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alpine, я студент 6 курса Воронежского мед института, лично мне было бы интересно знать как построена система оказания помощи в штатах. Мне было бы также интересно получить стажировку в штатх, получение любого профессионально опыта, в частности зарубежного практического я считаю замечательной вещью. Медицина в США на гораздо более высоком уровне чем у нас, поэтому есть чему учится. [Ответ]

Сообщение от :
не вижу смысла в практике американских врачей в России, но можно попытаться меня переубедить

согласен. [Ответ]

okay.. I guess my Russian is pretty rusty so I'll write in very clear English

I was talking what we call student/doctor exchanges, NOT practicing. I, too, don't see any reason for American docs to go and work in Russia However, exchange visits (what strider called stazherovka, I suppose) might be very helpful. First-tier American med school, like harvard, yale, upenn, case-western sponsor their students for international elective clerkships, which usually take place during the last (fourth) year in med school. So student chooses a place in the world, and goes there to have clinical experiences, almost all expenses paid. I have a ton of friends who went to France, Spain, India, Latin America of course, Nepal, Israel. I know of people who went to St. Peterburgh and Kazan. Such clerkships usually last a month or so. So I'm very interested to go to Russia and India. There are also docs who travel to other countries and provide care free of charge. There is a large group that travel to Haiti every year. I know of one guy here, a cardiothoracic surgeon, he regularly travels to St. Peterburgh and performs some crazy cardiac surgeries for free. So he comes for a month, brings equipment, does his thing, and leaves. My girlfriend worked with an ophthalmologist who flies around the world and provides free eye care. I myself volunteered for a organization which provided free care to anyone who couldn't afford to pay.

Anyway... So this is what I meant, are there people in Russia who'd say, yeah it's a good idea for American med students to come and learn our ways of practicing [Russian] medicine, and perhaps we can learn something at the same time. Would they even allow us to touch patients? I mean, even though we're only med students, we've got some clinical experience. in my school we start to learn to take care of patients almost from day one. And the whole educational system couldn't be more different. We're so science and evidence-based. On top of all the learning, we have to do research, and there is even an extra year dedicated to research only during which we have to write a thesis. [Ответ]

alpine, ты очень клёво пишешь по русски, у нас местные не все так могут [Ответ]

Сообщение от STRIDER:
alpine, я студент 6 курса Воронежского мед института, лично мне было бы интересно знать как построена система оказания помощи в штатах. Мне было бы также интересно получить стажировку в штатх, получение любого профессионально опыта, в частности зарубежного практического я считаю замечательной вещью. Медицина в США на гораздо более высоком уровне чем у нас, поэтому есть чему учится.

Well, I don't see much of a problem of coming for some postdoctoral fellowship for a year or two -- it's mostly a matter of logistics. What I question, though, is that whatever you learn here would be easily applicable back at home. I guess in terms of patient care, it's going to be okay, although I know little about how medicine is practiced in Russia. However, the systems are so drastically different. Would it be easy to bring home all the skills and then find no equipment that makes those skills so effective? having said this, I don't have a shadow of doubt that those motivated Russian med student and young doctors who would be able to soak up all the advance skills will be in position to become leaders in russia and advance russian medicine beyond where it is now. So study english, and advertise your interests.

As far as US health care system is concerned, there quite a bit of various sources on the web. But to know it well, one need to learn it form within. There is no other way. By the way, keep in mind that the US health care is not the first in the word as far as coverage and quality is concerned. See here http://en.wikipedia.org/wiki/Health_..._United_States [Ответ]

check out this
http://www.aans.org/international/international.asp
http://www.clevelandclinic.org/educa...quirements.asp
http://www.med.yale.edu/education/os...ves/index.html

this site is great for everything:
http://forums.studentdoctor.net/index.php [Ответ]

alpine, если бы я еще по английски говорил, как ты по русски... [Ответ]

oberst, очень много смысла... для них ))) кто это подпустит студента скажем 4 курса к больному в ЮС? а тут можно набраться опыта.. [Ответ]

Сообщение от Archy:
кто это подпустит студента скажем 4 курса к больному в ЮС? а тут можно набраться опыта..

As far as bioethics is concerned, we've come a long way since Tuskegee study. So no need for unnecessary contempt. Let me tell you what curriculum in a typical north american (yes, Canada, too) med school looks like. Medical education here is considered graduate. Which means that nobody gets into med school straight from high school and without graduating from college. So, get your bachelor's first. More so, it's not unusual to take some time off before applying to med school and do something else, often not even remotely related to medicine.

Okay, so by the time you get around to apply to med school, you're at least 21 years old. If you look at various statistics, you'll find that average age at matriculation is 22. First-tier schools (yale, harvard, johns hopkins, upenn, case, stanford, etc) tend to have even older students (24), because these schools are looking for those who've done some other things in life and matured enough to realize medicine is their true calling, and that they have very good reasons and motivation to become physicians. Getting in is a separate topic, and let's not focus on it for now (but see here: http://more.studentdoctor.net/wiki/index.php/Main_Page).

