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Afeldsher (German:Feldscher,Polish:Felczer,Czech:Felčar,Hungarian:Felcser, Russian:фельдшер,Swedish:Fältskär,Finnish:Välskäri) is ahealth care professional who provides various medical services limited to emergency treatment and ambulance practice.[1] As such, a feldsher is one kind ofmid-level medical practitioner.
In Russia,Ukraine and in other countries of the formerSoviet Union, feldshers provide primary-, obstetric- and surgical-care services in many rural medical centres and clinics across Russia,[2]Armenia,[3]Kazakhstan,[4]Kyrgyzstan,[5]Mongolia[6] and Uzbekistan.
Similar types of mid-level practitioners are known by different titles in different countries, includingadvanced practitioner (United Kingdom),clinical associate/clinical officer (in parts ofsub-Saharan Africa),community health officer (India),medical assistant (United States),nurse practitioner (Australia, Canada and US), andphysician assistant (Canada and US). TheInternational Standard Classification of Occupations, 2008 revision, collectively groups such workers under the categoryparamedical practitioners.[1]
The wordFeldsher is derived from the GermanFeldscher, which was coined in the 15th century.Feldscher (orFeldscherer) literally means "(battle-)field shearer" and was the term used forbarber surgeons in the German and Swiss armies from the 17th century until professional military medical services were established, first by Prussia in the early 18th century. Today, Feldshers do not exist in Germany anymore, but the term was exported with Prussian officers and nobles to Russia. An All-Russia Union of Feldshers was founded in 1905. They were regarded as "Middle Medical Workers".[7]
The Feldsher system of rural primary care provided some of the inspiration for China'sbarefoot doctors.
Today feldshers can be found in every medical setting from primary to intensive care.[8] They are often the first point of contact with health professionals for people in rural areas.
Training for feldshers can include up to four years of post-secondary education, including medical diagnosis and prescribing.[4] They have clinical responsibilities that may be considered midway between physicians and nurses. They do not have fullprofessional qualifications as physicians.[9]
The training program typically includes basic pre-clinical sciences:anatomy,physiology,pharmacology,microbiology, laboratory subjects, etc.; and advanced clinical sciences:internal medicine andtherapeutics,neurology andpsychiatry,obstetrics,infectious diseases andepidemiology,preventive medicine,surgery, andtrauma,anesthesiology andintensive care,pediatrics, and other clinical subjects such asophthalmology,otorhinolaryngology,dermatology, andsexually transmitted infections,ambulance service andpre-hospital emergency medicine, andbattlefield medicine.
Ambulance workers. ISCO code: 2240.
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