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Laid down by the Norwegian Ministry of Health and Social Affairs on 20th December 2001 in pursuance of Act No. 64 of July 1999, the Health Personnel Act, Section 48, subsection 2 b, Act No. 66 of 19 November 1982 relating to the Municipal Health Services Section 6-1, and Act No. 61 of 2nd July 1999 relating to Specialist Health Services, etc. Section 3-5. Amended 19th December 2002 No. 1714.
CHAPTER ONE: GENERAL PROVISIONS..........................................2
Section 1: Objective and Goals.................................................2 Section 2: Scope...........................................................2 Section 3: Definitions and Explanations...........................................2 Section 4: Implementation and Content of the Practical Training...........................2 Section 5: Assignment of Place of Practical Training...................................3 CHAPTER II: APPLICATION FOR PRACTICAL TRAINING......................................3 Section 6: Application for Practical Training........................................3 Section 7: Postponement of Application for Practical Training............................3 Section 8: Postponement of Practical Training after Submission of Application.................3 Section 9: Special Considerations with Respect to Assignment of Place.......................3 CHAPTER III: ESTABLISHMENT AND DISTRIBUTION OF TURNUS PLACES...........................4 Section 10: Establishment and Distribution of Turnus Places.............................4 Section 11: Receipt of Turnus Candidates by Order....................................4 Section 12: Selection of Turnus Place and Transfer to Waiting List.........................4 CHAPTER IV: DETAILS CONCERNING THE TURNUS PLACE AND RIGHTS AND DUTIES OF TURNUS CANDIDATES. . . .5 Section 13: The Duties of the Turnus Place.........................................5 Section 14: The Status of the Turnus Candidate......................................5 Section 15: Obligation to Accept the Allocated Turnus Place.............................5 Section 16: Inability to Complete the Period of Practical Training..........................5 Section 17: Turnus Grant to the Municipality........................................6 Section 18: Salaries and Running Expenses.........................................6 Section 19: Housing........................................................6 CHAPTER V: APPROVAL OF PRACTICAL TRAINING.........................................6 Section 20: Approval of Turnus Place.............................................6 CHAPTER VI: OTHER REGULATIONS..................................................6 Section 21: Authority to Issue Guidelines and Grant Exemptions...........................6 Section 22: Appeals.........................................................6 Section 23: Entry into Force...................................................7 Section 24: Transitional Regulations.............................................7 Section 25: Changes in Other Regulations..........................................7 SUPPLEMENTARY NOTES..........................................................8
through working under specific guidance. . med. f) Turnus post: Post which is included in the approved number of posts established by the Norwegian Directorate for Health and Social Affairs to provide practical training. The regulations also apply to persons with authorisation as doctors from other countries. degree.Chapter One: General Provisions Section 1: Objective and Goals The objective of the practical training (turnus) is to provide the turnus candidate with the necessary experience. followed by 6 months within municipal health services. med. and which is filled by an turnus candidate. a) Student: Person studying medicine. g) Turnus grant: Grant allocated to the turnus place to contribute to the implementation of the practical service for turnus candidates. and who are required to serve a period of practical training in Norway in full or in part. e) Turnus licence: Licence issued by the Norwegian Directorate for Health and Social Affairs. including experience of acute conditions (emergencies). no. 1379. b) Medical graduate: Person with a cand. med. training and supervision. degree or equivalent foreign examination approved as equivalent to a Norwegian cand. The regulations also apply to the places where the practical training is carried out. The practical training shall be properly organised and carried out in accordance with current regulations and with the goals set by the Norwegian Directorate for Health and Social Affairs. degree). cf. Section 4: Implementation and Content of the Practical Training As a general rule the practical training should be contiguous with successfully completed medical studies (cand. c) Turnus candidate: A medical graduate who has commenced a period of practical training (turnus) and who is licensed to serve a period of practical training. in order to obtain Norwegian authorisation. Chapter 1A of Regulations Relating to Licensing of Health Personnel of 21st December 2000. Section 3: Definitions and Explanations The following terms as used in these regulations. and be served continuously for 18 months. as well as acquiring practical routines in order to carry out general medical work properly and independently. The practical training consists of 12 months served at a hospital. shall have the references specified below. as well as to the supervisor and the doctor who is responsible for the practical training. Section 2: Scope These regulations apply to medical graduates and turnus candidates who are required to serve a period of practical training in order to obtain authorisation as a medical practitioner (doctor) in Norway. d) Turnus place: Hospital or municipality where the practical training takes place.