So, a typical med student has bachelor's (not necessarily in biology or chemistry, could be political science or anthropology or music, anything goes), and optional 2-4 years of professional experience. Some have master's, and yet some, but very few, even Ph.D.'s. The first two years of the typical curriculum is basic science. When I say basic, I mean we learn how body functions (first year) and how it breaks down (second year). Basic doesn't mean simple or old stuff (of course, we study things that have been known for awhile -- cell division hasn't really changed in the past 30 years ). What we learn is a bleeding edge of science. And bioethics

It's important to realise that most med schools (all first-tier, anyway) are associated with universities. They are _not_ free standing institutions. Universities are of course where science happens. So med schools are designed to teach medicine as much as medical science and research. All first-tier schools require research experience (meaning you won't get in without it; again doens't have to be siRNA research, if you spent 2 years doing some soft science like sociology, it counts. What they look for is ability to think critically), and continue to engage students in research throughout all 4 years. Some even require a thesis (yale, harvard, case). Sometimes there is an additional (5th) year to do just that -- do research and write a thesis. Research and science are firmly intertwined with medical education. With this in mind...

At the end of the second year we take the first step of USMLE exams (a.k.a. The Boards). It's a one-time deal -- there is no second chance. This score along with USMLE Step 2 will determine your competitiveness for residency Match, and therefore the rest of your life (but, again, it's a separate discussion).

The last two years are called clinical. This is when you get to "touch" patients, and the more, the better. The entire third and most of fourth year is spend on the wards. Every month we "rotate" through various required clerkships: ambulatory medicine, internal medicine, primary care, peds, surgery, ob/gyn, clinical neuroscience, anesthesiology, and psychiatry (the list could vary from school to school in one or two rotaions, but core is core). Not only do you get to "touch" patients, you are required to take history, do physicals, order labs and tests, make sure everything gets done, discuss differential diagnosis with residents (usually), a fellow or an attending. And as you are responsible for 3 to 6 patients on the floor, it gets pretty busy. During the surgery rotation (and emergency medicine) you do get to do a lot of suturing and see lots of lacerations and dog bites Some even do get to assist in some relatively simple surgeries, for instance appendectomy or cholecystectomy (which is now done moslty laparoscopically). But it's hard to get chosen even with strong motivation since, as a med student, you're at the lowest rung of the ladder, and will have to compete with residents. And so, if all of them got bored with appendectomy, you get to assist.

Then there are elective rotations, which usually are pretty flexible and designed to let you "try out" specialties that haven't been covered during the required block. First-tier schools allow their students the greatest degree of flexibility: students can take elective of their choice, and even in any part of the world. So during this time I, for example, would be able to request an ED rotation in Voronezh, Russia or Tel-Aviv, Israel, or a family medicine one in some indian reservation, and, after making sure I have good reasons and working all logistics, the school would let me do it.

Following graduation from med school (which by now seems like a mad school ), you match with residencies (postdoctoral education). It's mandatory in order to get fully licensed. Duration varies depending on the specialty, with the shortest being three years, and the longest (surgery and radiology) -- 5 years. If you desire to specialize even further (for instance you want to become a cardiothoracic surgeon instead of general one, or a neuroradiologist), there is optional fellowship (1-3 years). And then, you're full-fledged physician with an independent license. And it only took seven to 12 years For some, it takes even longer if they choose to interrupt their residency and do some research. Some residencies actually require it. For instance, first-tier hospitals like MGH, Cleveland Clinic, Yale require their residents do research and publish. Any questions? [Ответ]

Archy, у меня тоже проскочила подобная мысль, кстати. [Ответ]

oberst, тут еще одна мулька есть - новые лекарства/технологии - обкатка. FDA (Federal Drug Adm.) организация еще та... из-за нее антиблевотики в юс устаревшие мама не горюй...
мне в далласе напрямую предлагали возглавить центр изучения фетальной терапии и где же? В МЕКСИКЕ тк в юс она запрещена, а желающих пропасть.... [Ответ]

нам недавно один амер лекцию читал, из той х ерни которую он нес, я понял только одно: "на детях в частности на детдомовцах планируют исптывать эффективность БАД и витаминов и еще хрен знает чего ...блаблабла."все это подводится под благотворительность и гумонитарную помошь, но вот мне как то мало верица в чистоту помыслов этих зарубежных добродетелей... [Ответ]

А может быть человек правда хочет узнать что-то новое для себя?

for Alpine: i`m a doctor too...and it will be very intersting for me to have some studing in USA...but i donn`t know how to do it...it seems to me it`s imposible because we(russian doctors) need to improve our diplomas first...
What do you think about it?

