The Order of General Nurses, Midwives and Medical Assistants from Romania*

The title of medical assistant is generic and designates a group of professions in the health field other than general nurse or midwife.

The recognition of medical assistant qualification titles obtained in another EU Member State aims to facilitate the right of establishment and the holder's access to the profession on the territory of Romania. The practice of the profession is allowed after obtaining membership in the Order of General Nurses, Midwives and Medical Assistants of Romania (OAMGMAMR), as a result of the recognition stopped qualification.

This procedure does not apply to qualification titles of medical assistant obtained in a state other than those mentioned (third state) nor in the case of temporary or occasional provision of specific health care services in Romania by medical assistants established in one of the other EU Member States.

Procedure description:

• Within 30 days from the registration date, OAMGMAMR notifies the applicant, confirming receipt of the file and, as the case may be, requesting the missing documents.
• Within a maximum of 3 months from the notification, the applicant is obliged to complete the file with all the requested documents. If the applicant does not respect the completion deadline, at its expiration, OAMGMAMR archives the file and informs the applicant in writing to this effect. Within 120 days from submitting the complete file, the OAMGMAMR Commission for the recognition of qualifications as general nurse, midwife, and medical assistant obtained in another EU Member State, in a state belonging to the EEA, or in the Swiss Confederation analyzes the applicant’s education and professional experience and formulates a well-justified proposal regarding the way of resolving the request, as follows:

a) Recognition of the qualification without application of compensatory measures. Based on this proposal, the President of OAMGMAMR issues the decision of qualification recognition.

b) Recognition of the qualification with compensatory measures. This proposal as well as the curricular differences established by the OAMGMAMR Commission for the recognition of qualifications as general nurse, midwife and medical assistant, the associated bibliography and the duration of the adaptation internship are approved by the President of OAMGMAMR and communicated to the applicant within the mentioned 120-day deadline. If the applicant opts to take an aptitude test, the date of the test is set by mutual agreement within a maximum of 6 months from the date the compensatory measure recognition is approved by the President of OAMGMAMR.

The President of OAMGMAMR issues the decision of qualification recognition based on the documents attesting the completion of the compensatory measure by the applicant.

In both situations, the decision to recognize the qualification is communicated to the applicant and the OAMGMAMR branch of his/her domicile, in order to obtain the membership certificate and professional authorization.

The procedure applies to midwives whose training, or, as the case may be, professional experience acquired in another EU Member State, in a state belonging to the EEA or in the Swiss Confederation, meets the recognition criteria for automatic qualification provided for in Directive no. 2005/36/EC on the recognition of professional qualifications. The automatic recognition of the midwife qualification aims to facilitate their access to the profession and, accordingly, to facilitate the exercise of the right of establishment in Romania for the professionals concerned.

This procedure does not apply to midwifery qualifications obtained in a state other than those mentioned (third country) nor to midwives established in any other EU Member State for the purpose of providing temporary or occasional healthcare services specific to the profession in Romania.

The automatic recognition of midwifery qualifications is carried out by the Order of Nurses, Midwives and Medical Assistants of Romania (OAMGMAMR) designated by law as the competent authority for this profession.

Procedure description:

Within 30 days from the date of registration, OAMGMAMR notifies the applicant, confirming receipt of the file and, as the case may be, requesting completion with the missing documents. Within 3 months from the notification, the applicant is required to complete the file with all the requested documents. If the applicant does not comply with the deadline for completion, upon its expiration, OAMGMAMR classifies the file and informs the applicant in writing in this regard.

Within 90 days from the date of submission of the complete file by the applicant, the documents submitted are analyzed by the OAMGMAMR Committee for the recognition of qualifications of general nurses, midwives, and nurses obtained in another EU Member State, a state belonging to the EEA or in the Swiss Confederation, and, based on its thoroughly justified proposal, the President of OAMGMAMR issues the decision for automatic recognition of the midwife qualification.

The decision is communicated to the applicant and to the OAMGMAMR branch of their domicile, for the purpose of obtaining the membership certificate and authorization in the profession. The holder whose midwife qualification has been recognized may register as a member of OAMGMAMR only after proving that they possess the Romanian language skills necessary to carry out professional activities.

After obtaining OAMGMAMR membership, the holder practices as a midwife with the rights and obligations provided by law for Romanian citizen midwives.

