AGREEMENTON THE RECOGNITION OF PROFESSIONAL QUALIFICATIONS OF NURSES, VETERINARY SURGEONS, PHARMACISTS, AND MIDWIVES IN THE CENTRAL EUROPEAN FREE TRADE AGREEMENT CONTEXT("Off. Herald of RS - Treaties", No. 8/2024) |
Preamble
The representatives of Albania, Bosnia and Herzegovina, Kosovo*, Montenegro, North Macedonia and Serbia (hereinafter referred to as "Parties")
__________
* This designation is without prejudice to positions on status, and is in line with UNSCR 1244/1999 and the ICJ Opinion on the Kosovo declaration of independence.
In the context of economic integration, pursuant to the Central European Free Trade Agreement ("CEFTA 2006"), in line with Article V of the General Agreement on Trade in Services and for purposes of furthering the liberalisation of trade in services within the CEFTA.
Having in mind the goals and priorities stipulated by the Common Regional Market Action Plan 2021-2024 ("CRM") aimed at removing obstacles to the recognition of professional qualifications, by adopting and implementing a "European Union (EU) framework for automatic recognition of professional qualifications for 7 professions and the EU system of automatic recognition" based on the coordination of minimum training conditions;
Noting that no provision of this Agreement may be interpreted as to exempt the Parties from their respective rights and obligations under existing treaties;
Aiming to encourage the mobility of professionals, better matching of skills with labour marketneeds and increased productivity;
Underlining the objectives of promoting regulatory harmonisation and approximating the laws and regulations of the Parties with European Union (EU) law; in particular seeking toenable free movement of professionals by transposing into the regional framework Directive 2005/36/EC of the European Parliament and of the Council of 7 September 2005 on the recognition of professional qualification, as amended by Directive 2013/55/EU of the European Parliament and of the Council of 20 November 2013.
Intending to establish the automatic recognition of professional qualifications based on minimum training requirements and to apply it to all 4 professions laid down in this Agreement and the aforementioned Directive and to appoint the professions which satisfy the appliance of the minimum training requirements within the Annexes in not more than 2-year time (in addition to the other three professions listed in the Agreement on the recognition of professional qualifications of doctors of medicine, doctors of dental medicine and architects in the Central European Free Trade Agreement context, done on 3.11.2022).
Have agreed as follows:
GENERAL PROVISIONS
Article 1
1. This Agreement establishes the rules on automatic recognition of evidence of formal qualifications based on minimum training conditions within Parties for access to and performance of the regulated profession, as well as harmonized minimum training conditions in one or more other Parties, and which allow the holders of said qualification (hereinafter: professionals) to pursue the same profession in a Party (hereinafter: receiving Party) other than the Party in which they obtained their professional qualifications (hereinafter: referred to as the issuing Party).
Article 2
1. This Agreement shall apply to natural persons, as defined in Annex I of the Additional Protocol 6, as professionals of the issuing Party wishing to pursue a regulated profession in a receiving Party contingent upon the harmonized minimum training conditions, on either a self-employed or employed basis. Each Party will allow a professional of the issuing Party, in possession of evidence of professional and formal qualifications within the meaning of Article 3(1)(b) which are not obtained in the receiving Party to pursue a regulated profession within the meaning of Article 3 (1)(a) within such a Party in accordance with its rules and relevant legislation. This recognition shall respect the minimum training conditions laid down in this Agreement. If evidence of formal qualification is not in line with the minimum training conditions, as laid down in this Agreement, the recognition of professional qualification shall be subject to a General system of recognition.
2. This Agreement applies to the following professionals: nurses, veterinary surgeons, midwives, and pharmacists, as defined and listed in Annex I, Annex II, Annex III, and Annex IV, respectively.
3. Each Party shall submit to the Joint Working Group on Recognition of Professional Qualifications the laws, regulations and administrative provisions, which it adopts with regard to the issuing of evidence of formal qualifications in the professions covered by this Agreement.
4. For the purpose of implementation and application of this Agreement, higher education institutions shall have accredited study programmes and/or licensed study programmes harmonized with the minimum training requirements laid down in the Annexes of this Agreement.
Article 3
1. For the purposes of the present Agreement, the following definitions apply:
a) "regulated profession": a professional activity or group of professional activities, access to which, the pursuit of which, or one of the modes of pursuit of which is subject, directly or indirectly, by virtue of legislative, regulatory or administrative provisions to the possession of specific professional qualifications; in particular, the use of a professional title limited by legislative, regulatory, or administrative provisions to holders of a given professional qualification shall constitute a mode of pursuit;
b) "professional qualifications": qualifications attested by evidence of formal qualifications, an attestation of competence issued by a competent authority in the Party designated pursuant to legislative, regulatory or administrative provisions of that Party, on the basis of either a training course or a specific examination, and/or professional experience;
c) "evidence of formal qualifications": diplomas, certificates and other evidence issued by an authority of a Party designated pursuant to legislative, regulatory or administrative provisions of that Party and certifying successful completion of professional training obtained mainly in a Party;
d) "competent authority": any authority or body empowered by a Party specifically to issue or receive training diplomas and other documents or information and to receive the applications, and take the decisions, referred to in this Agreement;
e) "regulated education and training": any training which is specifically geared to the pursuit of a given profession and which comprises a course or courses complemented, where appropriate, by professional training, or probationary or professional practice.
f) The structure and level of the professional training, probationary or professional practice shall be determined by the laws, regulations or administrative provisions of the Party concerned or monitored or approved by the authority designated for that purpose;
g) "professional experience": the actual and lawful full-time or equivalent part-time pursuit of the profession concerned in a Party;
h) "professional traineeship": a period of professional practice carried out under supervision provided it constitutes a condition for access to a regulated profession, and which can take place either during or after completion of an education leading to a qualification;
i) "natural person" as defined in the CEFTA framework
j) "European Credit Transfer and Accumulation System or ECTS credits": the credit system for higher education used in the European Higher Education Area;
k) The Joint Working Group on for the Recognition of Professional Qualifications (JWGRPQ);
l) "CEFTA": Central European Free Trade Agreement;
m) "RCC": Regional Cooperation Council.