P.S. You may wrigth me to private [Ответ]

Сообщение от :
i donn`t know how to do it...

I don't know either . There is quite a bit of info on the web, though. Since you already hold an MD (at least technically you do), what you want to do is to come for either some fellowship or residency program. I would imagine there are a ton of factors you need to juggle, like what kind of medicine you'd like to do, your competitiveness, immigration and visa issues, mobility, family considerations, etc...

a couple of links to start

http://www.aamc.org/students/medstud...ship/start.htm
http://www.russiandoctors.org/residents/mahon.shtml
http://www.internationaldoc.com/

Сообщение от :
it seems to me it`s imposible because we(russian doctors) need to improve our diplomas first...

Russian doctors have exactly the same potential as american ones. My girlfriend's primary care doc is russian, for instance. And she loves her. I'd say, forget what your diploma says. What you need is clinical skills, perseverance, fairly good English (although I sometimes hear residents with such poor English I wonder how they get around here at all, not to mention their bed side communication skills). Some degree of research wouldn't hurt either.

If you have questions, don't hesitate to ask.

You can also take a roundabout route. Keeping residency in mind, try to set up a short-term educational/observational visit. You won't have any clinical privileges, but would be able to learn and shadow, like med students do. Those program do exist. What's good about such programs is 1) you learn the system, the language, the lifestyle. 2) you get to know people and show your skills and knowledge. 3) you will be able to ask for recommendation letters. 4) partial or full financial support. 5) access to educational materials, including USMLE.... [Ответ]

look who came here: the dude who wants to do "extreme" medicine so he could go back and impress his gf with bears on the street and drinking vodka from plastic cups at winter
man, you can join peace corps and update your cv in that way
it will save you money and patients' health

i'm wondering how did you find this forum though because if you are serious and could give me real reasons why you are so interested to do externship in Russia i could probably help you

для интересующихся
все гораздо сложнее чем товарищ написал
но реально и тому есть примеры [Ответ]

for alpine
even if lamer's not right (actually I doubt it’s true) don’t be that hurt
i believe you will find what you are looking for one day ‘cause there a lot of med students in russia (and in voronezh as well) who are really interested in that subj
also check out a forum of our med academy www.vgma.ru
there a lot of idiots hangin’ over there for chat only but you’ll be able to find a couple or even a bunch of thinkin’ human beings

and by the way welcome russia
you’ll like our country
it’s can’t be explain by scientists but Americans like the rf after they stay here for some time
i can’t realize why but still it’s true
[Ответ]

I was interested couple of years ago. Now I've got new subjects to thing about.
Anyway, I agree with VeDMed - gd'luck, Alpine. [Ответ]

Сообщение от ВеДМеД:
for alpine
even if lamer's not right (actually I doubt it’s true)

интересно в чем я не right и что именно true? [Ответ]

емое тема то прошлогодняя [Ответ]

Ааа! Бугага! А я седня смотрю - тема интересная, и посты свежие есть)))
Во засада, мы оказывается вообще не в контексте.
Позорище... [Ответ]

alpine, чувак! Не едь сюда лишь по одной причине: Большинство (не все, конечно) врачей у нас гады те еще. Единственное, чему можно тут научится - это губить здоровье людей, безразлично относиться к больным, коррупции и дикому непроффесионализму. Даже в платной медецине часто встречаются бестолковые врачи.
Есть, кончено, изумительные люди, но их совсем мало...

Для тех, кто будет со мной спорить, утверждая, что их друг (родственник) является отличным врачем, всегда внимательным к пациентам и прочая херня, сразу говорю: этот аргумент засунте куда по дальше - это они для вас такие хорошие. [Ответ]

Сообщение от Eek:
alpine, чувак! Не едь сюда лишь по одной причине: Большинство (не все, конечно) врачей у нас гады те еще. Единственное, чему можно тут научится - это губить здоровье людей, безразлично относиться к больным, коррупции и дикому непроффесионализму. Даже в платной медецине часто встречаются бестолковые врачи.
Есть, кончено, изумительные люди, но их совсем мало...
Для тех, кто будет со мной спорить, утверждая, что их друг (родственник) является отличным врачем, всегда внимательным к пациентам и прочая херня, сразу говорю: этот аргумент засунте куда по дальше - это они для вас такие хорошие.

иик мы тут уже обсудили тема то старищая альпин уже и не читает ее наверно
гадов у нас много но и хороших врачей тоже много а не

Сообщение от :
совсем мало...

то что это не аргумент согласен врач всегда поразному относится к своим и к чужим
а ехать альпину сюда может и стоит он научится выживать без техники без оборудования иногда и без света в операционной на одном умении и знании как это делают наши рачи [Ответ]