​The procedure applies exclusively in the case where midwives who benefit from automatic professional recognition in the territory of the EU, EEA or the Swiss Confederation, established in order to practice the profession in one of these states, travel to the territory of Romania in order to temporarily or occasionally perform midwifery activities.
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Particularities:

The temporary or occasional nature of the provision of midwifery activities is determined, on a case-by-case basis, by the Order of General Nurses, Midwives, and Medical Assistants of Romania (OAMGMAMR), depending on their duration, frequency, periodicity, and continuity. During the provision of services, the midwives concerned:

- exercise the profession on the territory of Romania under the professional title of midwife;

- are exempt from the obligation to register with OAMGMAMR and from paying the membership fee; - are automatically registered with OAMGMAMR during the provision of these services; - are subject to professional, regulatory or administrative provisions regarding professional qualifications and the use of titles, provisions regarding serious professional acts that directly and specifically affect the protection and safety of the beneficiaries of the services provided, as well as the disciplinary provisions provided by law for Romanian citizen midwives, members of OAMGMAMR; - are exempt from the accreditation procedure provided by the health social insurance legislation. The service-providing midwives are required to inform in advance the National Health Insurance House of the services they are about to provide in the territory of Romania, and in emergency situations, within a maximum of 7 days from the provision thereof.

Procedure description:

I. Upon receiving the declaration, OAMGMAMR checks the documents and, if necessary, requests the provider to supply the missing documents; Within 30 days from the submission of the complete file, the applicant's documents are submitted for analysis to the OAMGMAMR Commission for the recognition of general nurse, midwife, and medical assistant qualifications obtained in another EU Member State, in an EEA state or in the Swiss Confederation. Its proposal is submitted to the President who approves the temporary automatic registration with OAMGMAMR of the applicant and the approval for the temporary provision of midwifery services in Romania.

The approval for the temporary provision of midwifery services and respectively the temporary automatic registration with OAMGMAMR is communicated to the applicant and to the OAMGMAMR branch in the territorial district of the healthcare unit where the applicant is to provide the respective services in Romania.

II. In case of renewal of the prior declaration, after checking the temporary and occasional character of the service provision by the OAMGMAMR Commission for the recognition of general nurse, midwife, and medical assistant qualifications obtained in another EU Member State, in an EEA state or in the Swiss Confederation, the President of OAMGMAMR approves the provision of temporary midwifery services and, respectively, the temporary automatic registration of the applicant at OAMGMAMR, within 30 days from receiving the declaration. These are communicated to the applicant and the OAMGMAMR branch in the territorial district of the healthcare unit where the applicant is to provide the respective midwifery services in Romania. In the event of lack of reaction from OAMGMAMR within the deadline specified at points I and II, the services may be provided.

The term "medical assistant" is generic and designates a group of professions in the health field other than those of general nurse and midwife.

The procedure applies exclusively in cases where medical assistants, who intend to practice their profession in another EU Member State, travel to Romania to temporarily or occasionally carry out professional activities.

Particularities:

-The temporary or occasional nature of medical assistant professional activities is determined, case by case, by the Order of General Nurses, Midwives, and Medical Assistants in Romania (OAMGMAMR), depending on their duration, frequency, periodicity, and continuity.

-During the provision of services, the respective medical assistants:

• practice the profession in Romania with the professional title established by OAMGMAMR and provided by law for the respective medical assistant profession;
• are exempt from the obligation to register with OAMGMAMR and from the payment of the membership fee;
• are automatically registered with OAMGMAMR during the provision of those services;
• are subject to the professional, regulatory, or administrative provisions regarding professional qualifications and the use of titles, provisions concerning serious professional acts that directly and specifically affect the protection and safety of beneficiaries of the services provided, as well as disciplinary provisions provided by law for Romanian citizen medical assistants, members of OAMGMAMR;
• are exempt from the accreditation procedure provided by social health insurance legislation.

Service providers have the obligation to inform the National Health Insurance House in advance about the services to be provided on Romanian territory, and in case of emergency, within a maximum of 7 days from their provision.

Procedure description:

I. At the first provision of services in Romania, OAMGMAMR may verify the provider’s professional training in order to avoid serious harm to patient health due to lack of professional qualification of the provider, and without exceeding the necessary scope in this regard.

Within 30 days from the receipt of the declaration and all the mentioned documents, the OAMGMAMR Commission for the recognition of nurse qualifications, midwife, and medical assistant qualifications obtained in another EU Member State, a state belonging to the EEA, or in the Swiss Confederation analyzes the applicant’s training.