Article 4
The recognition of professional qualifications by the receiving Party shall allow natural persons to gain access in that Party to the same profession as that for which they are qualified in the issuing Party and to pursue it in the receiving Party under no less favourable conditions as its natural persons.
PRINCIPLES OF RECOGNITION
Article 5
Rules related to professional, statutory or administrative nature
Where a professional moves, the professional shall be subject to professional rules of a professional, statutory or administrative nature which are directly linked to professional qualifications, such as the definition of the profession, the use of titles and serious professional malpractice which is directly and specifically linked to consumer protection and safety, as well as disciplinary provisions which are applicable in the receiving Party to professionals who pursue the same profession in receiving Party.
Article 6
Principles of automatic recognition
1. Each Party shall recognize evidence of formal qualifications as nurse responsible for general care, as veterinary surgeon, as midwife, and as pharmacist, listed in Annex I, Annex II, Annex III, and Annex IV, respectively, which satisfy the minimum training conditions referred to in Annex I, Annex II, Annex III, and Annex IV, respectively, and shall, for the purposes of access to and pursuit of the professional activities, gives such evidence the same effect, as the evidence of formal qualifications, which it itself issues.
Such evidence of formal qualifications must be issued by the competent bodies in the issuing parties and accompanied, where appropriate, by the certificates listed in Annex I, Annex II, Annex III, and Annex IV, respectively.
2. Such updates shall not entail an amendment of existing essential legislative principles in Parties regarding the structure of professions as regards training and conditions of access by natural persons. Such updates shall respect the responsibility of the Parties for the organisation of education systems.
Article 7
The Parties shall, in accordance with the procedures specific to each Party, ensure, by encouraging continuous professional development, that professionals, whose professional qualification is covered by this Agreement, are able to update their knowledge, skills and competences in order to maintain a safe and effective practice and keep abreast of professional developments.
Article 8
Without prejudice to the acquired rights specific to the professions concerned, in cases where the evidence of formal qualifications as nurse responsible for general care, as veterinary surgeon, as midwife, and as pharmacist of the Parties, does not satisfy all the training requirements referred to in this Agreement, each Party shall recognise as sufficient proof evidence of formal qualifications issued by those Parties insofar as such evidence attests successful completion of training, which began at dates to be proposed by the Joint Working Group and is accompanied by a certificate stating that the holders have been effectively and lawfully engaged in the activities in question for at least three consecutive years during the five years preceding the award of the certificate.
PROCEDURE FOR THE RECOGNITION OF PROFESSIONAL QUALIFICATIONS
Article 9
Common procedure for the recognition of professional qualifications
1. The receiving Party shall acknowledge the receipt of the application within 30 days of receipt and inform the applicant of any missing document. If the applicant does not submit the supplement to the documentation, the competent body will reject the application as incomplete, unless the candidate justifies the reasons for missing the deadline.
2. The procedure for examining an application for authorization to practice a regulated profession must be completed as quickly as possible and lead to a duly substantiated decision by the competent authority in the receiving Party in any case within three months after the date on which the applicant’s complete file was submitted, and in these events, reasons shall be explained in the recognition decision.
3. The decision, or failure to reach a decision within the deadline, shall be subject to appeal according to the general rules of each Party.
Article 10
The recognition of professional qualifications shall encompass the possibility to resort to an effective recourse mechanism for the applicant. In the case that the recognition is not granted, the applicant must have recourse to an authority, which is differently composed to the one having refused the demand. That authority will decide the appeal after having given the applicant the possibility to be heard within a reasonable period of time.
Article 11
Documents and certificates which may be required of the applicant in accordance with this Agreement
1. Documents
a) Proof that a person concerned is a natural person of a Party.
b) Evidence of formal qualifications giving access to the regulated profession in question, as listed in Annex I, Annex II, Annex III, and Annex IV, respectively.
c) Evidence of professional qualification within the meaning of Article 3(1)(b), accompanied with the certificate of the competent authority stating that the professional has been effectively and lawfully engaged in the activities in question for at least three consecutive years during the five years preceding the award of the certificate.
d) Where the competent authority of a receiving Party requires of persons wishing to take up a regulated profession proof that they are of good character or repute or that they have not been declared bankrupt, or suspends or prohibits the pursuit of that profession in the event of serious professional misconduct or a criminal offence, that receiving Party shall accept as sufficient evidence, in respect of applicants from Parties wishing to pursue that profession, the production of documents issued by competent authorities in the issuing Party, showing that those requirements are met. Those authorities must provide the documents within a period of two months.
e) Where the competent authorities of the issuing Party do not issue the documents referred to in the first subparagraph, such documents shall be replaced by a declaration on oath - or, in Parties where there is no provision for declaration on oath, by a solemn declaration - made by the natural person concerned before a competent judicial or administrative authority or, where appropriate, - or qualified professional body of the issuing Party; such authority - shall issue a certificate attesting the authenticity of the declaration on oath or solemn declaration.
