Student’s duties during the practical training

While taking practice the student is obliged:

1. To complete execution of the tasks stipulated by the program of the training.

2. To submit to the rules of the internal labour schedule existing in the medical establishment.

3. To study and follow strictly the rules of labour safety, safety precautions and training sanitary.

4. To bear responsibility for carried out work and its results of the staff.

5. To fill in necessary documentation stipulated by the program of the training.

6. To present materials of the training to the training department not later than in September.

The program of the training practice in therapy

1. Work at a hospital. Carrying out a ward doctor-intern assistant’s duties.

2. Work at a polyclinic during the out-patient reception hours as the local therapist assistant.

3. Carrying out a 2 night watches.

4. Carrying out 2 conversations with patients on prevention of diseases.

5. Work in a procedure room. Carrying out diagnostic and medical manipulations (an injection, a puncture, bloodletting, blood transfusion, catheterization, taking materials for bacteriological and histological researches etc.)

6. Work in an urgent and intensive therapy ward. Carrying out actions on emergency indications (artificial lung ventilation, closed-chest cardiac massage, heart electro stimulation, etc.). Introduction of medicinal substances on urgent indications.

7. Taking care of patients and their preparation for radiological and functional researches (electrocardiogram, electrocardiography, ultrasonic research, fibrogastroscopy, spirography, etc.).

8. Work at a reception ward. Participation in examination of patients, rendering them urgent help, carrying out sanitary and epidemiologic processing and transportation.

9. Educational and research work. Writing summary papers in definite fields of internal medicine with deep study of modern literature.

Work at therapeutic in-patient department

The student works at the department as doctor’s assistant. His work includes the following:

1. Acquaintance with personnel, accommodation and equipment of the department.

2. Everyday work with 4-6 patients, filling in necessary documentation (case history, list of indications).

3. Participation in morning medical conference (meeting) and making a report on night watch.

4. Participation in daily rounds of the wards made by the head doctor, participation in consultations with reports on supervised patients.

5. Active taking part in treatment, prescribing and rendering therapeutic aid to patients.

6. Carrying out medical manipulations (puncture, blood transfusion etc.) under the doctor’s supervision and independently.

7. Together with doctors of the therapeutic and diagnostic departments carrying out examination of patients (tool, radiological and others).

8. To assist at autopsy (path-anatomical dissection).

9. Filling in report documentation on practice.

10. Mastering practical skills which include:

    1. Professional skills of behaviour at hospital and skills of dialogue with patients.

    2. Examination of a patient:

• taking case history

• External examination (objective data)

• Palpation of the chest, lymph nodes

• Percussion and auscultation of the lungs, heart and vessels

• Feeling pulse

• Determination of the heart and lungs borders

• Percussion and palpation of the liver, spleen

• Examination and palpation of the abdomen

3. Carrying out therapeutic manipulations.

- Hypodermic and intramuscular injections, intravenous injections

- Drop-by-drop introduction of medical substances with preparation of the system

- Cupping, applying warm compresses

- Gastric lavage

- Duodenal and gastric sounding

- Cleansing, nutritional and medicinal enema applications

- Preparation of the gastrointestinal tract, bile-excreting ducts, kidneys for radiological research

- Puncture of the abdominal cavity

- Pleural puncture

- Blood group determination according to AVO and RH systems

- Blood transfusion with carrying out biological tests

- Bloodletting

10.4 Laboratory researches treatment:

- Clinical blood analysis

- General urine analysis, Nechiporenko’s and Zimnitskiy’s tests

- Gastric juice and duodenal sounding analysis

- General lipids and lipid spectrum analysis

- Albuminous fractions

- Blood bilirubin and bilious pigments

- Reumatests (C-reactive protein, seromucoid, sialic acid, diphenylamine probe)

- Activity of enzymes ( АСТ, АЛТ, ЛДГ, КФК)

- Blood sugar fasting and after sugar loading

- Creatinine and urea of blood

- Amilase content in blood, in urine

- Blood electrolytes

- Копроцитограммы

- Clinical sputum analysis, sputum microflora analysis and its sensitivity to antibiotics, atypical cell analysis

10.5 Interpretation of results of the tool and morphological methods of research:

- spirograms, Tiffno tests

- electrocardiograms

- phonocardiograms

- echocardiograms

- esophagogastroduodenoscopy

- roentgenograms of heart, lungs, vessels and joints

- cholecystograms

- ultrasonic research of the liver, bile ducts, pancreas and kidneys

- radioisotope researches of the thyroid gland and kidneys (renography)

- skenograms of the liver, kidneys

- Proctosigmoidoscopy

- histological research of the stomach mucous membrane biopsy material and other organs tissues

10.6 Rendering urgent medical help at:

- hypertonic crisis

- cardiac asthma and pulmonary edema

- paroxysmal heart rhythm impairments

- Angina pectoris and myocardial infarction

- cardiogenic shock, faint, collapse

- pulmonary embolism

- anaphylactic shock, urticaria, Quincke’s edema

- asthmatic status at bronchial asthma

- spontaneous pneumothorax

- pulmonary bleeding

- diabetic comas (hypersmolar, ketoacidotic)

- hypoglycemic coma

- thyrotoxic crisis

- acute adrenal gland insufficiency

- tetany at hypoparathyrosis

- hepatic and renal colic

- gastroenteric bleeding

- acute pancreatitis

- acute renal insufficiency

- uremic coma

- poisoning with household toxic substances (acids, alkalis, phosphoorganic substances, sleeping draughts, mushrooms)

- carrying out anterior nasal packing at nasal bleeding

- carrying out closed chest cardiac massage

- acute respiratory insufficiency

- burns of esophagus

- hyperthermia

- acute brain circulation disturbance, edema of brain, epileptic attacks.