training

Year family medicine established: 2003 (Seifert et al., 2008)

Type of Training: Residency

Length of Training: 6 years of medical school (University of Tartu, 2018) followed by a 3-year family medicine training program (Krzton-Krolewiecka et al., 2013)

Number of institutions that offer family medicine: There is 1 university (Krzton-Krolwiecka et al., 2013) that has family medicine education, University of Tartu (Brekke et al., 2013)

Number of family medicine residents graduating each year: unknown

practice

Number of family doctors in country (2016): 1,061 family physicians (Eurostat, 2016)

Physician to population ratio (2006): 63.5 family physicians per 100,000 people (Masseria et al., 2009).

Number of family doctors in country (2016): 1,412 family physicians (Eurostat, 2016)

Physician to population ratio (2006): 56.1 family physicians per 100,000 people (Masseria et al., 2009).

DALY: 18,900 per 100,000 individuals (Due to all Causes).

Life Expectancy:

• Females 2017: 73.3 years

• Males 2017: 82.2 years

Mortality rate 2017:

• 2017 Males: 155 per 1,000 male adults.

• 2017 Females: 56 per 1,000 female adults.

Infant Immunization-HepB3: % of 1-year-old children received: 93%

College of Family Physicians (Y or N):

• Yes: Family Physician Association of Estonia

training

Family medicine was established in Estonia in 2003 (Seirfert et al, 2008). The current method in their healthcare system for training family doctors is 6 years of medical school (University of Tartu, 2018) which is followed by a 3-year family medicine training program.41 There is only one university (Krzton-Krolewiecka et al., 2013) that has family medicine education, the University of Tartu (Brekke et al., 2013)

practice

In 2006, there were 63.5 family physicians per 100,000 people (Masseria et al, 2009) and as of 2016 1,061 family physicians were practicing (Eurostat, 2016). The full extent of the role of family physicians is somewhat unknown, but they are involved in basic curative care like minor surgeries, vaccinations for children, screening tests for adults, family planning, dispensing pharmaceutical prescriptions, care for children, obstetrics care, or perinatal care. They can also purchase services from other providers like x-rays or CT scans (Masseria et al, 2009).

According to a key informant, “there is a partial gatekeeping system [in Estonia]. People need a referral from a GP to see a specialist, otherwise the EHIF will not pay for the specialist’s services and the patients have to pay themselves. A referral is not required if the patient needs specialized medical care in connection with a trauma, tuberculosis, eye disease, skin disorders or sexually transmitted disease, or in cases where gynecological or psychiatric care is provided. Direct access to all specialists is possible if the costs of the visit are paid privately.” (personal interview, 2018).