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19 Dec 2016

Medical education in Russia is experiencing underfunded even on the level of teachers. Low wages force them to look for additional income, which, in turn, leads to a drop in motivation for the development of education. The theory takes precedence over practices that partially invalidates this same theory, because it is not supported by the skills. Doctors clinical departments, which are attached to senior students, perceive them as best as free labor for blood pressure and writing diaries, and at worst, simply put them in the lobby and asked to be quiet and do not interfere with work. Patients often do not like the fact that during the inspection looks at them not only a doctor but also a dozen young people. Hospital, Research Institute can not afford to abandon the patients, it is clear. It would be good if the patient understands and that research institutes not only treat, but also to teach. Now it is unclear how to enter patients in the education process: a legally distinct circuits not.

- Absence in Russia the concept of evidence-based medicine - a global problem. No distinct standards of medicine, uniform clinical guidelines, protocols understandable. Each himself scientific authority, but in general it is not clear how to teach young doctors. Still alive the concept of scientific schools, which is morally obsolete 35-40 years ago. In the Urals, young doctors can learn what a stroke is treated, "Cerebrolysin" in Peter say: "What a delusion, it is better" Actovegin "in Moscow will register" Semax ", and the Kaliningrad near by Germany, so they do such names do not know and believe that it is not necessary to treat stroke, and the need to engage in the rehabilitation and prevention of recurrent stroke.

When the Germans and Americans see Russian recipes in Latin, they rounded the eye and say: «! What the fuck» They do not understand the language in which it is written.

The approaches to the diagnosis and treatment of some diseases may differ substantially in the two treatment departments of the university. This makes it impossible to standardize care and greatly complicates the process of creating a unified clinical guidelines, which, in turn, makes it impossible to create a single educational standard for doctors. In an attempt to introduce a single educational standard of the teachers are trying to teach him, but somehow in vain: they do not know or understand.

- Among the subjects taught in our medical schools, the proportion is very low. In the world of modern medicine with no knowledge of English, for example, has nothing to do. 30-40 years ago medical knowledge updated every five years and the same number had to wait for them to translate and adapt. Now news happen every week, and the ability to control the process without knowledge of the language is completely absent. About 98% of current scientific and educational medical literature is available in English. Medical ethics have allegedly taught, but in a very truncated version: a series of lectures, which is read on the 4th or 5th year student, usually in the farthest audience, in the darkest corner, at 6 pm in the winter. medical ethics Anthology covers the entire spectrum of medical communication and patient, doctor and patient family member, doctor and colleagues. And our doctors do not have these skills: the ability to win, to show attention, support the patient; how to report a hard diagnosis to explain the treatment plan and all its nuances, how to communicate with their relatives - we do not teach it!

A specialist who is treating a patient in the chain are not the first to see the story of his illness, with 80 percent probability exclaim: "What a fool you ordered this scheme ?!". Well, not so much about co-workers, and even in the presence of the patient! It is a violation of all the canons of the world's health, and human ethics and therapeutic communication, but not every Russian doctor knows about it. We nurses do not always have a clear understanding of what is a medical secret and how to store it. Medicine - moral sphere, then no specific knowledge is indispensable. Theory and practice of communication with colleagues, patients and their relatives recognized worldwide critical skills acquired during the training. It's part of medical psychology of law, which very clearly defines many parameters physician communication and patient. first trainings were held recently in Moscow.

- When the Germans and Americans see Russian recipes in Latin, they rounded the eye and say: «What the fuck!». They do not understand the language in which it is written. From Latin rejected all the leading medical-oriented country, has long recipes are written in national languages, Latin and is considered an anachronism. I do not have anything against the Latin as the cultural knowledge, but the hours spent on training her in the Russian medical school, it is meaningless.

- We have been witnessing the restriction of specializations. Old format, in which the physician knows all exhausted. Over the past 20 years, the volume of medical knowledge has increased a hundred times, and human memory with the amount of information is already unable to cope. In many medical areas are divided into narrow specialization, and this trend will grow. Russian medicine is beginning to focus on the Western model of practice - it can also be called a trend stood out.

- No, it is nothing moves at the system level. The doctor decides whether or not to take a particular approach to treatment, and other international guidelines, but much is obvious that the Western model is most effective. Good doctors are distinguished from the bad percentage of permissible error. Super-surgery makes cardiac surgery complications in America with a probability of 1%, that is, they can have one person out of a hundred. After the operation, the average heart surgeon allegedly risking 2% of US patients, and we have - 10%. There are brilliant doctors, honor and praise them, but this one, but hundreds of thousands are needed.

We still have the family doctor makes home visits to elderly patients and performs not its job, and the work of social workers - treats conversation.

The difference between ordinary and outstanding doctor in Russia and America, too, is not comparable. There between the level of knowledge and skills recognized and conventional medicine star doctor of the city hospital she was in a couple of items we have are these people can be in two different universes.

80% of the medical staff of hospitals has a secondary education, it is nurses. And they provide a successful treatment in hospitals around the world - it's a fact. Nurse - serious, prestigious profession in which you can develop a lifetime. In the West, it is a well-paid profession - basic middle class doctors often come in the top of his stamp. Related to this, of course, and a huge educational motivation and the amount of education received by students at the universities. In America, such a situation is impossible to a heart surgeon, for example, appointed a US patient in the office on the floor below. Because there is a doctor in any specialty he works on ultrasound apparatus. We still policeman armed with tools for the initial examination, makes home visits to elderly patients and performs not its job, and the work of social workers - treats conversation.

- It's all old history and has long been a profanation, not education. It is on its last legs. Now we are moving to a system of continuous education of physicians. Enter it extremely difficult, and, in theory, you first need to standardize primary health education, but it is as it is. Advances in technology, of course, contributes to the fact that the doctor was trained continuously. There certification system to confirm certificate for continuing education - there are different analogues in the world. Practicing physician should periodically visit the allotted number of lectures and webinars, to report on each study subject: to prepare reports, write articles, participate in research. After loading each work in the author credited evaluation points, the desired amount of which eventually confirmed the certificate.

In Russia, the so-called accreditation - a multi exam with several huge disadvantages. Firstly, the lack of unified and clear sound standards can not create normal tests and tasks. Second, doctors who graduated from high schools 25-30 years ago, most of them badly imagine modern medical trends and, accordingly, was originally put in unequal conditions.


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