CELEX: 51980PC0914
Language: en
Date: 1980-01-28
Title: 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 (submitted to the Council by the Commission)

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 ---pagebreak--- COMMISSION OF THE EUROPEAN COMMUNITIES
                                                COM(80)914 final
                                                Brussels , 29 January 1981
                                         )ν
                         Ρ!         ί    '
                                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 acti­
    vities of doctors
                   ( submitted to the Council by the Commission )
C0MC80 ) 914 final
 ---pagebreak---             , .                EXPLANATORY MEMORANDUM
I. ORIGIN AND AIMS OF THE PROPOSAL
I. On 16 June 1975 the Council adopted Directive 75 / 362 / EEC concerning
the mutual recognition of diplojnas , certificates and other evidence of
formal qualifications in medicine , including measures to facilitate the
effective exercise ot the right of establishment and freedom to provide
services , together with Directive 75 /363 / EEC concerning the coordination
of provisions laid down by law, regulation or administrative action in
respect of activities of doctors*.
                   . ^             '                                    '
2 - The aim of this proposal is to amend these two Directives . The main
amendment proposed concerns Directive 75 /363 / EEC and relates to part-time
specialist training, together with proposals for certain technical
amendments to the two Directives which it seemed advisable as a result of
experience acquired since the entry into force of the Directives and
changes in national legislation.'
3 ^ The legal basis for the proposal is found in the Treaty establishing
the European Economic Community, in particular Articles 49, 57 and 66 .
II . PART-TIME SPECIALIST TRAINING
     Article 2(1 ), C2 ) and ( 3 ) of the proposal
                                                                          \ '
1 . Article 2 of Directive 75 / 363 / EEC lays down the requirements for
training in specialized medicine . Paragraph 1(c ) of this Article
particularly states that such training shall be given in a full-time
course . Article 3 paragraph 1 , on the other hand, although it confirms
this principle, authorizes part-time specialist ' training under certain
conditions . Moreover, paragraph 3 provides for a review of the situation
to enable the Council to decide whether, on a proposal from the Commission,
the provisions of paragraphs 1 and 2 should be retained or amended .
* Official Journal of the European Communities , No L 167 of 30 June 1975 .
 ---pagebreak--- 2 . In this context the Commission consulted the Advisory Committee on
Medical Training set up by. the Counci l Decision of 16 June 1975 *.     Having
examined the question , the Committee delivered an opiniori on the part-time
training of specialists at its meeting on 28 and 29 November 1978 .
                                                                J
The main conclusion in the opinion is that full-time training , as
prescribed in Article 2(1)(c ) of Directive 75 / 363 / EEC , should be the norm
and any derogation therefrom should be granted by the national authorities
only in the case of doctors whose personal circumstances , such as family
obligations , prevent their attendance at full-time courses throughout
the training period .
The Committee also considered that to avoid the possibility of different
interpretations of the meaning of full-time and part-time training , and
to ensure , that regardless of the method of training followed , it should
be of a comparable high standard , the characteristics of full-time and
part-time training for specialists should be defined .       Accordingly,
it attached a definition of these concepts to its opinion .
Lastly, the Committee did not believe it was possible for the time being
to single out from among the specialized fields under consideration those
where only full-time training would be practicable .       In certain Member
States where part-time training is recognized , it is permissible in all
specialized fields , even though in certain cases the entire curriculum
cannot be covered .   Accordingly it recommended that the question should
be reviewed in some years' time after a more thorough study had been made
of the content and organization of specialist medical training .
* Official Journal of the European Communities , No L. 167 of 30 June 1975 .
 ---pagebreak---                                        -  3 -
3 . The Commission supported the opinion of the Advisory Committee on
Medical Training : its substance is set out in Article 2(1 )/ ( 2 ) and ( 3 )
                                            1              -
of the proposal .
