lääkärien (n = ) vastausten jakauma vastausvaihtoehtojen aivan liian vähän tai liian vähän osalta (%). (respondents graduated in , n=1,066-1,078) Lääkäri 2013

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18 Contents of medical studies Which competencies are absolutely needed to be able to work as a doctor at the day of graduating from medical school? and what can be left out of basic medical studies, perhaps to be studied during specialisation (PGT), or as CME/CPD?

19 Continuum MD PGT Life Long Learning (CME, CPD)

20 Specialities estimates towards 2030 In total 50 specialities in Finland Source: FMA

21 Example: Too Many Plastic Surgeons in relation to estimated need in 2030 Selvityshenkilön arvio Plastiikkakirurgia Koulutustarve Koulutus /vuosi Lääkäreitä 2030 Lääkäreitä 2030 / as Hyks 24 1,6 56 2,6 Tyks 11 0,7 18 1,9 Tays 10 0,7 20 1,7 Kys 6 0,4 16 2,0 Oys 7 0,5 13 1,7 Yhteensä 58 3, ,1 Erikoisalakohtainen koulutustarve/vuosi Hyks Tyks Tays Kys Oys Yht. v Plastiikkakirurgia 1,7 0,7 0,7 0,4 0,5 4 6 Source: Ministry of Social Affairs & Health

22 What shall I be (when I get old)? Website Erikoisalani.fi ( My Speciality ) Established in January 2016 A total of visits during the first year ( different persons)

23 Trends in Health Care Technological development Changes in population demographics Changes in disease profiles Improving treatments Personalized medicine, genomics Role of the patient growing Increasing choice of freedom Citizens demands and expectations Inequalities in the population, need of adjusted messages Division of work between medical, nursing, paramedical, social etc. professions SOTE reform, changes in SOTE funding, public economies Cross-border HC (in EU) Telemedicine, ehealth, mhealth Priorization in HC? When and how? International developments vs. trends in Finland

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25 Future Physician Work Changes needed in the curricula and in the training after it? Basic medical education (6 years) Specialization (5 to 6 years) CME / CPD Changes in the role and every-day work of a doctor? How should we be prepared? Predicting the future is making the future

26 Potential roles for a doctor in the future Physician 2030 Project FMA

27 Old time GP Future GP Accessibility, long-term contacts with patient and their families Focus in comprehensive approach for each patient Process controller, gatekeeper Responsible for accurate and up-to-date information of the patient

28 Coach Coaching individuals and groups of people Empowerment of the patient crucial, setting goals together with the patient Interpreting and communicating relevant and correct information to the patient High competence for motivating and communication necessary

29 Innovator Doctors strongly involved in IT and other technological research and development, multiprofessional teams Entrepreneurship, team work skills and a positive attitude for collaboration elementary

30 Data Analyst / Effectiviness Specialist Analysing data on invidual as well as population level Decides on resource focusing in order to maximize desired output (=health) Operates mainly in the background, does not usually meet patients physically Utilizes data sources and techonology in a souverain manner

31 Skilled Specialist Operative specialist, a member of a multiprofessional team Most probably work in highly specialized centers of excellence Clinical skills, ability for quick decision making

32 Protector of Humanity Speaks for the weakest, missionary of hope Carries professional responsibility and is influential in society Can work in the health & social care system or e.g. in the 3rd sector, media or politics Broad societal view and high ability to collaborate

33 Key competencies suggested (not dependent on the speciality area chosen) Communication skills, ethics, multiprofessionalism, leadership, team work, new tools for data search, data utilization skills, economics, new service models, e-services, service processes, and dynamics of professional roles... in addition to purely medical items.

34 The purpose of the Physician 2030 Project is To increase awareness of the change Support individual doctors to think about what is coming, with a positive approach and curiosity Challenge doctors to develop their own work in order to be ready for the future Well-being in work and in life is the big goal

35 Summary In all learning and education quality first Life-long learning MD PGT CME/CPD A broader view on competencies needed Adaptation to continuous change

36 Support (from) your colleagues for the best of the patient. 36

37 THANK YOU! - KIITOS!