Field training 
“Clinical practice (Doctor’s assistant)”
Specialty – 31.05.01 General Medicine
The total labor output of the discipline is 9 credits, 324 hours.  

The goal of the practice is to study the work of a doctor in hospital’s therapeutic and surgical units, as well as the work of an obstetrician in a maternity hospital; to further improve the skills acquired by students during the study of internal diseases, surgery, obstetrics. The objectives of the field training are:
acquiring the practical skills and competences by students in the scope of duties of a doctor in hospital’s therapeutic and surgical units, as well as of an obstetrician in a maternity hospital in accordance with the Federal State Educational Standard of Higher Education in specialty 31.05.01 - General Medicine; getting familiar with the operating mode of therapeutic, surgical, maternity wards and women's consultations; further improving the skills in examining patients with the most frequent therapeutic and surgical diseases (clarification of complaints, medical history, examination, palpation, percussion, auscultation); using physical, instrumental, radiological, laboratory examination data for diagnosing in stationary conditions; studying the procedure for admission and discharge of patients; acquiring and consolidating the skills in maintaining medical records, issuing disability certificates, compiling extracts from medical histories, etc.; acquiring the skills in physiological birth delivery and conducting primary treatment of newborns; getting familiar with the work of a physiotherapy room, the technique of procedures; getting familiar with the work of a functional diagnostics unit, radiology room, pathology unit; further improving communication skills with patients, their relatives, hospital unit staff; further improving the skills in promoting a healthy lifestyle (health education). The program of the field training "Clinical practice (doctor’s assistant)" refers to the base part of block C2 of the discipline.  

The process of studying the discipline is aimed at the formation of the following competences:

•  readiness to keep medical records (GPC-6);
•  readiness for medical application of drugs and other substances and their combinations in solving professional problems (GPC-8);
•  the ability to assess morphofunctional, physiological conditions and pathological processes in the human body to solve professional problems (GPC-9);
•  the ability and readiness to conduct preventive medical examinations, clinical examinations and to carry out clinical observation (SPC-2); 
•  the ability and readiness to conduct anti-epidemic measures, organize public protection in the foci of especially dangerous infections, in a deteriorating radiation situation, natural disasters and other emergency situations (SPC-3);
•  the ability and readiness to apply socio-hygienic methods for collecting and medico-statistical analysis of information on indicators of public health (SPC-4);
•  readiness to collect and analyze patients’ complaints, their medical history, examination results, laboratory, instrumental, pathological and other studies in order to recognize a condition or establish the presence or absence of a disease (SPC-5); 
•  the ability to determine the main pathological conditions in patients, symptoms and syndromes of diseases, nosological forms in accordance with the International Statistical Classification of Diseases and Related Health Problems, 10th revision (SPC-6); 
•  readiness to conduct examination of temporary disability, to participate in a medical and social examination, to certify person’s biological death (SPC-7);
•  the ability to determine the tactics of managing patients with various nosological forms (SPC-8);
•  readiness to provide medical care for sudden acute diseases, conditions, exacerbation of chronic diseases that are not accompanied by a threat to patient’s life and do not require emergency medical care (SPC-10);
•  readiness to render emergency medical care in conditions requiring urgent medical intervention (SPC-11); 
•  readiness to manage physiological pregnancy, birth delivery (SPC-12);
•  readiness to render medical care in emergency situations, including participation in medical evacuation (SPC-13);
•  readiness to determine the need for applying natural healing factors, drug, non-drug therapy and other methods to patients requiring medical rehabilitation and spa treatment (SPC-14); 
•  readiness to teach patients and their relatives basic hygiene measures of health improvement, the skills of self-monitoring skills basic physiological indicators that contribute to maintaining and strengthening health, and preventing diseases (SPC-15);
•  readiness for educational activities to eliminate risk factors and to develop healthy lifestyle skills (SPC-16);
•  the ability to apply basic principles of organization and management in the field of protecting the health of citizens in medical organizations and their structural divisions (SPC-17); 
•  readiness to participate in assessing the quality of medical care using basic medical and statistical indicators (SPC-18);
•  the ability to organize medical care in emergency situations, including medical evacuation (SPC-19).

During the field training “Clinical practice (doctor’s assistant an outpatient clinic)” students learn: etiology, pathogenesis and preventive measures of the most common diseases of internal organs; modern classification of diseases; clinical pictures, course features and possible complications of the most common diseases that occur in a typical form in different age groups; diagnostic methods, diagnostic capacities of direct examination methods of patients undergoing therapeutic treatment; modern methods of clinical, laboratory, instrumental examination of patients (including endoscopic, radiological methods, ultrasound diagnostics); the basics of organizing inpatient care for various population groups, the principles of clinical examination, rehabilitation of patients undergoing therapeutic treatment. 

Based on the acquired knowledge, students obtain the abilities to determine patient’s status: to collect anamnesis, to conduct surveys patients and / or their relatives, to conduct physical examinations of patients (examination, palpation, auscultation, measurement of blood pressure, determination of the properties of arterial pulse, etc.); to assess patient’s condition to decide on the need for medical care; to conduct an initial examination of systems and organs: respiratory, cardiovascular, blood and blood-forming organs, digestive, endocrine, urinary, to assess social factors affecting patient’s physical and psychological health: cultural, ethnic, religious, individual, family, social risk factors; to give a preliminary diagnosis – to synthesize patient’s information in order to determine a pathology and its causes; to outline the scope of additional examination in accordance with the prognosis of a disease, to clarify the diagnosis and obtain a reliable result; - to formulate a clinical diagnosis; to develop a therapeutic action plan, taking into account the course of a disease and its treatment; to formulate indications for the chosen method of treatment taking into account etiotropic and pathogenetic agents, to substantiate pharmacotherapy for a particular patient, to evaluate the effectiveness and safety of treatment; to use the methods of primary and secondary prevention (on the basis of evidence-based medicine) in medical activities, to establish cause-and-effect relations of health status changes induced by environmental factors. 

Students develop the skills in proper managing of medical records (preparing a medical history setting out all the main sections, substantiating a clinical diagnosis, examination and treatment plans, as well as diaries and stage epicrisis when working with therapeutic patients); general clinical examination methods (questioning, examination, palpation, percussion, auscultation) for diseases of internal organs; interpreting the results of laboratory, instrumental diagnostic methods pathologies of internal organs; using an algorithm of a comprehensive clinical diagnosis of therapeutically-treated diseases; an algorithm for making a preliminary diagnosis with subsequent referring a patient to the appropriate doctor, making a differential diagnosis for a therapeutic pathology; applying basic medical diagnostic and treatment measures when rendering first aid in emergency and life-threatening conditions. 

Types of educational work: unsupervised work of students, students’ work supervised by a teacher. 

The study of the discipline ends with a differential credit mark

 

Subject syllabus