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  1. Process of RecognitionForeign Degree Holders Cases Committee Foreign Degree Holders (CBGV) Advicecommittee to the Minister of Health in the Netherlands Warsaw, Poland, January 14th 2003, mr. Niels P. Wijkhuijs, secretary CBGV

  2. Midwife Iran (CASE 1) Diploma (1992):female, Iran nationality, refugee Shedid Beheshti University in Iran (four years) “Bachelor of science” Practical Experience: • 1992-1993: Clinical centre in Iran (obligatory social service) • 1994: license • 1994-1998: midwife clinic in Iran Nuffic (Naric) educational level about four years (non-university) higher education Decision of the Committee Foreign Degree Holders • Entrancelevel of the training: about the same level • The education does not compare with the training level in the Netherlands • Lacks training in skills with characteristic elements of the Dutch training: riskselection and policy, organization of medical care, homedeliveriy, independent professional practise. These elements are of essential importance to practise midwivery in the Netherlands • Curriculum contains subjects like “physical education”, “foreign language”, ”Farsi”, “Islamic culture”, “Persian literature” and “history of Islam”

  3. Midwife Iran (CASE 1) Decision of the Committee Foreign Degree Holders • Practical experience: • no practical experience in the last five years • difference between Iranian and Dutch practice on riskselection and policy, homedeliveries and independent professional practise: no compensation Advice from the Committee Foreign Degree Holders • Not equivalent: no level by training and experience that is equivalent or almost equivalent to that of a Dutch midwife • Advice to send her to a educational institute for additional training, based on the Dutch requirements. It’s up to these institutes to decide on the level of entrance into the training. • A good working knowledge of the Dutch language is essential for working in health care. The diploma “Dutch as a second language (NT2-II) is required for an additional training but – according to the Committee – not enough for working is health care. Decision from the Minister of Health Not yet!

  4. Nurse Belgium (I) (CASE 2) Diploma (2000):male, Belgium nationality Provincial Secondary School in Belgium (three years) “Psychiatric Nurse” Practical Experience: • 2000 – to-day: in Holland as an “assistant-nurse” Nuffic or Colo (Naric) no advice asked Decision of the Committee Foreign Degree Holders • At least ten years general education? Yes. • The committee has made inquiries about his education and professional experience in a talk with the applicant • Three years secondary vocational training in the direction ‘psychiatric nurse’: comparable to the “old” Belgium training en does not compare to Dutch requirements (based on EU-directive and ‘Qualified for the future’). • No practical workperiod during the training on mental disabilities, rest of practical workperiods: short and apparantly no practical practice in a general hospital. • Restricted areas: no clarity on nursetechnical actions during the training.

  5. Nurse Belgium (I) (CASE 2) Decision of the Committee Foreign Degree Holders • Practical experience: the practical experience is of recent date but of a short period Advice from the Committee Foreign Degree Holders • According to 92/51/EU (General System): essential differences • Adaptation period or aptitude test (choice applicant): in case of an adaptation period, the committee advises to let this consist of professional practice in de categories ‘clinical care’ (especially oncology), ‘maternity, ‘child and youthcare’ and ‘homecare’. Decision from the Minister of Health By adjustment of the European Sectoral Directive 77/452/EU – by 2001/19/EU – this diploma is put newly on the list of diplomas (automatically recognized). The date of this diploma is before this adjustment. The applicant has some professional experience, but not “three out of five” (required rights). If he can hand over an declaration from the Belgian Authorities, stating that his training meets with the European requirements of 77/452/EU, he will be registered into the BIG-register.

  6. Nurse Belgium (II) (CASE 3) Diploma (1996):female, Belgium nationality Department Childnursing, Katholic Higher Education Institute Kempen in Belgium’: “Graduate Childnurse” Practical Experience: • 1997-2001: in Belgium as a childnurse Nuffic or Colo (Naric) no advice asked Decision of the Committee Foreign Degree Holders • At least ten years general education? Yes. • Comparison: Three years of training in the direction ‘child nurse’ does not compare to Dutch requirements (based on EU-directive and ‘Qualified for the future’): the training does not include the carecategories: psychiatry, geriatry, mental disabilities, chronically ill and homecare.

  7. Nurse Belgium (II) (CASE 3) Decision of the Committee Foreign Degree Holders the practical experience is of recent date but only in the fields of neonatology and pediatry (onesided). Attention! In the file a declaration (November 2002) from the Belgian Authorities was included, stating that this training was of at least three years higher education as foreseen in 89/48/EU (General System). After the applicant found out that the Committee was to conclude ‘essential differences’, the applicant send in a new declaration (November 2003) from the Belgian Authorities, stating that this diploma replaces the diploma of ‘Graduate hospitalnurse’ as on the list of Sectoral Directive 77/453/EU Advice from the Committee Foreign Degree Holders • According to 89/48/EU (General System): essential differences • Adaptation period or aptitude test (choice applicant) • Gather Information from the Belgian Authorities about the two different declarations on the General System and the Sectoral Directive. Decision from the Minister of Health Not yet!

  8. Nurse Uruguay (CASE 4) Diploma (2000):female, Uruguayan nationality • public Medical Higher Education Institute (registered nurse A), not finished • 18 months vocational secondary training (nurse B, ‘carenurse’) • Three and a half years training ‘registered nurse A’ at private Medical University in Montevideo, Uruguay. Practical Experience: • As “carenurse”: 1996-2000 • As ‘registered nurse A’ since January 2001 Nuffic or Colo (Naric) no advice asked Decision of the Committee Foreign Degree Holders • At least ten years general education? Yes. • The committee has made inquiries about the education and professional experience in a talk with the applicant • Based on both trainings: theoretical and practical hours (and total) compare to Dutch requirements (based on EU-directive and ‘Qualified for the future’). • The carecategories ‘clinical care’, ‘surgery’, ‘psychiatry’, ‘homecare’ are included, but to a lesser level.