Article 3 of the proposal                                           -
4 . Provision had to be made to enable any beneficiaries of the existing
Article 3 of Directive 75 / 363 / EEC to complete their specialized training
after the entry into effect of the new Article 3 .        A transitional
provision to this effect is laid down in Article 3 of the present proposal
Article 2(6 ) of the proposal
5 . Article 3 in Directive 75 / 363 / EEC is not the only Article in this
Directive that provides for a derogation from the criteria governing
specialist training set out in Article 2 .      Article 7 provides for an
additional derogation enabling the Member States providing for a method
of part-time specialist training at the time of notification of the
Directive to maintain it for candidates who began such training no later
than four years preceding the said notification .       s
                                                      1                 x .
The scope of the derogation laid down in Article 7 is therefore broader
than that laid down in Article 3 and relates to training which does not
even meet all the requirements set out in Article 3 .         For example , it
does not require the part-time nature of the training . to be offset by an
extension ( see the first sentence of Article 3(2 ).        On the other hand ,
the Council set a deadline for this derogation which expired on 20 June "
1979 .                                        .
The French Government , however , by a letter of 14 March 1980,, requested
the Commission to propose to the Council that this derogation be extended
until the , end of 1982 . In view of the considerable reorganization
involved and the need to respect the rights of students engaged in
training , the reform of medical training implemented in France pursuant to
Law No 79-565 of 6 July 1979 concerning medicine and pharmacy would
necessitate retention of the derogation laid down in Article 7 until end
1982 .             '                                                        v
 ---pagebreak---                                         -  4 -
6 . It should be pointed out that the types of training covered by Article
7 are not covered by the provisions on the mutual recognition of diplomas ,
certi f i catej &nc! other evidence of formal qualif Icitiona in specialized
medicine set out in Articles 4 and 6 of Directive 75 / 362 / EEC .    Strictly
speaking , therefore , the beneficiaries of Article 7 of Directive
75 / 363 / EEC would be. entitled to use the title of specialist in the country
in which they were trained and to practise specialized medicine under that
title , but would not be entitled to freedom of movement in the Community
as a medical specialist .
There would appear to be a contradiction here between the spirit and
letter of the Directives .
7 . The Commission consulted the Committee of Senior Public Health
Officials , set up by Council Decision of 16 June 1975 , on the questions
raised in paragraphs 5 and 6 above .
                                \
At its meetings on 17 and 18 June 1980, the Committee was in favour of
extending the derogation .        The majority of the Committee also considered
that the medical specialists to whom it applied should also benefit from
freedom of movement , provided it was subject to special conditions
similar to those set out in Article 9 of Directive 75 / 362 / EEC , while a
minority held that the conditions set out in Article 8 of that Directive
should apply .
The Commission has adopted this opinion and followed the views of the
majority of the Committee because they appear to be more in line with the
spirit of the Directive .
The Commission 's proposal on this question is set out in Article 2(6 ) of
                             /
the present proposal .
8 . Clearly there is a contradiction between the provisions of Article 2(1 )
 ( 2 ) and (3 ) of this proposal and those in paragraph 6 of the same Article :
the former seek to reduce the possibilities for part-time training while
the other seeks to extend an additional derogation which expired in
June 1979 .
* Official Journal of the European Communities , No L 167 of 30 June 1975 .
 ---pagebreak---                                        -   5 -
This , however, is no more than an apparent contradiction . The derogation .
covering training referred to in Article 2(6 ) of the proposal is intended
to expire shortly ( end of 1982 )*     It » sol * aim i « to enable a Member State,
where there are two possibilities for specialist training, to eliminate
the one that does not comply with the Directives , oursuant to a law that
has already been adopted , while allowing for a certain lapse of time to
protect students at present engaged in training .
