The Order of General Nurses, Midwives and Nurses of Romania*

The title of nurse is generic and designates a group of professions in the health field other than that of general nurse or midwife.

The recognition of nurse qualification titles obtained in another EU Member State aims to facilitate the right of establishment and access to the profession for the title holder on the territory of Romania. The profession is exercised after obtaining the status of member of the Order of General Nurses, Midwives, and Nurses of Romania (OAMGMAMR), following the recognition of the qualification.

This procedure does not apply in the case of nurse qualification titles obtained in a state other than those mentioned (third country) nor in the case of temporary or occasional provision of health care services specific to the profession in Romania by nurses established in other EU Member States.

Procedure description:

• Within 30 days from the date of registration, OAMGMAMR notifies the applicant, confirming the receipt of the file and, if necessary, requesting the completion with missing documents.
• Within a maximum of 3 months from the notification, the applicant is obliged to complete the file with all the requested documents. If the applicant does not comply with the completion deadline, upon its expiration, OAMGMAMR closes the file and informs the applicant in writing in this regard. Within 120 days from the submission of the complete file, the OAMGMAMR Commission for the recognition of qualification titles of general nurse, midwife, and nurse obtained in another EU Member State, in a state belonging to the EEA or in the Swiss Confederation, analyzes the training and professional experience of the applicant and formulates a thoroughly justified proposal regarding the way to resolve the request, namely:

a) Recognition of the qualification without compensatory measures. Based on this proposal, the President of OAMGMAMR issues the decision for recognition of the qualification.

b) Recognition of the qualification with compensatory measures. This proposal, as well as the curricular differences established by the OAMGMAMR Commission for the recognition of general nurse, midwife, and nurse qualifications, the related bibliography, and the duration of the adaptation internship are approved by the President of OAMGMAMR, and communicated to the applicant within the 120 days mentioned. If the applicant opts to take an aptitude test, the test date is set by mutual agreement, within a maximum of 6 months from the date of approval by the President of OAMGMAMR of the recognition of the qualification with compensatory measures.

The President of OAMGMAMR issues the decision for recognition of the qualification based on the documents attesting the completion of the compensatory measure by the applicant.

In both situations, the decision for recognition of the qualification is communicated to the applicant and the OAMGMAMR branch of their domicile, for obtaining the membership certificate and authorization to practice the profession.

The procedure applies to midwives whose training, or, as the case may be, professional experience acquired in another EU Member State, in a state belonging to the EEA or in the Swiss Confederation, meets the criteria for automatic recognition of qualifications provided for in this respect by Directive no. 2005/36/EC on the recognition of professional qualifications. The automatic recognition of the midwife qualification aims to facilitate their access to the profession and, respectively, to facilitate the exercise of the right of establishment on the territory of Romania for the professionals concerned.

This procedure does not apply in the case of midwife qualification titles obtained in a state other than those mentioned (third country) nor in the case of midwives established in one of the other EU Member States for the provision of temporary or occasional health care services, specific to the profession, in Romania.

The automatic recognition of midwife qualification titles is carried out by the Order of Nurses, Midwives and Medical Assistants of Romania (OAMGMAMR) designated by law as the competent authority for this profession.

Procedure description:

Within 30 days from the date of registration, OAMGMAMR notifies the applicant, confirming receipt of the file and, as the case may be, requesting completion with the missing documents. Within 3 months from the notification, the applicant is obliged to complete the file with all the requested documents. If the applicant does not comply with the deadline for completion, upon its expiration, OAMGMAMR closes the file and informs the applicant in writing in this regard.

Within 90 days from the date of submission of the complete file by the applicant, the documents submitted are analyzed by the OAMGMAMR Commission for the recognition of general nurse, midwife and nurse qualifications obtained in another EU Member State, a state belonging to the EEA or in the Swiss Confederation and, based on the well-justified proposal of this commission, the OAMGMAMR President issues the decision for the automatic recognition of the midwife qualification.

The decision is communicated to the applicant and to the local OAMGMAMR branch where the applicant resides, for the purpose of obtaining the membership certificate and authorization in the profession. The holder whose midwife qualification has been recognized may register as a member of the OAMGMAMR only after proving that they have the necessary Romanian language skills required for performing professional activities.

After obtaining the OAMGMAMR membership status, the holder practices as a midwife with the rights and obligations provided by law for midwives who are Romanian citizens.

