Abdul Rashid Popal (54) is not allowed to become a GP in Norway. Even if he wants to. It is because he lacks a course, which all GPs must have. The course is called LIS1. – I have applied eleven times, says Popal. Doctors can apply for these positions twice a year. LIS1 is short for “doctor in specialization part one”. But even if there is a shortage of doctors in Norway today, and 235,000 Norwegians lack a GP, there are not enough such course places. 25 years in the industry At a desk in a large shared office at Ullerud health center in Drøbak, Popal points to the computer screen. Here he is employed as a substitute nursing home doctor. He shows off his CV: over 25 years as a doctor, many years as a surgeon, letters of reference from previous employers and a bunch of courses. He is a doctor of medicine, from the Tashkent medical academy in Uzbekistan. He has specialist expertise in gastrosurgery, and has also worked as a surgeon for Doctors Without Borders. In other words, he is overqualified for the job here at the health centre. Popal can point to a number of high-ranking positions and many years of work experience as a surgeon and doctor. Photo: Rolf Petter Olaisen Popal can point to a number of high-ranking positions and a long number of years of work experience as a surgeon and doctor. Photo: Rolf Petter Olaisen He is constantly praised for this CV. But in Norway it is not enough. – Do you have the LIS1 course, they ask me. No I have not. LIS1: Doctor in specialization (part one) In order for a fully qualified doctor to become a general practitioner, he must have completed the LIS1 rotation. This is the first compulsory part of doctors’ special education. The LIS1 service replaced the traditional rota service for doctors as of September 2017. The LIS1 service lasts for 18 months, with 12 months in hospitals and 6 months in municipal health and care services. The LIS positions are advertised in the Directorate of Health’s job portal by the health organizations in collaboration with the municipalities. There are two appointment rounds per year, split half in autumn and spring. 01/09/2021 was the start of 544 for doctors in the LIS1 rotation. On an annual basis, this corresponds to 1,088 positions. In spring 2021, there were 1,240 applicants for 544 LIS1 positions. 45 percent of the applicants were offered a position. Sources: Norwegian Medical Student Association, Directorate of Health, The Norwegian Medical Association. Competing with newly graduated doctors Every time these treatment positions are advertised, approximately half are rejected. Many newly graduated doctors also want this course. So many people are in the same boat as Popal. Although the politicians want to solve the GP crisis with NOK 690 million in the state budget, they also propose to cut 31 annual LIS1 positions. Popal has only been called to one job interview since 2017. He believes there should be separate rules for doctors from abroad. In its proposal for the national budget, the Storting asked the government to look more closely at exactly this, so that doctors like Popal can have their experience approved. Before moving to Norway, Popal worked as a gastrosurgeon in “Doctors without borders”. Photo: Rolf Petter Olaisen Before moving to Norway, Popal worked as a gastrosurgeon in “Doctors without borders”. Photo: Rolf Petter Olaisen The GP crisis So even though Norway is in a GP crisis, and even though Popal has years of experience and not least the will to want to contribute, he does not get the opportunity. He himself calls it differential treatment and age discrimination. – One of the most frustrating things is that you don’t even get feedback. On the one hand I am overqualified, on the other I am underqualified. I don’t know what else I can do, says Popal. Popal also has a letter of recommendation for an LIS1 position from a former employer in the Norwegian healthcare system. Photo: Rolf Petter OlaisenPopal also has a letter of recommendation for an LIS1 position from a former employer in the Norwegian healthcare system. Photo: Rolf Petter Olaisen Bottleneck The head of the Norwegian Medical Student Association, Maja Elisabeth Mikkelsen, has a simple explanation for the problem: – The number of LIS positions does not meet the need at all. The association believes that Norway needs 150 more such positions per year, 350 if Norway is to stop bringing in doctors from abroad. Mikkelsen says that the doctors call this a bottleneck – a paradoxical problem. – Now you almost have to have work experience as a doctor to get a LIS1 position. This course is supposed to be a beginner’s position for doctors, where you get guidance, says Mikkelsen. In 2019, Norway announced 950 such training positions. Today, this figure is 1,150, but Mikkelsen explains that this figure is still not high enough. Leader of the medical student association blames the bottleneck on political will. Photo: Legeforeningen Leader of the medical student association blames the bottleneck on political will. Photo: The medical association news has spoken to several of the newly graduated medical students who were rejected for this autumn’s positions. They do not dare to speak about the problem, at the risk of it ruining the next time they apply. Gradual improvement Confronted with the LIS problem, the Directorate of Health points out that there have been 200 new positions since 2019. – So there is an improvement, but the number of LIS1 positions is a budget issue that lies outside the Directorate of Health’s authority, says divisional director Sissel Husøy. They will not comment on the case of Popal. Division director of the Directorate of Health, Sissel Husøy, says the challenges with LIS1 positions are budget issues. Photo: Thomas Marthinsen Divisional director of the Directorate of Health Sissel Husøy says the challenges with LIS1 positions are budget issues. Photo: Thomas Marthinsen – But is it okay that Popal has to go through a “beginner’s course” in order to work as a GP? – We are working to improve the LIS1 scheme and we have proposed several measures for doctors with extensive clinical experience from abroad. Husøy also does not want to comment that several newly qualified doctors are afraid to speak out. 18 months of paperwork During the past few years, Popal has worked as a supervising physician in the Oslo area. Here he worked alongside several doctors in LIS1 positions. – I asked one of them what an LIS doctor did when he was at work. He told me that he had mostly been writing income journals for 18 months. The employees at Ullerud helsebygg hope on Popal’s behalf that he will get through to an LIS1 position. Photo: Rolf Petter Olaisen The employees at Ullerud helsebygg hope on Popal’s behalf that he will get through to an LIS1 position. Photo: Rolf Petter Olaisen Popal wants to make it clear that he has great respect for the young doctors who have gone through years of theory, and now need to get out into practice. – But that’s not what they get. We need to start using the resources we have.
ttn-69
The surgeon Abdul is not allowed to work as a GP in Norway – news Oslo and Viken – Local news, TV and radio