III . TECHNICAL AMENDMENTS TO DIRECTIVES 75 / 362 / EEC AND 75 /363 / EEC
1 . Articles 1(1 ) and (2 ) and 2(4 ) and ( 5 ) of tiie proposal
The first set of amendments applies to the denominations of specializations
in one language or all the Community languages set out in Articles 5(3 )
and 7(2 ) of Directive 75 / 362 / EEC and in Articles 4 and 5 of Directive
75 / 363 / EEC . They are contained in Article 1(1 ) and (2 ) of this proposal
in the case of Directive 75 / 362 / EEC , and in Article 2(4 ) and ( 5 ) of this
proposal in the case of Directive 75 / 363 / EEC .    They concern either -
specializations whose denomination has been changed in a Member State
( for example , in Belgium where the , term " physiotherapy" has been replaced
                              t -
by "médecine physique "), or specializations incorrectly set down in the
Directives ( for example , in France "obstétrique et gynécologie médicale "
is replaced by " gynécologie obstétrique ), or incorrect translations into
German ( for example , "ophthalmologie" i s replaced by " Augenhei Ikunde ").
2 . Article 1(3 ) to ( 7 ) of the proposal
Article 1(3 ) to (7 ) contains amendments to certain provisions of Directive
75 / 362 / EEC to bring them into line with similar provisions subsequently
adopted by the Council in Directive 78/ 1026 / EEC concerning the free
movement of veterinary surgeons .
 ---pagebreak--- Here the intention is simply to harmonize the provisions dealing with the
same subject in the various Directives on freedom of movement for the
liberal professions .
Article 4 of the proposal
3 . Article 4 of the proposal for a Directive is intended to ensure the
recognition of any rights acquired in a Member State - in this case
Luxembourg - by migrant doctors in a similar situation to national
beneficiaries of such rights . It was included in the proposal following
the elimination in Luxembourg in December 1978 of the titles of
specialist in neuro-psychiatry and radiology . Its wording is based on
Article 9(4 ) of Directive 75 / 362 / EEC which covered a similar situation in
1975 .
IV . DATE OF ENTRY INTO FORCE AND DESTINATION
Articles 5 and 6 of the proposal
The provisions regarding the date of entry into force and destination
of the proposal are set out in Articles 5 and 6 . With respect to the
date of entry into force, it is proposed that the Member States adopt
                                                                      *
the necessary measures for incorporation into national law within a
period of one year following notification of the Directive since these
measures should not give rise to any particular problems . .
 ---pagebreak---                                 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
 ---pagebreak---    THE COUNCIL OF THE EUROPEAN COMMUNITIES ,
                                    »
   Having regard to the Treaty establishing the European Economic Community,
   and in particular Articles 49, 57 and 66 thereof .
   Having regard to the proposal from the Commission,
   Having regard to the Opinion of the European Parliament ,                               -
   Having regard to the Opinion of the Economic and Social Committee,
   Whereas changes in the legislation of the Member States and experience
                                                                     1                 2
   gained from the application of Council Directives 75 / 362 / EEC and 75 / 363 / EEC
, have made certain technical amendments necessary,
   Whereas Article 3(3 ) of           Directive 75 /363 / EEC provides that " Four
   years at the latest after notification of this Directive in the light of
   a review of the situation , acting on a proposal from the Commission , and
   bearing in mind that the possibility of part-time training should continue
   to exist in certain circumstances to be examined separately for each
   specialty, the Council shall decide whether the provisions of paragraphs
   1 and 2 should be retained or amended".
                                                                                         /
   Whereas pursuant to       the principle of full-time training for medical
   specialists , the derogation in favour of part-time training should be
   limited still further.
   Whereas the validity of the provisions of Article 7 of Directive 75 / 363 / EEC should be
   extended until 31 December 1982 to enable those Member States where part-
   time training for medical specialists does not comply with the provisions
   of Articles 2 and 3 of that Directive to complete the process of reform intro­
   duced in order to end this type of training .
