KarshievaS, 31.03.2017 16:39, 72

The Cancer Prevention Foundation and the Petrov Oncology Research Institute have begun the third admission to the Higher School of Oncology - residency for young doctors. They take sixth-year students, interns and residents there according to a very strict competition, from all over the former USSR. There will be nine places in the residency.

Residents will be taught the latest cancer treatment protocols, scientific work, communication with patients and many other important things. Russian, European, American oncologists will teach (therefore, one of the key requirements for young doctors will be fluent English, they will have to speak, read, and write). The residency itself will be free (the residency is paid by the Foundation). Young doctors will be paid a stipend of 15,000 rubles from this year, besides this year they will be compensated for housing.

“The residents will be taught by the best oncologists in the world. We organize internships in the West, we will teach our doctors not only to treat, but also to teach other residents. This is the most important thing, this is the graduation criterion for the Higher School of Oncology,” says Ilya Fomintsev, Executive Director of the Cancer Prevention Foundation.

“Our goal is to provide graduates with the skills necessary for the practice of modern oncology, for conducting research and educational activities that are in demand. This is an evolving project, the ultimate goal of which will be the adaptation of the Western concept of postgraduate education (residency) for Russia,” says Vadim Gushchin, lecturer at the Higher School of Economics, head of the department of oncology at the Mercy Clinic (Baltimore, USA).

The competition will be held in three stages. In the first one, students' questionnaires and applications will be examined, in the second, they will talk to them in English and offer tests in medicine and oncology. In the third round, the teachers of the School will look at the candidates in person, give them new tasks in medicine, medical ethics and communication with patients.

“In the third round, candidates give speeches to patients about why they want to become oncologists,” explains Fomintsev. Patients rate them. We need to know how patients react to them, how empathic they are. We are interested in how they behave, this is a competition that reveals them very well. They solve ethical problems that do not have a correct answer. But we are interested in how they will respond. In general, we will teach this later, they take exams in communication with patients on live actors. Naturally, they do not know how to communicate with patients now. It does not depend on the suspension of the language, on communication skills. they teach it."

“We are interested in people with the best general medical knowledge and the best clinical thinking. In general, we are of little interest whether the candidate knows oncology or not. This is why he goes there to study oncology, he cannot know it well, even if he studied well at the university, because oncology is poorly taught in Russia. Highly".

Applications for the competition can be submitted until April 16. Detailed information about the competition, its conditions and training at the GSE can be found on the competition website http://hso.nenaprasno.ru. Community for members: https://vk.com/hso2017.

Categories: Russian science Research Institute of Oncology named after V.I. N. N. Petrova

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A couple of years ago, the Higher School of Oncology (HSO) was launched in St. Petersburg, a joint project of the Cancer Prevention Foundation and the N. N. Petrov Oncology Research Institute. The training program for young oncologists is designed for graduates of medical universities and interns. There were two sets, a third is being prepared. In total, 17 students study at the Higher School of Economics, geography - from Kaliningrad to Blagoveshchensk and from Velsk to Kharkov.

It is extremely difficult to get into the HSE. Applications are submitted by about 300 people, the candidate must go through three rounds. Everyone looks and evaluates: in addition to profile knowledge and an average grade at a university (with a score below four, they are eliminated immediately) - the level of English, motivation, and even pages on social networks. In the second round they are asked to write an article for patients, and in the third round they are asked to give a speech to them about why you want to become an oncologist. “One began to read poetry - this is immediately a minus. Although the poems were heartfelt,” says Ilya Fomintsev, executive director of the Cancer Prevention Foundation. Finally, they offer to solve an ethical problem, for example: “You are the only one who knows that your colleague made a mistake that led to the death of a patient. What will you do in this situation? There is no correct answer. “But the fact that the candidate answers reveals him,” Fomintsev explains.

