KURSK STATE MEDICAL UNIVERSITY

CERTIFICATE
OF PRACTICAL TRAINING
OF STUDENTS

Speciality: 060101 General medicine

KURSK 2011
 Certificate

of practical training of the student in the specialty 060101 '' General Medicine'' is worked out on
the basis of the state educational standard of higher professional education in the specialty
060101 '' General Medicine '' confirmed in agreement with the Ministry of public Health of the
RF. By the order of state education of the R.F. of 10.03.2000, No 130, of medical specialties and
corresponding qualification characteristics of the physician (Ministry of public Health of the RF,
2000), the test of practical skills of the graduate of the medical faculty of higher educational
establishments (management of scientific and higher medical establishments, YMO Ministry of
health of the RF, 1998), standard curriculum and educational programms for training the
specialist in the specialty of '' General Medicine ''
The certificate consists of three main parts:
- Practical skills in basic disciplines of medico-biological and medico-preventive profile, the
cycle (rotation) of general professional and clinical disciplines;
- Skills which must be acquired by the students during their professional practice as the
assistant of the nurse, assistant of a nurse of the first aid, assistant of the doctor in the clinic
and assistant of the first aid;
- The list of practical skills for the final state attestation of the graduates in the specialty
060101 '' General Medicine''.
The certificate permits, with the exception of duplication, to value the practical training
of the student during the whole period of training at separate departments and during the period
of professional practice, to give the state attention commission the final assessment of practical
skills of the graduate at the interdisciplinary examination.
 CERTIFICATE
OF PRACTICAL TRAINING OF THE MEDICAL STUDENTS
Speciality 060101 General medicine

Credit book ______

Family name

Name

Date of entrance to the medical faculty of KSMU___________

Graduation date_____________

Stamp

Date of application ________

Dean of faculty__________________
 LIST OF PRACTICAL SKILLS

NURSING (introduction to therapy and general surgery)

SKILLS CARRIED OUT

1. Fill out passport information in the case history (3).
2. Conduct sanitary treatment of the patients (2-3).
3. Transport of hospitalised patients (3).
4. Preparation of a functional hospital bed and other devices with the aim
of setting a comfortable position for the patient (3).
5. Changing of underwear and the bedding (2-3).
6. Care of the hair, ears, eyes, skin and oral cavity (3).
7. Prophylaxis of bedsores (2-3).
8. Feeding the patients (3).
9. Control of the sanitary state, visits, and parcels of the patients (3).
10. Conversation with patients (3).
11. Washing the patients (3).
12. Giving the bedpan and its disinfecting (3).
13. Catheterization of the urinary bladder (2-3).
14. Collection of specimens for urine, sputum and stool analysis(2-3).
15. Observation of the appearance, patient's state; checking the pulse,
counting the respiratory rates and measuring the blood pressure (3).
16. Oxygen therapy (2-3).
17. Taking temperature (3).
18. Measuring height and weight, and chest cavity volume (3).
19. Dripping droplets into the eyes, ears and nose (3).
20. Preparation and use of hot-water bottles and ice bags (3).
21. The use of medical cans, mustard plasters and compresses (3).
22. The use of ointments, powders and iodine for external applications
(3).
23. Collection of medications and distribution of them, to be taken for
internal use (3).
24. Sterilisation of medical materials, medical hypodermic syringes and
medical needles (3).
25. Subcutaneous injections (3).
26. Intravenous injections (3).
27. Intramuscular injections (3).
28. Participation in the blood transfusion (3).
29. Preparation of the patients for ultrasound and X-ray examination (3).
30. Setting of enemas (3).
31. Taking gastric juice (3).
32. The duodenal probe (3).
33. Putting the rectal gas tube (3).
34. Washing out of the stomach (3).
35. Attending the patient's conference (3).
36. Duty in different departments of the hospital (3).
37. The work of the operation nurse (3).
38. The work of the anaesthesiology nurse (3).
39. Assistance at the operations (3).
40. Presence at the operations (3).
41. Bandaging at the operations (3).
42. Application of splints, fixed dressing and plasters of "Paris bandage"
(3).
43. First aid for patients with vomiting (3).
44. Application of the tourniquet (3).
45. First aid for patients with stomach, nasal, intestinal and pulmonary
bleeding (3).
46. First aid for patients with heart pain (3).
47. Observation and fixation of excited patients (3).
48. Knowledge of the guiding documents (3).

Teachers signature________________________________________________

1. to know the manipulations and their indications

2. to evaluate the results
3. to do it independently

INTRODUCTION TO THERAPY
SKILLS CARRIED OUT
1. Patient examination: (3).
- patients complaints (3).
- systems review (3).
- Medical and life history (3).
- Primary and differential diagnosis (3).
- General inspection
2. Systems examination (3).
- respiratory;
- cardiovascular;
- gastrointestinal;
- hepatosplenic;
- endocrine;
- urinary.
3. Laboratory analysis: (2).
- blood (2).
- urine (2).
- sputum (2).
- stomach juice examination (2).
- duodenal juice examination (2).
- specific gravity analysis (2).
- cholesterol, triglycerides, LDL,HDL (1-2).
- inflammatory tests (1-2).
- BUN, creatinine (1-2).
- bilirubin (1-2).
- coagulogram (1-2).
- electrolytes (1-2).
- , acid base disorders (1-2).
- stool analysis (1).
4. ECG analysis (1-2).
 5. Respiratory function tests (1-2).
- ECG (1-2).
6. Manipulations
- subcutaneous injection (3).
- intramuscular injection (3).
- intravenous injection (3).
- blood transfusion and their alternatives (3).
- gastric lavage (3).
- stomach incubation (2-3).
- duodenal incubation (3).
- preparation of the patients for ultrasound and X-ray examination (2-3).

Teachers signature________________________________________________

GENERAL SURGERY
SKILLS CARRIED OUT
1. Preparation of bandage material (3).
2. The stacking of materials, dressing gowns and linen to the dressing box
(3).
3. Ways of processing of hands of the surgeon (3).
4. Wearing of sterile clothes (3).
5. Engineering of restriction by sterile linen of an operational field (3).
6. Engineering of manual pressing of blood vessels in typical places
(temporal artery, common carotid artery, subclavicular artery, brachial
artery, femoral artery, belly (abdominal) aorta and peripheral arteries of
upper and lower extremities) (3).
7. Imputing of a turn over (3).
8. Engineering of imposing a tourniquet (3).
9. Engineering of stopping bleeding by methods of joint hyperinflation (3).
10. Definition of blood groups, realization of tests before transfusion of blood
(2-3).
11. Installation of a system for blood transfusion and filling it in (3).
12. Filling in the documentation about blood transfusion (3).
13. Definition of the validity of blood to transfusion. The control of blood
storage (2-3).
14. Toilet of wounds. The initial surgical processing of a wound (2-3).
15. Removal of seams (2-3).
16. Imposing of triangular (scarf) bandages (2-3).
17. Engineering of a bandage usage (gauze bandage). Rules of bandaging (3).
18. Rules of applying bandages on various body areas (3).
19. The instruction for individual package (first-aid kit) usage (3).
20. The Kramers trunk and its usage (3).
21. The Dietrichs trunk (tire) and rules of imposing it (3).
22. Reading of X-Ray (2).
23. Preparing (preparation) of plaster bandages (3).
24. Participation in removal and imposing plaster bandage (2-3).
25. Engineering of reposition of a shoulder dislocations by Kokher (2).
26. Gathering of the anamnesis (3).
27. The description of the local status (3).
28. Measurement of growth and thoracic cage size (3).
29. Measurement of body temperature (3).
30. Definition of a pulse rate, breath (3).
31. Measurement of arterial pressure (3).
32. Describing history of illness (3).
33. Distribution of medicines on chambers for patients (3).
34. Carrying the patient from a bed to a wheelchair, from a wheelchair to
operational or bandage table and back (3).
35. Statement of mustard plasters, jars, imposing of a compress (3).

