No C 230/12 Official  Journal  of the European  Communities 10. 9. 81 
Opinion  on the proposal  for a Council  Directive  amending  Directive  75/362/EEC  concerning 
the mutual  recognition  of diplomas,  certificates  and other  evidence  of formal  qualifications  in 
medicine,  including  measures  to facilitate  effective  exercise  of the right  of establishment  and 
freedom  to provide  services  and  Directive  75/363/EEC  concerning  the coordination  of 
provisions  laid  down  by law,  regulation  or administrative  action  in respect  of activities  of 
doctors 
A. LEGAL  BASIS  FOR  THE  OPINION 
On 16 February  1981  the Council  referred  the abovementioned  proposal  to the Economic  and 
Social  Committee  in accordance  with  Article  49 of the Treaty  establishing  the European 
Economic  Community. 
B. OPINION  OF THE  ECONOMIC  AND  SOCIAL  COMMITTEE 
The Economic  and Social  Committee  prepared  its opinion  on the above  matter  at its 189th 
plenary  session  held  in Brussels  on 1,2  and  3 July  1981. 
The full text of the opinion  is as follows: 
THE  ECONOMIC  AND  SOCIAL  COMMITTEE, 
Having  regard  to the Treaty  establishing  the European 
Economic  Treaty,  and  in particular  Article  49 thereof, 
Having  regard  to the request  made  by the Council  of the 
European  Communities  on 16 February  1981  for an 
opinion  on the proposal  for a Council  Directive  amending 
Directive  75/362/EEC  concerning  the  mutual 
recognition  of diplomas,  certificates  and other  evidence 
of formal  qualifications  in medicine,  including  measures 
to facilitate  effective  exercise  of the right  of establishment 
and freedom  to provide  services  and  Directive 
75/363/EEC  concerning  the coordination  of provisions 
laid down  by law,  regulation  or administrative  action  in 
respect  of activities  of doctors, 
Having  regard  to the decision  taken  by its Bureau  on 24 
February  1981,  constructing  the Section  for Industry, 
Commerce,  Crafts  and Services  to prepare  an opinion  and 
a report  on the matter, 
Having  regard  to the opinion  issued  by the Section  for 
Industry,  Commerce,  Crafts  and Services  at its meeting 
on 2 and 3 June  1981  (sitting  of 2 June  1981), 
Having  regard  to the oral report  made  by the rapporteur, 
Mrs Heuser, 
Having  regard  to the discussions  at its 189th  plenary 
session,  held  on 1,2  and  3 July  1981  (sitting  of 1 July 
1981), 
HAS  ADOPTED  THE  FOLLOWING  OPINION 
by a unanimous  vote: 
1. General  comments 
1.1. The  Committee  acknowledges  the Commission's 
endeavours  to take  a further  step  towards  the upward harmonization  of the effective  exercise  of doctors'  right  of 
establishment,  by proposing  amendments  to Directives 
75/362/EEC  and  75/363/EEC. 
1.2. The  sole  purpose  of the amendments  to Directive 
75/362/EEC  is to incorporate  practical  knowledge 
acquired  since  the Directive's  entry  into  force.  Therefore, 
these  amendments  can  be largely  ignored  in this 
opinion. 
1.3. The  only  substantive  amendment  concerns  the 
training  of doctors  as specialists,  as dealt  with  in Directive 
75/363/EEC  and  an Annex  hereto. 
1.4. So  far it has been  the rule  that this training  has to 
be full-time,  though  derogation  allowing  part-time 
training  in special  cases  have  been  in force  since  1979. 
The Committee  deeply  regrets  that  the  proposed 
extension  of these  derogations  until  1982  will  further 
undermine  the principle  of full-time  training. 
1.5. The  Committee  recognizes  that  special 
circumstances  in one Member  State  makes  it necessary  for 
these  derogations  to be extended.  It thinks,  however,  that 
there  should  be no further  extension  beyond  the new 
deadline  under  any circumstances,  since  otherwise  there 
would  be no guarantee  that  specialists  were  being 
properly  trained  everywhere. 
1.6. The  Committee  would  point  out  that  the 
Commission  proposal,  which  was  submitted  very  hastily 
at the request  of the Member  State  concerned,  could  have 
been  used  to solve  two  other  long-standing  problems 
relating  to the establishment  of doctors  which  have  been 
the subject  of applications  and proposals  from  Member 
States. 
