Training Of Medical Personnel Research Articles

Організаційні форми підготовки медичних кадрів із питань паліативної допомоги

Purpose - to study modern views, advanced world and national experience in training medical personnel for palliative care. Materials and methods. Recommendations of international organizations, domestic regulations on palliative care, curricula of medical universities and colleges. Results. It is established that the definition of «Palliative Care» and the levels of its provision, regulated by the current legislation of Ukraine, do not correspond to modern international approaches. The National curricula on palliative care developed by us on the principle of vertical integration and approved by the Ministry of Health in 2014, nowadays, in the era of transition to full autonomy of universities, is outdated. There is no medical specialty «palliative care» in Ukraine. Medical specialists can acquire knowledge and skills in palliative care only within the framework of their continuous professional development at the postgraduate level. According to an EAPC White Paper on Palliative Care Education, the three-level system of medical education based on core competencies and core constituents of palliative care is offer. Conclusions. The system of medical education in Ukraine requires correction in order to acquirement core competencies of palliative care by all medical workers. No conflict of interests was declared by the authors.

Влияние эксклавности и уровня доходов населения на потребительские предпочтения пациентов на рынке медицинских услуг

The article presents the results of a qualitative analysis of the influence of exclavity and the level of income of the population on the consumer preferences of patients in the medical services market using the Kaliningrad region as an example. Economic disparity in access to healthcare services contributes to the psychographic stratification of healthcare consumer preferences. Territorial isolation from the country and the proximity of foreign countries leave an imprint on the social and economic life of the population of an exclave subject and commitment to medical tourism. M a t e r i a l s a n d m e t h o d s . In the period from September to November 2022, a one-time comparative study of consumer preferences for choosing a country and a medical organization in the medical services market of 773 working-age residents of the Russian Federation was planned and conducted. All respondents were stratified into two groups according to their place of residence: residents of the Central Federal District and the Kaliningrad Region. The groups were comparable in terms of gender and age. Methods used: open online survey, qualitative analysis, statistical. The significance of differences in the percentages of the trait was estimated by the Fisher angular transformation coefficient (φ) with a given confidence level of 95%. R e s u l t s . The influence of exclavity and income level on consumer preferences for choosing a medical organization has been established. The features of the priority motivators for the choice of public, private or foreign medical services of the respondents of the Kaliningrad region are revealed. The comfort of receiving medical services (“lack of queues”) was 1,4 times more likely to motivate the choice of private medicine among respondents in the Kaliningrad region compared to respondents in other regions. The demand for the services of private and foreign clinics in the exclave territory is proportional to the level of income. Medical tourism services were used by 28,7% of respondents from the exclave territory who prefer private medicine. C o n c l u s i o n . A distinctive feature of consumers of medical services in the exclave Kaliningrad region is the increase in demand for private medicine and treatment abroad in proportion to the increase in income levels. Respondents from the exclave territory are 1,4 times more likely to choose private clinics and 23,9 times more likely to use medical tourism services compared to residents of the Central Federal District. Every fourth respondent in the Kaliningrad region does not trust the quality of training of doctors in the Russian Federation. Transport accessibility of the EU countries, dissatisfaction with the level of training of medical personnel, the lack of a number of medical services in the Russian Federation, the ability to realize the desire to combine treatment with a trip abroad with a sufficient level of income of the population in the exclave region, along with a shortage of medical personnel in the subject, contribute to increasing the attractiveness of private medical organizations, import of medical services and outflow of patients abroad. Recommendations are given to increase the attractiveness of state medicine in the exclave territory.

A Systematic Review of Heart Rate Variability as a Measure of Stress in Medical Professionals.

