Feldsher (German: Feldscher, Polish: Felczer, Russian/Cyrillic: Фельдшер) is a health care professional who provides various medical services in the Russian Federation and other countries of the former Soviet Union, mainly in rural areas. For example, feldshers provide primary, obstetrical and surgical care services in many rural medical centres and ambulatories across Russia, Armenia, Kazakhstan, Kyrgyzstan and Uzbekistan.
The equivalent type of provider may also go under different titles in different countries and regions, such as physician assistant in the United States or clinical officer in parts of sub-Saharan Africa. They are collectively grouped under the category “paramedical practitioners” in the International Standard Classification of Occupations, 2008 revision.
The word Feldsher is derived from the German Feldscher, which was coined in the 15th century. Feldscher (or Feldscherer) literally means "field shearer,", but was the term used for barber surgeons in German and Swiss armies from the 17th century until professional military medical services were established, first by Prussia in the early 18th century. The term was then exported with Prussian officers and nobles to Russia.
Today feldshers can be found in every medical setting from primary to intensive care. They are often the first point of contact with health professionals for people in rural areas.
Education and training
Training for feldshers can include up to four years of postsecondary education, including in medical diagnosis and prescribing. They have clinical responsibilities that may be considered midway between those of physicians and those of nurses. They do not have the full professional qualifications as physicians.
The training program typically included basic pre-clinical sciences: anatomy, physiology, pharmacology, microbiology, laboratory subjects, etc.; and advanced clinical sciences: internal medicine and therapeutics, neurology and psychiatry, obstetrics, infectious diseases and epidemiology, preventive medicine, surgery and trauma, anesthesiology and intensive care, pediatrics, and other clinical subjects such as ophthalmology, otolaryngology, dermatology and sexually transmitted diseases, ambulance service and pre-hospital emergency medical care, army field medical-surgical training.
- Health care providers
- Allied health professions
- Clinical officer, a similar category of health care provider in sub-Saharan Africa
- Physician assistant, a similar category of health care provider in the United States
- Farmer R et al., "The Russian Health Care System Today. Cleveland Clinic Journal of Medicine, 2003; 70(11) http://www.ccjm.org/content/70/11/937.full.pdf
- World Health Organization. National Health Accounts of the Republic of Armenia 2006. Yerevan, 2007 - http://www.who.int/nha/country/arm/nha2006.pdf
- European Observatory on Health Care Systems: Health Care Systems in Transition: Kazakhstan. Copenhagen, 1999 - http://www.euro.who.int/__data/assets/pdf_file/0003/95115/E67903.pdf
- World Health Organization and Ministry of Health, Kyrgyzstan. Integrated Management on Emergency and Essential Surgical Care (IMEESC). Bishkek, Kyrgyzstan, 2005 - http://www.who.int/surgery/Report_Kyrgyzstan_Facilitators_workshop.pdf
- World Health Organization and Ministry of Health, Uzbekistan. Assessment of the mental health system in Uzbekistan. Tashkent, Uzbekistan, 2007 - http://www.who.int/mental_health/evidence/uzbekistan_who_aims_report.pdf
- World Health Organization. Classifying Health Workers. Geneva, 2010.
- World Health Organization Regional Office for Europe: Primary Health Care - http://www.euro.who.int/en/what-we-do/health-topics/Health-systems/primary-health-care/facts-and-figures, accessed 15 March 2011.
- Floyd K et al. Health-systems Efficiency in the Russian Federation: Tuberculosis Control. Bulletin of the World Health Organization 2006; 84(1): 1-80 http://www.ccjm.org/content/70/11/937.full.pdf
Kossoy E & Ohry A. The Feldsher: Medical, Sociological and Historical Aspects of Practitioners of Medicine with below University Level Education, the Magnes Press, the Hebrew University, Jerusalem, 1992. (ISBN 965-223-789-2).