Medical Education in RussiaLast year a delegation from the World Health Organization visited Moscow. The delegates were interested in medical education inRussia. Some of them came to the Moscow Medical Academy and had a talk on this subject with Dr. Ivanov, the Dean of the Medical Faculty.Dr. Conroy: Dr. Ivanov, my colleagues and I are here by the arrangement with the World Health Organization. We should like to receive some information on the training of doctors in your country and about the curricula in the medical institutions of higher learning, or medical schools as we call them.Dean: I'll be happy to answer all your questions.Dr. Conroy: First of all, would you kindly tell us who has the right to enter a medical school in your country?Dean: Any citizen of our country who has a complete secondary education may apply to medical school.Dr. Conroy: Applicants have to take examinations, don't they?Dean: Yes, quite so. All the applicants are required to take entrance competitive examinations in biology, chemistry, and the Russian language. And those who obtained the highest marks in the examinations are admitted. Applicants who have finished school with a gold or silver medal are allowed to take only one examination. If they get an excellent mark, they are admitted to the medical school.Dr. Brown: Would you tell us, please, how your students are instructed?Dean: The instruction at higher schools is given through lectures, group instruction and practical classes.Dr. Scott: Is the attendance at lectures and classes voluntary?Dean: No, it is compulsory for all students.Dr. Conroy: How is the students' knowledge checked?Dean: Our academic year begins on September 1st and is divided into two terms of four months each. At the end of each term the students have to pass a number of examinations.Dr. Brown: We should like to know something about your medical curriculum, if we may.Dean: Well, the course of study lasts 6 years and covers basic preclinical and clinical subjects. In the pre-clinical years the curriculum is uniform for the students of the medical, preventive medicine, stomatological and pediatric faculties. During the first two years students study physics, general, organic, inorganic and biological chemistry. The students also study human anatomy, physiology, histology, microbiology, Latin, a foreign language, and philosophy. Beginning with the third year special clinical subjects are introduced - all branches of internal medicine, surgery, gynaecology, obstetrics, ophthalmology, infectious diseases and others. At the end of the third year students take a six-week practical course. They perform the duties of nurses. After their fourth year students take another practical course during which they are ex- posed to direct doctor-patient communication at the department of internal diseases as well as at the surgical department, and the department of obstetrics and gynaecology. Working as doctor's assistants, students master a definite number of medical and diagnostic procedures. Senior students also do a practicum in out-patient departments. They have to attend lectures, seminars, and clinical conferences as well.Dr. Conroy: Dr. Ivanov, you've told us about undergraduate clinical training in the Medical Faculty. How does the training course at a medical school end? And what about specialization?Dean: You see, in our country graduate medical students take a final state examination which includes theoretical questions in internal diseases, surgery and obstetrics and gynaecology, as well as in clinical cases. The graduates also have to demonstrate their practical skills. Those who have passed the examination receive their diploma, which certifies them as doctors. Having received a diploma they may either take a one-year internship course qualifying them as general health care specialists, or a two-year residency course qualifying them as narrow specialists.Dr. Brown: Dr. Ivanov, would you kindly tell us what facilities your doctors have for specialization?Dean: Interns and residents work under the direct supervision of experienced specialists in clinics and in major hospitals. Medical graduates can also apply for the post-graduate training. For three years postgraduates do research into one of the important problems of modern medicine, prepare a thesis, defend it, and obtain an academic degree of Candidate of Medical Science.Dr. Conroy: Dr. Ivanov, thank you very much for the talk. Dean: You are most welcome. If you like, I'll gladly show you through some of our clinical hospitals and departments. Dr. Brown: We'd be much obliged to you.