Assistant Doctors Project – Estonia (EstMSA)

Name of the activity: Assistant Doctors Project

Country/NMO: Estonia (EstMSA)

Program: Health Systems


Contact information: [email protected]

Type of the activity: Education


General description:

Most of the students work as assistant doctors during the summer (when they have enough time and when the need for help is highest), some students also work all year round. They can be placed into any department provided the student has had the corresponding clinical rotations. EstMSA is the main administrator for the system, we hold the feedback surveys and are in contact with the government, hospitals and doctors if need be. A great deal of advocacy goes into generating the necessary changes on a national level.

Focus area:

Health System Innovation

Problem statement:

The project aims to adress the problem, that medical students do not have a lot of opportunities to do practical work during their studies. Before this project, our students could only work in hospitals as assistant nurses, which is not enough for aquiring practical skills. The other issue this project aims to tackle, is the lack of workforce in hospitals during the summer.

Target groups and beneficiaries:

This activity was designed to the benefit of medical students and healthcare facilities. Our target groups are medical students in Estonia, Estonian hospitals and general practitioners. Beneficiaries are the same groups as students will gain knowledge and skills, hospitals and GPs will have a bigger workforce, and in the future, better prepared young doctors. Beneficiaries are also the patients, who receive more detailed care and in turn their satisfaction benefits the hospitals.

Objectives and indicators of success:

1. The system is working – by the summer of 2011 the government has passed a law that allows the first assistant doctors to work in Estonian hospitals (achieved 16.12.2016).
2. Working as an assistant doctor is a natural part of becoming a doctor in Estonia – by 2020 60% of the final year medical students have worked as assistant doctors, by 2020 90% of assistant doctors have worked in a healthcare facility in Estonia.
3. The system is efficient – by 2018 a law has been passed that allows assistant doctors to have access to our e-Health system and can write preliminary prescriptions from their own information system account (achieved 03.03.2017).
4. The system is sustainable – by 2020 the system has funding from the government.
5. The system gets positive feedback from both students and employers – every year at least 70% of students and healthcare facilities rate satisfaction with the system at least 4 or higher (on a 5 step scale).


Working together with the government, mainly the Ministry of Social Affairs, hospitals, the Estonian Medical Doctors Union, and the Estonian General Practitioners Union, we set up the details of the system and the Ministry of Social Affairs managed to pass a law to allow students to take part in giving medical services. Continuous work with the same parties to develop further towards our goals.

Plans for evaluation:

The changes and developments can be assessed step by step – if we have identified the problem, we communicate it to the relevant parties (e.g. the Ministry of Social Affairs) and the final step would be a change in the laws (as has been already accomplished) or a budget and funding for the system. Every year we ask the students and healthcare facilities to fill a survey, where they can assess the satisfaction with the system and give input to what needs to be changed or developed further.

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