f) Where a receiving Party requires of its own professional wishing to take up a regulated profession, a document relating to the physical or mental health of the applicant, that Party shall accept as sufficient evidence thereof the presentation of the document required in the issuing Party. Where the issuing Party does not issue such a document, the receiving Party shall accept a certificate issued by a competent authority in that Party. In that case, the competent authorities of the issuing Party must provide the document required within a period of one month.
g) Where a receiving Party requires-professionals to take up a regulated profession, the
- proof of the applicant’s financial standing,
- proof that the applicant is insured against the financial risks arising from the professionals’ professional liability in accordance with the laws and regulations in force in the receiving Party regarding the terms and extent of cover, that Party shall accept as sufficient evidence an attestation to that effect issued by the banks and insurance undertakings of another Party.
Where a Party so requires for professionals, an attestation confirming the absence of temporary or final suspensions from exercising the profession or of criminal convictions shall be provided.
2. Other Certificates
To facilitate the application of the present Agreement, the Parties may prescribe that, in addition to evidence of formal qualifications, the natural person, who satisfies the conditions of training required, must provide a certificate from the competent authorities of his or hers and any other issuing Party stating that this evidence of formal qualifications is that covered by the requirements laid down in this Agreement
3. Format and language
All documents and certificates referred to in this article shall be accepted by the competent authority of the receiving Party in the format and language determined by the legislation of the issuing Party. The receiving Party maintains the right to request translation of documents and certificates in one of its official languages by the applicant.
Article 12
1. If, in a receiving Party, the use of a professional title relating to one of the activities of the profession in question is regulated, applicants from the other Party, who are authorised to practise a regulated profession, shall use the professional title of the receiving Party, which corresponds to that profession in that Party, and make use of any associated initials.
2. Where a profession is regulated in the receiving Party by an association or organisation, applicants from Parties shall not be authorised to use the professional title issued by that organisation or association, or its abbreviated form, unless they furnish proof that they are members of that association or organisation.
3. If the association or organisation makes membership contingent upon certain qualifications, it may do so, only under the conditions laid down in this Agreement, in respect of applicants from other Parties, who possess professional qualifications.
Article 13
The receiving Party shall ensure that the right shall be conferred on the natural persons concerned to use academic titles conferred on them in the issuing Party, and an abbreviated form thereof, in the language of the issuing Party. The receiving Party may require a title to be followed by the name and address of the establishment or examining board it was awarded by. Where an academic title of the issuing Party is liable to be confused in the receiving Party with a title which, in the latter Party, requires supplementary training not acquired by the beneficiary, the receiving Party may require the beneficiary to use the academic title of the issuing Party in an appropriate form, to be laid down by the receiving Party.
DETAILED RULES FOR PURSUING THE PROFESSION
Article 14
1. A Party shall, if deemed necessary require from the service provider benefiting from the recognition of the professional qualifications to have sufficient knowledge of languages necessary for practicing the profession in the receiving Party.
2. A Party shall ensure that any controls carried out for controlling compliance with the obligation under paragraph 1 shall be limited to sufficient knowledge of one official language of that Party.
3. Any language controls shall be proportionate to the activity to be pursued. The professional concerned shall be allowed to appeal such controls under the law of the receiving Party.
ADMINISTRATIVE COOPERATION
Article 15
1. The Parties shall ensure that the following information is publicly available in English language and through the contact points for services:
a) a list of all regulated professions in the Party including contact details of the contact persons for each regulated profession according to Article 18(4);
b) the requirements and procedures for all professions regulated in the Party, including all related fees to be paid by natural persons and documents to be submitted by natural persons;
c) details on how to appeal, under the laws, regulations and administrative provisions, decisions of Parties adopted in relation to this Agreement.
2. The Parties shall ensure that the information referred to in paragraph 1 is provided in a clear and comprehensive way and that it is easily accessible remotely and by electronic means and that it is kept up to date.
3. The Parties shall ensure that any request for information addressed to the contact points for services is replied to as soon as possible.
Article 16
Joint Working Group on Recognition of Professional Qualifications
1. The Joint Working Group on Recognition of Professional Qualifications (JWGRPQ) shall facilitate and supervise the implementation and application of this Agreement.
2. Members of the JWGRPQ shall be, inter alia, tasked with provision of information and assistance as is necessary concerning the recognition of professional qualifications provided for in this Agreement, such as information on the legislation, regulations and administrative provisions governing the recognition of professional qualifications.
3. Terms of Reference of the JWGRPQ shall be adopted no later than one year after the adoption of this Agreement.
Article 17
1. The Parties shall notify to the JWGRPQ a list of all existing regulated professions, specifying the activities covered by each profession, and a list of regulated education and training, and training with a special structure, no later than 18 months after the adoption of this Agreement. Any change to those lists shall also be notified to the JWGRPQ without undue delay. The CEFTA and RCC Secretariats shall set up and maintain a publicly available database of regulated professions, including a general description of activities covered by each profession.
2. The Parties shall examine whether requirements under their legal system restricting the access to a profession or its pursuit to the holders of a specific professional qualification, including the use of professional titles and the professional activities allowed under such title, referred to in this Article as ’requirements’ are compatible with the following principles:
a) requirements must be neither directly nor indirectly discriminatory;
b) requirements must be justified by overriding reasons of general interest;
c) requirements must be suitable for securing the attainment of the objective pursued and must not go beyond what is necessary to attain that objective;
d) Parties shall inform the JWGRPQ about findings thereof.
