Translation:
The representative of the AT committee claims (SvD Debatt, June 11th) that the government's initiative for fast-tracking is based on a simplified perception of the problems facing newly arrived physicians. This is not true. Elimination unnecessary delays is, in no way, in conflict with keeping the standards as high as before.
In the three-part dialogue carried out with the relevant employers, labour unions, and authorities and departments, none has suggested lowering the ability requirements for physicians or any other profession.
The problems we have identified, and are now developing solutions for, are among other things a deficient assessment of competence early in the process. The same goes for the shortage of possibilities to learn professional Swedish early and high thresholds for getting a good introduction to Swedish healthcare. There are also difficulties gaining admission to the desired supplementary education for non-EU/EEA medical graduates, currently offered at three universities.
A tangible problem, which the government has already taken an initiative to solve, are the long delays at the National Board of Health and Welfare (NBHW, in Swedish "Socialstyrelsen") which currently are about 11 months for the first step of the process for non-EU/EEA medical graduates. The NBHW has been granted additional funding of 10 million SEK during 2015 to solve the problem.
A serious problem is the division of responsibility between different parties. Today the Swedish state is responsible, through the Swedish Public Employment Service (SPES, in Swedish "AF"), for providing information and political labour market efforts. The NBHW is responsible for validation of education and other decisions in the process. The municipalities arrange language education at Swedish For Immigrants (SFI) and Komvux. The employers announce AT positions and decide whether to offer trial services and employment. The universities manage the one-year supplementary education.
The lack of structure and the fractured responsibility primarily affect the applicants, but also entail a socioeconomic waste of resources. Thusly, it is a very complex situation that needs to be addressed through simplification.
The Swedish National Audit Office (SNAO, in Swedish "Riksrevisionsverket") directed criticism (RIR 2011:16) at the past government in 2011 for not implementing the changes demanded by previous propositions and commissions. This government has now taken the initiative for a three-part dialogue with parties concerned to develop constructive solutions.
The figures presented by the AT committee, showing that more fail at the AT test, are highly relevant och support that there is a need for more efficient management. That it takes a long time from completed medical education to finally being able to take the AT exam could account partially for the lowered performances. It is also true that there are possibilities to work as an unlicensed physician after going through the AT internship. These rules are the same for Swedish-educated and foreign-educated. If physicians, regardless of origin, pose a patient security risk, the employer should naturally inform the NBHW which can then revoke the permission.
A shortened time to employment would mean a more intact professional knowledge. Faster application management and knowledge validation, profession-adapted language education and improved possibilities to get a good introduction to Swedish healthcare would elevate both the professional and the linguistic competence. Today's lack of a well thought out and efficient path to Swedish medical license makes the path unnecessarily long and complex.
