Only in the General Hospital in Pljevlja, there are 10 people who graduated from the "Dositej Obradović" High School in Novi Sad and five people who graduated from the Tutin High School. This can be seen from the documentation that Center for Investigative Journalism of Montenegro (CIN-CG) received under the Law on Free Access to Information (SPI) from that health institution.
Tutin High School was closed in July 2019, just three years after its establishment, because it was found to have illegally organized exams for requalification and requalification. The cessation of work was ordered by the Serbian Ministry of Education after an inspection. It was also proven that some written assignments of part-time students were graded without being reviewed. By the way, the school was located in a small attic of a house in Tutin, on the first floor of which technical inspections of cars were carried out. Some of the diplomas of this school held by the employees of the General Hospital in Pljevlja were issued just a few months before its closure. However, no one checked the diplomas of the employees in Pljevlje after the Serbian educational authorities found illegalities.
"Dositej Obradović" high school in Novi Sad is mentioned in the files of the large investigation of the Prosecutor's Office of Bosnia and Herzegovina (BiH) and the State Agency for Investigation and Protection (SIPA) in 2023 due to the illegal issuance and sale of diplomas. One of the citizens of Bosnia and Herzegovina, who was arrested in the action of these Bosnian-Herzegovinian institutions, worked as an intermediary for the "Dositej Obradović" Secondary School in the period from 2014 to 2023, when, together with the employees of that school, he found candidates in the territory of Bosnia and Herzegovina who would buy diplomas issued by that Serbian school institution.
It is not known for sure how many employees who belong to the medical staff with secondary or higher education who work in Montenegrin healthcare with these or similar diplomas from problematic educational institutions. CIN-CG addressed numerous public health institutions throughout Montenegro and asked them to submit educational documents of medical staff with secondary education. After several months of waiting, until the publication of this text, apart from the General Hospital in Pljevlja, only the Clinical and Hospital Center Kotor and the Special Hospital for Orthopedics, Neurosurgery and Neurology "Vaso Ćuković" in Risno submitted the documentation.
On the basis of this documentation, CIN-CG was able to confirm that people with diplomas from the closed Tutin High School also work in these institutions. - one nurse at the Kotor Clinical Hospital Center and one medical technician at the "Vaso Ćuković" hospital.
All these diplomas were issued in the period from 2016 to 2022 and were recognized without problems by the National Information Center of Montenegro (ENIC Center), which is in charge of recognizing diplomas from abroad.
In Montenegro, as CIN-CG previously announced, there are about 25 fake diplomas in various fields. Many of these diplomas belong to employees in the health sector, mainly medical staff with secondary or higher education - medical technicians and nurses.
"The problem of fake diplomas indicates that the state does not control the quality of providing health services to the citizens of Montenegro. Therefore, the health of citizens is not a priority. The state tacitly allowed the production of fake diplomas in order to fill the missing jobs in the health care system and present it as a success," Žanka Cerović, president of the Medical Chamber of Montenegro (MLJCMG), told CIN-CG.
Cerović believes that this is an indicator of the social trend of favoring political affiliation over knowledge and education.
"For a long period of time, political affiliation is a ticket for employment, and education and knowledge are in the background, so the diploma has become just a 'formal paper' that must be attached when hiring," she states.
"There are fake diplomas in other professions as well, but it is especially dangerous when they are in healthcare, which involves working with people, treatment, operations, therapy, monitoring patients... The job of healthcare workers is, first of all, a humane one, but also a responsible one. and demanding work, so it would have to be performed by highly educated people, who have gone through years of learning, training, and specialization," points out psychologist Stela Burzanović for CIN-CG and says that all of this can increase citizens' distrust in the health system. Ignorance, she claims, can lead to serious mistakes.
And from the National Association of Nurses and Midwives of Montenegro (NUMSBCG) for CIN-CG, they warn that the presence of fake diplomas among health and gynecological-obstetric technicians who provide health care and midwifery services calls into question the safety of patients and the provision of equal health care throughout the country.