Article 18
Principles of administrative cooperation
1. The Parties shall work in close collaboration and shall provide mutual assistance in order to facilitate implementation and application of this Agreement. They shall ensure the confidentiality of the information which they exchange.
2. Through the JWGRPQ, the Parties shall exchange information which they deem necessary for the pursuit of activities under this Agreement. In so doing, they shall respect personal data protection rules provided for in the relevant legislation of the Parties.
3. Each Party shall exchange information with other Parties through the JWGRPQ on processes by which they will award or receive evidence of formal qualifications and other documents or information, and receive applications and take the decisions referred to in this Agreement.
4. Through the JWGRPQ, each Party shall provide to the other Parties, the name of a contact person for each regulated profession, who will provide all relevant information and support cooperation between the Parties in relation to that specific regulated profession.
FINAL PROVISIONS
Article 19
The Parties shall bring into force the laws, regulations, and administrative provisions necessary to comply with this Agreement at the latest eighteen months from the entry into force of this Agreement according to its Article 21. The Parties shall inform the JWGRPQ thereof.
Article 20
1. All Annexes form an integral part of this Agreement.
2. The information that must be provided by the Parties in Annex I, Annex II, Annex III, and Annex IV, shall be provided by the competent authorities and shall be submitted to the JWGRPQ no later than 18 months after this Agreement has entered into force according to its Article 21.
3. The Parties shall ensure that the information provided in Annex I, Annex II, Annex III, and Annex IV is maintained up to date and amended as necessary by the JWGRPQ in accordance with Article 6(1)(2) of this Agreement.
Article 21
1. This Agreement is subject to ratification, acceptance, or approval in accordance with the relevant requirements. The formal notice of ratification, acceptance, or approval shall be deposited with the Depositary.
2. This Agreement shall enter into force on the thirtieth day upon the deposition of the third formal notice of ratification, acceptance, or approval for the Parties that have deposited their instrument of ratification, acceptance, or approval.
3. For each Party depositing its formal notice of ratification, acceptance, or approval after the date of the deposit of the third formal notice of ratification, acceptance or approval, this Agreement shall enter into force on the thirtieth day after the day on which that Party deposits its formal notice of ratification, acceptance, or approval.
4. North Macedonia shall act as Depositary and shall notify all Parties to this Agreement of any notification received in accordance with this Article and any other act or notification relating to this Agreement.
Article 22
1. Each Party may propose amendments to the Agreement by sending a written notification to the Depositary. The Depositary shall refer this notification to the JWGRPQ referred to in Article 16 of this Agreement.
2. Proposals of amendments shall be adopted by consensus of all members of the JWGRPQ. These proposals shall be referred to CEFTA body responsible for Trade in Services.
3. When adopted, the amendments shall be submitted to the Parties for ratification or approval.
4. Amendments shall enter into force in accordance with the rules and procedure set out in Article 21.
Article 23
1. This Agreement is concluded for an indefinite period of time.
2. Each Party may, at any time, denounce the Agreement by making a written notification to the Depositary, who shall notify the other Parties of this denunciation.
3. Such denunciation shall take effect six months after the date on which the depositary received the notification.
Article 24
All disputes arising from this Agreement will be resolved through the CEFTA 2006 Dispute Settlement Mechanism.
Article 25
The Parties acknowledge the rights of any CEFTA Party to accede to this Agreement.
The Agreement is drawn up in the English language, in, one original version, which will remain in the possession of the Depository. Each party will receive one verified copy of the Agreement.
Done at Tirana, on 16.10.2023.
RECOGNITION ON THE BASIS OF COORDINATION OF THE MINIMUM TRAINING CONDITIONS
NURSES RESPONSIBLE FOR GENERAL CARE
All of the provisions in Annex I are taken from the EU Directive 2005/36/EC on the recognition of professional qualifications as amended by EU Directive 2013/55/EU of the European Parliament and of the Council of 20 November 2013.
Article 1
Training of nurses responsible for general care
1. Admission to training for nurses responsible for general care shall be contingent upon possession of qualification or certificate providing access, for the studies in question, to universities, higher education institutions of a level recognised as equivalent or at vocational schools or through vocational training programmes for nursing.
2. Training of nurses responsible for general care shall be given on a full-time basis and shall include at least the programme described in Article 3 of Annex I.
3. The training of nurses responsible for general care shall comprise a total of at least three years of study, which may in addition be expressed with the equivalent ECTS credits, and shall consist of at least 4 600 hours of theoretical and clinical training, the duration of the theoretical training representing at least one third and the duration of the clinical training at least one half of the minimum duration of the training. Parties may grant partial exemptions to professionals who have received part of their training on courses which are of at least an equivalent level.
The Parties shall ensure that institutions providing nursing training are responsible for the coordination of theoretical and clinical training throughout the entire study programme.
4. Theoretical education is that part of nurse training from which trainee nurses acquire the professional knowledge, skills and competences required under paragraphs 6 and 7. The training shall be given by teachers of nursing care and by other competent persons, at universities, higher education institutions of a level recognised as equivalent or at vocational schools or through vocational training programmes for nursing.
