Health Systems in Transition

Health systems in transition

Portugal

in November), graduates undertake a general internship for 12 months

(

Ano Comum

), including 3 months of training in the primary care setting

(general practice and public health), and 9 months of training in the hospital

setting (Internal Medicine, Paediatrics, General Surgery and an optional

internship). On completion of the general internship, graduates are placed in

their postgraduate training positions, according to the results that they achieved

on the national examination: the results determine the order by which the

positions – medical specialties and formative institutions – are taken. At the

completion of the first year of training, junior doctors are free to practice

without supervision. The duration of specialized training is determined by the

specialist colleges of the Medical Association and varies according to different

medical specialties: medical (i.e. hospital non-surgical) specialties: 5 years;

surgical specialties: 6 years; general practice/family medicine and public health:

4 years. Specialists must be skilled in the diagnostic and treatment procedures

of their own specialty and must be proficient in related techniques. They also

have to carry out research and publish scientific articles, which are evaluated

in curriculum analysis. After recognition of their aptitude, they can apply for a

hospital position or go on to private practice.

Nurses

In Portugal, there have been no nursing auxiliaries or equivalents, since the

1980s. Currently, there are 31 public and 19 private nursing schools offering

general nursing training, some of which offer two courses per year.

Nurses graduate after 4 years of university-level training as general nurses

and are able to provide general nursing care in every health care context (hospital

or primary care). In order to do that, they must register with the Portuguese

Nursing Association. To become a specialist nurse, nurses have to enrol in

at least 2 years of general nursing practice and must attend a specialization

course (

Cursos de Pós-Licenciatura de Especialização em Enfermagem

)

offered by nursing schools (Ordinance No. 268/2002, of 13 March 2002). This

specialized training comprises theoretical and in-service training in the area of

specialization and is of 900 hours duration (approximately three semesters). The

only exception is midwifery training, which lasts at least 18 months full-time

with the obligation of conducting at least 40 normal deliveries. The vacancies

are determined by each nursing school offering the specialized training.

Currently, there are seven areas of specialization:

•

mental health and psychiatry

•

community health

•

midwifery