Understanding the physiological effects of responding to crises is a critical component in understanding how to manage and prepare medical professionals to be crisis responders. Heart rate variability (HRV) is the variation in rate between a succession of R-R intervals. This variation is not only affected by physiological processes such as respiration or metabolic rate but is also directly controlledby the autonomic nervous system. As such, heart rate variability has been proposed as a noninvasive tool to measure the physiological stress response. The aim of this systematic review is to consolidate heart rate variability literature in the context of medical emergencies to determine if heart rate variability changes predictably from baseline when responding to medical crises. This may demonstrate utility as an objective, noninvasive measure of stress response. A systematic literature review of six databases yielded 413 articles, 17 of which met our inclusion criteria of being written in English, measuring HRV in healthcare providers, and measuring HRV in real or simulated medical resuscitations or procedures. Articles were then analyzed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) scoring system. Out of the 17 articles reviewed, 11 demonstrated statistically significant results showing heart rate variability responding in a predictable manner to stress. Three articles utilized a medical simulation as the stressor, six used medical procedures, and eight used medical emergencies encountered during clinical work. Overall, a predictable trend in heart rate variability metrics of standard deviation from the mean value of normal-to-normal(N-N) intervals (SDNN), root mean square of the successive differences (RMSSD),mean number of times per time interval in which the change in successive normal sinus (N-N) intervals exceeds 50 ms (PNN50), low frequency % (LF%), and low-frequency-to-high-frequency ratio (LF/HF) was observed when responding to stress. This systematic literature review showed that heart rate variability among healthcare providers responding to stressful scenarios follows a predictable pattern of change and expands our understanding of the physiology of stress in healthcare providers. This review supports the use of HRV to monitor stress during high-fidelity simulation to ensure that appropriate physiological arousal is achieved during the training of medical personnel.

Long-term follow-up of patients in fracture liaison services: problems and solutions (literature review and own data)

To reduce the frequency of fragility fractures, Fracture Liaison Services are being created worldwide. One of the most difficult parts in their organization is considered to be the creation of an effective system of long-term patient management. Many factors are involved in this process, concerning the patient, the team of specialist, the peculiarities of the organization of primary health care, and many others. On the one hand, it has been shown that the inclusion of patients in FLS increases their commitment to the implementation of doctor’s recommendations. On the other hand, there are a number of barriers depending both on the characteristics of the patient himself (polymorbidity, severity of the condition, decreased cognitive function, fear of side effects, low motivation to treat osteoporosis) and on various aspects in the medical care organization. The article analyzes the importance of training patients and medical personnel, approaches to the choice of therapeutic tactics, optimization of the process of succession management of patients, the availability of a system of information exchange between medical institutions. Using the example of the Yaroslavl’ FLS, the possibilities of improving various aspects of medical care are analyzed, as well as local problems that arose at various stages of the development of this service, and the measures that were applied to resolve them.

ВОЕННАЯ КАФЕДРА УЧРЕЖДЕНИЯ ОБРАЗОВАНИЯ «ВИТЕБСКИЙ ГОСУДАРСТВЕННЫЙ ОРДЕНА ДРУЖБЫ НАРОДОВ МЕДИЦИНСКИЙ УНИВЕРСИТЕТ», КАК СОСТАВНАЯ ЧАСТЬ СИСТЕМЫ ПОДГОТОВКИ ОФИЦЕРОВ ЗАПАСА МЕДИЦИНСКОЙ СЛУЖБЫ

The article presents the history of the creation and development of the military department of the Vitebsk State Medical Institute (University), the training of medical personnel from the moment of its formation to the present, as well as brief information about the activities of the department staff.

РОЛЬ ПРОИЗВОДСТВЕННОЙ ПРАКТИКИ В ПРОФЕССИОНАЛЬНОМ СТАНОВЛЕНИИ ВРАЧА

Health care is a key sphere of society’s life, and health indicators and life expectancy of the population depend on its condition and wellfunctioning. The article focuses on peculiarities in teaching and professional training of doctors in modern Russia. It is important to indicate that the work carried out implements the analytical task of studying exclusively the learning process at medical faculties, nevertheless, the identified trends can be partially extrapolated to all other medical specialties. It raises issues related to the level and quality of training of medical personnel in Russia. In that regard, the features of the implementation of higher medical education in Russian universities are described. In particular, the author identifies the main trends and transformations in the processes associated with obtaining the profession of a doctor. The aspects of professional training related to the implementation of clinical practice and their impact on the future career of a young doctor and his development as a specialist are analyzed separately.

