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Hintergrund: Aktuell wurden in den meisten Flächenbundesländern Landarztquoten eingeführt oder sind in Planung. Hiernach werden Studienplätze an Studierende vergeben, die sich, nach Durchlaufen eines speziellen Auswahlverfahrens, zu einer späteren hausärztlichen Tätigkeit [zum vollständigen Text gelangen Sie über die oben angegebene URL]

The Brandenburg Medical School “Theodor Fontane” (MHB) was founded in 2014 by municipal and non-profit institutions in Bernau, Brandenburg an der Havel and Neuruppin to train more physicians for the non-metropolitan region of Brandenburg. Since the 2015 summer term, 48 medical students have been enrolled each year, accepted through the university’s own selection process in which the score on the German school-leaving exam (Abitur) and time spent on the waiting list play subordinate roles. Tuition fees can be partially financed through scholarship agreements with regional hospitals if the applicants commit themselves to medical specialist training (Facharztweiterbildung) at a particular hospital. The main places of study are Neuruppin and Brandenburg an der Havel; there is a decentralized study phase from the eighth to tenth semester of study. The Brandenburg Reformed Medical Curriculum (BMM) complies with the model clause contained in the German regulations governing the licensing of medical doctors (ÄAppO). The curriculum is based on problem-based learning (PBL) and focused on competencies and consists of integrated interdisciplinary modules that combine, from the very beginning, basic sciences with clinical and theoretical medical subjects. The focus on general practice is visible in the regularly held “Practical Days” (Praxistag) during which second-year students and above have the opportunity to observe at participating medical practices and familiarize themselves with primary care in Brandenburg. A special focus of BMM is on the acquisition and development of communication and interpersonal skills. These are imparted through a longitudinal curriculum referred to as “Teamwork, Reflection, Interaction, Communication” (TRIK). High value is placed on critical thinking and scientific scholarship and this is reflected in an eight-week academic placement in which the students independently write a research paper. Several different teaching formats ensure that, along with learning specific subjects, sustained personal development can also take place. BMM’s decentralized study phase starting in the eighth semester represents a special part of the curriculum in which students complete their clinical training in small groups at selected cooperating hospitals in Brandenburg. This phase encompasses not only hospital placements and other local patient-centered courses, but also centralized instruction via video conferencing to assure that basic sciences and clinical theory continue to be covered. Knowledge- and performance-based semester assessments, in particular OSCEs, reinforce the practical aspects of the training. These replace the M1 state medical examination in the first study phase. The first medical students are now in their ninth semester as of April 2019, making it still too early for final evaluations. The curriculum, successfully implemented to date, already satisfies core requirements of the Master Plan 2020 for undergraduate medical education (Masterplan Medizinstudium 2020) with the curriculum's organization and structure, curricular content, assessment formats and student admission process. With its decentralized structure, BMM specifically addresses the social and health policy challenges facing rural regions of Brandenburg. This is the first curriculum that has taken on the improvement of healthcare in rural regions as its central aim., Die Medizinische Hochschule Brandenburg Theodor Fontane (MHB) wurde 2014 von kommunalen und gemeinnützigen Trägern in Bernau, Brandenburg an der Havel und Neuruppin gegründet, um mehr Ärztinnen und Ärzte für die Non-Metropolen-Region Brandenburg auszubilden. Seit dem Sommersemester 2015 werden jährlich 48 Medizinstudierende aufgenommen, die über ein eigenes Auswahlverfahren ausgewählt werden, in dem Abiturnote und Wartezeit eine nachrangige Rolle spielen. Studiengebühren können durch Stipendienverträge mit regionalen Kliniken teilfinanziert werden, wenn sich die Bewerber/innen zur Weiterbildung in der Klinik verpflichten. Das Studium findet überwiegend an den Standorten Neuruppin und Brandenburg an der Havel statt, im 8. bis 10. Semester folgt ein dezentraler Studienabschnitt. Der Brandenburger Modellstudiengang Medizin (BMM) folgt der Modellklausel der ÄAppO. Das Curriculum ist POL-basiert und Kompetenz-orientiert und besteht aus integrierten interdisziplinären Modulen, die von Anfang an Grundlagen-, klinisch-theoretische und klinische Fächer zusammenbringen. Der Fokus auf Allgemeinmedizin schlägt sich unter anderem im regelmäßigen „Praxistag“ nieder, an dem die Studierenden ab dem 2. Semester bei niedergelassenen Lehrärztinnen und -ärzten hospitieren und über eine Integration in den Praxis-Alltag die ambulante Versorgung im Land Brandenburg kennen lernen. Ein besonderer Schwerpunkt des BMM liegt auf Erwerb und Förderung kommunikativer und sozialer Kompetenzen. Diese werden durch ein Längsschnittcurriculum „Teamarbeit, Reflexion, Interaktion, Kommunikation“ (TRIK) vermittelt. Dem wissenschaftlichen Denken und Arbeiten wird ein hoher Stellenwert beigemessen, der sich unter anderem in einem achtwöchigen Wissenschaftspraktikum niederschlägt, in dem die Studierenden eine eigenständige Forschungsarbeit erstellen. Mehrere Lehrformate stellen sicher, dass neben dem „Fach“-Unterricht eine nachhaltige Persönlichkeitsentwicklung stattfinden kann. Eine Besonderheit des BMM stellt das dezentrale Studium ab dem 8. Semester dar, in dem die Studierenden in Kleingruppen an ausgewählten kooperierenden Kliniken in Brandenburg ihre klinische Ausbildung absolvieren. Dieser Abschnitt umfasst neben Stationspraktika und weiteren lokalen Patienten-nahen Lehrangeboten auch zentralen Unterricht, der über ein Videokonferenznetzwerk realisiert wird und die weitere Beteiligung der Grundlagen- und klinisch-theoretischen Fächer sicherstellt. Wissens- und Performanz-basierte Semesterabschlussprüfungen unterstützen, insbesondere durch OSCEs, die Praxis-Orientierung der Ausbildung. Sie ersetzen im ersten Studienabschnitt die M1-Staatsprüfung. Die ersten Medizinstudierenden sind ab April 2019 im 9. Fachsemester, so dass es für abschließende Beurteilungen noch zu früh ist. Das bisher erfolgreich etablierte Curriculum erfüllt bereits heute in Bezug auf Aufbau des Studiengangs, Ausbildungsinhalte, Prüfungsformate und Studierendenauswahl zentrale Forderungen des „Masterplans Medizinstudium 2020“. Mit seiner dezentralen Struktur adressiert der BMM spezifisch die gesellschaftlichen und gesundheitspolitischen Herausforderungen der Non-Metropolen-Region Brandenburg. Er ist der erste Studiengang, der es sich zentral zur Aufgabe macht, die ärztliche Versorgung in ländlichen Regionen zu verbessern., GMS Journal for Medical Education; 36(5):Doc49