1.7. These  concern  the rules  governing  the training  of 
general  practitioners  and  the  question  of whether, 
contrary  to current  practice,  doctors  who  want  to practise 
10. 9. 81 Official  Journal  of the European  Communities No C 230/13 
immediately  after  qualifying  should  be required  to serve  a 
preparatory  period  before  being  admitted  as NHS 
doctors. 
1.8. Both  problems  concern  extremely  important 
aspects  of health  policy  which  are in urgent  need  of a 
solution. 
2. Specific  comments 
Article  1 
2.1. Page  3 (2) (a) (3):  The  heading  in the German 
text should  be 'Kinder-  und  Jugendpsychiatrie'  and  not 
'Kinder-  und  Jugendlichenpsychiatrie'. 
Article  2 
2.2. Reference  is made  here  in connection  with 
full-time  training  to a new  Annex  in which  the conditions 
governing  this training  are defined  for the first  time.  Since 
training  is to be possible  not only  in the establishments 
listed  in Article  2 (1) (d) of Directive  75/363/EEC,  it is 
proposed  that  this  provision  be amended  to read  as 
follows: 
'(d) it shall  be in a university  centre,  in a teaching 
hospital  or in a health  or other  establishment 
approved  for  this  purpose  by the  competent 
authorities  or bodies'. 
The following  addition  must  also  be made  to the German 
version  of the  second  paragraph  of point  1 in the 
proposal's  Annex  (this  addition  does  not concern  the 
English  text): 
'Sie setzt  die Beteiligung  an samtlichen  arztlichen 
Tatigkeiten  in der Krankenhausabteilung  oder  in der 
zugelassenen  Einrichtung  voraus,  in  der  die 
Weiterbildung  folgt 
Article  3 
2.3. The  conditions  under  which  part-time  training 
may be permitted  have  been  made  more  restrictive  and are 
explained  in greater  detail  than  in the  Annex.  The 
Committee  welcomes  this in principle  and,  in particular, 
the fact that part-time  training  is to be given  at a standard 
qualitatively  equivalent  to full-time  training  and that  this 
standard  of training  is not  to be impaired  by time restrictions  or the  practice  of private,  remunerated 
professional  activity. 
2.4. Since  these  are the very  principles  which  have  not 
been  observed,  the Committee  thinks  that  more  detailed 
provisions  - as laid  down  in the draft  Directive  - are 
long overdue  in order  to ensure  a stricter  application  of 
the rules. 
Article  3 (3) 
2.5. The  Committee  doubts  whether  it is wise  to 
exclude  part-time  training  for this or that  specialty  under 
the strict  conditions  described  in Article  3 (3). Basically, 
all that has to be done  is for the training  in each  specialty 
to be organized  in such  a way  that  the  requisite 
quantitative  and  qualitative  standards  for  part-time 
training  are met. 
Annex,  point  1 
2.6. The  last paragraph  in point  1 on page  7 should 
read as follows: 
'Remuneration  shall  be such  that  it will  be necessary 
for trainee  specialists  to engage  in any  other  paid 
activity,  and there  shall  be no discrimination  between 
the trainee  specialists  and other  doctors  working  in the 
same  establishment.' 
Reasons: 
2.7. The  purpose  of  this  amendment  is 
self-explanatory. 
In the German  text 'die Stellen  sind  so dotiert'  must  also  be 
changed  to 'die  Stellen  mussen  dotiert  sein  und  zwar 
so . . .' and  'Facharzte'  must  be changed  to 'Arzte', 
because  doctors  do not become  specialists  until  they  have 
completed  their  training. 
Annex,  point  2: 
2.8. The  requirements  laid down  here  meet  with  the 
Committee's  express  approval  because  they  are designed 
to put a stop  to current  abuses  and,  by providing  for 
proportional  remuneration,  they  will  also  enable 
part-time  training  to be pursued  without  the  doctor 
having  to take  on an unreasonable  amount  of paid  work, 
thereby  unduly  restricting  the time  he can spend  on his 
studies. 
Done  at Brussels,  1 July  1981. 
The Chairman 
of the 
Economic  and  Social  Committee 
Tomas  ROSEINGRAVE