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By: Dr. Maciek Godycki-Cwirko, family physician and co-ordinator in
Regional Training Unit for Family Physicians
Country and health care structure
The Republic of Poland is a country of 312 685 square kilometres with
38.6 million inhabitants in 1997, of whom nearly two thirds live in urban
areas. The country is divided into 16 voivodships.
Up to 1991 health care services were state organized and centralized.
The 1991 Health Care Institutions Act allowed for different types
of ownership of health care organizations, health care institutions became
autonomous registered organizations or 'independent units' responsible
for their own budgets and service decisions.
From January 1999, 16 regional and 1 national autonomous health insurance
funds replaced tax funded centralized structure for financing of public
health care.
Primary health care
The primary care system was in the past 40 years based on a network
of health service units located where people live, work or study. Until
recently, there was no concept of a family physician or general practitioner.
In the 3300 primary health care centres in the country in 1998, primary
care physicians were mainly specialists in internal medicine, obstetrics/gynaecology
or paediatrics. In rural areas, primary care was provided through small
polyclinics or outpatient centres staffed by an internal medicine specialist,
an obstetrician–gynaecologist, a paediatrician, a dentist, a midwife,
nursing and ancillary staff. In the smaller villages, the primary health
care centre could consist of one doctor and a nurse. In urban areas, primary
care services were provided in large polyclinics, which also housed some
specialist services and diagnostic facilities. Emergency care was provided
by district ambu-lance services and in emergency care units.
Since 1991 a family medicine model with primary care organized around
individual or group physician practices has been dicussed. To support
this new model the College of Family Physicians in Poland was set up in
Warsaw in 1992. Since 1993 specialist training in family practice has
begun and since 1995 primary health care has been provided by growing
number of group practices or by family practitioners on contract with
the health insurance funds.
Family doctors are contracted on a capitation basis, taking care of
patients who have registered on their lists.
Human resources, education and training
Poland had 2.4 doctors per 1000 inhabitants in 1996 and is regarded
as having too many specialists with more than three specialists for every
primary care doctor.
There are eleven Medical Schools in the country. Undergraduate medical
education lasts for 6 years followed by a compulsory pre-registration
year internship. Vocational training (residency) in family medicine takes
four years, with a shorter retraining course for physicians who are already
internal medicine specialists, pediatricians, surgeons or gyneacologists.
Residents spend about one third of the whole training period in family
physicians surgeries.
To get the family physician diploma they need to pass the speciality
exam, which consist of 4 parts: multiple choice question test, objective
structured clinical exam, communication skills exam and oral exam.
Country co-ordinator for Poland:
Maciek Godycki-Cwirko
Regional Traininig Unit for Family Physicians
Medical University of Lodz
Ul. Kopcinskiego 20
90-153 Lodz, Poland
E-mail: maciekgc@krysia.uni.lodz.pl
Poradnia Lekarzy Rodzinnych
Honorata Bluszczyk, Katarzyna Kosiek & Maciek Godycki-Cwirko
ul. Pomorska 96
91-402 Lodz
Phone: 0+48+42 678 16 95
Geography
Lodz is the second biggest city in the country with the population
of about 850 000 inhabitants. It is located almost exactly in the geographical
center of Poland, what makes it an excellent point for planning sightseeing
escapades. It is 1486 km east from Paris and 1471 km east from London.
Clinic, doctors and staff
Our clinic is situated in a refurbished facility in urban area near
local church, post office and shops and near by hospital. It has about
4000 patients registered, who are taken care of by three family doctors.
Even though the clinic is computerized we still use paper records. It
is a teaching practice and usually we have two residents and medical students
on premises. There are also three nurses, one of them being also midwife.
We take medical care of local secondary school (lyceum) with about 500
students. We are also involved in research activities.
Accomodation
At present we are not able to offer any accommodation in our houses
but will assist in getting one in the academic hotel. There is also low-cost
accommodation available in youth hostels.
Contact
If you are interested in a two-week stay at our practice, please contact
us by phone or e-mail:
Dr. Maciek Godycki-Cwirko
Phone 0+48+42 678 16 95;
e-mail: maciekgc@krysia.uni.lodz.pl
Praktyka Lekarzy Rodzinnych
Anna Bucior & Krystyna Chudziak
ul. Prymasa Stefana Wyszynskiego 41a
22-400 Zamosc
Phone: 0+48+84 639 26 83
Geography
Zamosc is a town in the southeastern part of Poland in a picturesque
region called Roztocze. Full of historical monuments it has been included
in the UNESCO World Heritage list.
Clinic, doctors and staff
Our practice is situated in one of the new housing estates in the
city. It has about 5000 patients, who are taken care of by two family
doctors, Dr. Anna Bucior and Dr. Krystyna Chudziak. At the time being
there are two residents, Wioletta Biernacka and Tomasz Winniczuk. There
are also four nurses and one midwife. Our doctors and nurses are constantly
improving their qualifications by attending courses, medical conferences
or continuing their studies.
We cooperate with hospitals and other medical practices in Zamosc as well
as with the local government and social organizations.
Accomodation
We can offer accommodation for two persons in our houses (free).
There are also hotels in Zamosc: 1 day stay costs approx. 80-216,00 PLN
for single-bed room , or 140-280,00 PLN double bed room (including breakfast).
Contact
If you are interested in a two-week stay at our practice, please contact
us by phone or e-mail:
Dr. Krystyna Chudziak
Mobile phone: 0+48-606338146;
Phone 0+48+84 6396580;
e-mail: kryszam@poczta.wp.pl
Dr. Tomasz Winniczuk
Mobile phone: 0+48-604214189;
e-mail: Winniczuk@hoga.pl
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