On completion of basic medical training, the new professional may undergo additional theoretical and practical internship to become certified in a particular field. The theoretical part takes place in practice within the universities.
The practical internship takes place with internship supervisors approved by the FPS Public Health (see internship supervisor approval section above). Depending on the specialties, this additional training can last between three and six years, at the end of which the specialist physician in training can request approval in the desired specialty (e.g. orthopaedic surgery, etc.). After this specialisation, the specialist physician can take further training to acquire an additional qualification such as intensive care or clinical haematology.
Specialist physicians in training are called MSFs.
FUNDING FOR PRACTICAL INTERNSHIP
Since the conclusion of a collective agreement in May 2021, all MSFs have the same minimum basic pay in hospitals in Belgium. Their salaries are funded as follows:
- by the fees they generate by performing procedures;
- by the funding allocated to hospitals in the budget of financial resources.
In addition, the internship supervisor also receives compensation for the educational component of the internship, via NIHDI.
For more information about remuneration: www.health.belgium.be
QUALITY OF THE PRACTICAL INTERNSHIP
The MSF internship quality project is being conducted in several phases. Its ultimate goal is to improve the quality of internship, in particular through the implementation of a new internship quality monitoring system.
ANALYSIS OF THE QUALITY SYSTEM IN DIFFERENT COUNTRIES
The Federal Centre of Health Care Expertise (KCE) published a report in 2010 entitled "Critères de qualité pour les lieux de stage des candidats-médecins généralistes et candidats-spécialistes". This report compares the quality system of internship sites in Belgium with those in France, Canada, the United Kingdom, Switzerland and the Netherlands.
To incorporate the innovations made since 2010, the training quality assessment and improvement project team conducted a similar exercise comparing the quality systems of these different countries.
It was concluded that Belgium has taken few concrete steps towards a quality system, while other countries are still developing. The best practices from other countries will be used in the development of a new quality system.
E-BROCHURE FOR MSFS
In March 2022, the FPS launched an e-brochure for MSFs. It aims to inform MSFs of the complex division of competencies, the legislation and the structures available in the event of problems during internship.
It provides support and answers questions that MSFs often face during their internship.
Consult this brochure: www.macs-aso.be
Key players in training were interviewed to help conceptualise a quality system. They included MSFs, internship supervisors and coordinating internship supervisors.
These questionnaires allowed us to evaluate the current situation and have a vision of the future of the internship.
The questions were based on the existing legislation and the criteria of the WFME (World Federation of Medical Education), as well as on the systems of other countries and feedback from the representatives of the assistants' associations and the members of the "Medical Specialists" working group of the Superior Council of Specialist Physicians and General Practitioners.
The results, collected in June 2022, were analysed throughout the summer. A report is being prepared and will be sent to the Minister of Health's office at the end of the year with recommendations. This report will then be published.
THE FUTURE OF MSF INTERNSHIP
Based on the survey results, a step-by-step plan will be developed to improve the quality of training. This will also require the adaptation of the current legislation.