   OJ No L 167 , 30.6.1975 , p.1
  20J No L 167, 30.6.1975, p.14
 ---pagebreak---                                           - 2 -
HAS ADOPTED THIS DIRECTIVE :
                     _ "  .              Article 1
Directive- 75 / 363 / EEC is hereby amended as follows :
1 - In Article 5(3 )
    ( a ) in the German version , the undermentioned titles are replaced as fotlows :
          ( 1 ) " - Anästhesie-Wiederbelebung " by
                " - Anästhesiologie-Wiederbe lebung "
          ( 2 ) " - Ophthalmologie " by " - Augenheilkunde "
          ( 3 ) " - Otorhinolaryngologie " by - Hals- Nasen-Qhrenhei Ikunde "
          (4 ) " - Pädiatrie " by " - Kinderheilkunde "             - '
    ( b ) in all versions
          ( 1 ) under " anaesthetics ", in the case of :
                - Germany, " Anasthesie " is replaced by "Anastj^esiologie"
                - Belgium, "anesthesiologie/ anesthesie " is replaced by
                  " anesthesiologie/ anesthesiologie "
          (2 ) under " obstetrics and gynaecology"- in the case of : '
                - Belgium , " gynécologie-obstetriquef gynaecologie-verloskunde "
                  is replaced by
         –        " gynécologie-obstétrique /gynécologie -ver loskunde "
                - France , " obstétrique et gynécologie médicale " is replaced by
                  " gynécologie /obstétrique "
          < 3 ) under " - oto- rhino- laryngology' , . in the case of
                - Germany,    Hals-, Nasen-, Ohrenhei Ikunde " 4s replaced by
                  "Hals - Nasen-Ohrenhei Ikunde "
          (4 ) under "paediatrics ", in the case of
                - Belgium, " pédiatrie /pediatrie " is replaced by
                  "pédiatrie/ kindergeneeskunde "
 ---pagebreak--- In Article 7(2 )
(a ) in the German version , the following headings should be amended :
     ( 1 ) "Mi krobiologie-Bakteriologie is replaced by "Mikrobiologie und
           Infektionsepidemiologie "
     (2 ) " Neuro-Psychiatrie is replaced by , Nervenhei Ikunde
           ( Neurologie und Psychiatrie )"
     (3 ) "Kinderpsychiatrie " is replaced by " Kinder und Jugenlichen-
           psychiatrie"
( b) in all versions         ,•
     ( 1 ) under "microbiology-bacteriology", the following is added :
           - Germany : Mikrobiologie und Infektionsepidemiologie"
           - in the case of the Netherlands, bacterioloqie" is replaced
              by "medische mi crobiologie"                  ti '
     <2 )  under "biological chemistry", in the case of
           - Luxembourg, "biochimie" is replaced by " chimie biologique"
     (3 )  under "paediatric surgery", in the case of
           - Luxembourg, " chirurgie infantile is replaced by
              " chirurgie pédiatrique"
     (4 )  under "physiotherapy , in the case of
           - Belgium, "physiotherapie-/fysiotherapie" is replaced by
              "medecine physique /f ysische geneeskunde"
           and the following is added : " Luxembourg - rééducation et
              réadaptation fonctionnelles "
     (5 )  under neuropsychiatry , in the case of
           - Germany, "Neurologie und Psychiatrie" is replaced by
              "Nervenhei Ikunde ( Neurologie und Psychiatrie )"
     (6)   under "dermato-venereology", in the case of
           - Germany, Dermatologie und Venerologie IS replaced by
              " Dermatologie und Venerologie / Haut- und Geschlechtskankheiten
     (7 )  under "diagnostic radiology" the following is added :
           "Luxembourg : radiodiagnostic "                       '
     (8)   under " radiotherapy", the following is added :
           " Luxembourg : radiothérapie
     (9)   under " child psychiatry" the following is added :
           " Luxembourg : psychiatrie infantile
           " United Kingdom : chi Id and adolescent psychiatry
 ---pagebreak---    3 . Article 11(3 ) is replaced by the following :
   " If the host Member State has detailed knowledge of a serious matter which
   has occurred outside its territory and which , is likely to affect the
   taking up of the activities concerned within its territory,. it may inform
   the Member State of origin or the Member State from which the foreign
                  <                                       ,     '       i '
   national comes .                                  -
   The Member State of origin or the Member State from which the foreign
   national comes shall verify the accuracy of the facts .        The authorities
   in that State shall themselves decide on the nature and extent of the
   investigation to be made and shall inform the host Member State of any
   consequential action which they take with regard to the certificates or
   documents they have issued .                             ...    :'
                         •     •                                   1 ■.