very special circumstances must apply. Section 9: Special Considerations with Respect to Assignment of Place A candidate for practical training may apply to the Norwegian Directorate for Health and Social Affairs for permission to serve the turnus period at a given location (special placement). The practical training within municipal health services should mainly consist of general clinical practice and include general public health duties. 4 months at a ward of Internal Medicine. If such an application for postponement is granted. Section 5: Assignment of Place of Practical Training The practical training shall be served at a turnus post established in accordance with Section 10. sub-section 4. Section 6 above. in full or in part. or Gynaecology and Obstetrics. Paediatrics. In general. Application for such postponement must be submitted to the Norwegian Directorate for Health and Social Affairs as soon as the need is apparent. The student / candidate will have to apply and participate in the draw. and 4 months at any of the following wards Psychiatry. Chapter II: Application for Practical Training Section 6: Application for Practical Training Applications for practical training should be submitted on the form specified and forwarded to the Norwegian Directorate for Health and Social Affairs by the dates set by the Directorate. and may comprise. When special circumstances so warrant. Section 6 above. either a) 4-months at a ward of General Surgery. the student/candidate must submit a renewed application for practical training. Section 12. application for special placement should be submitted at the same time as the application for practical training. 3 . Any other work carried out while waiting for placement or during a period of postponement of the practical training. cf. but will be assured of a place. cf. Section 8: Postponement of Practical Training after Submission of Application In order to obtain postponement of practical training once an application has been submitted. be recognised as part of the turnus period as defined in these regulations. cf. shall under no circumstances. or b) it may be served as two 6-month periods each of General Surgery and Internal Medicine. If such postponement is granted. the Norwegian Directorate for Health and Social Affairs shall have the power to grant further postponement of application for practical training. Section 7: Postponement of Application for Practical Training The student / candidate may postpone their application for practical training in such a manner that the commencement is delayed by up to 6 months from the expected time of commencement. Anaesthetics.The practical training at a hospital should be served in departments providing emergency care. the student/candidate must submit their application for practical training at the appropriate time. Such an application is binding on the student / the candidate.
The regional health enterprises will establish the allotted number of turnus places within the health region. Section 6-1. the Act Relating to Specialist Health Services. a. The number of turnus places in municipal health services is established for each county by the Norwegian Directorate for Health and Social Affairs. has sole responsibility for one or more children under 12 years of age. The turnus place should be allowed to comment on the proposed order before it is issued. warrant granting of the request to serve the turnus period at a given location. or in reasonable proximity to a place where the spouse or partner has been posted to serve the basic military training or its civil equivalent. Section 11: Receipt of Turnus Candidates by Order The Norwegian Directorate for Health and Social Affairs may order any health enterprise and any municipality to accept turnus candidates for their practical training. The Norwegian Directorate for Health and Social Affairs may issue guidelines for the establishment of turnus places and their distribution in Norway. has Saami as his/her first language and wishes to serve the turnus period in a Saamispeaking area of the country. When all the available turnus places have been selected. students/candidates who may not have obtained a place will be transferred to a waiting list. etc. c. and the Act Relating to the Municipal Health Services.Special placement may be allotted if the applicant. and the places are distributed to the municipalities by the County Governors. Chapter III: Establishment and Distribution of Turnus Places Section 10: Establishment and Distribution of Turnus Places The Norwegian Directorate for Health and Social Affairs determines the number of turnus places to be established in hospitals and municipalities. an order to accept a turnus candidate should be issued in good time before the arrival of the candidate(s). Section 12: Selection of Turnus Place and Transfer to Waiting List The Norwegian Directorate for Health and Social Affairs should arrange for a draw which will assign the order in which turnus candidates select turnus places. gives other reasons. b. Section 3-5. d. cf. . has children under 12 years of age and wishes to serve the turnus period at. which given due consideration. As far as possible. These students/candidates will have their turnus period postponed by up to 6 months. to hospitals within each health region as well as to municipalities within each County. A decision to issue such an order may be appealed in accordance with the provisions of the Public Administration Act. The Norwegian Directorate for Health and Social Affairs distributes the turnus places for hospitals to the regional health enterprises.