ДИНАМИКА КАДРОВОГО ОБЕСПЕЧЕНИЯ МЕДИЦИНСКИХ ОРГАНИЗАЦИЙ В АСПЕКТЕ ДОСТИЖЕНИЯ ЦЕЛЕВЫХ ПОКАЗАТЕЛЕЙ РЕАЛИЗАЦИИ ФЕДЕРАЛЬНОГО ПРОЕКТА

Sufficient number and level of training of medical personnel largely determine the availability and quality of medical care. The federal project “Providing medical organizations with qualified personnel” is aimed at eliminating the problem of personnel shortage. Solutions to the personnel problems should be based on the results of continuous monitoring with a detailed analysis of statistical data. The purpose of the study is to analyze and evaluate dynamics in staffing of medical organizations in 2017-2021. Material and methods. The study was carried out on the basis of the information database of the Russian Research Institute of Health, based on the federal statistical observation form N30 for 2017-2021. The study used analytical, statistical methods and the method of comparative analysis. Results. The number of full-time medical positions in first years of the federal project implementation has been reduced, probably with the aim of achieving the required level of staffing of full-time positions by individuals with the full-time to part-time ratio of no more than 1.2. Simultaneously with the reduction in the number of full-time positions, the number of individual doctors increased, therefore, the indicator of staffing of full-time positions with natural persons was increasing until 2019 with a decline in the full-time to part-time ratio. A significant increase in the number of full-time medical positions during the pandemic has negated the previous reduction. The difference in the growth rate of the number of individual doctors and the number of full-time positions has led to decreased staffing level in general across all medical organizations, mainly due to a significant reduction in the indicator in units providing inpatient care. However, the indicators of staffing and staffing level of units providing outpatient care are higher compared to inpatient settings. Discussion. Analysis of the dynamics in indicators of doctor staffing in the period from 2017 to 2021 does not allow us to project achievements of the target staffing level in units providing outpatient care with the full-time to part-time ratio of 1.2 by 2024. Conclusion. Dynamics in the staffing level tends to reverse compared to the planned one under the Federal project, the full-time to part-time ratio remains high, especially in inpatient settings. The imbalance of staffing remains. Additional measures are needed to solve the personnel problem and promptly resolve the issue of salaries of medical workers to achieve a certain material security without a secondary job.

High altitude/trauma emergency training for medical personnel deployed at medical facility on chardham yatra route

High altitude/trauma emergency training for medical personnel deployed at medical facility on chardham yatra route

ДЕЯТЕЛЬНОСТЬ БЕЛОРУССКОГО МЕДИЦИНСКОГО ИНСТИТУТА В ЯРОСЛАВЛЕ В ГОДЫ ВЕЛИКОЙ ОТЕЧЕСТВЕННОЙ ВОЙНЫ (1943-1944)

The article is devoted to the activities of the Belarusian Medical Institute in evacuation in 1943-1944. During the Great Patriotic War, the medical institutes of Belarus temporarily suspended their work. Their activities resumed in Yaroslavl, where in 1943 the Belarusian Medical Institute was opened, uniting the Minsk and Vitebsk institutes. In 1944, the only graduation of doctors was carried out. After the liberation of Belarus from the fascist invaders, the Belarusian Medical Institute was reevacuated to its republic. In Yaroslavl, on its basis, the Yaroslavl Medical Institute was opened, where many teachers and students continued to work and study. The article, based on archival documents, analyzes this period of activity of Belarusian scientists in the training of medical personnel of higher education.

Challenges of bone marrow transplant for sickle cell disease in resource limited setting

Sickle cell disorders (SCD) are a group of inherited disorders that results from both parent being carriers, haemoglobin AS resulting in haemoglobin (SS), causing anemia, infections, pain, stroke, priapism, sequenstration crisis, multiple organ dysfunctions etc. There are several ways of managing sickle cell disorder but the best way, which is considered a gold standard cure for the disease is a successful bone marrow transplant of haematopoietic stem cells (HSCT). Bone marrow (BM), Peripheral blood (PBSC) and Umbilical cord blood (UCB) are rich in stem cells. In order to have a good bone marrow transplant, without graft rejection, the laboratory plays a vital role especially in compatibility testing of donor and recipients at the various stages of the transplant, which includes initial stage, during the transplant and follow up testing to ensure tolerance to the new graft and testing for chimerism. There are various types of transplant which include Autologous, Allogeneic (Sibling/ Unrelated Donor), Parent or relative, etc. The various pre transplant tests includes: Sickling test, High Performance Liquid Chromatograph (HPLC), Genetic studies, RBC Indices Hb – 6-9 gm/dL, Peripheral Smear, Retic count Reticulocytosis, ESR, Bone marrow analysis. Post-transplant test Includes Engraftment Analysis, Complete Blood counts, kidney function, liver function, Cholesterol, HIV, Hepatitis B, Hepatitis C, additional infectious studies (Endemic testing), Urinalysis etc. Haemopoietic transplantation challenges in a resource limited settings like Nigeria are enormous and they includes: Danger of serious illness associated with donor-to-patient stem cell transplant, lack of appropriate donors, Graft-versus-host disease (GVHD), Inadequate Human resource, Inadequate equipped facility, cost of the service, Corruption, Lack of political will, Leadership incompétence, Lack of strategic planing, Policy inconsistency, Lack of qualified personnel, Poor healthcare administration, Conflict of interest among health workers. The cost of Bone Marrow Transplantation is highly exorbitant to Nigerians and government need to play vital role towards funding part of the cost and alleviating the pain of sickle cell. Effective implementation of National Health Insurance Scheme and address corruption are the most efficient ways the cost would be subsidized. Appropriate information campaigns largely championed by maternal and child health-care professionals would significantly contribute to raising the level of awareness and acceptance of Cord Blood donation. Training and re training of medical personnel cannot be over emphasized.