After entering the GSE, the whole life of the project participant is subordinated to oncology. From eight to nine in the morning, residency training begins - mainly at the Oncology Research Institute, located in the village of Pesochny near St. Petersburg. Lectures are held on Saturdays: the basic course is devoted to making clinical decisions in oncology (it is taught by an active surgeon-oncologist in the USA Vadim Gushchin); there is also a course in clinical epidemiology and medical statistics, a course in communication with patients (in particular, they teach how to treat them as equals) and others. “GSE students are so immersed in oncology that they have nothing else to talk about. If they start talking about the relationship of the sexes, everything ends with the topics of the human papillomavirus and cervical cancer, ”says Ilya Fomintsev.

“They are trained in evidence-based medicine, the scientific method of decision making in oncology,” he adds. - Oncology consists of solutions. Most of them have scientific research. To be able to search, read, evaluate their reliability and apply - this is the professional mechanism. In addition, Fomintsev says, students are taught to see their own cognitive distortions - what influences decision making (for example, the authority of a colleague) - and work with them.

The Foundation's website states that the GSE program over five years should result in at least 60 specialists trained according to international standards. You can find out how to help the project.

On the eve of World Cancer Day on February 4, The Village spoke with three GSE students about what it's like to devote your whole life to oncology at 25, whether they have empathy for patients, and what misconceptions they face about cancer.

Katya Baron, 25, surgical oncologist

About the series "First Aid" and Krasnoyarsk

I come from a family of doctors, but no one forced us to make our choice (my brother, for example, is not a doctor). I have dreamed of becoming a doctor since I was five years old. As a child, I had a real first aid kit - with needles, syringes and even a scalpel. My toys were constantly dry from daily injections. Mom worked in an ambulance, and she and I watched the series Emergency Room (“Ambulance”) with George Clooney.

As a result, I went to a medical school in Krasnoyarsk. But initially I wanted to do emergency care, not oncology. Therefore, I chose surgery - you can’t imagine more urgently. And then a misfortune happened in my family: my aunt, whom I loved very much, died of pancreatic cancer. She was an oncologist. This event impressed me so much that I decided to start working on cancer after my internship in surgery.

And I ended up at the Higher School of Economics on a bet. I was finishing my internship and wanted to get into residency in oncology in Moscow. I came across a funny online advertisement about residency in St. Petersburg "without bribes and majors." I left my details on the page to learn more about the competition. The application was not sent. And then Ilya Fomintsev wrote to me on VKontakte. He began to ask about what I would like to do, pour questions on medicine - I answered. And he suddenly announced that if I now answer his last question, I will get into the third round of selection, bypassing the second. I'm a gambler, so I agreed. It was a question that could not be answered on the Internet. Ilya gave a day. I answered and got into the third round.

In general, I am a fan of my native Krasnoyarsk and would really like to return there, but it is not so easy. It just seems that you can hang yourself with diplomas and certificates from cool places - and you will be accepted with open arms. In fact, no one is waiting for us, so many are afraid to leave: they want to work where they have taken root. The problem is that our Russian diploma very often does not say anything about a person, so hospitals want to first look at a specialist and evaluate him on their own.

About surgery and targeted drugs

In oncology, there are three large groups of treatment methods: drugs, radiation, and surgery. If we talk about operations, then, as we were convinced in the residency, almost everything can be operated on if desired. As for the drugs, targeted ones are being studied from the new ones: these are drugs that, when they enter the bloodstream, destroy only the cells that are their target, and can slow down the spread of the tumor.

It becomes clear to the whole world that with a scalpel in your hands you cannot keep up with cancer. Surgeons won't beat cancer. In most cases, cancer is a systemic disease (with the exception of very early stages). Now the stake is on the same targeted drugs, on chemotherapy. That is, far from all problems are solved by surgery, sooner or later a person needs other systemic methods of treatment. This is the so-called modern multidisciplinary approach in oncology: when a person with cancer is treated simultaneously by a therapist, a radiation therapist and a surgeon. The three of them develop optimal tactics. There is an understanding of the importance of this approach in hospitals in large cities - where doctors regularly fly to conferences, they are used to the exchange of experience. In some regions, this is little understood. But here the question is not even to our doctors. It’s just that the world has only recently become aware that surgery cannot save everyone.