The boom in fake diplomas occurred during the coronavirus pandemic
"First, two hygienists, one from the laboratory and the other from the surgical department, suddenly started working as nurses. They would finish their standard shift, and then we would see them in white coats," a health worker at a health facility in the north of Montenegro, who wished to remain anonymous, told the Center for Investigative Journalism of Montenegro (CIN-CG).
The problem of fake diplomas in the hospital where he works, he says, became visible shortly before the coronavirus pandemic. He believes that due to the lack of staff, the virus also led to a pandemic of fake diplomas.
"Since it is a small town where we all know each other, it was not difficult to understand that something suspicious was happening. Word quickly spread about where to get diplomas".
First, CIN-CG's interlocutor points out, Tutin was mentioned, where for a certain sum one could easily get the diploma needed for the job of a nurse.
"Now, let's say, some colleges in Belgrade are 'current' where lectures are organized on weekends and where people go for 'improvement'".
For the purposes of this research, CIN-CG conducted an online questionnaire addressed to medical personnel in the private and public sector of the health system of Montenegro. About 200 healthcare employees were surveyed.
The results showed that almost 50 percent of the respondents suspected that one of their colleagues has a fake diploma - most often medical staff who work with a high school diploma, and less often doctors.
It is interesting, however, that in most cases (as many as 96 percent) employees in the health sector did not decide to report suspicious cases. In the answers, they mainly explain that the reason for this is that they do not trust the institutions, as well as that they believe that a systemic response to this problem is needed and that it should be initiated by the administrations of health institutions.
"Nurses with fake diplomas, for example, are first assigned to outpatient clinics, because there they do not have prolonged contact with patients and are constantly under medical supervision, so the possibility of making a cardinal mistake is less," says one respondent who works as a doctor.
After a few months, he explains, when they "gain experience", these nurses start working in the wards in shifts, and this is where serious problems arise that are kept silent.
"It is very difficult and unpleasant when we have to watch their every move and correct the mistakes they make, starting from inadequate preparation of therapy, giving the wrong therapy, incorrect use of medical terminology, and all the way to being rude to patients or other employees," explains this doctor.
One nurse points out that in the institution where she works, there have been cases where her colleagues with dubious diplomas prepared therapies in a non-sterile manner.
"So much for knowledge about, say, the dangers of sepsis," states this respondent.
Another healthcare worker states that it happened that medical technicians, who are questionable as to how they obtained their diplomas, call intravenous solutions "infusion" in front of patients, and bone fractures, instead of fractures, - invoice.
The health worker from the north whom we mentioned earlier claims that in the inpatient hospital where he is employed, and where patients with the covid-19 virus were placed during the pandemic, it was nurses with questionable diplomas who worked.
"Imagine what can happen when someone with a bought diploma, without a day of practice, is given the task of providing oxygen support to patients".
Cerović points out that nurses and technicians, among other things, must know how to adequately administer the therapy prescribed by the doctor, which therapies they must not provide at the same time, as well as which side effects the patient may experience in certain cases as a result of certain therapeutic actions. They must know medical procedures, as well as recognize certain symptoms in patients and, if necessary, immediately report them to the doctor.
"Relying on staff with fake diplomas, our healthcare system loses significantly in the quality of service provision," says the president of the Medical Chamber of Montenegro.
In the course of this research, CIN-CG obtained the diplomas of three employees at the General Hospital in Pljevlje who retrained in June 2020, four months after the start of the pandemic, at the Foča High School Center in the entity of Bosnia and Herzegovina - Republika Srpska, and thus obtained title of medical technician. Through retraining, as CIN-CG learns from well-informed sources, it was quick and easy to obtain the diplomas required for the profession of nurse or technician.
Cerović believes that no form of "requalification" or obtaining a diploma should be allowed after three visits to the appropriate health institution.