ОСОБЕННОСТИ ПРОФЕССИОНАЛЬНОЙ ПОДГОТОВКИ БУДУЩИХ ВРАЧЕЙ

The article discusses the features of the professional training of future doctors. The need to address this issue is dictated by the fact that in the domestic, as well as in the foreign system of higher education, the possibilities of information technology are being actively introduced. Based on the analysis, the authors note the effectiveness of information technology training in ensuring the quality of training of medical personnel. The data presented by the authors on the specifics of the training of future doctors, and the analysis of educational programs in medical educational institutions allows us to conduct a comparative analysis between the educational systems of countries for the training of doctors and highlight the best methods for implementation in the educational process.

DEVELOPMENT OF HEALTH PERSONNEL IN MEDICAL EQUIPMENT MANAGEMENT IN PAYANGAN GENERAL HOSPITAL, GIANYAR, BALI

The quality of health services to the community must always be improved as a form of responsibility for health workers. One of the important things in improving the quality is maintaining the quality of medical equipment. Some things that must be considered in medical devices are the measuring value and safety of the device itself. Some of the tools that are often used in hospitals are Oxygen Concentrator, Nebulizer, SPO2, ECG, Defibrillator, Bedside Monitor, Ventilator, Infuse Pump, Syringe Pump, Baby Incubator, Phototherapy, Bubble CPAP, Doppler and Suction Pump. This community service activity is to assist the hospital in taking an inventory of the health equipment they have, making it easier to collect data on which equipment can still be used or must be repaired and conduct training for technicians and medical personnel. The method of activities carried out is observation, lectures, inventory and direct practice of function testing and repair of medical devices. This activity was attended by several technicians and medical personnel from Payangan General Hospital in the hope that all medical personnel will understand the medical equipment that is often used. The results of this activity were several equipment that needed repairs such as tools, ECG, Nebulizer, Baby Incubator, Oxygen Concentrator, Suction Pump, Phototherapy, Bubble CPAP and Doppler. This activity indirectly provides knowledge and experience to medical personnel, with the hope that the service life of all medical equipment will be longer.

Drill; A Solution to Reduce Mistriage in Prehospital Emergency Setting

Background: Triage is used as one of the main concepts in the emergency medicine to differentiate between critically ill patients or patients in a non-emergency situation. Miss-triage occurs if the prioritization of patients or injured is not done correctly for any reason. Miss-triage occurs in two forms of over and under triage. According to studies, the incidence of miss-triage is high worldwide. Exercising is one of the ways to reduce the amount of miss-triage. Objectives:. This two-group pretest post-test intervention study aimed to investigate the effect of drilling on the miss-triage of emergency medical service personnel. Methods: The tools used in this study included: demographic information form questionnaire, Triage Decision Making Inventory (TDMI), and designed START/jump START triage scenarios. After collecting the required data, these data were analyzed by appropriate parametric and non-parametric statistical tests, including mean and standard deviation, independent t-test, paired t-test, K-square. Results: Results showed that the Miss-triage rate decreased from (34.1%) before the intervention to (9.1%) after the intervention in the experimental group. Moreover, after drill, the score of triage decision-making power increased from (121) to (136.91). However, in the control group, no statistically significant change was observed in the amount of miss-triage and triage decision-making power in emergency medical service personnel at the end of the study (p>.05). Conclusion: The findings of the present study revealed the effectiveness of this exercise method in reducing miss-triage in participants. Thus, this method could be used in emergency medical service personnel training and preparation programs.