5. Clinical training is that part of nurse training in which trainee nurses learn, as part of a team and in direct contact with a healthy or sick individual and/or community, to organise, dispense and evaluate the required comprehensive nursing care, on the basis of the knowledge, skills and competences which they have acquired. The trainee nurse shall learn not only how to work in a team, but also how to lead a team and organise overall nursing care, including health education for individuals and small groups, within health institutes or in the community.
6. Training for nurses responsible for general care shall provide an assurance that the professional in question has acquired the following knowledge and skills:
(a) comprehensive knowledge of the sciences on which general nursing is based, including sufficient understanding of the structure, physiological functions and behaviour of healthy and sick persons, and of the relationship between the state of health and the physical and social environment of the human being;
(b) knowledge of the nature and ethics of the profession and of the general principles of health and nursing;
(c) adequate clinical experience; such experience, which should be selected for its training value, should be gained under the supervision of qualified nursing staff and in places where the number of qualified staff and equipment are appropriate for the nursing care of the patient;
(d) the ability to participate in the practical training of health personnel and experience of working with such personnel;
(e) experience of working together with members of other professions in the health sector.
7. Formal qualifications as a nurse responsible for general care shall provide evidence that the professional in question is able to apply at least the following competences regardless of whether the training took place at universities, higher education institutions of a level recognised as equivalent or at vocational schools or through vocational training programmes for nursing:
(a) competence to independently diagnose the nursing care required using current theoretical and clinical knowledge and to plan, organise and implement nursing care when treating patients on the basis of the knowledge and skills acquired in accordance with points (a), (b) and (c) of paragraph 4 in order to improve professional practice;
(b) competence to work together effectively with other actors in the health sector, including participation in the practical training of health personnel on the basis of the knowledge and skills acquired in accordance with points (d) and (e) of paragraph 4;
(c) competence to empower individuals, families and groups towards healthy lifestyles and self-care on the basis of the knowledge and skills acquired in accordance with points (a) and (b) of paragraph 4;
(d) competence to independently initiate life-preserving immediate measures and to carry out measures in crises and disaster situations;
(e) competence to independently give advice to, instruct and support persons needing care and their attachment figures;
(f) competence to independently assure the quality of, and to evaluate, nursing care;
(g) competence to comprehensively communicate professionally and to cooperate with members of other professions in the health sector;
(h) competence to analyse the care quality to improve his own professional practice as a nurse responsible for general care.
Article 2
Pursuit of the professional activities of nurses responsible for general care
For the purposes of this Agreement, the professional activities of nurses responsible for general care are the activities pursued on a professional basis and referred to in Article 3 of Annex I.
Parties may provide, in relevant legislation, for partial exemptions from parts of the training programme for nurses responsible for general care listed in Article 3 of Annex I, to be applied on a case-by-case basis provided that that part of the training has been followed already during another specialist training course listed in Article 3 of Annex I, for which the professional has already obtained the professional qualification in a Party. Parties shall ensure that the granted exemption equates to not more than half of the minimum duration of the training course in question.
Each Party shall notify the Joint Working Group and the other Parties of its legislation concerned for any such partial exemptions.
The Parties shall make the issuance of evidence of specialist medical training contingent upon possession of evidence of basic medical training referred to in Article 3 of Annex I.
Article 3
Training programme for nurses responsible for general care
1. The training leading to the award of a formal qualification of nurses responsible for general care shall consist of the following two parts.
A. Theoretical instruction
a. Nursing:
- Nature and ethics of the profession
- General principles of health and nursing
- Nursing principles in relation to:
- general and specialist medicine
- general and specialist surgery
- child care and pediatrics’
- maternity care
- mental health and psychiatry
- care of the old and geriatrics
b. Basic sciences:
- Anatomy and physiology
- Pathology
- Bacteriology, virology and parasitology
- Biophysics, biochemistry and radiology
- Dietetics
- Hygiene:
- preventive medicine
- health education
- Pharmacology
c. Social sciences:
- Sociology
- Psychology
- Principles of administration
- Principles of teaching
- Social and health legislation
- Legal aspects of nursing
B. Clinical instruction
- Nursing in relation to:
- general and specialist medicine
- general and specialist surgery
- child care and paediatrics
- maternity care
- mental health and psychiatry
- care of the old and geriatrics
- home nursing
2. One or more of these subjects may be taught in the context of the other disciplines or in conjunction therewith.
3. The theoretical instruction must be weighted and coordinated with the clinical instruction in such a way that the knowledge and skills referred to in this Annex can be acquired in an adequate fashion.
Article 4
Evidence of formal qualifications of nurses responsible for general care
Party |
Evidence of formal qualifications |
Body awarding the qualifications |
Professional Title |
Reference date |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
VETERINARY SURGEONS
All of the provisions in Annex I are taken from the EU Directive 2005/36/EC on the recognition of professional qualifications as amended by Directive 2013/55/EU of the European Parliament and of the Council of 20 November 2013.
Article 1
Training of veterinary surgeons
1. The training of veterinary surgeons shall comprise a total of at least five years of full-time theoretical and practical study, which may in addition be expressed with the equivalent ECTS credits, at a university or at a higher institute providing training recognized as being of an equivalent level, or under the supervision of a university, covering at least the study programme referred to Article 3 of Annex II.
2. Admission to veterinary training shall be contingent upon possession of a diploma or certificate entitling the holder to enter, for the studies in question, university or higher education institutions recognised to be of an equivalent level for the purpose of the relevant study.
