Medical education and postgraduate training in Russia: an update

The aim of this preprint was to overview some aspects of medical education and postgraduate training in Russia during the last 5 decades. Apart from review of literature, it is based on observations of the author since the 1970s. After the 6-year undergraduate medical education, to become a specialist in any field of medicine, a 2-year postgraduate program (ordinatura) without a preceding internship has been the usual way. In 2016 the internship was abolished; so that the postgraduate training has on average become shorter. Less common is a 3-year program (aspirantura) that includes research for a candidate's thesis. Previously, certificates of medical specialists could be obtained after a 1-year internship. Insufficient quality of training was pointed out by several experts. After completion of the postgraduate training, medical specialists must go every 5 years on a continuing education course up to one month long. Last time, many online courses have been developed; while their quality is improving thanks to the availability of foreign literature on the Internet and advances of health information technology. Several specific drawbacks of medical education and postgraduate training are discussed. More cooperation with the international professional community is needed. Without profound restructuring, the system of postgraduate training in Russia can be adapted to the international standards if its options (2and 3-year programs) would be transformed into consecutive steps. The total postgraduate training time would thus amount to 5 years, include preparation of a thesis and examinations to be awarded a degree equivalent to M.D. and a specialist certificate. Physicians not interested in research could prepare a thesis in a form of a literature review. Curricula including rotation should be modernized and adjusted to the corresponding fields of medicine. With time, the above-mentioned components of the training can be amalgamated in a unified system. In conclusion, the medical postgraduate training in Russia must be prolonged, intensified and better organized.