Hintergrund: Studien belegen, dass interprofessionelle (IP) Zusammenarbeit von Angehörigen der Gesundheitsberufe positive Effekte auf gesundheitsbezogene Outcomes hat. IP Zusammenarbeit wird aber häufig durch mangelndes Wissen über die Qualifizierung und die Kompetenzen der jeweiligen[zum vollständigen Text gelangen Sie über die oben angegebene URL], Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA), des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ) und der Chirurgischen Arbeitsgemeinschaft Lehre (CAL)

Zielsetzung: Die Teilnehmer*innen sind imstande prozessurale Herausforderungen bei der Einführung eines Videokonferenznetzwerkes zu identifizieren und erste Lösungsansätze zu entwickeln. In der Rolle der Studierenden und der Lehrenden erkunden die Teilnehmer*innen live [zum vollständigen Text gelangen Sie über die oben angegebene URL], Gemeinsame Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA), des Arbeitskreises zur Weiterentwicklung der Lehre in der Zahnmedizin (AKWLZ) und der Chirurgischen Arbeitsgemeinschaft Lehre (CAL)

Problemstellung/Ziele: Im Brandenburger Modellstudiengang Medizin (BMM) sind verschiedene Kooperationspartner involviert, primär aus dem infrastrukturschwachen Flächenland Brandenburg. Vom 8. bis 10. Semester sollen die Studierenden in Kleingruppen in den verschiedenen Krankenhäusern[zum vollständigen Text gelangen Sie über die oben angegebene URL], Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA)

This report examines the drivers of the undeclared economy in Croatia, the current organisation of the fight against undeclared work, and reviews the current and potential policy approaches and measures for tackling undeclared work in Croatia.\ud \ud Drivers of the undeclared economy in Croatia: Recently, significant advances have been made in explaining the determinants of undeclared work. To explain undeclared work, it has been understood that every society has institutions which prescribe, monitor and enforce the ‘rules of the game’ regarding what is socially acceptable. In all societies, these institutions are of two types: formal institutions that prescribe ‘state morality’ about what is socially acceptable (i.e., laws and regulations), and informal institutions which prescribe ‘citizen morality’ (i.e., socially shared rules, usually unwritten). \ud \ud Viewed from this institutional perspective, undeclared work is explained as arising when the failings of formal institutions lead to state morality being different to citizen morality. In the last few years, multiple studies have identified these formal institutional failings. Undeclared work is more prevalent when there is: lower GDP per capita; higher public sector corruption and lower quality governance; lower expenditure on labour market interventions to help the most vulnerable groups; lower social expenditure, and social transfer systems that are ineffective in reducing the level of inequality and severe material deprivation. \ud \ud To tackle the undeclared economy in Croatia, therefore, there will be a need to continue to:\ud \ud • improve the level of GDP per capita;\ud \ud • improve governance and reducing public sector corruption;\ud \ud • maintain and improve the levels of expenditure on labour market interventions to help the most vulnerable groups from its current low relatively base level;\ud \ud • persist with increasing social expenditure; and couple this with,\ud \ud • developing more effective social transfer systems that reduce the levels of income inequality and levels of severe material deprivation in Croatian society.\ud \ud Besides addressing these structural determinants, there are many additional organisational and policy initiatives that can be also pursued to tackle the undeclared economy. \ud \ud Organisation of the fight against undeclared work: institutional framework: Croatia has neither a single agency responsible for the fight against undeclared work, nor a central body responsible for ensuring coordinated action by the multifarious departments involved in tackling undeclared work. Instead, there is a more fragmented approach. Responsibility for tackling undeclared work is distributed across a range of institutions, with each taking responsibility for different segments of the undeclared economy. Whilst labour law violations are the responsibility of the Labour Inspectorate, tax non-compliance responsibility lies with the Ministry of Finance and social security and insurance fraud violations with the social insurance bodies. There is currently little coordination in the fight against undeclared work across the multifarious institutions in strategic, operational or data-sharing terms, and no common cross-cutting targets. The quality of governance, therefore, needs to be improved. A more coordinated response is required, which in part will be dealt with by the decision to establish a State Inspectorate in late 2017. \ud The involvement of social partners in relation to tackling undeclared work remains relatively weak, with little involvement in decision making. Given that tackling undeclared work requires their participation, greater involvement of the social partners is recommended. \ud \ud Current policy approach and measures: an evaluation: Croatia currently employs a relatively narrow deterrence approach and the policy measures heavily focus upon deterring participation in undeclared work by increasing the penalties and risks of detection. Little emphasis is put on improving the benefits of and incentives for declared work, or more indirect preventative tools, such as awareness raising campaigns and dealing with the imperfections and failings of formal institutions (e.g., by facilitating procedural and redistributive justice and fairness, and pursuing wider economic and social policies). There is therefore a need to shift away from such a heavy reliance on deterrence measures to the broader use of preventative incentives, as well as awareness raising and a focus upon targeting and tackling the major drivers of the undeclared economy.