3. Training as a veterinary surgeon shall provide an assurance that the professional in question has acquired the following knowledge and skills:
(a) adequate knowledge of the sciences on which the activities of a veterinary surgeon are based and of the respective Party law relating to those activities;
(b) adequate knowledge of the structure, functions, behaviour and physiological needs of animals, as well as the skills and competences needed for their husbandry, feeding, welfare, reproduction and hygiene in general;
(c) the clinical, epidemiological and analytical skills and competences required for the prevention, diagnosis and treatment of the diseases of animals, including anaesthesia, aseptic surgery and painless death, whether considered individually or in groups, including specific knowledge of the diseases which may be transmitted to humans;
(d) adequate knowledge, skills and competences for preventive medicine, including competences relating to inquiries and certification;
(e) adequate knowledge of the hygiene and technology involved in the production, manufacture and putting into circulation of animal feedstuffs or foodstuffs of animal origin intended for human consumption, including the skills and competences required to understand and explain good practice in this regard;
(f) the knowledge, skills and competences required for the responsible and sensible use of veterinary medicinal products, in order to treat the animals and to ensure the safety of the food chain and the protection of the environment.
Article 2
Acquired rights specific to veterinary surgeons
For the purposes of this Agreement, the evidence of formal qualifications as a veterinary surgeon are the activities pursued on a professional basis and referred to in Article 3 of Annex II.
Parties may provide, in relevant legislation, for partial exemptions from parts of the programme studies leading to the evidence of formal qualifications in veterinary medicine listed in Article 3 of Annex II, to be applied on a case-by-case basis provided that that part of the training has been followed already during another specialist training course listed in Article 3 of Annex II, for which the professional has already obtained the professional qualification in a Party. Parties shall ensure that the granted exemption equates to not more than half of the minimum duration of the training course in question.
Each Party shall notify the Joint Working Group and the other Parties of its legislation concerned for any such partial exemptions.
The Parties shall make the issuance of evidence of veterinary medical training contingent upon possession of evidence of basic medical training referred to in Article 3 of Annex II.
Article 3
Study programme for veterinary surgeons
The programme of studies leading to the evidence of formal qualifications in veterinary medicine shall include at least the subjects listed below.
Instruction in one or more of these subjects may be given as part of, or in association with, other courses.
A. Basic subjects
- Physics
- Chemistry
- Animal biology
- Plant biology
- Biomathematics
B. Specific subjects
a. Basic sciences:
- Anatomy (including histology and embryology)
- Physiology
1. Biochemistry
- Genetics
- Pharmacology
- Pharmacy
- Toxicology
- Microbiology
- Immunology
- Epidemiology
- Professional ethics
b. Clinical sciences:
- Obstetrics
- Pathology (including pathological anatomy)
- Parasitology
- Clinical medicine and surgery (including anaesthetics)
- Clinical lectures on the various domestic animals, poultry and other animal species
- Preventive medicine
- Radiology
- Reproduction and reproductive disorders
- Veterinary public medicine and public health
- Veterinary legislation and forensic medicine
- Therapeutics
- Propaedeutics
c. Animal production
- Animal production
- Animal nutrition
- Agronomy
- Rural economics
- Animal husbandry
- Veterinary hygiene
- Animal ethology and protection
d. Food hygiene
- Inspection and control of animal foodstuffs or foodstuffs of animal origin
- Food hygiene and technology
- Practical work (including practical work in places where slaughtering and processing of foodstuffs takes place)
Practical training may be in the form of a training period, provided that such training is full-time and under the direct control of the competent authority, and does not exceed six months within the aggregate training period of five years study.
The distribution of the theoretical and practical training among the various groups of subjects shall be balanced and coordinated in such a way that the knowledge and experience may be acquired in a manner which will enable veterinary surgeons to perform all their duties.
Article 4
Evidence of formal qualifications of veterinary surgeons
Party |
Evidence of formal qualifications |
Body awarding the evidence of qualifications |
Certificate accompanying the evidence of qualifications |
Reference date |
|
|
|
|
|
MIDWIVES
All of the provisions in Annex I are taken from the EU Directive 2005/36/EC on the recognition of professional qualifications as amended by Directive 2013/55/EU of the European Parliament and of the Council of 20 November 2013.
Article 1
1. The training of midwives shall comprise a total of at least:
(a) specific full-time training as a midwife comprising at least three years of theoretical and practical study (route I) comprising at least the programme described in Article 4 of Annex III, or
(b) specific full-time training as a midwife of 18 months’ duration (route II), comprising at least the study programme described in Article 4 of Annex III, which was not the subject of equivalent training of nurses responsible for general care.
The Parties shall ensure that institutions providing midwife training are responsible for coordinating theory and practice throughout the programme of study.
2. Admission to training as a midwife shall be contingent upon one of the following conditions:
(a) possession of qualification or certificate providing access, for the studies in question, for admission to a midwifery school for route I;
(b) possession of evidence of formal qualifications as a nurse responsible for general care referred to Article 4 of Annex III for route II.
3. Training as a midwife shall provide an assurance that the professional in question has acquired the following knowledge and skills:
(a) detailed knowledge of the sciences on which the activities of midwives are based, particularly midwifery, obstetrics and gynecology;
(b) adequate knowledge of the ethics of the profession and the legislation relevant for the practice of the profession;
(c) adequate knowledge of general medical knowledge (biological functions, anatomy and physiology) and of pharmacology in the field of obstetrics and of the newly born, and also knowledge of the relationship between the state of health and the physical and social environment of the human being, and of his behaviour;
(d) adequate clinical experience gained in approved institutions allowing the midwife to be able, independently and under his own responsibility, to the extent necessary and excluding pathological situations, to manage the antenatal care, to conduct the delivery and its consequences in approved institutions, and to supervise labour and birth, postnatal care and neonatal resuscitation while awaiting a medical practitioner;
(e) adequate understanding of the training of health personnel and experience of working with such personnel.
