1. Orthopaedics and Traumatology in Finland
Ilkka Kiviranta
Professor of Orthopaedics and Traumatology
Orthopaedist-in-Chief, Helsinki University Hospital

2. FINLAND
population 5.5 million
area km2

3. FINLAND
Length 1057 km, width 542 km
Population density 18 persons / km2
2 million
3.5 million

4. Outline Health care reform in Finland Statistics of specialists
Training of orthopaedists
Finnish Orthopaedic Association

5. Health care in Finland Public health care system Private health care
Oulu
Kuopio
Tampere
Helsinki
Turku
Public health care system
every Finn is covered by the public health insurance
Private health care
25 % of all services

6. Health care system in Finland
Oulu
Kuopio
Tampere
Helsinki
Turku
Primary health care
communities are responsible to organize health care services for their residents
151 consortiums of municipalities run public health centers
Specialist care
20 hospital districts
5 university hospitals (expert responsibility areas)
15 central hospitals

7. Health care system in Finland
Oulu
Kuopio
Tampere
Helsinki
Turku
Costs are 18.5 billion € / year
(national budget 54 billion €)
9.1 % of gross national product
increase rate 1.9 % per year
Government launched a social and healthcare reform in 2015
to reduce the costs
to reduce the number of health care organizers
to centralize the services

8. New health care system 2017
18 counties will organize health care (previously 151)
24/7 on-call hospitals 12 (previously 20)
Operative treatment will be centralized to larger hospitals
may cause transfer of orthopaedists to bigger hospitals
ON-CALL HOSPITALS:
University hospitals (5)
Central hospitals (7)
Central hospitals, limited on-call (8)

9. Orthopaedists in Finland 2015
488 specialists of working age (69 f / 419 m)
14 % female
8,9 orthopaedists / people
Workplaces
2004
2009
2014
Public hospital 82 % 76 % 73 %
Private practice 13 % 19 % 23 %
Other 5 % 5 % 4 %

10. Training of orthopaedists
Organized by 5 Universities under the administration of Ministry of Social Affairs and Health
The specialist degree requires
6 years of medical practice including 9 months in public health centers
theoretical and administrative courses
passing a national written exam
A right to practice issued by the National Supervisory Authority for Welfare and Health (Valvira)

11. Training of orthopaedists
22 new orthopaedists graduate per year
The forecast by Ministry of Social Affairs and Health showed that the need of specialist will be 16 / year
Number of training positions will be reduced to avoid unemployment
Number of orthopaedists

12. Training of orthopaedists
Common trunk
3 years
Specialist training
Current situation
(since Jan 1, 1999)
3 years

13. Training of orthopaedists
Common trunk
Specialist training
Current situation
3 years
3 years
The trainee needs to wait for the specialist training in university hospitals for 1 to 2 years
Free entrance to common trunk training
Training needs to be renewed

14. European Curriculum in Orthopaedics and Traumatology
UEMS/EBOT 2015

15. Training of orthopaedists
Common trunk
Specialist training
Current situation
3 years
3 years
Basic clinical education 1 year +
General education 5 years
Plan
6 years
Entrance examination
Training in central hospitals and university hospitals

16. Finnish Orthopaedic Association
Founded in 1951
650 members
Meetings:
Annual Meeting in November, 3 days
Winter Meeting, 5 days
Spring Meeting, 2 days, biennially
Finnish Journal of Orthopaedics and Traumatology
Economical situation improved
more grants for members

17. Summary The Finnish health care system is under great changes
Training of orthopaedists will be improved
Finnish Orthopaedic Association is the biggest surgical specialist association in Finland