About colorectal cancer

Of the proven risk factors and prevention of this type of cancer - nutritional culture: a high intake of animal fats combined with a low intake of fiber (in addition, up to 20% of colon cancer is hereditary). But there are many misconceptions here. For example, for a long time it was believed that the consumption of red meat is a factor in the occurrence of such cancer, and then a study appeared that in hereditary vegetarians the intestinal wall is in a state of constant inflammation, and this may also be a risk factor. In general, they agreed that it is better to eat red meat no more than once a week, and the rest of the time - either poultry or fish.

Screening for colorectal cancer can reduce not only mortality but also morbidity. The fact is that the tumor grows from polyps in the colon. And if a polyp is found, it is removed, and the incidence decreases. There are studies according to which the formation of polyps can reduce the use of aspirin, so people abroad, it happens, consciously begin to drink aspirin after 45 years.

Volodya Kushnarev, 25 years old, pathologist

About Arrowsmith and getting up at six in the morning

I am from the Amur region, the village of Tambovka. Once upon a time, I was greatly impressed by the book of Nobel laureate Sinclair Lewis "Arrowsmith" - it tells about the formation of a student of medical microbiology. I read the book in eighth grade, then re-read it three more times. Sometimes I compare myself to the main character, Martin Arrowsmith.

I graduated with honors from the Amur State Medical Academy in Blagoveshchensk. He trained for a year in Freiburg - in the group of Irina Nazarenko "Biology of tumors and exosomes". After the internship, I realized that I was really interested in oncology. And I decided that I would connect my life with experiments: I wanted to study the mechanisms of cancer development.

Having moved to St. Petersburg, I rented a three-room apartment with two other HSE residents near the Prospekt Prosveshcheniya metro station. The road to the research institute takes about 30–40 minutes, if there are no traffic jams. I usually get up around six o'clock in the morning: I have to be at work by eight. I usually leave work at half past one at night.

I devote all my free time to my profession. Right now I want to participate in the competition of young scientists of research institutes - before February 6, you need to submit abstracts, the deadline is close. Me Katya (Baron. - Approx. ed.) pulled off - said: "Quickly run here - you need to give an interview." And at that time I was sitting in the laboratory with one of the researchers: we were looking at various forms of breast cancer. Our task was to compare the automatic method for the analysis of the Ki-67 proliferative activity index in tumor cells with the level that we assess visually.

About expensive books and types of cancer

The main instrument of a pathologist is a microscope, but now there are many additional research methods: like all specialties, ours is developing in the field of IT technologies and biotechnology. You need to constantly be aware. There is always something to do, because the correct diagnosis, patient treatment and prognosis depend on you. You are guided by a clinician who is waiting for the conclusion. Clinicians are constantly calling: we are trying to explain that, on average, a conclusion takes about a week, but everyone wants it in two days.

All our literature is in English, we work in accordance with international standards, including WHO collections (the so-called Blue Books). The department always has a set of fresh books, in addition to the necessary specialized literature. To be honest, I myself could not even buy one book: for example, the cost of a WHO book is about 150 dollars, and there are 12 of them. There are publications that cost 40-60 thousand rubles each. You look at a shelf of books and realize that there are half a million.

One of the problems of our profession is that there are very few young personnel: the population of pathologists is rapidly aging. However, we believe that the older the pathologist, the more experienced he is: he reviewed more cases, learned more. Our value rises with age, like wine, with terabytes of glass, pictures that you look at.

Everyone thinks that the pathologist deals exclusively with the autopsy of bodies. It's not, but autopsies are also part of the job. I first started autopsies on my own at 23. It was not scary, I take it easy. Partly because my grandmother was a veterinarian, and I often - from the age of seven or eight - went with her to animal dissections.