Article 2
Procedures for the recognition of evidence of formal qualifications as a midwife
1. The evidence of formal qualifications as a midwife referred to Article 4 in Annex III shall be subject to automatic recognition so far as they satisfy one of the following criteria:
(a) full-time training of at least three years as a midwife, which may in addition be expressed with the equivalent ECTS credits, consisting of at least 4 600 hours of theoretical and practical training, with at least one third of the minimum duration representing clinical training;
(b) full-time training as a midwife of at least two years, which may in addition be expressed with the equivalent ECTS credits, consisting of at least 3 600 hours, contingent upon possession of evidence of formal qualifications as a nurse responsible for general care referred to Article 4 in Annex III;
(c) full-time training as a midwife of at least 18 months, which may in addition be expressed with the equivalent ECTS credits, consisting of at least 3 000 hours, contingent upon possession of evidence of formal qualifications as a nurse responsible for general care referred to Article 4 in Annex III, and followed by one year’s professional practice for which a certificate has been issued in accordance with paragraph 2.
2. The certificate referred to in paragraph 1 shall be issued by the competent authorities in the Parties. It shall certify that the holder, after obtaining evidence of formal qualifications as a midwife, has satisfactorily pursued all the activities of a midwife for a corresponding period in a hospital or a health care establishment approved for that purpose.
Article 3
Pursuit of the professional activities of a midwife
1. The provisions of this section shall apply to the activities of midwives as defined by each Party, without prejudice to paragraph 2, and pursued under the professional titles set out in Article 4 of Annex III.
2. The Parties shall ensure that midwives are able to gain access to and pursue at least the following activities:
(a) provision of sound family planning information and advice;
(b) diagnosis of pregnancies and monitoring normal pregnancies; carrying out the examinations necessary for the monitoring of the development of normal pregnancies;
(c) prescribing or advising on the examinations necessary for the earliest possible diagnosis of pregnancies at risk;
(d) provision of programmes of parenthood preparation and complete preparation for childbirth including advice on hygiene and nutrition;
(e) caring for and assisting the mother during labour and monitoring the condition of the fetus in utero by the appropriate clinical and technical means;
(f) conducting spontaneous deliveries including where required episiotomies and in urgent cases breech deliveries;
(g) recognising the warning signs of abnormality in the mother or infant which necessitate referral to a doctor and assisting the latter where appropriate; taking the necessary emergency measures in the doctor’s absence, in particular the manual removal of the placenta, possibly followed by manual examination of the uterus;
(h) examining and caring for the new-born infant; taking all initiatives which are necessary in case of need and carrying out where necessary immediate resuscitation;
(i) caring for and monitoring the progress of the mother in the post-natal period and giving all necessary advice to the mother on infant care to enable her to ensure the optimum progress of the new-born infant;
(j) carrying out treatment prescribed by doctors;
(k) drawing up the necessary written reports.
3. Parties may provide, in relevant legislation, for partial exemptions from parts of the training programme for midwives listed in Article 4 of Annex III, to be applied on a case-by-case basis provided that that part of the training has been followed already during another specialist training course listed in Article 4 of Annex III, for which the professional has already obtained the professional qualification in a Party. Parties shall ensure that the granted exemption equates to not more than half of the minimum duration of the training course in question.
Each Party shall notify the Joint Working Group and the other Parties of its legislation concerned for any such partial exemptions.
The Parties shall make the issuance of evidence of specialist medical training contingent upon possession of evidence of basic medical training referred to in Article 5 of Annex III.
Article 4
Training programme for midwives (Training types I and II)
The training programme for obtaining evidence of formal qualifications in midwifery consists of the following two parts:
A. Theoretical and technical instruction
a. General subjects
- Basic anatomy and physiology
- Basic pathology
- Basic bacteriology, virology and parasitology
- Basic biophysics, biochemistry and radiology
- Paediatrics, with particular reference to new-born infants
- Hygiene, health education, preventive medicine, early diagnosis of diseases
- Nutrition and dietetics, with particular reference to women, new-born and young babies
- Basic sociology and socio-medical questions
- Basic pharmacology
- Psychology
- Principles and methods of teaching
- Health and social legislation and health organisation
- Professional ethics and professional legislation
- Sex education and family planning
- Legal protection of mother and infant
b. Subjects specific to the activities of midwives
- Anatomy and physiology
- Embryology and development of the fœtus
- Pregnancy, childbirth and puerperium
- Gynaecological and obstetrical pathology
- Preparation for childbirth and parenthood, including psychological aspects
- Preparation for delivery (including knowledge and use of technical equipment in obstetrics)
- Analgesia, anaesthesia and resuscitation
- Physiology and pathology of the new-born infant
- Care and supervision of the new-born infant
- Psychological and social factors
B. Practical and clinical training
This training is to be dispensed under appropriate supervision:
- Advising of pregnant women, involving at least 100 pre-natal examinations.
- Supervision and care of at least 40 pregnant women.
- Conduct by the student of at least 40 deliveries; where this number cannot be reached owing to the lack of available women in labour, it may be reduced to a minimum of 30, provided that the student assists with 20 further deliveries.
