UDC: 614.212:378.4 (1-87)
DEVELOPMENT OF UNIVERSITY CLINICS ABROAD
Nakipov
Zh.B., Shaydarov M.Z., Seysembekov T.Z.,
Dubitsky
A.A., Bayganova Zh.A.
JSC
“Medical University Astana”. Republic of Kazakhstan, Astana
Relevance. Around the world educational process in medical education is
inseparably linked with university clinics, scientific researches, development
and deployment of new medical technologies. In the modern, equipped with
advanced technologies university clinics, specialized, including hi-tech
medical care is realized. Since the beginning of the XIX century the system of
medical education is based on model of university clinics which are the best in
the country, many of them are widely known around the world. These educational
institutions are financed from the federal and municipal budget and own means
of university that allows them to have perfectly equipped clinics and to
contain in the staff of highly professional teachers. In the countries of the
European Union (EU) and USA at each university there is an own clinic.
Purpose. To study foreign experience of university clinics.
Materials and methods. Secondary sources of foreign data. The information and analytical
method, the content analysis, indicators of a ratio and comparison is used.
Results and their
discussion. In our material we considered a
condition of university clinics of the leading foreign countries: Germany,
France, Great Britain, Switzerland, USA, Israel.
University medicine in Germany - one of the oldest in the world. The
first university clinics in the country arose in the XVIII century. According
to Ministry of Health of Germany, now in Germany about 40 university clinics
work. They are located practically in all regions of the country. There is
so-called "tripartite alliance": clinic, medical faculty of higher
education institution and management of higher education institution. The
university clinic is responsible for providing students of medical faculty of
higher education institution with workplaces in clinic and creation of
conditions for research activity; the faculty is responsible for process of
training of experts and carrying out research work; the higher education
institution is responsible for functioning of all educational process, success
training and maintenance of financing.
Models
of cooperation of university clinics and higher education institutions in
Germany:
-
cooperation of university and clinic;
-
integration of clinic into structure of university
Financing
of university clinics in Germany is carried out, as a rule, from three sources:
funds are allocated by the government of the federal land where this clinic is;
funds are allocated by the federal government; funds are allocated by the
scientific organizations and special funds. In addition financing can be
carried out by the private financial organizations and even the EU. Nearly a
quarter of fixed assets is allocated in universities for the scientific and
research purposes.
The
majority of clinics in Germany are legal entities which part of the supervisory
board representatives of university and the respective federal land are.
The
majority of clinics in Germany are legal entities which part of the supervisory
board representatives of university and the respective federal land are.
The university hospital centers of France (so-called CHU - Centres
hospitaliers universitaires) represent the medical institutions connected with
universities one of two ways: the hospital center is one of divisions of
university; the hospital center represents the independent establishment
connected with university any agreement. CHU - the regional state centers. They
make the Uniform network over all country uniting 32 establishments. The part
of the personnel of the university hospital centers is at the same time both
the medical employees, and the teachers that is working for two institutions
and receiving a double salary.
The
uniform network of university clinical centers provides a third of
hospitalization in the public medical institutions of the country and all
complex of medical services in the field of urgent ambulance, home visiting
service, primary medical care by all types of diseases. Financing is carried
out by the state, social insurance, the charitable organizations.
University clinics of Great Britain (University Hospitals or Teaching
Hospitals) are included into National health system (National Health Service).
Hospitals of Great Britain within NHS are operated by hospital trusts - Acute
Trusts which provide quality of the medical services provided to patients and
rational use of the allocated funds, and also define strategy of development of
hospitals. Some Acute Trusts are the regional or national centers for rendering
of services of more specialized character, others are connected with
universities or medical schools and participate in training of medical
professionals. The leading national authority rendering to young specialists
assistance in passing of medical practice on the base - Association of
university clinics of Great Britain (Association of UK University Hospitals).
The Association includes 43 trusts. Thus one trust can be responsible for some
university clinics and hospitals. In London there are 12 hospital trusts. The
capital also dominates on number of the employees working in such clinical
hospitals - about 38 thousand people.
University clinics of Switzerland give active support to medical
faculties, annually giving opportunity of practical training approximately for
two thousand students. In university clinics more than one thousand doctors of
science and professors who constantly improve the skills and knowledge work at
a constant basis. According to official data for 2010, 24 students from 27,
done practical training in clinics, then became the qualified doctors.
University clinics of Switzerland along with providing practical experience to
students of medical faculties, give the chance to the employees to complete
increase courses professional development or to get additional education.
So,
for example, the University clinic of Zurich offers the employees more than 100
various programs for internal training.
Statistically
during the period from 2005 to 2010 researches and scientific works of doctors
from university clinics of Switzerland were quoted nearly 50 thousand times.
University clinics of the USA carry out some social functions: they give
opportunity of training and practice for future physicians, conduct innovative
researches, offer medical care to the poor and unprotected segments of the
population, and also render highly specialized medical services by the
seriously ill patient to patients. In the country more
than one thousand training clinics functions, 400 leading clinics are included
into Council of clinics at educational institutions and health systems (Council
of Teaching Hospitals and Health Systems, COTH) Associations of the American
medical schools. The academic medical centers provide needs of nearly a half of
uninsured and poor patients.
Annually
university clinics give training opportunity to more than 75 thousand doctors
(including stomatologists). University clinics receive a financial compensation
for expenses which they bear on training of the medical personnel and providing
treatment to needy citizens, on the basis of IRB coefficient (number of doctors
to quantity of beds).
Clinics in Israel aren't integrated on university Wednesday, and
function as the independent centers which are used by universities as the
clinical base. Carrying out profile medical functions, such clinics aren't at
the same time educational institutions. An exception are Hadass's clinic and
clinic of university Bør-Schew - hospital of "Forty" where
doctors can be engaged at the same time in treatment of patients and carrying
out the academic researches, and also educational activity. At hospital of
"Forty" the medical college is open.
Hadass's
clinic is clinic of the Jerusalem Jewish university. On the basis of clinic
five schools training experts in the field of medicine, stomatology, the
organization of health care, work therapy function. Here more than a half of
scientific researches of Israel is conducted. The clinic provides medical
services more than to one million people a year.
Conclusions.
Thus we see that around the world the main centers of training, scientific
researches and delivery of health care of the highest level are university
clinics. University clinics are versatile medical and diagnostic offices,
structures with the powerful laboratories, the highly skilled faculty which are
rationally combining educational, scientific and medical work in the course of
training of the doctor of the expert.
Carried out in Kazakhstan reforming of medical education, science and
public, including practical health care insistently dictates need of acceptance
of essential measures for improvement and effective integration, all these
components, in system of preparation of medical shots in higher education
institutions. Same already giving of the status of universities to medical schools,
therefore, of radical revision of all system of training according to this
status is devoted.
Today,
in the legislation of the Republic of Kazakhstan, there are no standard and
legal bases of the organization and functioning of full-fledged university
clinics according to requirements of a current state of medical education and
public health care, as is the prerequisite for carrying out the real research.
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