Based on its conclusions, the President approves how to resolve the applicant’s request, namely:

• not to verify the provider’s qualification, automatic temporary registration with OAMGMAMR and approval of temporary provision of medical assistant services in Romania;
• after verifying qualification:

1) request the provider to pass an aptitude test, or

2) temporarily register the provider automatically with OAMGMAMR and grant approval for temporary provision of medical assistant services in Romania.

In cases where the qualification verification of the applicant may lead to situations causing a delay in decision-making, OAMGMAMR notifies the applicant, within the aforementioned 30-day period, of the reasons for the delay. The situations are resolved within 30 days from notification, and the decision is finalized within 60 days from their resolution.

The aptitude test is applied when a significant difference is found between the provider's qualification as a medical assistant and the training required in Romania for the corresponding specialization, to the extent that this difference may negatively affect public health and cannot be compensated by the applicant's professional experience as well as by knowledge, skills, and competencies acquired through lifelong learning, formally validated by a relevant body for this purpose.

After the medical assistant in question takes the aptitude test, OAMGMAMR decides regarding the provision of the service by the latter, and the services can be provided within 30 days from the date of the decision.

Approval for temporary provision of medical assistant services and, respectively, automatic temporary registration with OAMGMAMR are communicated to the applicant and to the OAMGMAMR branch in the territorial area of the healthcare facility where the applicant is to provide the services in question in Romania.

II. In case of renewal of the declaration, after verifying the temporary and occasional nature of the provision of services by the OAMGMAMR Commission for recognition of nurse, midwife, and medical assistant qualifications obtained in another EU member state, a state belonging to the EEA, or in the Swiss Confederation, the President approves the temporary provision of midwife services and, respectively, automatic temporary registration of the applicant with OAMGMAMR, within 30 days from receipt of the declaration. These are communicated to the applicant and to the OAMGMAMR branch in the territorial area of the healthcare facility where the applicant is to provide the services in question in Romania.

If OAMGMAMR does not make a decision within the deadlines established above, the service may be provided.

The procedure applies to midwives whose training, or, as the case may be, professional experience, acquired in another EU Member State, in a state belonging to the EEA or the Swiss Confederation, does not meet the criteria for automatic recognition of qualifications provided for this purpose by Directive no. 2005/36/EC on the recognition of professional qualifications. The recognition with compensatory measures of the qualification of midwife aims to facilitate their access to the profession and, respectively, to facilitate the exercise of the right of establishment on the territory of Romania by the professionals concerned. In this regard, midwives in this situation take an aptitude test for the recognition of the qualification, in Romania.

This procedure does not apply to midwife qualification titles that meet the compliance requirements set by Directive no. 2005/36/EC on the recognition of professional qualifications, if the holder requests recognition of the qualification for establishment in Romania, or the provision of specific healthcare services of the profession on a temporary or occasional basis in Romania, nor to midwife qualification titles obtained in a state outside the EU (third country).

The recognition with compensatory measures of midwife qualification titles is performed by the Order of Nurses, Midwives and Medical Assistants of Romania (OAMGMAMR) designated by law as the competent authority for this profession.

Procedure description:

Within 30 days from the date of registration, OAMGMAMR notifies the applicant, confirming the receipt of the file and, if applicable, requesting the completion with missing documents. Within 3 months from notification, the applicant is obliged to complete the file with all required documents. If the applicant does not respect the completion deadline, at its expiration, OAMGMAMR archives the file and informs the applicant in writing of this fact.

Within 120 days from the submission of the complete file, the OAMGMAMR Commission for the recognition of general nurse, midwife and medical assistant qualifications obtained in another EU Member State, an EEA state, or the Swiss Confederation (OAMGMAMR Commission for the recognition of professional qualifications) analyzes the training and professional experience of the applicant and formulates a thoroughly justified proposal regarding the way to resolve the request, respectively:

· a) Recognition of the qualification without taking the aptitude test. Based on this proposal, the President of OAMGMAMR issues the decision to recognize the qualification.

· b) Recognition of the qualification after taking the aptitude test. This proposal as well as the curricular differences and the corresponding bibliography established by the OAMGMAMR Commission for the recognition of professional qualifications are approved by the President of OAMGMAMR and communicated to the applicant within the mentioned 120 days. The date for taking the aptitude test is mutually agreed with the applicant within a maximum of 6 months from the date of approval by the President of OAMGMAMR.

