Arstiteaduskond Eesti riigi taasiseseisvumise protsessis. Medical Faculty in the Process of Recreation of Estonian Republic

Abstract

The paper gives a review of teaching medicine in the Soviet period at the University of Tartu and brings forth the changes made in the period of rebuilding the independent country. Already in the Soviet time the Medical Faculty occupied a noteworthy place in the Estonian public health-care system. However, in the autumn of 1944 the faculty started its work in very difficult conditions. Staffing the faculty was a rather complicated task. The property of the faculty was either destroyed or in a very damaged state. Nevertheless, the indispensable structure was restored and, especially from 1960-s some remarkable results in teaching and also in research were obtained. Great assistance in the training of the new generation of the teaching staff and scientists was rendered by medical scientists of the Medical Academy of the USSR. From 1960-s onward considerable number of young staff members had even a possibility to work in different distinguished centres abroad. It is worth to mention that most of the students received state stipend and the life in the dormitories was cheap. In the Soviet period young and ambitious students and also young doctors were motivated to start academic career since the salaries in the University were higher than in the general health-care system. Among many problems were shamefully backward structure and buildings, particularly in pre-clinical subdepartments, and also great difficulties in the communication with the Western World. Nevertheless, the faculty was able to maintain teaching medicine in Estonian. The transition started from 1989. Tartu became an „open city“, and we had many visitors from different countries. Despite difficulties in newly independent Estonia the government invested and in 1999 new Biomedicum was inaugurated. Hence, the preclinical subdepartments were moved from their XIX century lodgings. Another development was to unite in 1991 different public healthcare institutions into the Tartu University Hospital. In the academic year 1991/1992 the new curriculum was introduced. It followed all European principles of teaching medicine. The same concerned postgraduate programs. In 1993/1994 residency programs were approved for all medical specialities. However, there are still several problems which need attention. The loyalty to the profession somewhat decreased, especially in the first years of transition. Due to remarkable differences in salaries some young physicians preferred to work for the pharmaceutical firms or moved abroad. The same concerns to the academic career where years of hard work are considerably less remunerated compared with the clinical practice.