a) provide the necessary training. The Norwegian Directorate for Health and Social Affairs may give guidelines relating to the selection of turnus places and to the implementation of the waiting list arrangements. The turnus place shall see to it that the turnus candidate is able to complete the practical training in accordance with the current regulations and goals set. but in such a manner that they are assured of a place. Section 14: The Status of the Turnus Candidate The turnus candidate has status as an employee. and the responsibilities of the employer are incumbent on the turnus place. The testimonial should explicitly state whether the period of practical training has been satisfactorily completed and in conformity with the goals set. who have been assigned a place. the turnus place should make every effort to put him/her on the right way according to the circumstances. Section 15: Obligation to Accept the Allocated Turnus Place The turnus candidate is obliged to report for duty at the appointed place. The turnus place is bound to accept the allocated turnus candidate. and supervision. Section 16: Inability to Complete the Period of Practical Training If it becomes apparent that any turnus candidate is unable to complete the period of practical training in accordance with the current regulations and the goals set. the turnus place shall inform the Norwegian Directorate for Health and Social Affairs describing the circumstances. and has to apply again. after informing the person concerned. the turnus place shall notify the Norwegian Directorate for Health and Social Affairs without delay. Section 6. At the end of the period of practical training the turnus place shall see to it that a testimonial is given from the personal supervisor and the doctor responsible for practical training. guidance. b) appoint a personal supervisor for the turnus candidate. and c) see to it that the turnus candidate is evaluated along the way and at the end of each period of practice. give up their places. The testimonial should contain a recommendation as to whether the period of practical training should be approved. the students/candidates on the waiting list will be offered a place in the order assigned to them in the draw. 5 . cf. as a part of the approval of the practical training. Chapter IV: Details Concerning the Turnus Place and Rights and Duties of Turnus Candidates Section 13: The Duties of the Turnus Place The turnus place is responsible for arranging matters in such a way that the practical training may be implemented at the place assigned. If this does not meet with success. the candidates from the waiting list are pooled with the other candidates. A candidate who does not accept the appointed place. including. If a turnus candidate does not report for duty. At the next draw.In the event that students/candidates. will lose it.
the Norwegian Directorate for Health and Social Affairs may decide to withdraw the grant or decide to cancel the allocation of turnus candidates for a given period. if necessary. and may. Section 18: Salaries and Running Expenses Salaries and running expenses in connection with the implementation of practical training will be covered by the turnus place. The Norwegian Directorate for Health and Social Affairs decides whether the practical training may be approved as required for obtaining authorisation as a doctor. Section 19: Housing The turnus place is responsible for providing accommodation for the turnus candidate. Chapter V: Approval of Practical Training Section 20: Approval of Turnus Place It is incumbent upon a turnus candidate to obtain testimonials to confirm that the practical training has been completed as prescribed in current regulations and in conformity with the goals set. When special circumstances so warrant.The Norwegian Directorate for Health and Social Affairs shall see to it that the turnus candidate is offered counselling and further supervision. the Norwegian Board of Health may grant exemption from provisions in these regulations. cf. Section 22: Appeals Decisions made in accordance with these regulations may be appealed in accordance with . Section 17: Turnus Grant to the Municipality The municipalities involved will receive a grant for their assistance in the implementation of periods of practical training. Should the municipality during certain periods not be allocated a turnus candidate. the municipality will continue to receive the grant. Section 12. The Directorate may demand that all or part of the practical training in a hospital or in a municipality should be repeated. remove the candidate from service. In special cases it may be decided that a turnus candidate has to gain more competence in given areas before their practical training is approved as complete. In the event that the municipality fails to fulfil its duties as per the current regulations. Chapter VI: Other Regulations Section 21: Authority to Issue Guidelines and Grant Exemptions The Norwegian Directorate for Health and Social Affairs may issue guidelines to supplement and facilitate the implementation of these regulations.
the following changes apply: --- 7 . shall apply as relevant until new guidelines and goals are issued. shall commence on January 15th 2002. but in such a manner that a) Turnus candidates whose practical training commenced during the winter of 2001 shall start their practical training in the municipality on January 15th 2002. b) Turnus candidates.the regulations of the Public Administration Act. who are due to start their practical training in a municipality during the winter of 2002. Section 24: Transitional Regulations The regulations enter into force on January 1st 2002. The guidelines and goals which were in force according to previous regulations when the present regulations enter into force. Section 25: Changes in Other Regulations As of January 1st 2002. Section 23: Entry into Force These regulations enter into force on January 1st 2002.