· The President of OAMGMAMR issues the decision to recognize the qualification based on the documents attesting the passing of the aptitude test by the applicant.

· The decision to recognize the qualification is communicated to the applicant and the OAMGMAMR branch of his/her domicile, for the purpose of obtaining the membership certificate and authorization in the profession.

· The OAMGMAMR decisions regarding the recognition of the nurse qualification may be appealed within 30 days from communication to the competent courts.

· The holder whose midwife qualification has been recognized may register as an OAMGMAMR member only after demonstrating that he/she has Romanian language skills necessary for performing professional activities.

· After obtaining the OAMGMAMR member status, the holder exercises the profession of midwife with the rights and obligations provided by law for midwives who are Romanian citizens.

The procedure applies exclusively in cases where midwives with professional training that does not meet the criteria for automatic recognition of qualification provided by Directive no. 2005/36/EC obtained in another EU Member State, an EEA State or in the Swiss Confederation come to the territory of Romania to practice midwifery activities temporarily or occasionally.

Particularities:

The temporary or occasional character of providing professional midwifery activities is determined, case by case, by the Order of Generalist Nurses, Midwives, and Medical Assistants of Romania (OAMGMAMR), depending on their duration, frequency, periodicity, and continuity.

During the provision of services, the respective midwives:

• practice the profession on the territory of Romania under the professional title provided by law for the respective midwife profession;
• are exempt from the obligation to enroll in OAMGMAMR and from the payment of the membership fee.
• are automatically registered in OAMGMAMR during the provision of midwifery services;
• are subject to professional, regulatory, or administrative provisions regarding professional qualifications and the use of titles, provisions concerning serious professional acts that directly and specifically affect the protection and safety of the beneficiaries of the services provided, as well as disciplinary provisions provided by law for midwives who are Romanian citizens, members of OAMGMAMR;
• are exempt from the accreditation procedure provided by social health insurance legislation. Midwife service providers are required to inform in advance the National Health Insurance House about the services they are about to provide on the territory of Romania, and in case of emergency, within a maximum of 7 days from their delivery.
  

Procedure Description:

I. At the first provision of services in Romania, OAMGMAMR may verify the professional training of the midwife in order to avoid serious harm to the patient's health due to the provider's lack of professional qualification and without exceeding the necessity in this regard. Within 30 days from the date of receiving the declaration and all the mentioned documents, the OAMGMAMR Commission for recognition of nurse, midwife, and medical assistant qualifications obtained in another EU Member State, an EEA State or in the Swiss Confederation analyzes the applicant's training. Based on its conclusions, the President approves the way to resolve the applicant's request, as follows:

*not to verify the provider's qualification, approval of the temporary provision of midwifery services in Romania, and their automatic temporary registration with OAMGMAMR.

*after verifying the qualification:

1) to request them to pass an aptitude test, or

2) to automatically temporarily register them with OAMGMAMR and grant approval for the temporary provision of midwifery services in Romania.

In cases where, during the verification of the applicant's qualification, situations occur that could lead to delays in making a decision, OAMGMAMR notifies the applicant, within the above-mentioned 30-day period, of the reasons for the delay.

The ascertained situations are resolved within 30 days from notification, and the decision is made within 60 days from their resolution.

The aptitude test is applied in cases of a significant difference between the service provider's midwifery qualification and the midwife training required in Romania insofar as this difference can negatively affect public health and cannot be compensated by the applicant's professional experience as well as by the knowledge, skills, and competences acquired through lifelong learning, formally validated for this purpose by a relevant body. After the midwife in question takes the aptitude test, OAMGMAMR decides on the provision of the service by her, and the provision of services can take place within 30 days from the date of the decision.

The approval for the temporary provision of midwifery services and, respectively, the temporary automatic registration with OAMGMAMR is communicated to the applicant and the OAMGMAMR branch in the territorial area of the healthcare unit where they are to provide the respective services in Romania.

II. In case of renewal of the declaration, after verifying the temporary and occasional nature of the provision of services by the OAMGMAMR Commission for recognition of general nurse, midwife and medical assistant qualifications obtained in another EU Member State, an EEA State, or in the Swiss Confederation, the President approves the approval of the temporary provision of midwifery services and respectively the temporary automatic registration of the applicant at newly at OAMGMAMR, within 30 days from the receipt of the declaration.

These are communicated to the applicant and the OAMGMAMR branch in the territorial area of the healthcare unit where they are to provide the respective midwifery services in Romania.