  9. Nurse Uruguay (CASE 4) Decision of the Committee Foreign Degree Holders • Practical experience: the practical experience is of recent date and partly compensates the differences in training Advice from the Committee Foreign Degree Holders Almost equivalent to the Dutch training: the applicant can be registered in the BIG-register under a clause of working for half a year under supervision in psychiatry and for half a year under supervision in a general hospital. The recent professional experience of the applicant compensates the carecategory of ‘homecare’ in the training. Besides: the applicant wants to work at a department ‘Internal kidneydialysis’ in a hospital ‘homecare’ not needed. Decision from the Minister of Health Almost equivalent, claused registration in the BIG-register: half a year supervision ‘psychiatry’ and half a year supervision ‘general hospital’.

  10. Nurse Cuba (CASE 5) Diploma (1994):male, Ethiopian nationality, refugee • Three years training ‘Nursing Technician’, Health Polytechnical Institute in Cienfuegos op Cuba. • Additional training of one year in anesthesia. Practical Experience: • 1995/1996: parttime as ‘anesthesia and resuscitation’-nurse. Nuffic or Colo (Naric) no advice asked Decision of the Committee Foreign Degree Holders • At least ten years general education? Yes (probably). • Not enough theoretical and practical hours (and total) compare to Dutch requirements (based on EU-directive and ‘Qualified for the future’). • The carecategories ‘geriatry’, ‘mental disabilities’, ‘chronically ill’ are included in the training. • The additional training in anesthesia is one-sided and doen’t compensate the differences in training.

  11. Nurse Cuba (CASE 5) Decision of the Committee Foreign Degree Holders Practical experience: the practical experience is not of recent date and only parttime for the period of a year. Because of obscurities, the committee has made inquiries about the education and professional experience in a talk with the applicant Advice from the Committee Foreign Degree Holders Based on the documents and the talk with the applicant: not equivalent to the Dutch training: the applicant can not be registered in the BIG-register: the training is mainly technical, carecategories are missing, no patientcontact and no independent practical practice. No compensation by professional experience. • Advice to send him to a training institute for additional training, based on the Dutch requirements. It’s up to these institute to decide on the level of entrance into the training. • A good working knowledge of the Dutch language is essential for working in health care. The diploma “Dutch as a second language (NT2-II) is required for an additional training but – according to the Committee – not enough for working is health care. Decision from the Minister of Health Not equivalent, send to training institute for additional training

  12. Nurse Denmark (CASE 6) Diploma (September 8th 1978):female, Danish nationality ‘Sygeplejerske’ (Danish language) Practical Experience: • 1979-1988 fulltime nurse in Denmark • 1988-1996 parttime nurse in Denmark • since 1996: no practical experience Nuffic or Colo (Naric) no advice asked Decision and advice of the Committee Foreign Degree Holders no advice asked by Minister of Health First decision from the Minister of Health Diploma ‘Sygeplejerske’ is listed in Sectoral Directive 77/452/EU, but her diploma dates before the mentioned date of June 27th 1979. The applicant has professional experience but not of recent date; no clause “three out of five” (required rights) Offer: to participate in a specific course for nurses with a diploma from before the mentioned date

  13. Nurse Denmark (CASE 6) Second decision from the Minister of Health • Based on the newly given information by the applicant and juridical advice, the minister states that a declaration by the Danish authorities – stating that this training meets with the EU-requirements – is also sufficient for automatic recognition in the BIG-register. • Such a statement is given by the Danish authorities and added to the file • The applicant can be registered in the BIG-register • Additional advice to take part in the specific course for nurses, because of her lackof professional experience in recent years. Appeal Claim: compensation for the damage (no work in the Netherlands), caused by the unnecessary belated decision by the Minister of Health. • appeal dismissed Higher appeal • compensation allowance for the clerkcosts – no other compensation – because the ‘right term’ of four months was not mentioned in the information, send by the Minister of Health.

  14. Nurse Romania (CASE 7) Diploma (1988):female, Romanian nationality • ‘Diploma de Bacalaureat, profilul Sanitar’ • ‘Certificat de absolvire a Scolli Postliceale, specialitatea Asistent Medical Generalist’ Practical Experience: • Seven years on a department ‘neurosurgery’ in Romania • Parttime in Italy in ‘homecare’ and in a home for ‘psycho-geriatic en psychiatric patients’ • Since December 2002: as ‘carenurse’ in the Netherlands. Nuffic or Colo (Naric) no advice asked Decision of the Committee Foreign Degree Holders Both trainings together don’t meet the required hours and carecategories in the Netherlands. The conclusion would be to reject her application: not equivalent. Based on additional information about the professional experience and copies of certificates of courses, the applicant was invited for a talk with the applicant It appeared that her diplomas were acknowledged and registered in Italy (EU- member).

  15. Nurse Romania (CASE 7) Decision and advice of the Committee Foreign Degree Holders The fact that the applicant is registered in Italy, based on an acknowledgment of her Romanian diplomas in Italy (no Italian diploma), means that a decision has to be made by the Minister of Health within three months. Advice of the Committee Foreign Degree Holders Still in progress: at present juridical talks on two separate ways essential differences? not equivalent? • adaptation period send to training institute • aptitude test for additional training

  16. Information & questions: Mr. N. (Niels) P. Wijkhuijs secretary Committee Foreign Degree Holders PO Box 16114 2500 BC The Hague The Netherlands Telephone: 0031-70-3406156 Fax: 0031-70-3405105 E-mail: np.wijkhuijs@minvws.nl Website: www.buitenlandsediplomahouders.nl (English pages under construction)