This report examines the drivers of the undeclared economy in Croatia, the current organisation of the fight against undeclared work, and reviews the current and potential policy approaches and measures for tackling undeclared work in Croatia. Drivers of the undeclared economy in Croatia Recently, significant advances have been made in explaining the determinants of undeclared work. To explain undeclared work, it has been understood that every society has institutions which prescribe, monitor and enforce the ‘rules of the game’ regarding what is socially acceptable. In all societies, these institutions are of two types: formal institutions that prescribe ‘state morality’ about what is socially acceptable (i.e., laws and regulations), and informal institutions which prescribe ‘citizen morality’ (i.e., socially shared rules, usually unwritten). Viewed from this institutional perspective, undeclared work is explained as arising when the failings of formal institutions lead to state morality being different to citizen morality. In the last few years, multiple studies have identified these formal institutional failings. Undeclared work is more prevalent when there is: lower GDP per capita; higher public sector corruption and lower quality governance; lower expenditure on labour market interventions to help the most vulnerable groups; lower social expenditure, and social transfer systems that are ineffective in reducing the level of inequality and severe material deprivation. \ud \ud To tackle the undeclared economy in Croatia, therefore, there will be a need to continue to: • improve the level of GDP per capita;\ud \ud • improve governance and reducing public sector corruption;\ud \ud • maintain and improve the levels of expenditure on labour market interventions to help the most vulnerable groups from its current low relatively base level;\ud \ud • persist with increasing social expenditure; and couple this with \ud \ud • developing more effective social transfer systems that reduce the levels of income inequality and levels of severe material deprivation in Croatian society.\ud \ud Besides addressing these structural determinants, there are many additional organisational and policy initiatives that can be also pursued to tackle the undeclared economy. \ud \ud Organisation of the fight against undeclared work: institutional framework Croatia has neither a single agency responsible for the fight against undeclared work, nor a central body responsible for ensuring coordinated action by the multifarious departments involved in tackling undeclared work. Instead, there is a more fragmented approach. Responsibility for tackling undeclared work is distributed across a range of institutions, with each taking responsibility for different segments of the undeclared economy. Whilst labour law violations are the responsibility of the Labour Inspectorate, tax non-compliance responsibility lies with the Ministry of Finance and social security and insurance fraud violations with the social insurance bodies. There is currently little coordination in the fight against undeclared work across the multifarious institutions in strategic, operational or data-sharing terms, and no common cross-cutting targets. The quality of governance, therefore, needs to be improved. A more coordinated response is required, which in part will be dealt with by the decision to establish a State Inspectorate in late 2017. The involvement of social partners in relation to tackling undeclared work remains relatively weak, with little involvement in decision making. Given that tackling undeclared work requires their participation, greater involvement of the social partners is recommended. \ud \ud Current policy approach and measures: an evaluation Croatia currently employs a relatively narrow deterrence approach and the policy measures heavily focus upon deterring participation in undeclared work by increasing the penalties and risks of detection. Little emphasis is put on improving the benefits of and incentives for declared work, or more indirect preventative tools, such as awareness raising campaigns and dealing with the imperfections and failings of formal institutions (e.g., by facilitating procedural and redistributive justice and fairness, and pursuing wider economic and social policies). There is therefore a need to shift away from such a heavy reliance on deterrence measures to the broader use of preventative incentives, as well as awareness raising and a focus upon targeting and tackling the major drivers of the undeclared economy.