"Adequate knowledge and education in the field of the medical profession cannot be acquired 'extraordinarily'. Only diplomas obtained in respectable health institutions should be considered, which many countries practice, and the possibility of part-time education for many professions, especially medical ones, should be abolished, as well as practice, i.e. the possibilities of retraining without adequate regular education", she states.
No one from the Ministry of Health is a member of the working group that should examine diplomas
Recently, the first session of the interdepartmental working group was held, which was established in May 2024 by the Ministry of Education, Science and Innovation (MPNI), whose purpose is to propose a method of checking educational documents obtained at private and public educational institutions abroad. It was agreed to make a decision to suspend the recognition of educational documents obtained at those institutions that are under investigation by competent authorities in the countries where they were founded - Serbia, Bosnia and Herzegovina, and Kosovo, where most of the problematic diplomas come from.
"Educational institutions that are known to issue dubious diplomas, as well as those against which various criminal investigations are being conducted, should be urgently checked additionally in the diploma verification process," one of the members of this group and the coordinator of Alternative Montenegro, an organization, told CIN-CG who has been fighting against fake diplomas for years, Zarija Pavićević.
He will request that, if several fake diplomas from the same address are found, all diplomas issued by that educational institution, which are recognized in Montenegro, be declared invalid in the entire country, and their owners processed automatically.
It is disputed, however, that no one from the Ministry of Health is a member of the MPNI working group.
This was confirmed to CIN-CG from the Ministry of Health, which is currently conducting the procedure of checking the diplomas and certificates of all employees in that government department.
So far, they claim, they have checked 60 diplomas in the Ministry and all of them, they say, are credible. These are mostly diplomas obtained at educational institutions in Montenegro.
"The verification of the educational documents of all employees in public health institutions is underway, and in the event that the competent authorities determine that the diplomas are not credible, they will be sanctioned," said the Ministry of Health.
The NUMSBCG points out that until now they have had no official information and reports of cases of fake diplomas among secondary medical staff.
"It is a systemic problem in the country, not only in health care, but also in other professions in Montenegro. Quality education of nurses, midwives, health and gynecological-obstetric technicians is of essential importance for ensuring quality, patient safety and services based on knowledge and skills", according to this association.
They explain that the recognition and control of diplomas in the region and Europe is usually done by the Chambers of Nurses, Midwives, Health and Gynecology-Obstetric Technicians.
However, such an institution, whose task is, among other things, to issue and revoke work licenses, keep a register of issued licenses and adopt a code of ethics for nurses, midwives and technicians and take care of its application, does not yet exist in our country.
The program for the accession of Montenegro to the European Union and the harmonization with the Directive on the recognition of professional qualifications from 2013 foresees the opening of the Chamber for nurses, midwives, health and obstetric technicians of Montenegro. This is defined by the Law on Health Care, as well as the Law on Health Care patients from 2010, which even states that the establishment of this chamber will be carried out within six months from the entry into force of that law.
And in the Healthcare Development Strategy for the period from 2023 to 2027, the opening of such a chamber is stated as one of the goals.
"With the formation of the Chamber of Nurses, many issues related to fake diplomas in this field can be adequately resolved. By issuing licenses, the Chamber of Nurses could make a significant contribution to the verification of diplomas for the work of middle and senior medical personnel. This is exactly what the Medical Chamber of Montenegro does, which seriously controls the documentation for each issued license, i.e. work permit for all doctors in Montenegro," Cerović points out.
In her opinion, a big contribution must be made by the health inspection, which should perform its work much more seriously and with more knowledge.
"That is not the case today. The institutions of the system must put knowledge and education before political affiliation, establish strict criteria in the part of checking diplomas obtained outside of Montenegro, as well as that the probationary work of persons with these diplomas be more seriously controlled", she notes.
For more than five years, there have been no judgments against medical personnel for falsifying diplomas
CIN-CG has already written about the mechanisms that state institutions have to review dubious diplomas, as well as what the practice of the courts has been so far when it comes to this criminal act in general. In short - trade in fake diplomas is symbolically sanctioned.