- Active participation with breech deliveries. Where this is not possible because of lack of breech deliveries, practice may be in a simulated situation.
- Performance of episiotomy and initiation into suturing. Initiation shall include theoretical instruction and clinical practice. The practice of suturing includes suturing of the wound following an episiotomy and a simple perineal laceration. This may be in a simulated situation if absolutely necessary.
- Supervision and care of 40 women at risk in pregnancy, or labour or post-natal period.
- Supervision and care (including examination) of at least 100 post-natal women and healthy new-born infants.
- Observation and care of the new-born requiring special care, including those born pre-term, post-term, underweight or ill.
- Care of women with pathological conditions in the fields of gynaecology and obstetrics.
- Initiation into care in the field of medicine and surgery. Initiation shall include theoretical instruction and clinical practice.
The theoretical and technical training (Part A of the training programme) shall be balanced and coordinated with the clinical training (Part B of the same programme) in such a way that the knowledge and experience listed in this Annex may be acquired in an adequate manner.
Clinical instruction shall take the form of supervised in-service training in hospital departments or other health services approved by the competent authorities or bodies. As part of this training, student midwives shall participate in the activities of the departments concerned in so far as those activities contribute to their training. They shall be taught the responsibilities involved in the activities of midwives.
Article 5
Evidence of formal qualifications of midwives
Party |
Evidence of formal qualifications |
Body awarding the evidence of qualifications |
Professional Title |
Reference |
PHARMACISTS
All of the provisions in Annex I are taken from the EU Directive 2005/36/EC on the recognition of professional qualifications as amended by Directive 2013/55/EU of the European Parliament and of the Council of 20 November 2013.
Article 1
1. Admission to a course of training as a pharmacist shall be contingent upon possession of qualification or certificate providing access, for the studies in question, to universities, higher education institutions of a level recognised as equivalent or an institution under the supervision of a university.
2. Evidence of formal qualifications as a pharmacist shall attest to training of at least five years’ duration, which may in addition be expressed with the equivalent ECTS credits, comprising at least:
(a) four years of full-time theoretical and practical training at a university or at a higher education institution of a level recognised as equivalent, or at an institution under the supervision of a university;
(b) during or at the end of the theoretical and practical training, six-month traineeship in a pharmacy which is open to the public or in a hospital under the supervision of that hospital’s pharmaceutical department.
The training cycle referred to in this paragraph shall include at least the programme described in Article 3 of Annex IV.
3. Training for pharmacists shall provide an assurance that the person concerned has acquired the following knowledge and skills:
(a) adequate knowledge of medicines and the substances used in the manufacture of medicines;
(b) adequate knowledge of pharmaceutical technology and the physical, chemical, biological and microbiological testing of medicinal products;
(c) adequate knowledge of the metabolism and the effects of medicinal products and of the action of toxic substances, and of the use of medicinal products;
(d) adequate knowledge to evaluate scientific data concerning medicines in order to be able to supply appropriate information on the basis of this knowledge;
(e) adequate knowledge of the legal and other requirements associated with the pursuit of pharmacy.
Article 2
Pursuit of the professional activities of a pharmacist
1. For the purposes of this Agreement, the activities of a pharmacist are those, access to which and pursuit of which are contingent upon professional qualifications and which are open to holders of evidence of formal qualifications of the types listed in Article 4 of Annex IV.
2. The Parties shall ensure that the holders of evidence of formal qualifications in pharmacy at university level or a level recognised as equivalent, which satisfies the requirements of Article 1 of Annex IV, are able to gain access to and pursue at least the following activities, subject to the requirement, where appropriate, of supplementary professional experience:
(a) preparation of the pharmaceutical form of medicinal products;
(b) manufacture and testing of medicinal products;
(c) testing of medicinal products in a laboratory for the testing of medicinal products;
(d) storage, preservation and distribution of medicinal products at the wholesale stage;
(e) supply, preparation, testing, storage, distribution and dispensing of safe and efficacious medicinal products of the required quality in pharmacies open to the public;
(f) preparation, testing, storage and dispensing of safe and efficacious medicinal products of the required quality in hospitals;
(g) provision of information and advice on medicinal products as such, including on their appropriate use;
(h) reporting of adverse reactions of pharmaceutical products to the competent authorities;
(i) personalised support for patients who administer their medication;
(j) contribution to local or domestic public health campaigns.
3. If a Party makes access to or pursuit of one of the activities of a pharmacist contingent upon supplementary professional experience, in addition to possession of evidence of formal qualifications referred to Article 3 in Annex IV, that Party shall recognise as sufficient proof in this regard a certificate issued by the competent authorities in the issuing Party stating that the person concerned has been engaged in those activities in the issuing Party for a similar period.
Article 3
Course of training for pharmacists
- Plant and animal biology
- Physics
- General and inorganic chemistry
- Organic chemistry
- Analytical chemistry
- Pharmaceutical chemistry, including analysis of medicinal products
- General and applied biochemistry (medical)
- Anatomy and physiology; medical terminology
- Microbiology
- Pharmacology and pharmacotherapy
- Pharmaceutical technology
- Toxicology
- Pharmacognosy
- Legislation and, where appropriate, professional ethics.
The balance between theoretical and practical training shall, in respect of each subject, give sufficient importance to theory to maintain the university character of the training.
Article 4
Evidence of formal qualifications of pharmacist
Party |
Evidence of formal qualifications |
Body awarding the evidence of qualifications |
Certificate accompanying the evidence of qualifications |
Reference |