Notes of Russian young doctors

Im Februar haben ein paar deutsche IPPNW-Studis die Initiative ergriffen und mit einigen Studis der russischen IPPNW Kontakt aufgenommen – um gemeinsam über politische und medizinische Themen zu diskutieren. Wir fragten sie, ob sie Lust hätten, uns etwas über ihr Leben und Wirken als junge Ärzt*innen zu erzählen. Hier kommen sie zu Wort:

Svetlana Filatova, 23

It is always nice to read short stories about people’s lives from different countries. And we have got this opportunity as writers.

Hard to imagine a more accurate theme for history. Carpe diem. I’m a PA (Physician Assistant, Anm. d. Red.) now. And we are vaccinating people.

7:45 am: I go into the department. Coming 15 minutes before the start of the working day is enough to have time to prepare for work, but not enough to get ahead of people with insomnia – a small queue has already gathered in the corridor.

In the treatment room, I begin to prepare voluntary consent forms for vaccination. The old Minsk refrigerator rattles plaintively in the corner, reminding me to check the number of ampoules of Sputnik.

8:00 am: We perform about 70 examinations before the vaccinations and about the same number of vaccinations per day in the ambulatory care. The most common contraindication is an exacerbation of chronic diseases or ARVI (Acute respiratory viral infection, Anm. d. Red.) -vaccination in this case is carried out 2-4 weeks after the onset of remission.

After a pastime paradise in the queue, the vaccination will not take place and you will have to return in a month – I am not carrying this "joyful" news to the patient (thanks to the head of the department), this is done by the GP who conducted the examination.

12:00 pm: Destroying myths is not part of my professional duties. But this is an integral part of my work. The tricky question: What can affect the patient’s level of knowledge in such an area like medicine? Education level? Internet access? Age? Area of residence? Answer: none of the above. Life is complicated and unpredictable, and sometimes you are not able to guess from whom you will hear the next tricky question.

For example: Are there microchips in the vaccine?

My best today.

4:00pm: I open the empty (like my bank account) refrigerator and take out the broccoli. I have 20 minutes for lunch. Hiding in the far corner of the residents` office, I watch my colleagues who have just returned from the village of Knyazhevo.

The mobile vaccination point visits remote enterprises of the district for on-site vaccination.

Chewing on the god-awful vegetable, I calculate the time required to fill out the documentation. Each stage must be entered in the registry. Only after that it is possible to get a QR code. Pulling the mask up to the eyes and putting on glasses (the shiny forehead and shadows under the eyes have not made anyone handsome yet), I return to work.

7:45 pm: The security Officer looks at me reproachfully: The clinic closes in 15 minutes, and I'm still at my workplace. Turning off the computer with one hand, and swiping my things into my backpack with the other, I rush to the exit. My haste is not unreasonable – I have already been locked on the floor several times.

When I leave work, I try my best not to run, so it takes only 6 minutes to get home. But no matter how fast you run, you will not escape from fate. Direct proof of this are the windows of my apartment, facing the 7-storey building in which I spent the last 12 hours. Through these windows, I can see the purple light of the bactericidal lamp of the treatment room. The very office in which I will appear tomorrow at 7: 45.

Ekaterina Schelkanovtseva, 26

I'd like to tell you about one day of my life in a residency department.

Its location is the Chair of Internal Diseases, Sechenov University.

Morning is the best part of the day for me. I’m in a hurry to commute to the hospital morning report conference on time. It takes me one hour to get there. There are normally lots of people here: from students to Doctors of Medicine. We’re discussing severe patients' cases and their treatment strategy, asking questions and exchanging the latest news. It feels like we’re a team having common goals – to help people and to support each other.

Then I go to visit my mentor to discuss some challenging issues of science work. This is the most useful part of the day as I get really inspired and encouraged after our talks and obtain new knowledge.

Sometimes I have classes with students because our educational program in residency includes learning hours. I like teaching because it helps me keep my mind straight and learn something new. The only thing is that I can't accept is how the traditional way of teaching in my country looks like. In my personal perception, we have quite an outdated book of Internal Diseases, and when students read it and discuss something, that looks boring. That makes me feel confused so I try to keep up with the current researches and innovate the learning process.

My day is pretty busy and I continue with my work further on I am going to my work. They say business is equivalent to progress and success so I'm happy to have a busy lifestyle! I am a general practitioner in an outpatient hospital. We have to work because residents, students, PhD fellows in Russia have small scholarships and it is not enough to provide a proper living. But it's not a complaint at all and I love my job! I get excited communicating with people and helping them. In fact, I have a big number of interesting cases. I described a clinical case at an international conference and that was an eye-opening experience for me and an immense contribution to my future career.

George Isaev, 25

My hospital is situated in the center of Moscow. It’s a big clinic, which has a big number of different departments. We serve not only the Moscow region but all of Russia. I am a resident of the cardiology department. My day usually begins with checking the results of past day analysis and attending patients, after this it I write some observation papers and start preparing documents for the discharge of some patients. In the midday, we usually receive new patients. I examine them, make first prescriptions and tell them about our plans for their treatment. My supervisor and I have about 12–15 patients at one time. Sometimes it is a little hard to keep in mind all prescriptions and the day’s examinations of all patients, so I write it in my little notebook. After midday I start to do a “paper” job. We need to write a lot of documents for every patient. If somebody passed any examination, for e.g. echocardiography, EKG, I’ll interpret the patient's results. In my opinion, it’s really important to inform the patients about the process of their treatment. My work can be exhausting or sometimes monotonous, but for me, it’s the best thing which I possibly could do.

Elena Sukhanova, 25

It is not enIt is not enough to have a diploma to become a doctor in Russia. You need to pass an accreditation, which will give you the opportunity to start our work as a GP for 5 years.

The accreditation is an exam taken at the methodological center. The exam consists of three stages. Without passing one stage, you are not allowed to go to the next one, and it needs to be retaken.

The first stage is a test of 60 questions with four possible answers. One is given 60 minutes to solve it. This stage should be held internal, but due to the pandemic this year it was held external. The test is considered as passed if more than 60 points are scored. The points of the first stage are converted to the 100-point system and can be used when you are submitting documents to the residency.

The second stage consists of samples on simulators: intravenous injection, medical examination, physical examination, cardiopulmonary resuscitation and emergency medical care. Each task should take a maximum of 10 minutes to complete. The examinee enters the room where the examiner is sitting behind a glass wall. He gives commands through a microphone and tracks the progress, giving a point for correctly executed items during the process.

The third stage is the solution of clinical cases. This is also a test, but with two tasks, each of which provides 12 questions with one possible answer. This task is also given an hour to complete – 30 minutes per task. This stage is considered completed if you answered more than 17 questions correctly.