​The procedure applies exclusively in cases where midwives who benefit from automatic professional recognition in the territory of the EU, EEA, or in the Swiss Confederation, established for the purpose of practicing the profession in one of these states, travel to the territory of Romania to temporarily or occasionally exercise midwife activities.
​

Particularities:

The temporary or occasional nature of midwife activities is determined, on a case-by-case basis, by the Order of General Nurses, Midwives and Medical Assistants of Romania (OAMGMAMR), depending on the duration, frequency, periodicity, and continuity thereof. During the provision of services, the respective midwives:

- practice the profession in the territory of Romania under the professional title of midwife;

- are exempt from the obligation to register with OAMGMAMR and from paying the membership fee; - are automatically registered with OAMGMAMR for the duration of the provision of the respective services.-are subject to provisions of a professional, regulatory, or administrative nature regarding professional qualifications and the use of titles, provisions regarding serious professional acts that directly and specifically affect the protection and safety of the beneficiaries of the provided services, as well as disciplinary provisions provided by law for midwives who are Romanian citizens, members of OAMGMAMR; -are exempt from the accreditation procedure provided by the legislation on social health insurance. The provider midwives have the obligation to inform in advance the National Health Insurance House about the services they are to provide in the territory of Romania, and in case of emergency, within a maximum of 7 days from their provision.

Procedure description:

I. Upon receiving the declaration, OAMGMAMR checks the documents and, if necessary, requests the provider to complete the missing documents; Within 30 days from the submission of the complete file, the applicant's documents are subjected to the analysis of the OAMGMAMR Commission for the recognition of qualifications of general nurse, midwife, and medical assistant obtained in another EU Member State, in a state belonging to the EEA, or in the Swiss Confederation. The commission’s proposal is forwarded to the President, who approves the automatic temporary registration of the applicant with OAMGMAMR and the approval for the temporary provision of midwife services in Romania.

The approval for the temporary provision of midwife services and the automatic temporary registration with OAMGMAMR is communicated to the applicant and to the OAMGMAMR branch in the territorial area of the healthcare unit where the applicant is to provide the respective services in Romania.

II. In case of renewal of the prior declaration, after verification of the temporary and occasional nature of service provision by the OAMGMAMR Commission for the recognition of qualifications of general nurse, midwife, and medical assistant obtained in another EU Member State, in a state belonging to the EEA, or in the Swiss Confederation, the President of OAMGMAMR approves the temporary provision of midwife services and the automatic temporary registration of the applicant with OAMGMAMR, within 30 days from receipt of the declaration. These are communicated to the applicant and to the OAMGMAMR branch in the territorial area of the healthcare unit where the applicant is to provide the respective midwife services in Romania. In case of lack of reaction from OAMGMAMR within the deadline mentioned in points I and II, the services can be provided.

The designation of nurse is generic and refers to a group of professions in the health field other than that of general nurse and midwife.

The procedure applies exclusively in cases where nurses, established for the purpose of practicing the profession in another EU Member State, travel to the territory of Romania to temporarily or occasionally carry out professional activities.

Particularities:

-The temporary or occasional nature of carrying out professional activities as a nurse is determined, on a case by case basis, by the Order of General Nurses, Midwives and Medical Assistants of Romania (OAMGMAMR), depending on their duration, frequency, periodicity, and continuity.

-During the provision of services, the concerned nurses:

• practice the profession on the territory of Romania with the professional title established by OAMGMAMR and provided by law for the respective nursing profession;
• are exempt from the obligation to register with OAMGMAMR and from paying the membership fee;
• are automatically registered with OAMGMAMR during the period of providing those services;
• are subject to professional, regulatory, or administrative provisions regarding professional qualifications and the use of titles, provisions on serious professional acts that directly and specifically affect the protection and safety of the recipients of the provided services, as well as disciplinary provisions stipulated by law for Romanian citizen nurses, members of OAMGMAMR;
• are exempt from the accreditation procedure stipulated by health social insurance legislation.

Provider nurses are obliged to inform in advance the National Health Insurance House of the services they are to provide on the territory of Romania and, in case of emergency, within a maximum of 7 days from the provision of these services.

Procedure description:

I. On first provision of services in Romania, OAMGMAMR may check the provider's professional training in order to avoid causing serious harm to the patient's health due to the provider's lack of professional qualification and without exceeding what is necessary for this purpose.

Within 30 days from the date of receipt of the declaration and all mentioned documents, the OAMGMAMR Commission for the recognition of general nurse, midwife, and nurse qualifications obtained in another EU Member State, in a state belonging to the EEA or in the Swiss Confederation, analyzes the applicant's training.