Teachers signature________________________________________________

PATHANATOMY
SKILLS CARRIED OUT
1.Arrangement and filling in the histology request form with patients
particulars (2).
2.Filling in the post-mortem final examination report with diagnosis and
conclusion (2).

Teachers signature________________________________________________

OPERATIVE SURGERY
SKILLS CARRIED OUT
1. Dissection of soft tissues by scalpel (2-3).
2. Dissection of flat tissues (peritoneum, pleura, fascia, adhesions, etc.) by
scissors (3).
3. Cutting off ligatures (3).
4. Separation of soft tissues (muscles along fibers, mobilization of vessels and
nervous trunks, etc.) by blunt way (3).
5. Putting on and taking off the heamostatic forceps with the right and left
hand (3).
6. Temporal and terminal arrest of bleeding (3).
7. Making surgical knots (simple, reef, surgical) (3).
8. Putting of surgical sutures (continuous and interrupted) on soft tissues (skin,
subcutaneous tissue, muscles, aponeurosis, intestine, stomach,
parenchimatous organs) (3).
9. Inserting of the tracheostomic tube into trachea (3).
10. Puncture of extremities joints (shoulder, elbow, radiocarpal, hip, knee,
ankle) (3).
11. Puncture of the pleural and abdominal cavities (3).
12. Correct usage of subsidiary surgical instruments (3).
13. Topographoanatomical dissection (3).
14. Taking part in surgical operations in the capacity of surgeon, assistant,
operative nurse:
- on animals (2).
- on biomaterial (2).

Teachers signature________________________________________________

HYGIENE

SKILLS CARRIED OUT

1. Assessment of nutritional status of individuals and different
population groups by using clinical examination, antropometry,
biochemical evaluation, functional assessment, assessment of dietary
intake, vital and health statistics, ecological studies (2).
2. Food safety as an example of food surveillance, which is essential for
protection and maintenance of community health (2).
3. Prevention and control of foodborn disease (2).
4. Investigation of food poisoning (2).
5. Water quality management. Parameters for water quality
characterization and standards application. Treatment of drinking water
supplies (2).
6. Solid waste disposal and hazardous waste disposal (2).
7. Assessment of microclimate, ventilation and illumination in hospital.
Prevention and control of air pollution (2).
8. Relevance of result from laboratory animal toxicology studies.
Regulation of chemicals in occupational health. Prevention of chemical
poisonings (2).
9. Evaluation of noise pollution impact on human health. Measures for
noise pollution control (2).
10. Prevention of illnesses due to thermal extremes, nonionizing and
ionizing radiation (2).
11. Worker education (2).

Teachers signature________________________________________________

NEUROLOGY

SKILLS CARRIED OUT

1. Gait (2-3).
2. Pupils reactions testing direct and consensual reactions (2-3).
3. Test fields to hand movements (2-3).
4. Fundoscopy (2-3).
5. Eye movements to pursuit on upgaze and lateral gaze (2-3).
6. Facial sensation to light touch with finger tip in all three divisions of
trigeminal (2-3).
7. Facial movement testing (2-3).
8. Mouth cavity examining observation of palate. Please put out your
tongue (2-3).
9. Test neck flexion (2-3).
10. The arms: (2-3).
- look for wasting;
- test tone at wrist and elbow;
- observe outstretched arms with eyes closed (pronator test);
- test power (shoulder abduction, elbow flexion and extension, finger
extension and abduction and abductor pollicis brevis;
-reflexes (biceps, triceps and supinator).
11. Legs: (2-3).
-look for wasting;
-test tone at hip;
-test power (hip flexion and extension, knee flexion and extension,
foot dorsiflexion and plantar flexion);
-reflexes (knee, ankle and plantar response).
12. Sensation: (2-3).
-test joint position sense in toes and fingers;
-test vibration sense on toes and fingers;
-test light tough and pinprick distally in hand and feet.
13. Coordination-test finger-nose and heel-shin.
14. Examination of disturbances of higher functions: (2-3).
-assess understanding;
-test reading and writing;
-assess speech disorders;
-assess mental state;
-assess behavior.
15. Examination of vegetative symptoms (2-3).
16. Meningial syndrome diagnostics (2-3).
17. Lumbal puncture indications (2-3).
18. Evaluation of results of electroencephalography, rheoencephalography
Echo-encephalography, electromyography (1-2).
19. Evaluation of X-ray of scull and vertebra column (1-2).
20. Scull and vertebra column C-T scan and MRI investigation
results evaluation (1-2).
21. Emergency medical aid: (2-3).
-spine cord trauma;
-insult;
-epileptic status;
-myoastenia crises and cholinergic crises;
-acute pain syndrome due to radiculitis.

Teachers signature________________________________________________

EYE DISEASES

SKILLS CARRIED OUT

1. General examination of the eye and its appendages (3).
2. Palpation of lachrymal sac (3).
3. Washing of the conjunctiva sac, instillation of the eye drops, putting of eye
ointment (3).
4. Digital tonometry (2-3).
5. Visual acuity examination (3).
6. Visual field testing (3).
7. Color vision examination (3).
8. Monocular and binocular bandage (2-3).
9. Prescription of eye drops and ointment (2-3).
10. Binocular vision testing (3).
11. Emergency aid in: (2-3).
- phlegmon of the orbit;
- corneal ulcer;
- acute attack of the glaucoma;
- traumas of the orbit;
- perforating injuries;
- burns of the eye (thermal, chemical);
- acute conjunctivitis;
- acute iridocyclitis.

Teachers signature________________________________________________

STOMATOLOGY

SKILLS CARRIED OUT

1. Investigation of maxillofacial area: (3).
-inspection;
-internal investigation;
-teeth formula making.
2. Render in operation (opening of maxillofacial area abscess and phlegmona)
(2-3);
3. To render in bandage imposing after stomatological operations (2-3);
4. To impose different types of bandage and immobilization in case of jaw
fractures (2-3);
5. Traning of anesthesia procedure and teeth extraction in Fantom (3);
6. Reading of roentgenograms in case of stomatological disease (3).

Teachers signature________________________________________________

PSYCHIATRY

SKILLS CARRIED OUT

1. Students should know: (3).
- construction principles of modern International Classification of mental
disorders;
- the main groups of psychoactive drugs and principles of their choice,
contraindications of them and possible side effects;
- methods of investigations in psychiatry, their diagnostic possibilities and
indications;
- the main symptoms and syndromes of mental disorders, their diagnostic
meaning, the role of the syndromes in working out of treatment plan;
- data of epidemiology, important clinical features, course, treatment and
prognosis of mental disorders and possibility of social adaptation and
rehabilitation ;
- the main types of character pathology, their influence on course of mental
and somatic diseases and choice of psychotherapy methods in patients;
- principles of prophylactics of mental disorders.
2. Students should be able: to reveal opportunely acute mental disorders
which can be the source of danger for patients life or health and also for
people around (2-3).
3. To describe mental state and make a conclusion about the patients
condition. (2-3).
4. To organize observation, fixation and transportation of agitated patients (2-
3).
5. To be able to correct usage and esteeming the results of methods:
classification of objects, exclusion of the superfluous object, comparison of
concepts (2-3).
6. To be common with the characteristics of the thinking disorder syndromes,
specific for: schizophrenia, neuroses, psychostenias, personality disorders,
reactive psychoses, depressive paranoid and astenodepressive syndromes (2-
3).

Teachers signature________________________________________________

INFECTIOUS DISEASES

SKILLS CARRIED OUT

1. Interpretation of the main investigations methods:
- DA, IHA, CFT, IFA (2).
2. Mustering the specific diagnostics technology:
- skin tests (2);
- lumbar puncture (1);
- material collection (blood, bile, feces, urine) for culture (2);
- taking of mucus smears from fauces and nose, nasopharyngeal washes (2);
- preparation of thin & thick blood films (2).
3. Carrying out of the specific therapy using tests for hypersensitivity
checking (2-3).
4. Mustering the technology of specific drug injection:
- injection of serum, vaccines, immunoglobulins (2-3).
5. Ranging of the urgent therapy in:
- hypovolemic shock and dehydration syndrome (2-3);
- toxic shock (2-3);
- acute laryngotracheobronchitis (2-3);
- acute hepatic encephalopathy (2-3).

Teachers signature________________________________________________
 EPIDEMIOLOGY

SKILLS CARRIED OUT

1. Carrying out of descriptive methods of investigations in infectious &
noninfectious pathology (2).
2. Carrying out of analytic methods of investigations:
- determination of beginning & finishing of fly epidemic (2);
- determination of the annual & seasonal infectious morbidity levels
(2).
3. Using method of mathematical modulation in practice:
- calculation of forecast morbidity levels in acute intestinal infections
(2).
4. Observation of epidemic focuses:
- epidemiological surveillance (2);
- focal and concurrent disinfecting (2);
- emergent prophylactics (2).
5. Specific prophylactics of infectious diseases:
- using of active means (2);
- using of passive means (2).

Teachers signature________________________________________________

TRAUMATOLOGY AND ORTHOPEDICS

SKILLS CARRIED OUT

1. Developing a rapport with the patient (2-3).
2. Establishing communication with the patient (2-3).
3. History-taking (3).
general information, presenting complaints, history of presenting illness, past
illnesses, personal history, family history (3).
4. Examination.
4.1 Inspection: Open fracture, deformity and attitude, swelling, muscle
wasting, skin over the injury (3).
4.2 Palpation: temperature, tenderness, palpation of bone-ends, abnormal
mobility, bone repitus. Absence of transmitted movements (3).
4.3 Measurement: Shortening, range of movement of adjacent joints, muscle
wasting (3).
4.4 Conduction of special test (3).
5. Examination of radiographs (2-3).
6. Arrangement of further investigations (2-3).
7. Immobilization of the fractures (2-3).
8. Use of Plaster of Paris (2-3).
9. Hematoma block (2-3).
10. Manual closed reduction of the dislocation (2-3).
 Teachers signature________________________________________________

PEDIATRICS

SKILLS CARRIED OUT

1. Examination of a healthy and a sick child (3):
- anamnesis;
- general inspection;
- auscultation;
- assessment of pulse, respiratory rate and arterial blood pressure.
2. Making of a diet for a child under the 1st year of life (2-3).
3. Assessment of the main laboratory investigations depending on
childs age:
- general blood count (2);
- general urinary count (2);
- biochemical blood analysis (calcium, phosphorus, alkaline
phosphotase) (2).
4. Asessment of X-rays of the early-aged children:
- chest X-ray (2-3);
- X-ray of bones (2-3).
5. Urgent help in:
- hyperthermic syndrome (2-3);
- convulsions (2-3);
- croup (2-3).
6. Assessment of physical and neuro-psychological development of
children (2).
7. Clinical case history (2).

Teachers signature________________________________________________

OTORHINOLARYNGOLOGY
SKILLS CARRIED OUT
1. External examination and palpation of the ear (3).
2. Otoscopy (1-2).
3. Investigation of the hearing (2-3).
4. Investigation of the vestibular analysator (2-3).
5. Investigation of the conduction of the Eustachian tubes (2).
6. Cleaning of the ear (3).
7. Inflation of the Eustachian tubes (2-3).
8. External examination and palpation of the nose and paranasal sinuses
(2-3).
9. Anterior rhinoscopy (1-2).
10. Posterior rhinoscopy (1-2).
11. Investigation of the nasal breathing (2).
12. Investigation of the olfaction (2).
13. Anterior packing of the nose (2-3).
14. External examination and palpation of the neck (2-3).
15. Stomatoscopy (2).
16. Oropharyngoscopy (2).
17. Palpation of the nasopharynx (2-3).
18. Palpation of the larynx (2-3).
19. Indirect laryngoscopy (1-2).
20. Examination of the voice (2-3).

Teachers signature________________________________________________

UROLOGY

SKILLS CARRIED OUT

1. Gathering anamnesis and complains of urologic patients (3).
2. Inspection and palpation of kidneys in different positions of the
patient (3).
3. Inspection and palpation of external genital organs in male (3).
4. Diaphanoscopy of scrotum organs (2).
5. Digital rectal examination at phantom, at patients (2).
6. Interpretation of results of X-ray investigation (plain, excretory,
retrograde and antegrade urography, uretherography and cystography)
(2-3).
7. Interpretation of results of kidneys ultrasonography (2).
8. Taking part in rendering emergency medical care in renal colic attack
(2).
9. Taking part in accomplishing excretory urography (2).
10. Catheterization of urinary bladder by soft catheter (2).
11. Assistance at following operations:
- operations at scrotum organs;
- cystostomy;
- lumbotomy.
12. Rendering medical aid in following emergency cases:
- phimosis (2);
- acute urinary retention (2).

Teachers signature________________________________________________

IMMUNOLOGY AND ALLERGOLOGY DEPARTMENT

CARRIED OUT
SKILLS
1. To be able to prove necessity of immunologic and allergic examination (2-
3).
2. To have skills of work with a card of immunologic examination of the
human. To estimate results of immunologic examination (2-3).
3. To be able to carry out differential diagnostics of immune system diseases,
including HIV-infection (2).
4. To know a principle of statement of the basic tests of immune and
allergodiagnostics; preparation of blood, blood components, biological fluids
for immunologic analysis; count the number of T- and B-lymphocytes
(immunophenotyping), to determine phagocytic activity of neutrophils,
quantity of antibodies in blood (2).
5. To be able to determine "risk group" on immunodeficiency using the
unified diagnostic cards "Diagnostics of immunodeficiency and
immunopathology at primary immunologic inspection" (2).
6. To be able to estimate action of various immune preparations on immune
system (2-3).
7. To put skin allergic tests with noninfectious allergens. To estimate result of
skin allergic tests (1-2).
8. To carry out specific hyposensitization under the instruction of the
allergologist (1-2).
9. To put the diagnosis of allergic disease in acute stage and to stop the acute
allergic conditions (asthma attack, anaphylactic shock, urticaria, Quincke's
edema, etc.) (2-3).
10. To know the principles of immunorehabilitation (3).

Teachers signature________________________________________________

ANESTHESIOLOGY AND REANIMATOLOGY

SKILLS CARRIED OUT

1. A multi-step resuscitation technique used in case of clinical death
(ABC rule) (2-3).
- artificial lung ventilation using mouth-to-mouth, mouth-to-nose
methods, an AMBU breathing bag, an airguide introduction; an
overview of crycothetoidtomy techniques, trachea intubation (2-3);
- tracheotomy (1-2);
- closed-chest cardiac massage (2-3);
- medicamental cardiac stimulation, intracardiac injection (1-2);
- identification of clinical and biological death symptoms (2-3);
- electric cardiac defibrillation (2-3).
2. First aid in case of syncope, collapse, coma (coma of non-defined
etiology) (2-3).
3. First aid in case of acute respiratory insufficiency (2-3).
4. First aid in case of acute cardiovascular insufficiency (2-3).
5. First aid in case of exogenic poisoning (domestic and industrial) (2-3).
- vinegar essence poisoning;
- benzol poisoning;
- mushroom poisoning;
- nasogastral tube introduction (2-3);
- gastric lavage (2-3);
- conducting forced diuresis (2-3);
- antidote therapy (2-3).
6. Methods of extracorporal blood detoxication (hemodialysis,
hemosorbtion, plasmapheresis) (1-2).
7. First aid in case of
- insect, snake, animal biting (2-3);
- overcooling (2-3);
- heat stroke (2-3);
- electrotrauma (2-3);
- drowning (2-3);
- coma of non-defined etiology (2-3).

Teachers signature________________________________________________

DERMATOLOGY

SKILLS CARRIED OUT

1. Scraping of the lesions (2).
2. Diascopy, i.e. vitropression (3).
3. Three characteristic symptoms in psoriases: stearin spot, psoriatic
film, blood dew (3).
4. The method makes it possible to recognize the elements of lupus
vulgaris (apple-jelly phenomenon) (2-3).
5. Tests for the isomorphic reaction (1-2).
6. Dermatographia (2-3).
7. Pilomotor reflex (3).
8. Skin allergic tests (epicutaneous, scarification, intradermal) (2-3).
9. The consistencies determined of the lesions by palpation (2-3).
10. Nikolskys sign (3).

Teachers signature________________________________________________

INTERNAL MEDICINE
SKILLS CARRIED OUT
IV V VI
course course course
1. Diagnostic procedure:
- tredmil test (2);
- Holters monitoring (1);
- echocardiography (1);
- ultrasound examination of the abdominal cavity (1);
- ultrasound examination of the kidneys (1).
2. Results evaluations
- lung X-ray (2);
- heart X-ray (2);
- X-ray of the abdominal cavity (2);
- cholycistography (2);
- X-ray of the sella turcica (2);
- X-ray of the suprarenal gland (2);
- gastroduodenoscopy (2);
- ophtalmoscopy (2).
3. Evaluation of laboratory analysis.
- specific gravity, urine analysis (2);
- LDL, HDL, cholesterol, triglyceride (2);
- albumins (2);
- inflammatory tests (2);
- blood enzymes (2);
- coagulograms analysis (2);
- blood electrolytes (2);
- of the blood (2);
- basic reserves of the blood (2);
- urine analysis for glucose (2);
- urine analysis for acetone (2);
- glycemic profile (2);
- glycemic test (2);
- examination sella turcica X-ray (2);
- hormones evaluations t3,t4,renin, aldosterone (2);
- evaluation of the height and weight (2);
- radioisotopic methods of the endocrine glands (2);
- ketones body (2);
- 17-ketosteroids, 17- oxyketosteroids of urine (2);
- ascitic abdominal fluid analysis (2);
- pleural fluid analysis (2);
- sputum analysis (2);
- stool analysis (2);
- sputum analysis on bacteria (2);
- antibiotic resistance (2);
- find antigens for hepatitis;
- TB tests (2).
4. Emergency care
- hypertensive crisis (2-3);
- cardiac asthma (2-3);
- pulmonary edema (2-3);
- cardiac arrest (2-3);
- angina pectoris and myocardial infarction (2-3);
- syncope (2-3);
- attack of bronchial asthma , status asthmatics (2-3);
- third degree A-V block (2-3);
- cardiogenic shock (2-3);
- spontaneous pneumothorax (2-3);
- open and closed pneumothorax (2-3);
- diabetic coma (2-3);
- hypoglycemic coma (2-3);
- hepatic coma(2-3);
-acute renal failure (2-3);
 - acute suprarenal failure (2-3);
- thyrotoxic crisis (2-3).
5. Analysis and clinical examination
- bronchoscopy (2);
- respiratory function test (2);
- Swan-Ganss catheter (2);
- echocardiography and Dopplers investigation (2);
- ultrasoud of abdominal cavity (2);
- ultrasound of the kidney (2);
- parameter of the central hemodynamics (2);
- Dopplers investigation of carotid arteries (2);
- Dopplers investigation of vertebral arteries (2);
- coronarography (1-2);
- lymph node biopsy (1-2);
- liver biopsy (1-2);
- kidney biopsy (1-2).
6. Evaluation of results in different syndromes and diseases:
- thoracic cavity (2);
- X-ray of the kidneys (2);
- i/v urography (2);
- head (2);
- knee joints (2);
- hands and feet (2);
- hips (2);
- vertebral column (2);
- C-T scan (2);
- X-ray and tomography (2);
-MRI (2).
7. Evaluating of clinical results:
-puncture of the bone marrow (2);
-iron blood level (3);
- creatine (2).
8. To treat patients with stomach, duodenal ulcer and their
complications (2).
9. Take the case history of patient with stomach cancer (3).
10. Investigate a patient with stomach hernia (3).
11. Investigate a patient with inguinal hernia (syndromes and
symptoms) (2-3).
12. Take the case history from patients with breast diseases (3).
13. Investigate patients with breast cancer (symptoms and
syndromes) (2).
14. Evaluation and investigation patients with thyroid diseases (2-3)
15. Evaluation and investigation patients with surgical pathology of
thyroid gland (2).
16. To put the primary diagnosis in patients with thyroid diseases
(evaluation of the symptoms) (3).
17. To check signs of thyrotoxicosis (3).
18.To examine patients with the diseases of the colon (3).
19 To examine patients with the diseases of the transverse colon (3).
20. To make a plan of investigation in patients with liver diseases
(C-T scan, MRI, ultrasound, biopsy) (3).
21. Evaluation and investigationt patients with liver disease. (3).
22. Examination of the patient:
- main syndromes (3);
- list of differential diagnosis (3);
- differential diagnosis (3);
- to put the primary diagnosis (3);
- plan of investigation (3);
- analysis of the results (3);
- to put the clinical diagnosis and complications (3);
- plan of treatment (3);
- clinical evaluation of the treatment (3);
- epycrisis (3).
23. Rehabilitation program:
- in the hospital (2);
- in the polyclinic (2).
24. Indication and contraindication for
physiotherapy (2-3).
25. Emergency care
- acute myocardial infarction (2-3);
- anginal attack (2-3);
- Adams-Stocks syndrome (2-3);
- hypertensive crisis (2-3);
- cardiac asthma, pulmonary edema (2-3);
- syncopes (2-3);
- arrhythmias (2-3);
- cardiogenic shock (2-3);
- anaphylactic shock (2-3);
- attack of bronchial asthma (2-3);
- status asthmatics (2-3);
- diabetic coma (2-3);
- hypoglycemic coma (2-3);
- thyrotoxic crisis (2-3);
- hipothyroid coma (2-3);
- anemic coma (2-3);
- hepatic coma (2-3);
- nephrotic crisis (2-3);
- acute suprarenal failure (2-3);
- acute renal failure (2-3);
- acute hepatic failure (2-3).

Teachers signature________________________________________________

SURGERY
 SKILLS CARRIED OUT
1. Examination of surgical patients (3).
2. Be able: to take anamnesis of the patients with acute surgical diseases of
abdominal cavity organs (3).
3. To check symptoms of the muscular defans (Sitkovskij, Rovzing, Voskresenskij,
Bartomje-Mihelson, Schetkin-Bljumberg symptoms) (3).
4. To make the differential diagnosis of the patients with acute surgical disease of
abdominal cavity organs (3).
5. To compose the plan of the examination of the patients with acute intestinal
obstruction (3).
6. To check Valja, capotement , Obratzcov symptoms, to estimate auscultative
dates with cases of intestinal obstruction (3).
7. To acquire features of radiological examination of abdominal cavity organs with
acute intestinal obstruction: Klojber bowels, passage of contrast on intestines,
barium enema (3).
8. To compose the plan of conservative treatment of the patient with acute
intestinal obstruction (3).
9. To check Ker, Kalk. Ortner, Merfi, Mjussi-Georgievskij symptoms of patients
with acute cholecystitis (3).
10. To compose the plan of special methods examination of patients with acute
cholecystitis and its complications. (3)
11. To acquire indications and technical features of some surgical and endoscopic
methods of examination of patients GSD, acute cholecystitis and its complications.
12. To reveal Kerte, Voskresenskij, Mejo-Robson symptoms in case of acute
pancreatitis (3).
13. To compose plan of examination of patients with acute pancreatitis (3).
14. To reveal methods of examination, auscultation, palpation and percussion for
patients with acute peritonitis (3).
15.To compose plan of preoperative preparation and postoperative treatment of
patients with acute peritonitis (3).
16. To interpret data of laboratory, radiological and endoscopic examinations (3).
17. To collect anamnesis of patients with purulent diseases of the lungs and pleura
(3).
18. To reveal percussion and auscultative symptoms, characteristic for exsudative
damage of the pleura, pneumothorax , atelectasis, emphysema ,inflammatory
infiltration of pulmonary tissue (3).
19. To compose the plan of instrumental examination of patients with purulent
damage of the lungs and pleura (3).
20. To interpret result of radiological examination of cancer and purulent diseases
of the lungs and pleura (3).
21. To know technique of execution of medical diagnostic puncture of pleural
cavity in case of hydro- and pneumothorax (3).
22. Acquire indications and technical features of different ways of draining in case
of nonspecific lung destruction and methods of passive draining according to
Bulau (3).
23. To take the anamnesis of the patient with suspicion of the esophagus pathology.
24. Acquire features of radiological examination of esophagus and be able to reveal
x-ray semiology of diverticulas of the esophagus, achalasia and esophagus cancer
(3).
25. Acquire indication and technical features of different kinds of bugieurage of
esophagus structures (3).
26. To take anamnesis of patients with acute and chronic arterial insufficiency of
extremities (3).
27. To spend arterial vascular tests (Goldfljam, Opel, Lenjel Lovastin,
Panchenko tests) (3).
28. To determine pulsation of the stop arteries, popliteal, femoral, carotid, radial,
humeral arteries; to reveal auscultative semiology of arterial stenosis of different
localization (3).
29. To interpret results of aorto- arteriography (3).
30. To find out patients anamnesis in case of posttrombotic desease (3).
31. To fulfill the functional venous probes (2-3).
32. To put elastic bandage on the limb and select necessary size of elastic stockings
for patients with chronic venous insufficiency (3).
33. To compose the plan of the instrumental examination of the patients with
chronic venous insufficiency and to explain the phlebography (2-3).
34. To determine the gastroduodenal bleeding rate on the basis of hemodynamics
and blood analyses changes. To compose plan of dynamic observation for such
patients (2-3).
35. To base indications to operative treatment in case of gastroduodenal bleeding
(2-3).
36. To examine patients with diseases of pancreas (palpation of the abdomen in
Grotts position), to estimate results of the following methods: duodenography,
US-scanning,CT, angiography, ERSP (2).
37. To find out main complaints and accumulate anamnesis in case of mechanical
jaundice; to compose plan of differential diagnosis with usage of instrumental and
laboratory methods of investigation (2)
38. To assess received laboratory dates of pancreas function (2-3).
39. To find out the main complains with the diseases caused by stomach resections
(2-3).
40. To formulate clinical diagnosis in case of diseases caused by stomach
resections (2-3).
41. To fulfill prophylactic and curative heparinotherapy and substitute it in time by
indirect anticoagulative drugs. (2).
42. To determine the plan of patient examination in case of suspicion on
pulmonary embolism, to assess instrumental examination dates (2-3).
43. To perform duodenal intubations 1-2).
44. To perform pleural puncture (1-2).
45. To perform abdominal puncture (1-2).
46. To perform local infiltration anesthesia (1-2).
47. To put on elastic bandage in case of limb vein disease (2-3).
48. To examine the patients with trauma, acute surgical and chronic diseases of
heart, lungs, vessels, pleura, esophagus, stomach, small and large intestine, liver,
biliary tract, pancreas and estimate received dates (2-3).
49. To make patients ready for urgent and planned operations, perform correlation
of homeostasis disturbances (2).
50. To prepare all functional organism systems to operation and choose method of
anesthesia. To assist during planned operations in case of cholecystitis, intestinal
obstruction, wounds of thoracic and abdominal walls (2).
51. To take part in rendering urgent aid in case of incarcerated hernias and
appendicitis (2-3).
52. To take part in bleeding arrest in a wound. Novocain blocks, abscesses and
phlegmone opening, skin tumors removing, curative immobilization, fracture
reduction, joints puncture, skeletal traction (2-3).
53. To treat skin burns, assist in the operation of osteosynthesitis and limb
amputation by first assistant (2).
54. To curate patients after surgery, to dress the wound, to prevent postoperative
complications, to carry out prophylactic medical examination and rehabilitation
(2).
55. The first aid and following tactic in case of emergency conditions:
- burns (2-3);
- hemophtysis (2-3);
- gastrointestinal bleeding (2-3);
- acute abdominal disease (2);
- ulcer perforation (2);
- incarcerated hernia (2-3);
- acute cholecystitis (2);
- acute intestinal obstruction (2-3);
- appendicitis (2-3);
- acute pancreatitis (2-3);
- pneumothorax (2).

Teachers signature________________________________________________

OBSTETRICS AND GYNACOLOGY

SKILLS CARRIED OUT

1. Gynacological investigation (3).
- History;
- Speculum examination of vagina;
- Bimanual vaginal examination;
- Taking smear (swab, Gram stain) from urethra, cervical canal and
vagina to exclude (gonorrhea) and for cytological examination.
2. Fulfilling case history (3).
3. Colposcopy and biopsy of the cervix (1-2).
4. Diagnostic curettage (uterine cavity and cervical canal) (2).
5. Cervical polypectomy (2).
6. Culdocentesis (puncture of posterior fornix of the vagina) (1-2).
7. Probe examination of the uterine cavity (1-2).
8. Ultrasound and laboratory results interpretation (1-2).
9. Laparoscopy, hysteroscopy and hysterosalpingography results
interpretation (1-2).
10. Insertion and removal of the IUD (1-2).
11. Assisting in gynecological operation: (2).
- Conservative myomectomy;
- Cystectomy;
- Hysterectomy;
- Colpoperyneorrhaphy.
12. Stitch removal (1-2).
13. Daily round (1-2).
14. Induced termination of pregnancy (abortion) (1-2).
Teachers signature________________________________________________

PROGRAMME OF PRACTICAL TRAINING FOR MEDICAL STUDENTS

ASSISTENT OF MEDICAL NURSE

The aim of practical training:

1. To be informed about the structure and functions of the hospital, their departments and
services.
2. To obtain practical skills in nursing.
3. To acquire basic knowledge in deontological problems of medicine.

Basic knowledge
During practical training students use their theoretical knowledge and practical skills which were
acquired within the second year of medical education.

Plan of practical training

1. The duration of practice for medical students as assistants of the medical nurse is 24 working
days and is based on the course of patient's nursing.
2. The students are required to work in the departments of therapy and surgery for 2 weeks. In
each department there should be one night duty.
3. During the course of practical work in the therapeutic department, each student should be on
duty for at least 12 hours in the procedure room and 6 hours out of doors, 12 hours in the
surgical department and 6 hours in the dressing room. Work in the department must be under
the control of the medical nurse. The head nurse must control all kinds of medicines used by
junior medical nurses. Every day the student must describe the routine of the fulfilled work.
There will be an exam after the practical work.

The list of practical skills of the 2nd year medical students during practical training as
medical nurse assistant
Hospital_________________________________________________Course____________

SKILLS Date, signature

1. Fill out passport information in the case history.
2. Conduct sanitary treatment of the patients.
3. Transport of hospitalised patients.
4. Preparation of a functional hospital bed and other devices
with the aim of settinga comfortable position for the patient.
5. Changing of the underwear and the bedding.
6. Care of the hair, ears, eyes, skin and oral cavity.
7. Prophylactics of bedsores.
8. Feeding the patients.
9. Control of the sanitary state, visits, and parcels of the
patients.
10. Conversation with patients.
11. Washing the patients.
12. Giving the bedpan and its disinfecting.
13. Catheterization of the urinary bladder.
14. Collection of specimen for urine, sputum and stools
analysis.
15. Observation of the appearance, patient's state; checking the
pulse, counting the respiratory rates and measuring the blood
pressure.
16. Oxygen therapy.
17. Taking temperature.
18. Measuring the height and weight, and chest cavity volume.
19. Dripping droplets into the eyes, ears and nose.
20. Preparation and use of hot-water bottles and ice bags.
21. The use of medical cans, mustard plasters and compresses.
22. The use of ointments, powders and iodine for external
applications.
23. Collection of medications and distribution of those, to be
taken for internal use.
24. Sterilisation of medical materials, medical hypodermic
syringes and medical needles.
25. Subcutaneous injections.
26. Intravenous injections.
27. Intramuscular injections.
28. Participation in the blood transfusion.
29. Preparation of the patients for ultrasound and X-ray
examination.
30. Setting of enemas.
31. Taking gastric juice.
32. The duodenal probe.
33. Putting the rectal gas tube.
34. Washing out of the stomach.
35. Attending the patient's conference.
36. Duty in different departments of the hospital.
37. The work of the operation nurse.
38. The work of the anaesthesiology nurse.
39. Assistance at the operations.
40. Presence at the operations.
41. Bandaging at the operations.
42. Application of splints, fixed dressing and plasters of "Paris
bandage".
43. First aid for patients with vomiting.
44. Application of the tourniquet.
45. First aid for patients with stomach, nasal, intestinal and
pulmonary bleeding.
46. First aid for patients with heart pain.
47. Observation and fixation of the excited patients.
48. Knowledge of the guiding documents.

Every day the student should keep a diary

Date Name, age of the patient Procedure

1 2 3

Signature of Head of the department (every day)

Characteristic of
student____________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

Assistants signature

Mark

Date

PROGRAMME OF PRACTICAL TRAINING FOR MEDICAL STUDENTS

PHYSICIAN'S ASSISTANT IN THE EMERGENCY CARE AMBULANCE

The aim of practical training:

1. To be informed about practical functioning of the hospital emergency aid service
(ambulance).
2. To obtain practical skills in general aspects of emergency medical aid.
Basic knowledge
During practical training students use their theoretical knowledge and practical skills which were
acquired within the third year of medical education during courses of general
nursing, general surgery and therapy introduction.

Plan of practical training

1. The duration of practice for medical students as physician's assistant is 24 working days and is
based on the course of general surgery and introduction to therapy.
2. The students are required to work in the departments of emergency care (ambulance service)
with one night duty.
3. During the course of practical work in the emergency care service, each student should be on
duty for at least 12 hours . Work must be under the control of the supervisor. The duty doctors
and head of the department must control all student kinds of doings and used medicines. Every
day the student must describe the routine of the fulfilled work. There will be an exam after the
practical work.

List of practical skills for the 3d year medical students during practical
training as a physician's assistant in emergency care ambulance survive

Hospital_________________________________________________Course____________

SKILL Date, signature

1 Number of on-call duties.
2 First aid for respiratory failure.
3 Cardio Pulmonary Resusitation (OPR):
- mouth to mouth;
- mouth to nose.
4 Indirect cardiac massage.
5 Application of bandage or self-made bandage in external
Hemorrhage.
6 Intravenous injections.
7 Intramuscular injections.
8 Transport of patients from first site to second site.
9 Acute cardiovascular failure (pre-hospital measures).
10 Acute respiratory insufficiency.
11 Transport of patient with locomotor lesions.
12 Splint application.
13 Primary wound care: aseptic bandage application.
14 Transportation and bandage application in case of burns,
electric trauma and/or combined injuries.
15 Pre-hospital care and transport of spinal cord injuries.
16 First aid in case of vomiting.
17 First aid in case of chest pains.
18 Patients restraints in case over excitation.
19 First aid in gastric, intestinal, pulmonary
and nasal haemorrhage.

Every day the student should keep a diary

 Date Name, age of the patient Diagnosis Treatment
1 2 3 4

Signature of Head of the department (every day)

Characteristic of
student____________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

Assistants signature

Mark

Date

PROGRAMME OF PRACTICAL TRAINING FOR MEDICAL STUDENTS

PHYSICIAN ASSISTANT IN THERAPEUTICAL, SURGICAL,

GYNAECOLOGCAL DEPARTMENTS

The aim of practical training

1. To acquire practical skills for giving medical first aid in therapeutical, surgical, gynacological
diseases and obstetrics. With special attention devoted to emergency pathology.

2. To acquire practical skills for giving medical first aid in experimental conditions (for example-
during massive admission of patients while epidemic events).

Basic level of knowledge

During practical training students use their theoretical knowledge acquired by them in basic
clinical faculties - in therapy, surgery, in obstetrics and in gynecology and practical skills
acquired by them in these faculties as well.

Plan of practical training

Duration - 6 weeks (2 weeks - therapy, 2 weeks - surgery, 2 weeks - obstetrics).

Practical work of students consists of working days (6 hours daily) and 2 duties in surgical
as well as in therapeutic and obstetrics departments.
Introduction into the organization of the work of the departments and specialized hospital
offices. Acquaintance of students with the department, with its equipment and official medical
documents, with the organization of doctors, junior med. personnel which is carried out on the
first day. Deontological problems of medical practical work are considered.
In the hospital the student works as assistant of ward doctors under the supervision of the head of
the department, and is supposed to follow up 5-6 patients. Every day he has to fill in the journal
of a patient. With the help of the doctor he is obliged to make daily rounds and can fulfill the
treatment, diagnostic and other manipulations. In the process of practical training for the
students in therapy, they should even take part in Ro-entgenological investigations of the patient
under the instruction of medical personal, polyclinic procedures, undergo night duties in the
hospital together with duty doctors and go along with the doctor for emergency help.
Students should take part in pathologoanatomical postmortem. Students should be introduced to
the modernized method in exposing tuberculosis in adult and children, teach them to carry out
tests for tuberculosis and introducing with X ray methods for the check up of thorax. They
also have to take part in the performing of physiotherapy procedures.
The programme of practical training in therapy includes epidemiological works in those
clinics which have direct relation with the work the of Participating doctor, such as: diagnosis of
infectious diseases by clinical and laboratory methods; participating in the medical check ups.

Every day the student should keep a diary

Date Name, age of the patient Diagnosis Condition, treatment

1 2 3 4

List of practical skills for the 4th year medical students during practical
training as a physician's assistant in therapy
Therapy
Hospital_________________________________________________Course____________

SKILLS Date, signature

1. Examination of the patient.
2. Number of Patients.
3. Filling in the case history.
4. Consulting the patient in the polyclinic.
5. Number of assistants in the hospital.
6. Subcutaneous injection.
7. Intermuscular injection.
8. Intravenous injection (infusion).
9. Taking blood from the vein.
10. Blood transfusion & its alternatives.
11. Determination (if the Blood Group).
12. Electrocardiography.
13. Analysis of ECG.
14. Assisting in ultrasound examination:
- of the abdominal cavity;
- heart;
- kidneys.
15. Analysis of circulation function tests. Assisting in diagnosis
of Thoracic organs, x-ray examination
- fibrobronchoscopy;
- examination of oxygen content.
16. Assisting in x-ray diagnosis of digestive organs.
- x-ray examination fibrogastroscopy
17. Puncture of thoracic cavity.
18. Puncture of abdominal cavity, examination of ascitic fluid
19. Incubation of duodenum.
20. Incubation of gastric consistency.
21. Rinsing of stomach.
22. Analysis of blood test,
- chemical constituents of blood (aminotransferases, BUN,
bilirubin, electrolytes, cholesterol, lipids, glucose,
Immunoglobulins, proteins);
- PH of the blood.
23. Determination of blood clotting period of bleeding.
24. Urine test.
25. Sputum analysis.
26. Stool analysis.
27. Physiotherapy.
28. Giving first aid to the patient with Oedema of Lungs,
Arrhythmias,
Status asthmatics, Cardiac asthma.
29. Delivering Articles (in a defiaite topic).
30. Taking part in Conversations and arguments.

Signature of Head of the department (every day)

Characteristic of
student____________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

Assistants signature

Mark

Date

List of practical skills for the 4th year medical students during practical
training as a physician's assistant in surgery
Surgery
Hospital_________________________________________________Course____________
SKILLS Date, signature
1. Supplying services in the ward.
2. Working days in hospital
3. Consulting with patient in polyclinic.
4. Filling of the case history of new patients.
5. Giving local anaesthesia.
6. Cleaning the wound.
7. First surgical treatment of the wound.
8. Cutting of the Panaritium, Abscess, Flegmona (under the
control of a doctor).
9. Stanching wound.
10. Cutting of stitching.
11. Determination of blood group (under the control of a
doctor).
12. Taking part in blood transfusion & their components.
13. Assisting in intensive case:
Surgical patients;
Patients with purulent wound & septic (infected) wound;
Thoracal patients;
Proctologic patients;
Traumatological patients;
Urological patients;
Patients with cardiological pathology;
Burned patients.
14. Rectoromanoscopy.
15. Fistulography.
16. Rectal & vaginal diagnosis with finger.
17. Venesection, cateteriization of vein.
18. Cateterization of urinary bladder.
19. Assisting in operation
Laporoscopy;
Ultrasound;
X-ray diagnosis.

Signature of Head of the department (every day)

Characteristic of
student____________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

Assistants signature

Mark

Date

List of practical skills for the 4th year medical students during practical
training as a physician's assistant in obstetrics
Obstetrics
 Hospital_________________________________________________Course____________

SKILLS Date, signature

1. Daily examinations of patients.
2. Taking patients history.
3. Measurement of abdominal circumference.
4. Fundal measurement.
5. Leopold`s maneuvers.
6. Calculation of expected fetal weight.
7. Estimation of the date of delivery.
8. External pelviometry.
9. Auscultation of the fetal heart beats.
10. Speculum examination of the birth canal.
11. Taking vaginal smear.
12. Vaginal examination.
13. Amniotomy.
14. Assesing in vaginal deliveries.
15. Episiotomy.
16. Estimation of uterine contractions.
17. Estimation signs of placenta separation.
18. Assesing in Cesarean deliveries. Other operations.
19. Calculation of Apgar score.
20. Management of patient in normal puerperium.
21. Estimation of preliminary diagnosis.

Signature of Head of the department (every day)

Characteristic of
the student____________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________
__________________________________________________________________________

Assistants signature

Mark

Date

PROGRAMME OF PRACTICAL TRAINING FOR MEDICAL STUDENT

PHYSICIAN'S ASSISTANT IN EMERGENCY CARE DEPARTAMENT

The aim of practical training

1. To acquire practical skills for giving medical first aid in different parts of medicine.
2. To acquire practical skills for giving medical first aid in experimental conditions (for example-
during massive admission of patients while epidemic events).

3. To be able to provide effective diagnostics of emergency pathology in therapy, surgery,

obstetrics and gyneacology.

Basic level of knowledge

During practical training students use their theoretical knowledge acquired by them in basic
clinical faculties - in therapy, surgery, in obstetrics and in gyneacology and practical skills
acquired by them in these faculties as well.

Plan of practical training

1. The duration of practice for medical students as the physician's assistant is 24 working days. It
is based on the course of emergency care.
2. The students are required to work in the department for 4 weeks.
3. During the course of practical work in the department, each student should be on duty for at
least 12 hours in the procedure room and 6 hours out of doors. Work in the department must be
under supervision of the head of the department, and is supposed to follow up 5-6 patients.
Every day he has to fill in the journal of patient. With the help of doctor he can fulfil the
treatment, diagnostic manipulations. After practical work an exam will take place.
List of practical skills for the 5th year medical students during practical
training as a physician's assistant in emergency care department
Hospital______________________________________ Course___________
SKILLS Date, signature
1. Acute cardiac arrest/immediate death.
2. Syncope/collapse.
3. Anginal state (cardiogenic pains).
4. Acute cardiovascular failure.
5. Hypertensive crisis.
6. Kinds of shock:
-hypovolemic;
-hemorrhagic;
-traumatic;
-burns;
-anaphylactic;
-cardiogenic;
-septicotoxinic.
7. Comatose states:
-diabetic coma;
-apoplectic coma;
-unknown etiology coma.
8. Thyrotoxic crisis:
-adisonic (suprarenal) crisis.
9. Acute respiratory insufficiency due to:
-diphtheria;
-upper respiratory tract obstruction;
-drowning;
-strangulative asphyxia;
- asthmatic state;
-massive pneumonia;
-atelectasls;
-closed or open pneumothorax;
-hydro or haemothorax;
-pulmonary artery thromboembolism.
25. Crush-syndrome.
26. Burns and frostbites.
27. Dangerous conditions under plaster bandage.
28. Severe toothache and maxilofacial trauma.
29. Eyeball and adnexa oculi injuries:
-conjunctiva and cornea foreign bodies;
-eye contusion;
-UV eye lesion;
-acute glaucoma attack;
-chemical and thermal eye burns;
-acute retinal circulation disorders.
30. Emergent care:
-hyperpyrexia;
-convulsive syndrome;
-tetatus;
-renal colic;
-acute ischuria.

Every day the student should keep a diary:

Date Name, age of the patient Diagnosis Condition, treatment

1 2 3 4

Signature of Head of the department (every day)

Characteristic of
the student_____________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

Assistants signature

Mark

Date

LIST OF PRACTICAL SKILLS FOR STATE EXAMINATION

SKILLS
1. Anamnesis of the patients: social; 3
 bioloical;
genetic.
2. Antropomety: measurement of weight, high, chest and head circumference. 3
3. Estimation of the physical state of the body according to indexes and standards. 3
4. Functional stress testing. 3
5. Observation of the appearance, patient's state; checking the pulse, counting the 3
respiratory rate and measuring the blood pressure.
6. Estimation of patients health level according to complex approach. 3
7. Clinical investigation: inspection, palpation, percussion, auscultation. 3
8. Primary diagnosis establishment and its confirming, evaluation of pathology 3
severity and emergency medical aid severity.
9. To make plan of investigation. 3
10. To get plan of management. 3
11. Collection of specimen for urine, sputum and stools analysis, taking the blood, 23
bone marrow, lumbar liquid in case of somatic and infectious diseases.
12. Laboratery analyses results estimation: 3
-- General blood and urine. Stool analysis. 3
-- Biochemical blood analysis in somatic and infection diseases (electrolytes, 3
cholesterol, trigliceride, AST, ALT, creatinine, BUN, protein, bilirubin, GGT, AP).
-- Rheumatics probe (protein general level and spectrum, C-protein, etc.) 3
-- Urine analysis - (urea, creatinine, BUN, glucose, acetone, specific gravity), 3
electrolytes, creatinin clearance test, cholesterole, protein general level and
spectrum
-- Liver probes (bilirubin, AST, ALT, cholesterol, alcaline phosphatase, &- 3
glutamyl transferase, protein general level and spectrum, timol test
-- acid-base disorders; 3
-- glycemic profile, Amylase; 3
-- blood markers of virus hepatitis types (A,B,C,D,E); 3
-- immunogram (immunoglobulin, T and B cells); 23
-- serum markers of infection diseases - HIV , infectious mononucleosis tests, 2
AIDS, toxoplasmosis etc;
-- TB tests; 23
-- determination of blood group. Blood transfusion tests. 3
13. Coagulogram (PT, PTT, BT, TT, FACTORS 12) 3
14. Patients preparation to X-ray, ultrasound, gastroscopy, colonoscopy. 3
15. Estimation of instrumental investigation results:
-- evaluation of ulrrasound examination (heart, liver, kidney, spleen, pancreas, 3
thyroid gland, uterus);
-- results of duodenum and stomach juice investigation; 3
-- X-ray of the chest, GIT, GUT, joints, kidneys, scull, bile tract; 3
-- ECG (arrhythmias, blocks, hypertrophy, myocardial ischemia and infarction); 3
-- bronchoscopy and bronchography; 2
-- lumbar, sternal, pleural puncture. 12
16. Per rectal examination (toucher rectale) 23
17. Bronchial postural drainage. 23
18. Pregnancy tests external and internal investigation of pregnant, pregnancy 3
time estimation.
19. Pupil reaction. 3
20. Estimation of pathological syndromes which are revealed during patients 3
investigation, clinical diagnosis making.
21. Etiological, pathogenetic and syndromic therapy according to different 3
diagnosis.
22. Sanitary of ears, mouth and nose cavity. 3
23. Sanitary (cleaning) of eyes. 3
24. How to remove foreign bodies from eyes, nose, ears, mouth cavity. 3
25. Treatment of eye burns. 3
26. Nose cavity tomponade in case of bleeding. 3
27. Technology how to stop bleeding (manual, bandage application, etc.). 23
28. Gastric lavage, different clisma sorts. 3
29. Cleaning of the upper respiratory airway with pomp. 23
30. Urinary bladder catheterization. 3
31. Treatment of bedsore. 3
32. Dressing and cleaning of pus. 3
33. Injections ( IV, IM, SB). 3
34. Dressing with antibiotics. 3
35. Probe to prove if the vessels of the lower limb are intact. 2
36. Immobilization of patients with fractures. 3
37. Novocain block. 23
38. CPR (defibrillation). 23
39. To be in the delivery room. 3
40. Emergency care: cpr (defibrillation)
- burns; electrical trauma; 3
- acute respiratory failure; 3
- pulmonary edema; 3
- intoxications; 3
- burns of the esophagus; 3
- acute dehydratation; 3
- shocks ( cardiogenic, septic, anaphylactic etc.); 3
- hyperthermia; 3
- hypertensive crisis; 3
- brain edema; 3
- seizures;. 3
- epilepsy; 3
- DIC; 3
- syncope; 3
- sun burn; 3
- allergic reactions; 3
- bronchial asthma attack; 3
- angina pectoris; 3
- arrhythmias; 3
- diabetic coma; 3
- renal colic; 3
- acute respiratory and intestinal infections; 3
- animal bites; 3
- acute gastrointestinal bleeding; 3
- acute pneumothorax; 3
- bleeding from the lungs. 3
Disorders in: 3
- acute urinary obstruction; 3
- uterine bleeding; 3
- rupture of the uterus; 3
- ectopic pregnancy; 3
- eclampsia and preeclampsia. 3

Notes:
1. to know the manipulations and their indications
2. to take part in method executing to evaluate the results
3. to do it independently

Mark for practical skills_________________________________________

_________________________________________200______

State Examination Committee

The Chairman

Members of the Committee______________________________________________________

____________________________________________________________________________