About the fear of death and zumba

I thought about death because I faced it. This, of course, is not the most pleasant component of human life, but when you know about the mechanisms of the development of the disease, you are calmer. You can change your own lifestyle. I don't smoke, I go to the gym at least two or three times a week. Physical activity should be, because you are constantly at the microscope - this is sedentary work and eye strain. It is necessary to get rid of the factors of hypodynamia development. Some go to zumba dance lessons (after 18:00, 30-40 minutes each). This is also a way to unload.

When I was still in high school, I diagnosed myself with gastritis. He prescribed drugs for himself (expensive, by the way). But over time, you begin to understand that this is not necessary. Now I try not to project diseases onto myself.

You have to deal with misconceptions about oncology from time to time. From the common one: supposedly if you drink cola, it will lead to stomach cancer. Some people believe that cancer is contagious: they say that they will come to the oncology dispensary and get sick with some kind of tumor. I even heard from doctors that no one canceled the viral theory of cancer.

Nastya Gritsenko, 25 years old, surgical oncologist

About blood pressure monitors and tattoo

I am from Arkhangelsk, I studied in the chemical and biological class, so the choice was small: either medicine, or some kind of chemical and technological university. I chose medical. I am not a hereditary doctor, but in my early childhood I played with all sorts of old blood pressure monitors: my dad worked as an ambulance driver. So that I could clearly understand what I was getting into, my parents sent me right after school to sanitize in the hospital all summer. But I was not disappointed. It didn't seem to me that there was something so impossible in the hospital.

While I was studying, I worked as a nurse - first in hematology, then in oncology. I wanted to enter the Oncology Research Institute a year before the competition of the Cancer Prevention Foundation: I was preparing for the exam, I took a plane ticket, but before leaving I broke my leg. Once, the head of the oncology circle came to me with a request to fill out a questionnaire for participation in the competition of the Cancer Prevention Foundation, so that at least someone would represent the university. I resisted for a long time, but nevertheless filled out the questionnaire and sent it.

Passed to the second round. I was sent a topic to write an article that was absolutely not close to me. I thought about quitting everything, but I felt ashamed, and I decided to honestly finish it. I wrote an article in the evening and forgot. But Ilya Fomintsev called and said that the article was great and that they took me to the third round.

In general, I had a clear plan: a local internship and residency in my oncology dispensary. I even got a tattoo when I got my diploma - a set of surgical instruments. I kind of decided by accident. Ilya constantly tells everyone about this tattoo.

About fear and empathy

I do thoracic surgery (surgery of the chest. - Approx. ed.). These are very long operations. In our area, the vast majority are men, but I do not seek to wipe their nose with them, I just love the anatomy of the chest cavity. This is aesthetically beautiful, especially when it comes to reconstructive operations, when we create the anatomy ourselves. I don't notice those long hours in surgery. By the way, I had the opportunity to conduct operations on my own. It was something like a study trip to Arkhangelsk - I operated for a doctor who was absent from the department. But mostly I assist.

It's not scary to be an assistant: you just help the surgeon, what you need - you hold it, where you need it - you show it. It's scary when you operate, and there is no senior doctor behind you who will help and give advice. It's more scary before the operation than during. And it's scary after - you walk around the patient, check if everything is fine.

I cried only twice, and once here, in residency. For the first time, when a boy died, who had been in the department where I worked as a nurse for quite a long time. Here, probably, my unprofessionalism played, because I usually did not communicate with patients so as not to become attached to them. And they lay with us for a long time - for six months, for a year. But I developed an attachment to this boy. Losing him was hard.

This year the situation was, well, just classic - we analyze such cases in our classes dedicated to communication with patients. A young girl hides from her mother that the prognosis is bad, and the mother hides the same from her daughter. Separately, they talk normally and openly with the doctor, and when together, they try to protect each other. And it was also very hard.

About cancer and statistics

The main cause of esophageal cancer is alcohol consumption. Smoking also plays a role here. Prevention is simple - do not drink alcohol. As far as proper nutrition is concerned, there are no studies that have proven the involvement of spicy foods in the formation of esophageal cancer. There is an opinion that hot drinks can somehow affect its appearance. But again, this has not been proven.