It is interesting, however, that this research showed that in the Montenegrin courts in the period from 2018 to April 2024, there were no judgments related to the falsification of educational documents of medical staff, although there were criminal charges against medical workers in that period. This was confirmed to CIN-CG from all the basic courts in the country that are competent for these cases.
In December 2018, the Basic Court in Podgorica handed down the only verdict that somewhat concerns the problem of falsifying diplomas in the health profession against a woman who submitted a fake diploma from the Faculty of Pharmacy in Belgrade to the Ministry of Education that year. In the judgment, which CIN-CG had insight into, it is not written for what purposes she requested the recognition of that diploma. She received a two-year suspended sentence.
MPNI data show that since the beginning of 2024, only two criminal charges have been filed due to suspicion of falsification of an educational document required for the job of a medic. These are two criminal charges filed by the management of the General Hospital in Bijelo Polje in March 2024 against two nurses who were employed at that health facility. In the internal process of checking the educational documents of all employees, the administration suspected the validity of the diplomas of these two women, which were allegedly issued by the First Vocational High School in Nikšić.
CIN-CG addressed the administrations of all educational institutions in Montenegro where health personnel are trained and asked them if they were informed that there had been falsification of diplomas from any of the courses that exist in those schools or faculties and if they had reported those cases.
Except from the First Secondary Vocational School Nikšić, which confirmed to us that the diplomas of fake nurses in the hospital in Bijelo Polje were not valid and that the Bijelo Polje ODT filed charges against them, we were told by most educational institutions that there were no reports.
In 2022, Alternative Montenegro filed a criminal complaint with the Basic State Prosecutor's Office (ODT) in Pljevlja against more than 50 medical workers who work in various health institutions in that city - the General Hospital, the Health Center and the Home for the Elderly... From the Pljevlja ODT told CIN-CG only that the case is still in the investigation phase. They did not answer other questions related to these cases.
"Nothing has happened for two years, and we gave them everything. "According to our knowledge, until now the prosecutors have only spoken to those we reported and statements were taken from them," says Pavićević.
He points out that in the coming period, he will continue to file criminal charges against dozens of healthcare workers.
"We are currently analyzing the diplomas of employees in hospitals in Nikšić, Berane, Bar and Budva that we received from insiders".
At the end of 2023, the public heard the news that Miljana Pavličić, the then assistant director of the Institute for Public Health of Montenegro (IJZCG), worked and advanced in the service for more than 10 years with a fake diploma from the Chemistry Faculty of the University of Belgrade. This case, which "Vijesti" wrote about, pointed to problems in the cooperation of state institutions, since no one in the institution where Pavličić worked, as well as in the relevant ministries, allegedly knew that, as early as early 2014, the Basic Court in Podgorica had suspended her punished for the criminal offense of document forgery.
In addition to falsifying the diploma, Pavličić also falsified the decision on the nostrification of the fake diploma, and for this criminal offense, also at the end of 2023, was reported by the MPNI.
The then director of IJZCG Igor Galić resigned because of all this, and the diplomas of IJZCG employees are currently being examined by the MPNI.
The criminal trial against Pavličić is still ongoing.
Fake diplomas a global problem
Numerous cases of falsification of diplomas of nurses and technicians have been recorded all over the world.
One of the more notable occurred in 2023 in the United States of America (USA), when a complicated and coordinated scheme to sell thousands of fake nursing degrees and credentials was exposed. The action spanned five states: Florida, New York, New Jersey, Texas and Delaware and resulted in more than two dozen criminal charges of fraud and conspiracy against as many as 25 people. Falsified diplomas from accredited schools were sold to “future nurses” to help them bypass the eligibility requirements necessary to take the national nursing exam.
In 2018, a large network was also discovered in India that sold fake diplomas for nurses and other health workers. Kenya and Pakistan have also reported cases of nurses and other health workers using fake diplomas for employment.
These incidents, however, led to improved regulation, oversight of educational institutions, and licensing of health care professionals.
Bonus video:
