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90 years of the Kazan state medical academy



ISTORIYA MEDITSINA

UDC 961.75

90 YEARS of the KAZAN STATE MEDICAL ACADEMY

Kamil Shagarovich Zyyatdinov, Mars Konstantinovich Mikhaylov Kazan state Medical Academy for Post-Graduate Education

Proanalizirovna main stages of development of the Kazan state Medical Academy for Post-Graduate Education and its activity now.

In April, 2010 90 years from the date of the organization of the Kazan state Medical Academy for Post-Graduate Education are executed. Entering the next decade, we can sum up some results and analyze the main stages of development of institute (academies since 1995), inseparably linked with the history of our country.

Achievements of foreign and domestic medical science, development of the new branches of applied medicine, development of modern methods of diagnostics, prevention and treatment of various diseases with use of the latest diagnostic units, introduction of little-known medicines demand from the doctor of continuous updating of knowledge and acquisition of practical skills. The volume of knowledge gained in higher educational institutions which purpose is preparation of medical shots of the general profile is insufficient in order that the doctor could become the first-class expert: postdegree training and skills development are necessary, and institutions of additional professional education have to solve this problem.

In Russia the improvement of knowledge of doctors was carried out to XVSh — XIX of centuries mainly in a private order and only at some clinics of the universities. For the first time training of the affiliated doctors was begun in the thirties the XIX century at one of the oldest universities in Derpta. Since 1841 the domestic medical institution largest at that time — the medico-surgical academy — practices secondment of doctors for increase in their qualification in applied medicine. In 1858 at the same academy the Medical institute for improvement in sciences which gave to domestic medicine of wonderful scientists and teachers whom we by right consider coryphaeuses in improvement of skill of doctors was founded. Besides, considerable number of doctors from Russia in 278

dependences on the desires, aspirations and material resources undertook trips abroad, is more often to Germany, for the purpose of increase in the scientific and clinical qualification. However similar ways and ways of improvement in the conditions which developed in Russia in the second half of the XIX century could not solve a problem of further development of medicine and health care in general.

In 1885 in St. Petersburg at the initiative of the talented therapist, professor E.E. Eykhvald the Clinical institute of improvement of doctors (nowadays St. Petersburg Medical Academy for Post-Graduate Education) designed to introduce a new form of the postdegree preparation which is carried out by program and purposeful training in practice was organized. Creation of such institute in pre-revolutionary Russia was an important stage within development of the higher medical school for training of highly qualified medical personnel. In the first lecture professor E.E. A-hvald emphasized: "It is impossible to demand that now young doctors left medical faculties with that stock of practical knowledge and with that experience which can be acquired long practical, and in particular by hospital activity". The institute had to meet the lack which was inevitably arising between level of training of students at medical faculties and requirements of practice. Quickly enough neogenic clinical institute gained wide popularity and authority on the highest medical circles not only on Russia, but also abroad. However, despite great efforts from the largest scientists and their assistants, one clinical institute was not able to solve completely a problem of developing the skills of doctors in the country. Besides, in the conditions of the political and economic situation which developed as a result of imperialistic and civil wars, the institute was forced to stop the main work with the affiliated doctors. Sharply there was a question of creation in the USSR of network of this sort of institutes.

The enormous physical decrease of doctors which was a consequence of two wars which took place one by one and also epidemics of those years, not

it was compensated by releases of university medical faculties. More than 80 doctors were lost only by one Kazan, among them there were talented professors, associate professors, assistants to medical faculty of KGU. It was necessary to take urgent measures to completion of deficiency of medical shots. Sharply there was a question and of quality of their preparation. The violation of normal tenor of life caused by wars, economic and political blockade could not but affect the general level of professional qualification of physicians. The interrupted communication with world scientific centers, a lack of domestic and foreign literature, an emergency of clinics, hospitals and laboratories, lack of the necessary equipment have an adverse effect on a condition of medical education. Besides, from 1915 to 1920 the universities produced about 14 thousand doctors of wartime who were not in time to pass completely programs of the higher medical education. It was necessary to acquaint in extremely short terms with work in new conditions a large number of the doctors demobilized from the front and needing thorough updating of the knowledge. Optimum means only improvement of knowledge of doctors could be in such family way. The only Leningrad institute in the country could not cope with an objective: creation of the whole network of such institutes was required.

The Kazan GIDUV — the state institute for improvement of doctors became the Russia's second training center of doctors. In April, 1920 in the conditions of yet not ended civil war, hunger, epidemic, in the conditions of almost full economic sluggishness the management of the city and republic makes the decision on opening of Clinical institute supported Plank beds Healthcare Committee of RSFSR (the first people's commissar of health care — N.A. Semashko, the graduate of the Kazan university). Creation of such institute in Kazan had a number of very serious prerequisites. In 1918 — 1920 in the city owing to formation here of the western army the large number of the medical officers working in the numerous hospitals which were a part of the system of a headquarters medical unit of army concentrated. The medical faculty of the Kazan university attracted to itself all who sought to meet lacks in the theoretical and practical knowledge. But the university could not open a door of the audiences, laboratories and clinics for all comers which stream increased as approaching the end of civil war. The important value had also that circumstance that Kazan was the oldest center medical

education in which the largest scientific forces widely known not only in our country, but also abroad were concentrated. Opening of institute in Kazan promoted the solution of such important task as preparation of national shots for the Volga region and the East of Russia. This social order dictated by the life to honor of the Kazan medical public was supported by group of the famous doctors of the city who were actively participating in foundation of institute. V.I. Iordansky, R.A. Luriya, V.P. Pervushin were initiators of the petition for opening of institute. Subsequently R.A. Luriya was appointed the director of institute and the head of the department of internal diseases. In 1930 he was transferred to Moscow where he took active part in opening of the Central institute of improvement of doctors. A birthday Kazan GIDUVA is considered on April 22, 1920 — date of pronouncement of the relevant resolution of the Kazan gubispolkom. On February 9, 1921 the Council of People's Commissars of TACCP resolution No. 11 officially dekretirovat its opening. Support as idea, and the practical help from outstanding scientists of medical faculty of the Kazan university — M.N. Cheboksarov's professors, B.C was extremely important factor in the period of the organization of institute. Gruzdeva, R.Ya. Chistovi-cha, N.A. Gerkena.

The clinical institute received a number of wonderful buildings which till that time were occupied by military hospital: the former infirmary of community of nurses of the Red Cross (transferred as base to institute), the building of Country bank, the former mansion of the merchant M.I. Okonishnikov, the building allocated to institute from the nationalized fund where the trakhomatozny institute soon was placed. It is necessary to be surprised to insight of the management of that time of the republic — in Kazan in the same years open research institute of traumatology and orthopedics (it was part GIDUVA till 1945), trakhomatozny (institute of eye diseases), tuberculosis, the scientific research institute of microbiology and epidemiology continues to function. Unfortunately, all listed institutions either are liquidated for today or drag miserable existence.

Despite all difficulties of material and financial character, in 1920 the first 6 departments and clinics were created: internal diseases on 70 beds (the manager. — the prof. R.A. Luriya) with a x-ray office and the central clinical laboratory, nervous diseases on 30 beds (the manager. — prof. V.P. Pervushin), orthopedics and traumatology on 35 beds (the manager. — the prof. M.O. Friedland), skin and venereal diseases on 40 beds (the manager. — professional. A.L. Hitrov),

obstetrics and female diseases on 60 beds (the manager. — the prof. A.I. Timofeev), LOR-diseases on 20 beds (the manager. — prof. M.A. Chalusov). In creation and further formation of institute the big role was played by the first people's commissar of health care of the Russian Federation N.A. Semashko who in 1925 was elected by the honorary member of board GIDUVA.

It should be noted also that in life of Clinical institute there were periods when it seemed that a new institution will stop the existence. 1921 and 1922 when in connection with a difficult economic situation, unknown hunger in the Volga region closed newly established scientific and educational institutions were especially critical. This fate had to comprehend and Clinical institute. Visited it in October, 1921 as the head of the government commission on assistance starving the national commissioner of health care N.A. Semashko as further actions advised the director of institute R.A. Luriya: "To be curtailed, as much as possible, but to strong hold this establishment in hand. You hold till the best times when it is possible to develop it". In 20 — a big contribution to development of institute, its departments and clinics the people's commissar of health care of TACCP F.G. Mukhamedyarov, professors V.L. Bogolyubov, S.S. Zimnitsky, V.V. Chirkovsky, M.P. Tushnov, A.F. Favorskii, A.F. Samoylov, M.A. Dykhno, M.S Pil-nov, I.P. Vasilyev, K.G. Bol, N.K. Goryaev, I.F. Kozlov, V.M. Aristovsky, A.V. Vishnevsky, V.K. Trutnev and also then still young scientists, and then professors A.F. Agafonov, V.A. Gusynin, P.A. Badyul, T.D. Epstein, M.I. Mastbaum, I.I. Rusetsky, R.I. Lepskaya, A.N. Murzin, Ya.D. Pechnikov, L.M. Rakhlin, Yu.A. Ratner, N.E. Sidorov, M. of X brought the 30th years. Fayzulin.

In 1922 the institute was replenished with again organized departments and clinics: surgical on 50 beds (the manager. — the prof. A.V. Vishnevsky), eye diseases on 30 beds (the manager. — the prof. V.E. Adamyuk), trakhomatozny institute (the director — the prof. V.V. Chirkovsky), department of operational surgery and topographical anatomy (the manager. — prof. V.A. Gusynin), pathologies (manager. — prof. K.G. Bol), bacteriology (manager. — prof. M.P. Tushnov); the institute library was open.

Thirst of knowledge at doctors was so big that for rather short terms they managed to master the knowledge and practical skills necessary for them gained at institute in new conditions. Working in the afternoon in hospitals and civil medical institutions, in the second half of day the doctors came to institute, listened to lectures, participated in clinical rounds, operations, out-patient 280

receptions and laboratory researches. In the crowded audiences of the prof. R.A. Luriya gave lectures on a course of the general diagnosis of diseases of digestive tract and a course of radiodiagnosis of diseases of internals. Because of total absence at faculties of teaching a radiology these lectures attracted great interest of doctors listeners. Since the end of 1921 the prof. S.S. Zimnitsky started the lecturing at the rate of heart troubles and kidneys which had special methodological and clinical value in training not only of listeners, but also experienced therapists.

Since 1921 the outstanding domestic physiologist prof. A.F. Samoylov who provided not only extremely important and interesting course of graphic methods of a research of a cardiovascular system, but also given an opportunity to institute to use its laboratory at the Kazan university for records of electrocardiograms and the sound phenomena of warm activity took part in work of Clinical institute. A bit later, fall of 1924, in GIDUV the prof. N.K. Goryaev for teaching clinic of diseases of blood was invited. Educational development of rich clinical material was connected with scientific development by that. Research approach was a necessary element of pedagogical activity, allowing the doctor - to the listener to master methodology of the independent analysis and to critically perceive the scientific facts. For this purpose at institute scientific meetings of doctors GIDUVA were from the very beginning organized, held 2 — 3 times a month and differing — and it is very important — proximity of subject of reports and messages to daily medical practice. In the first five years more than 70 scientific meetings were held and about 200 scientific reports are respectively listened. In the next years other departments and clinics GIDUVA were organized: clinic of infectious diseases on 15 beds (the manager. — professional. S.S. Zim-nitsky), and urgent and field surgery (manager. — prof. V.A. Gusynin), department of social and experimental hygiene (manager. — prof. M.A. Dykhno), radiologies (manager. — prof. R.Ya. Gasul), tuberculosis (manager. — prof. M.I. Mastbaum). By the beginning of the Great Patriotic War 26 departments and one associate professor's course were part GIDUVA. The institute worked with big tension in the years of war. His many employees voluntarily left on the front. The leading professors held responsible positions in military-medical institutions, were chief specialists of fronts, the fleet and armies (L.M. Rakhlin, N.N. Spassky, M.I. Mastbaum, V.A. Gusy-nin, L.I. Shulutko, Yu.A. Ratner, V.N. On -

mos). The best forces were mobilized in field army, however educational and scientific and medical activity of institute continued. For dedicated work in the years of war over 160 employees of institute were awarded awards and the medals. B.S. Ginzburg and I.K. Lukyanov prepared scientific research of "A health care problem in the TACCP" devoted to problems of a sanitary condition of the republic, demographic processes and social hygiene for the end of war of professor. In the first post-war years at institute, researches on questions of aftercare of disabled people and also elimination of sanitary consequences of war in which the research and educational personnel which came back from fronts directly participated were developed. At this time such outstanding scientists as academicians A.I. Abrikosov, L.A. Orbeli, K.I. Scriabin evacuated to Kazan took part in work of institute.

The need for developing the skills of doctors sharply increased. The doctors demobilized from army needed new knowledge and practical skills for work already in the conditions of peace time. Therefore at institute the new departments and courses specialized in narrower directions of clinical medicine began to open. The institute gained considerable development in 60 — the 80th years. So, the total number of the trained doctors increased more than twice; the institute acquired the right to accept master's and doctoral dissertations to protection.

In a year of the 75 anniversary Kazan GIDUVA there was a historical event — on April 20, 1995 the Kazan GIDUV was transformed by Russian Federation Government decree No. 531 to academy of postdegree education that was recognition of his merits in preparation of medical shots. The Russian government adopted such resolution on two higher education institutions: To the central institute of improvement of doctors and Leningrad GIDUVU. In this regard it was necessary to revise all training programs, to pay special attention to quality of teaching and qualification of teachers, to prepare sufficient number of doctors of science.

Today the Kazan State Medical Academy (KSMA) is the largest medical center of postdegree training of doctors of the Volga federal region. The order MZ Russian Federation No. 436 of December 13, 2001 of KGMA creation in the Volga Federal District of coordination council on postgraduate and additional professional education of experts of health care is entrusted. The prof. M.K. Mikhaylov who worked rekto-was appointed its chairman

rum of 27 years (1980 — 2007). Since 2007 in this position — the rector prof. K.Sh. Zyyatdinov. The order MZ Russian Federation and Russian Academy of Medical Science No. 201/51 of June 4, 2001 KGMA is fixed by the curator of the Volga Federal District on obstetric and gynecologic and pediatric services. Within coordination council on health care in the Volga Federal District the section concerning health protection of mother and the child which chairman appointed the rector of KGMA prof. M.K. Mikhaylov, and the vice rector for scientific work — the prof. A.I. Safin is created.

Being a coordinator on postgraduate and additional professional education of doctors of the Volga Federal District, KGMA fully supports carrying out uniform state policy on skills development and professional retraining of personnel of health care for the benefit of the personality, societies and the states. Today in the Volga Federal District within the state system of postdegree education of experts of health care 13 institutes and faculties of a medical profile function. Their direct functions include additional professional education more than 120 thousand doctors of the district. Pedagogical and research work is conducted on the basis of 39 departments united in three faculties: therapeutic, surgical and medico-preventive. 372 employees take part in it, among them there are 23 full member and the corresponding member of the state and public academies of Sciences, 18 honored workers of science of the Russian Federation and RT, 53 deserved doctors of the Russian Federation and RT, 90 doctors and 215 candidates of medical sciences.