   Member States shall ensure the confidentiality of the infprmation which
   is forwarded ."       ~
   4 . Article 12(2 ) of the Directive is replaced by the following text :
2 . If the host Member State has detai led knowledge -of a serious matter
   which has occurred outside its territory and which is likely to affect
   the pursuit of the activities concerned within its territory , it may
 . inform the Member State of origin or the Member State from which the
   foreign national comes .
   The Member State of origin or the Member State from which the foreign
   national comes shall verify the accuracy of the facts .        The authorities
   in that State shall themselves decide on the nature and extent of the f
   investigation to be made and shall inform ^the host Member State of any .
   consequential action which they take with regard to the information
   which they have forwarded in accordance with paragraph 1 ."
   5 . After Article 15 the following new Article , 15a , is added :
                                     Article 15a
   " Where a host Member State requires its own nationals wishing to take up
   or pursue one of the activities referred to in Article 1 to take an oath
 ---pagebreak--- or make a solemn declaration and where the form of such an oath or
dec laration cannot be used, by nationals of other Member States , that Member
State'    shall ensure that an appropriate and equivalent form of oath or
declaration is offered to the person concerned ."
6 . The following provisions shall be inserted between the second and third
 subparagraphs of Article 16(1 ):
" For this purpose and in addition to the declaration provided for in
paragraph 2 relating to the services to be provided , Member States may ,
so as to permit the implementation of the provisions relating to
professional conduct in force in their territory, require either automatic
temporary registration or pro forma membership of a professional
organization or body or , as an     alternative , registration ,
provided that such registration or membership does not delay or in any
way complicate the provision of services or impose any additional costs
on the person providing the services ."
7 . Article 19 is deleted .
                                      Article 2
Directive 75 / 363 / EEC is  hereby amended as follows :
1 . Article 2(1)<c > is replaced by the following :
    " c ) it shall be a full-time course supervised by the competent
    authorities or bodies pursuant to paragraph 1 of the Annex hereto;"
2 . Article 3 is replaced by the following :
                                      Article 3
"1 . Without prejudice to tne principle of full-time training as set out
in Article 2(1 )( c ), ana until such time as the Council    takes • decisions
 ---pagebreak---   in accordance with paragraph 3 , Member States may permit part-time
  specialist training, under conditions approved by the competent national
  authorities , whan training on a full-time basis would not be practicable
            »                                                  -
  for well-founded individual reasons .
  2 . Part-time training shall be given in accordance with paragraph 2 of
  the Annex hereto and at a standard qualitatively equivalent to full-time
  training .   This standard of training shall not be impaired , either by
  its part-time nature or by the practice of private , remunerated
  professional activity .                                            '
  The total duration of specialized training may not be curtailed in those
  cases where it is organized on a part-time basis .
  3 . The Council shall decide by simple majority not later than
  whether the provisions of paragraphs 1 and 2 are to: be maintained or~
  amended in the light of a re-examination of the situation and' on a
  proposal by the Commission , with due regard to the fact that the
  possibility of part-time training should continue to exist in certain
  circumstances to be examined specialty by specialty ."
  3 . The following        Anjiex is added :
-                                            " ANNEX
                    Characteristics of full-time and part-time
                                  training of specialists
  1 . Full-time training of specialists
                ■ ■  ι I I ■ II ■ . .    I
  Such training shall be carried out in stipulated posts recognized as
  qualifying posts by the competent authority .
  It shall involve participation in all the medical activities of the
  department where the training is carried out , including on-call duties ,
  so that the trainee specialist devbtes to this practical and theoretical
  <*) This date should be calculated to be seven years after the date of
       the adoption of this Directive by the Council .
 ---pagebreak---                                           - 7 -
training all his professional activity throughout the duration of the
standard working week and throughout the year according to provisions
agreed by the competent authority .
Training may be interrupted for reasons such as military service , second­
ment , pregnancy or sickness .       The total duration of the training shall
not be reduced by reason of any interruption .
Remuneration shall be such that it will not be necessary for trainee
specialists to engage in any other paid activity .
2 . Part-time training of specialists
This training shall meet the same requirements as full-time training , from
which it shall differ only in the possibility of limiting participation
in medical activities to a period at least half of that provided for in
the second subparagraph of paragraph 1 .
The competent authorities shall ensure that the total duration and
quality of part-time training of specialists are not less than those of
full-time trainees , and shall accordingly take measures to satisfy them­
selves that proportional remuneration is attached to such part-time
training ."
4 . In Article 4 of the German version
    ( 1 ) " Anästhesie-Wiederbelegung " is replaced by " Anästhesiologie-
          Wiederbe legung "
    ( 2 ) " Hals -, Nasen-, Ohrenheilkunde " is replaced by
          "Hals -Nasen - Ohrenhei Ikunde "!
5 . In Article 5 of the German version
    ( 1 ) " Neuropsychiatrie " is replaced by " Nervenhei Ikunde ( Neurologie und
          Psychi atrie ")
    ( 2 ) " Mikrobiologie-Bakteriologie " is replaced by "Mi krobiologie-
          Infektionsépidemiologie ".
 ---pagebreak--- 6 . Article 7 is replaced by the following :              .
                                       Article 7
As a transitional measure and notwithstanding Articles 2(1 ) ( c ) and 3 ,        y
Member States whose provisions , laid down by law, regulation , or
administrative action , provide for part-time specialist training at the
time of notification of Directives 75 / 362 / EEC and 75 / 363 / EEC may continue
to apply these provisions to candidates who have begun training as
specialists not later than 31 December 1982 .
Each host Member State shall be authorized to require the beneficiaries
of the above paragraph to produce , in addition to their diplomas ,
certificates and other evidence of formal qualifications , an attestation
certifying that for at least three consecutive years out of the five
years preceding the issue of the attestation ^they have ■jn fact been lawfully
practising as specialists in the field concerned ."
                   /. -        '         -     ' ■  ,   '        -
                                      Article 3
                                                                           ' \
Under Article 3 of Directive 75 / 363 / EEC part-time specialist training
                             *
begun before ...;                may be completed in accordance with these
provisions .             - ,
                                      Article 4
    Member States which , before notification of this Directive , have
repealed the provisions laid down by law, regulation or administrative
* Date of entry into force of the amended Directive
 ---pagebreak---                                        - 9 -
action on the award of diplomas , certificates and other evidence of formal
qualification in neuropsychiatry or radiology and have , before notification
of this Directive , adopted measures relating to acquired rights en behalf of their own
nat ionals to regularize exi sting ci rcumstances , shal I accord the right to benefit
from such measures to nationals of the Member States , provided their
diplomas , certificates and other evidence of formal qualifications in
neuropsychiatry or radiology fulfil the conditions laid down in this
respect either in Articles 2 , 3 and 5 of Directive 75 / 363 / EEC , or in
Article 9(2 ) of Directive 75 / 362 / EEC .
                                      Article 5
     Member States shall take     the necessary measures to comply with this
Directive by 31 December 1982 at the latest .       They shall inform the Commission
thereof forthwith .
                                      Article 6
This Directive is addressed to the Member States .
  Done at Brussels ,                             For the Council