Exploration of innovative practice teaching path of red education in medical colleges

Through analysis of policy texts, the red ideological and political courses in medical colleges and universities were interpreted in the present paper, and the historical background of the ideological and political construction of the national curriculum was elucidated. In the present paper, the common structural problems in ideological and political curriculum construction projects in medical colleges at the present stage were analyzed in respect of the following aspects: the disarray and fragmentation of ideological and political curriculum quality education, the repeated construction in various professional courses and other problems, and various ideological ideas being inconsistent with each other. As such, through the expression of the red policy and the integration of the business scope of the teaching management department, a new measure was constructed to promote the construction of the whole environment education based on the ideological and political course of "party building", so as to strengthen the guidance of party building, implement the national education policy, promote the ideological and political construction of all kinds of courses, and apply the model to every link of course design and management based on "building morality and cultivating people". The model can lead and creatively build the ideological and political education system of various courses by organizing and coordinating, paying attention to the characteristics of professional medical personnel training, and exploring the education brand of teaching units. The model can also be used to establish a special work plan, fully utilize the wisdom of the ideological and political think tank of the curriculum, promote the high-quality development of the ideological and political curriculum, and build a new pattern of education in the whole environment. The ideological and political construction projects of all kinds of courses must be led by the party organization and change with each passing day, and the construction of the whole environment for educating people should be performed first, followed by reform of quality-oriented education and teaching reform. The wisdom of the group promotes the high-quality development of ideological and political courses, and allows for a new pattern of education in the whole environment to be constructed.

Expert consensus on diagnosis, treatment and prevention of allergic diseases(Part Ⅲ)

As the third part of the expert consensus on allergic diseases, this article includes efficacy evaluation, characteristics of allergic diseases in special populations, social and economic burden, psychological problems and prevention. The efficacy evaluation methods include symptom score, quality of life score and drug score. Allergic diseases of special populations have unique clinical characteristics and need special attention. The social and economic burden of allergic diseases is becoming heavier, which requires more attention. The three-level prevention of pollinosis can be completed through the "five in one" prevention and control strategies such as local vegetation survey, airborne pollen monitoring, epidemiological survey, standardized training of grassroots medical personnel, science popularization and academic lectures, which is more comprehensive and perfect than the "four in one" treatment strategy.

PP81 Barriers To Implementation Of Health Technology Assessment

IntroductionThe transition from the budget model of the healthcare system to compulsory social health insurance has created a competitive environment among hospitals in Kazakhstan. Managers are interested in introducing the most effective new technologies. Implementation of the health technology assessment (HTA) process in Kazakhstan began in 2010 but few managers have created a structure for HTA development in their hospitals. Our aim was to identify issues in the implementation of new health technologies in hospitals.MethodsStructured interviews were held with hospital managers and physicians in June 2020, and September 2021. In the first stage, the needs of hospitals in the implementation of new technologies were considered. In the second stage, the impact of COVID-19 on the introduction of new technologies in the hospital was addressed. Interviews were held on-line by mobile phone or zoom and lasted 25-30 minutes.ResultsThe first interviews involved 8 managers and 14 physicians from 5 hospitals. The needs of HTA for physicians was noted by respondents of both groups. Only a few physicians had been trained in HTA. Hospital staff lacked time and experience in preparing applications for new technologies by a national assessment unit and could not meet deadlines. Managers were interested in use of HTA for hospitals’ technologies in short-term timeframes within existing policies. However, physicians believed that long-term performance of technologies over 5 years or more should also be considered in hospital management. Physicians were aware of the importance of ethical considerations in the HTA of new health technologies. Managers did not consider ethical issues.At the second stage of the project, 5 managers and 8 physicians were interviewed. COVID-19 had shown the importance and necessity of developing the scientific potential of doctors, and of introducing HTA and training medical personnel in its use.ConclusionsPositive outcomes from the interviews were the interest of respondents in increasing their knowledge of the HTA process and acceptance of its importance at the hospital level.

