Medical Education

Medical Education 

the system for the training and advanced training of physicians, pharmacists, secondary (semi-professional) medical personnel, and medical researchers and educators.

Medical education dates from the third millennium B.C. In Russia the training of medical personnel began in 1654, when the Aptekarskii Prikaz (Pharmacy Department) established a medical school to train physicians for the army. Training became more systematic when the Moscow General Hospital opened a hospital school in 1707. The department of medicine at Moscow University (established in 1764) and the St. Petersburg Medical and Surgical Academy (opened in 1798) played an important part in the development of medical education and medical science in Russia.

On the eve of the October Revolution of 1917, a total of 17 higher medical educational institutions in Russia were training 8,600 students and graduating an average of 900 physicians per year. The medical schools were located primarily in Central Russia, the Ukraine, and the Baltic region; there were none in Middle Asia, Kazakhstan, Transcaucasia, or Byelorussia. Between 1918 and 1922, 16 new medical schools were opened, including several in Transcaucasia, Middle Asia, and Byelorussia. Curricula were reexamined, instruction in the preventive disciplines was broadened, subdepartments of public health were established, and in the clinical disciplines the emphasis was placed on preventive medicine. In 1928 it became mandatory for physicians to acquire practical experience after completing the four-year course of study. In 1930 university medical departments were reorganized into independent medical institutes and placed under the administration of public health agencies. In addition to general practitioners, medical institutes began to train health officers and pediatricians. Institutes and departments of stomatology and pharmaceutics were organized in 1936. A total of 16,400 stomatologists and pharmacists (the provizory) graduated in 1940.

A new stage in the improvement of higher medical education began in 1945. The period of study in departments of medicine, pediatrics, and public health was lengthened from five years to six, and in institutes and departments of stomatology and pharmaceutics from four years to five(1949). New medical institutes were organized in the Far East, Siberia, Kazakhstan, and Middle Asia.

As of the 1972-73 academic year, there were more than 90 institutes and university departments of medicine and pharmaceutics in the USSR. More than 250,000 specialists graduated with higher degrees in medicine or pharmaceutics between 1966 and 1972. The Soviet medical educational system takes into account the new demands placed on the public health system by today’s level of medical science and practice. Physicians are trained in the specialties of internal medicine, pediatrics, public health, and stomatology. Institutes and departments of pharmaceutics train specialists in pharmaceutics. The first two years, which are devoted to preclinical, general biological, and sociopolitical preparation, are essentially the same in all departments. Differentiation of the curriculum starts in the third year, when special disciplines and general medical training, which differs from department to department, are introduced. Generally, students are trained in the basic clinical and hygienic disciplines (internal medicine, surgery, obstetrics, gynecology, pediatrics, hygiene, epidemiology) in the fourth, fifth, and sixth years of study.

The resolution On Measures to Improve the Public Health System and Develop Medical Science in the Country, which was passed on July 5, 1968, by the Central Committee of the CPSU and the Council of Ministers of the USSR, defined the main goals of higher medical education. A system was introduced for the primary specialization, or internship (internatura) of physicians (the graduates of departments of internal medicine and pediatrics) in medical treatment and prevention facilities. Sixth-year students receive specialized training in the principal disciplines before starting their internship. Prediploma and postdiploma specialization have made it possible to move from training general practitioners to training specialists in the main clinical disciplines. Later, students can acquire the narrower specialties.

Research and teaching personnel are trained in graduate (aspirantura) and clinical residency (ordinatura) programs. As of Jan. 1, 1973, there were about 5,500 graduate students and more than 7,500 clinical residents enrolled in Soviet medical institutes. A network of departments was created for the advanced training of teachers in higher educational institutions of medicine and pharmaceutics. More than 16,500 teachers were enrolled in these departments between 1968 and 1973.

As of 1973, there were 13 institutes, as well as 23 departments in medical and pharmaceutical institutes, for the advanced training of physicians and pharmacists. About 75,000 physicians and pharmacists received some form of advanced or specialized training in 1972.

Feldshers (physicians’ assistants), midwives, public health assistants, and laboratory technicians are trained at secondary medical schools, as are nurses (including pediatric nurses), dental doctors (dentists without a professional degree), dental technicians, technicians for the installation and repair of X-ray and electrical medical equipment, opticians, and some pharmacists (the farmatsevty). The curricula provide for instruction in general medical, clinical, and special disciplines, in addition to general educational subjects. In the clinical and special courses considerable attention is given to practical training, academic study, and practical experience in public health facilities.

Abroad, physicians are trained in medical institutes, schools, university departments, and medical academies. The course of study takes five to seven years. In a number of countries the graduates of higher medical educational institutions must also serve as interns for one or two years (for example, in the Federal Republic of Germany, Finland, Sweden, and Yugoslavia). Higher medical education in the USA includes three stages: premedical studies in college (three or four years), medical education in a medical school or college (four years), and practical training and specialization (internship and residency).

REFERENCES

Petrovskii, B. V. “Opyt i perspektivy vysshego meditsinskogo obrazovaniia i usovershenstvovaniia vrachei v SSSR.” Sovetskoe zdravookhranenie, 1967, no. 6.
Petrovskii, B. V. “Zadachi sovershenstvovaniia podgotovki meditsinskikh kadrov.” Sovetskoe zdravookhranenie, 1971, no. 5.
Petrovskii, B. V. Zdorov’e naroda—Vazhneishee dostoianie sotsialisticheskogo obshchestva. Moscow, 1971.
Bagdasar’ian, S. M. Ocherki istorii vysshego meditsinskogo obrazovaniia. Moscow, 1959.
Ovcharov, V. K. K istorii razvitiia vysshego meditsinskogo obrazovaniia v SSSR. Moscow, 1957.

IU. F. ISAKOV