Based on its conclusions, the President approves the manner of solving the applicant's request, namely:

• not to verify the provider's qualification, automatic temporary registration with OAMGMAMR and approval of temporary provision of nursing services in Romania;
• after checking the qualification:

1) to require the applicant to pass an aptitude test, or

2) to automatically register him/her temporarily with OAMGMAMR and grant approval for temporary provision of nursing services in Romania.

In cases where, upon verification of the applicant's qualification, situations that may lead to a delay in the decision-making arise, OAMGMAMR notifies the applicant, within the above-mentioned 30-day period, of the reasons for the delay. The identified situations are resolved within 30 days from notification, and the decision is finalized within 60 days from their resolution.

The aptitude test applies in case of an essential difference between the provider's nursing qualification and the training required in Romania, for the corresponding nursing specialization, insofar as this difference may negatively affect public health and cannot be compensated by the applicant's professional experience as well as by the knowledge, skills, and competences acquired through lifelong learning, formally validated for this purpose by a relevant body.

After the aptitude test is taken by the concerned nurse, OAMGMAMR decides regarding the provision of service by the applicant, and the provision of services may be performed within 30 days from the decision date.

The approval of the temporary provision of nursing services and the respective temporary automatic registration with OAMGMAMR is communicated to the applicant and to the OAMGMAMR branch in the territorial area of the healthcare facility where he/she is to provide the services in Romania.

II. In case of renewal of the declaration, after checking the temporary and occasional nature of the service provision by the OAMGMAMR Commission for the recognition of general nurse, midwife, and nurse qualifications obtained in another EU Member State, in a state belonging to the EEA or in the Swiss Confederation, the President approves the approval of temporary provision of midwifery services and respectively, temporary automatic registration of the applicant with OAMGMAMR, within 30 days from receipt of the declaration. These are communicated to the applicant and to the OAMGMAMR branch in the territorial area of the healthcare facility where he/she is to provide the services in Romania.

If OAMGMAMR does not make a decision within the established deadlines, the service may be provided.

The procedure applies to midwives whose training, or, where applicable, professional experience acquired in another EU Member State, in a state belonging to the EEA or the Swiss Confederation, does not meet the criteria for automatic recognition of qualifications provided for this purpose by Directive no. 2005/36/EC on the recognition of professional qualifications. The recognition with compensatory measures of the qualification of midwife aims to facilitate their access to the profession and, respectively, to facilitate the exercise of the right of establishment on Romanian territory for the professionals concerned. In this sense, midwives in this situation take an aptitude test for the recognition of their qualification in Romania.

This procedure does not apply to midwife qualification titles that meet the conformity requirements provided by Directive no. 2005/36/EC on the recognition of professional qualifications when the holder applies for recognition of the qualification for establishment in Romania, or for the temporary or occasional provision of healthcare services specific to the profession in Romania, nor to midwife qualification titles obtained in a state outside the EU (third country).

The recognition with compensatory measures of midwife qualification titles is done by the Order of Nurses, Midwives and Medical Assistants from Romania (OAMGMAMR) designated by law as the competent authority for this profession.

Procedure description:

Within 30 days from the registration date, OAMGMAMR notifies the applicant, confirming the receipt of the file and, where applicable, requesting the completion with the missing documents. Within 3 months from the notification, the applicant is obliged to complete the file with all requested documents. If the applicant does not respect the completion deadline, at the expiry of this period, OAMGMAMR closes the file and informs the applicant in writing to this effect.

Within 120 days from the submission of the complete file, the OAMGMAMR Commission for the recognition of general nurse, midwife, and nurse qualifications obtained in another EU Member State, in a state belonging to the EEA, or in the Swiss Confederation (the OAMGMAMR Commission for the recognition of professional qualifications) analyzes the training and professional experience of the applicant and formulates a well-justified proposal regarding the manner of resolving the request, respectively:

· a) Recognition of the qualification without taking the aptitude test. Based on this proposal, the President of OAMGMAMR issues the decision to recognize the qualification.

· b) Recognition of the qualification after taking the aptitude test. This proposal, as well as the established curricular differences and related bibliography by the OAMGMAMR Commission for the recognition of professional qualifications, are approved by the President of OAMGMAMR and communicated to the applicant within the mentioned 120-day period. The date for taking the aptitude test is established by mutual agreement with the applicant within a maximum of 6 months from the date of approval by the President of OAMGMAMR.

· The President of OAMGMAMR issues the recognition decision of the qualification based on the documents attesting the applicant's passing of the aptitude test.

· The decision of recognition of the qualification is communicated to the applicant and to the local OAMGMAMR branch of their domicile, for obtaining the membership certificate and authorization to practice the profession.

· OAMGMAMR decisions regarding the recognition of the nurse qualification can be appealed within 30 days from the notification to the competent courts.

· The holder whose qualification as a midwife has been recognized may enroll as a member of OAMGMAMR only after proving that they have Romanian language knowledge necessary for carrying out professional activities.

· After obtaining the status of OAMGMAMR member, the holder practices the profession of midwife with the rights and obligations provided by law for Romanian citizen midwives.

The procedure applies exclusively in cases where midwives with professional training that does not meet the criteria for automatic recognition of qualification provided by Directive no. 2005/36/EC obtained in another EU Member State, an EEA state or in the Swiss Confederation travel to the territory of Romania to temporarily or occasionally perform midwifery activities.

Particularities:

The temporary or occasional nature of providing professional midwifery activities is determined, on a case-by-case basis, by the Romanian Order of General Nurses, Midwives and Medical Assistants (OAMGMAMR), depending on their duration, frequency, periodicity, and continuity.

During the provision of services, the respective midwives:

• practice the profession on the territory of Romania with the professional title provided by law for the respective midwifery profession;
• are exempt from the obligation to register with OAMGMAMR and from paying the membership fee.
• are automatically registered with OAMGMAMR during the period they provide midwifery services;
• are subject to professional, regulatory or administrative provisions regarding professional qualifications and the use of titles, provisions regarding serious professional misconduct that directly and specifically affects the protection and safety of the beneficiaries of the provided services, as well as disciplinary provisions provided by law for Romanian citizen midwives, members of OAMGMAMR;
• are exempt from the accreditation procedure provided by the health insurance legislation. Midwives providing services are required to inform in advance the National Health Insurance House about the services they intend to provide on the territory of Romania, and in case of emergency, within a maximum of 7 days from providing these services.
  

Procedure description:

I. At the first provision of services in Romania, OAMGMAMR may verify the professional training of the midwife in order to avoid causing serious damage to the health of the patient, due to the lack of professional qualification of the provider and without exceeding the necessary for this purpose. Within 30 days from the date of receiving the declaration and all the indicated documents, the OAMGMAMR Commission for the recognition of qualifications of general nurses, midwives and medical assistants obtained in another EU member state, in a state belonging to the EEA or in the Swiss Confederation analyzes the applicant's professional training. Based on its conclusions, the President approves the method of resolving the applicant's request, respectively:

*not to verify the provider's qualification, authorizing the temporary provision of midwifery services in Romania and the provider's automatic temporary registration with OAMGMAMR.

*after verifying the qualification:

1) to require the applicant to pass an aptitude test, or

2) to automatically temporarily register them with OAMGMAMR and to authorize the temporary provision of midwifery services in Romania.

In cases where, during the verification of the applicant's qualification, situations may arise that lead to delays in making a decision, OAMGMAMR notifies the applicant, within the aforementioned 30-day term, of the reasons for the delay.

The identified situations are resolved within 30 days from notification, and the decision is finalized within 60 days from the resolution of these situations.

The aptitude test applies when a significant difference is found between the midwife qualification of the service provider and the midwifery training required in Romania, insofar as this difference may negatively affect public health and cannot be compensated by the applicant's professional experience as well as the knowledge, skills, and competences acquired through lifelong learning, formally validated by a relevant body for this purpose. Following the aptitude test taken by the respective midwife, OAMGMAMR decides whether the service can be provided by her, and the provision of services can be performed within 30 days from the date of the decision.

The temporary authorization of midwifery service provision and the corresponding automatic temporary registration with OAMGMAMR are communicated to the applicant and the OAMGMAMR branch in the territorial area of the healthcare unit where the applicant will provide these services in Romania.

II. In case of renewal of the declaration, after verifying the temporary and occasional nature of the provision of services by the OAMGMAMR Commission for the recognition of professional qualifications of general nurses, midwives and medical assistants obtained in another EU Member State, in a state belonging to the EEA or in the Swiss Confederation, the President approves the temporary authorization of midwifery service provision and the corresponding automatic temporary registration of the applicant with OAMGMAMR, within 30 days from the receipt of the declaration.

These are communicated to the applicant and the OAMGMAMR branch in the territorial area of the healthcare unit where the applicant will provide the respective midwifery services in Romania.