will be assured of an opportunity to select a turnus place in the next draw. a research opportunity or maternity leave. Students who sit their final exam in June may expect to start their practical training during the summer or fall of the same year. Should the application be submitted. the Directorate will expect the circumstances to have arisen after the submission of the application. Applications for practical training are usually submitted before the final examinations have been passed. cf. Re Section 7 "Expected time of commencement" refers to the first possible placement after the final examination. Section 8.Supplementary Notes Re Section 3 Re d) "Hospital" may also include a private hospital which is founded by a grant from a regional health enterprise. who have been granted postponement in accordance with Section 8. e. For this reason a provision has been made to ensure that students. When discerning whether special reasons make it essential to postpone practical training once an application has been submitted. Such candidates will start their practical training up to 12 months after the expected time of commencement. Consent to postponement of application for practical training. medical care in family clinics. sub-section 2. General public health duties include i. and possibly planned. Section 7. subsection 2. In municipalities the grant is NOK 100 000 per candidate for 6 months. and the student is not successful in the final examination. and 15th February for training to start 15th August of the same year.a. will usually be due to a recognised. A student. nursing homes and prisons. Furthermore the "expected time of commencement" must be considered in light of the different dates for examinations at universities in other countries. med. and 8 when "special circumstances apply". Re Section 4 It is the responsibility of the municipality to see to it that the turnus candidate obtains the necessary experience and knowledge of general public health. cf. runs the same risk as any other student of ending up on a waiting list. Re Section 6 As the regulations enter into force. Students with examinations in certain other countries may need a supplementary course in Norway in order to have their foreign degree recognised as equivalent to a Norwegian cand. Re Section 8 The Directorate may grant postponement in a accordance with both Sections 7. the student must inform the Directorate for Health and Social Affairs without delay. event. Re g) Turnus grants are allocated on an annual basis. school health services. As these regulations enter into force the turnus grant for hospitals is NOK 25 000 per candidate. and that the circumstances could not reasonably be anticipated. the deadlines for submitting applications for practical training are 15th August for training to commence on 15th February the following year.g. . who decides to delay the application in order to start practical training 6 months later. This provision might apply if the student / candidate were to become the single parent of children below 12 years of age.
Such orders should be issued as far ahead of placement as possible under the circumstances. The commencement of the period of practical training will still follow the normal dates. Re Section 13 The duties of the turnus place are described in publication IK-17/98. ASA 4310. The practical details concerning the draw and the allocation of turnus places follow the guidelines issued by the Directorate for Health and Social Affairs. Re Section 12 The provisions in this Section deal with the main principles and procedures for selection of turnus place and transfer to a waiting list. Labour regulations. It is assumed that hospitals or municipalities. the provisions of the Public Administration Act apply. item 11 (Frame of reference for co-operation between the Association of Norwegian Municipalities and the Norwegian Medical Association on General Practice in Municipalities. The order may be valid for six months or for a longer period. who see the benefit to themselves. This entails that the regional health enterprise or municipality in question should be heard before the decision is made. cf. etc.Re Section 9 In the event that the Directorate for Health and Social Affairs agrees to special placement. Section 24. If an order is issued. Re Section 14 The turnus candidate is to be regarded as a temporary employee in the meaning of the Act on Worker Protection and Working Environment. the Directorate for Health and Social Affairs may order regional health enterprises or municipalities to receive turnus candidates.) 9 . spouse or partner or a child has a serious illness which makes it unreasonably difficult for them to move or manage on their own. Chapter 4 (Description of the Goals of Turnus training) and Chapter 5 (Implementation of the Turnus Period for Doctors). The Directorate for Health and Social Affairs will consult with the County Medical Officer in the relevant county before making these decisions. Re Section 11 Practical training for doctors is served in hospital or municipal general practice. Re Section 16 The last sub-section makes it incumbent on the Directorate for Health and Social Affairs to see to it that the turnus candidate is offered counselling and further supervision. In the event that the number of turnus places spontaneously established is insufficient. will establish turnus places. This will usually be implemented with assistance from the County Medical Officer. The "special considerations" that might apply under d) would be considered present if e. The provisions in this document apply as far as relevant until new guidelines are issued. This entails that the turnus candidate and the turnus place have to comply with Norwegian regulations concerning National Insurance. Re Section 18 Salaries and running expenses for turnus candidates in municipalities are governed by a set of agreements cf. the student / candidate will be allocated a place outside of the normal allotment procedure.g.
if the candidate is planning to do research). If the turnus candidate has had long periods of absence. The Directorate for Health and Social Affairs will make an overall evaluation. Re Section 22 As of 1st January 2002. including doctors in the Municipal Regular GP Scheme). and may decide that the practical training has not been adequate for approval to be given.g. the standard is described in Section 11 in SFS 2305 (Central agreement between the Association of Norwegian Municipalities and the Norwegian Medical Associations in relation to conditions of service for doctors and turnus candidates who are on contract with municipal health services. the Norwegian Registration Authority for Health Personnel (SAFH) is given the authority to make decisions in respect of the provisions in these regulations. Any requirements as to standard of housing etc. the Directorate may find it necessary to demand that part of the practical training should be repeated. Re Section 20 In practice.Re Section 19 Turnus candidates shall be provided with suitable accommodation while in hospital service as well as in municipal practice. In respect of practical training in municipal practice. There may be situations where the turnus candidate does not intend to apply for authorisation immediately on completion of the practical training (e. should be settled through negotiations between the organisations to which the parties belong. approval of the practical training (turnus) takes place in connection with processing of the application for authorisation as a medical practitioner. The appeals will be decided by the Directorate for Health and Social Affairs. Even in these cases a decision should be made at the termination of the turnus period as to whether the practical training may be approved. .
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