Современные проблемы и направления подготовки специалистов в области дезинфектологии

The article highlights the current problems of training medical personnel in the field of disinfection, the role of the quality of training specialists in the implementation of professional activities, the requirements for the development and implementation of educational programs of training in residency and additional professional programs, the features of maintaining modern databases on the education of specialists. Algorithms of formation by specialists and personnel services of applications for training in additional professional programs on the portal of continuous medical education of the Ministry of Health of the Russian Federation are presented. Keywords: disinfection, education programs, quality training RMACPE/FGBOU DPO RMANPO of the Ministry of Health of the Russian Federation.

Examining Perceptions Of Religious Coping, Health-Related Quality Of Life, And Healthcare Support Of ALS Caregivers

<h3>Research Objectives</h3> This cross-sectional study (N=8) built on a prior longitudinal case study (N=1) with a similar aim; that of understanding ALS caregiver experiences by exploring declines in swallowing and communication in ALS patients based on the results of one qualitative and two quantitative measurements. <h3>Design</h3> A mixed method cross-sectional design. <h3>Setting</h3> The interviews were conducted over the phone, per Centers for Disease Control and Prevention (CDC) social distancing guidelines. <h3>Participants</h3> Eight informal (non-compensated) family caregivers of ALS patients. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> 1) Qualitative interviews, 2) the Brief RCOPE (a 14-item measure of positive and negative religious coping with major life stressors), and 3) a health-related quality of life survey instrument (SF12v2). <h3>Results</h3> Interview data revealed anxiety related to anticipated losses and capacity to meet progressive unrelenting needs of care receivers. In addition, caregivers reported an increased burden as the disease progressed, perceiving a lack of medical personnel training necessary to meet their needs. Caregivers' religious coping ratings attested to feelings of less connectedness with God as the disease progressed. Health quality of life measures suggested emerging issues based on health status, energy levels, pain, and available time for responsibilities. <h3>Conclusions</h3> The unique challenges of ALS caregiver experiences and burdens consist of complex emotional, clinical, financial, secondary supportive care needs, and environmental issues. These perceived experiences and burdens have clinical implications for improved communication in working with caregivers to better meet their needs. <h3>Author(s) Disclosures</h3> Nothing to disclose.

남북관계 발전을 위한 공법적 쟁점 세 가지

Whether or not inter-Korean agreement= relations, which has been deepened by the blockade of North Korea’s external contacts due to COVID-19, and alleviating tensions caused by North Korea’s missile provocations and nuclear test attempts, an explicit basis is needed to promote continuous health and medical cooperation that is not shaken by political conditions as much as possible. The inter-Korean health and medical agreement includes the establishment of a cooperative system such as information exchange for joint response to infectious diseases, the establishment of a medical safety net, nutrition and health projects for infants and pregnant women, support for medicines and medical equipment, and education and training of health and medical personnel. Program development and implementation, cooperative projects to modernize medical facilities, and establishment of a regular communication system should be included.

Факторы социальной травматизации профессиональной группы врачей

The article reveals a sociological approach to the analysis of the concept of collective trauma understood as the destructive, dysfunctional consequences of social transformations concerning large groups of people. Currently, the professional medical community is particularly vulnerable to social trauma and often takes moral responsibility for it. The healthcare reform, begun in 2010, its economic, social, and psychological consequences became the main trigger for the formation and development of such a trauma. The novelty of this study lies in the substantiation of the application of the concept of social trauma concept application for analyzing the personal professional doctors’ activity. The aim of the study is to identify the factors of social traumatization of a social group of doctors. The objectives are: to substantiate special features of the social trauma concept actualization on the example of a professional group of doctors; to rank the identified factors of social traumatization; to determine the reasons for the formation of these factors. The qualitative sociological study using the in-depth interview method, attended by 35 doctors of various specialties, was conducted. The received interview texts were processed by using content analysis. The level of professional burnout of doctors was determined according to K. Maslach’s questionnaire. The socially traumatic factors of the professional activity of doctors were determined: high emotional stress from interactions with patients; the requirement to provide highly professional assistance; the serviceization of society; the level of managerial culture; work mode; rest mode; increasing responsibility for meeting professional standards; limiting the openness and publicity of professional activities; salary; the level of medical personnel training; occupational safety regime. It is concluded that a series of reforms in the Russian healthcare system brought doctors to the need to “fit in” with new requirements, when moral norms are deformed, and the performance of their professional duties is reduced. Such adaptation to “innovations” led to the formation of a social trauma in the professional medical community.