For consideration of works for a degree of the doctor and candidate of medical sciences for academies two dissertation councils where there takes place protection on six specialties function: radiodiagnosis, radiation therapy; nervous diseases; internal diseases; surgery; obstetrics and gynecology; traumatology and orthopedics. In 2009 the employees and applicants of academy defended 39 candidate and 7 doctoral dissertations. Annually in academy more than 8000 doctors on 55 specialties from all regions of Russia and the CIS countries improve the skills. In academy more than 300 interns, including foreign citizens study. Besides, 50 interns annually are trained; 157 graduate students and applicants carry out dissertation researches under the leadership of the leading scientists of academy. Also target interns and graduate students on a quota of the Ministry of Education and Science of the Russian Federation study. Constantly about -

new cycles of improvement on current problems of practical health care — family medicine, the organization and management of health care are found in modern social and economic conditions, informatization of health care, emergency medical service, specialized rehabilitology, training of experts for conducting examination of quality of medical care in the conditions of health insurance, an uroginekologiya, andrology and many other.

Scientific academies render the great scientific and methodical and medical and advisory assistance to practical health care. The KGMA clinical bases are the leading medical and diagnostic centers, clinics of the city and republic. Long since treat the academic clinics neurologic, therapeutic, obstetric and gynecologic, clinic of children's diseases. Annually the staff of academy advises tens of thousands of patients, performs the most difficult operations and diagnostic tests. The carried-out scientific programs are connected with improvement of continuous postdegree personnel training of health care, protection of family, health of mother and child, search and introduction of new medicines, the diagnostic equipment, improvement of methods of organ transplantation, development of the rehabilitation direction of health care. Results of scientific research widely take root into activity of institutions of practical health care.

A specific place in life of academy is held by the international activity. Scientific academies participate in the international congresses, forums, exhibitions, receive grants on scientific and inventive activity. The invitation of specialists of the foreign medical universities for lecturing, holding master classes and exchange of experience becomes good tradition.

Foreign partnership of academy develops within cooperation with WHO, the Munich academy of rehabilitation of development, Boston University, Institute of the analysis of policy of health care of the USA, medical faculty of Yale University (USA), the university of Lund (Sweden) and other international organizations.

In 2009 the academy published 27 monographs, more than 200 scientific articles are prepared and published in the reviewed magazines, 10 of them in a foreign press. Scientific magazines are issued: "Public health and health care", "Applied medicine", Vertebronevrologiya, "Alterna-

the tivny medicine", is published the academic medical newspaper. The library of academy has one of the large collections of medical literature — from domestic editions of the 18th century to the most modern — about 350 thousand units of storage. The library is placed a computer class on 11 jobs with access to the high-speed Internet where readers can use electronic databases on medicine — Medline, Scientific electronic library, the State central scientific medical library (Moscow). There is an access to bases of the Siberian state medical university, the Arkhangelsk and Yaroslavl medical academies, the Russian state library, "Dissertation fund". In 2010 the opening of electronic library is planned for 20 readers, to it all doctors of medical institutions of our republic from working and home computers in any time, convenient for them, will have access — it will be the first step by the beginning of the organization of continuous training in our academy.

KGMA has the big prospects of further development: in the nearest future opening of new departments is planned, gathers experience and the Center of new medical technologies improves the activity. The most important strategic tasks of academy are substantial increase of efficiency of educational and scientific, medical and advisory activity, improvement of processes of management of the system of postdegree training of doctors in the region and active participation in implementation of state programs of protection and strengthening of health of the population of the Republic of Tatarstan. Special attention in academy will be paid to innovative activity and its widespread introduction in practice. In this sphere the great opportunities open for talented youth and to its "headquarters" — council of young scientists. Now KGMA successfully solves the tasks set for it and the next 10 anniversary will note even more significant progress.

Arrived 01.02.10.

90 YEARS OF KAZAN STATE MEDICAL ACADEMY K.Sh. Zyyatdinov, M.K. Mikhailov

Summary

Analyzed were the stages of development of Kazan State Medical Academy of Postgraduate Education and its activities at present.

Christoffersen Harald
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