Evidence-based medicine relies only on research. Therefore, it cannot be said how dangerous, for example, vaping is for the lungs: there have been no studies on this subject yet. But overall, lung cancer rates are on the decline now. Although there is also a question for statistics: where did it come from? And another point: yes, a healthy lifestyle is now popular, people have begun to drink and smoke less, but, besides this, medicine has become more modern - the detection rate has increased. Now you can more often determine that a person died for a reason, namely from cancer. So now the situation with statistics is leveling off, and in fact we may not see a difference in numbers.

Help in preparing the material: Daniil Shirokov and Elizaveta Dubovik

FGBU "RSRCHT them. ak. A.M. Granov” of the Ministry of Health of Russia, citizens of the Russian Federation, foreign citizens and stateless persons who have received a higher medical education are accepted for training under residency programs, taking into account the qualification requirements for medical workers approved by the Ministry of Health of the Russian Federation.

Persons who have previously completed a full course of residency at the expense of the budget, do not have the right to re-enter and study at the residency at the expense of budgetary appropriations. Residency training is carried out only in full-time.

In 2019, admission to the residency of the Federal State Budgetary Institution "RNTsRHT them. ak. A.M. Granov” of the Ministry of Health of Russia is carried out according to the following educational residency programs:

Name of specialty	Specialty code	Target figures for admission to study at the expense of budgetary appropriations of the federal budget for the 2019/20 academic year	The number of places for admission to targeted training in specialties, directions at the expense of the budgetary allocations of the federal budget	Number of admission places under contracts for the provision of paid educational services
Radiology	31.08.08	2	1	4
Radiology	31.08.09	3	3	6
Ultrasound diagnostics	31.08.11	1	1	0
Oncology	31.08.57	4	3	4
Radiotherapy	31.08.61	0	0	4
Surgery	31.08.67	2	1	3
Urology	31.08.68	1	0	2
Total		13	9	23

List of documents required for admission to residency

Applicants must submit the following documents to the Department of Radiology, Surgery and Oncology:

1. Application addressed to the director of the Federal State Budgetary Institution “RNTsRHT them. ak. A.M. Granov” of the Ministry of Health of Russia with a request to be allowed to participate in the competition.
2. A copy and original for verification of an identity document.
3. A copy and original for verification of a document of the established form (a document on higher medical education in specialty (master's) programs and annexes to it).
4. A copy and the original for verification of a certificate of accreditation of a specialist or an extract from the final protocol of the meeting of the accreditation commission on recognizing an incoming accredited specialist (for persons who have completed the development of higher medical education programs in accordance with the federal state educational standards of higher education).
5. A copy and original for verification of a specialist certificate (if any).
6. A copy and original for verification of a military ID (if available).
7. A copy and original for verification of the certificate of registration of an individual with a tax authority.
8. Copy and original for reconciliation of the insurance certificate of compulsory pension insurance (SNILS).
9. 4 photographs 3×4 cm.
10. Copies and originals of documents indicating individual achievements (recommendations from educational and scientific organizations, recommendations from medical organizations, availability of published works, inventions).
11. Copies and originals of documents confirming disabilities requiring the creation of special conditions (if necessary).
12. For disabled people of groups I and II, disabled since childhood, disabled due to a military injury or illness received during military service - the conclusion of the federal institution of medical and social expertise on the absence of contraindications for training in the relevant educational organizations with a copy.

Applicants have the right to provide information about their individual achievements. Points awarded for individual achievements are included in the amount of competitive points. All information provided must be documented!

Accounting for the results of individual points is carried out by achieving based on the following criteria:

Scholarship holders of the President of the Russian Federation, the Government of the Russian Federation (if the scholarship was awarded during the period of obtaining higher medical or higher pharmaceutical education)	20 points
Document of the established sample with honors	15 points
The total length of service in the positions of medical and (or) pharmaceutical workers in the period from enrollment in higher medical or higher pharmaceutical education programs, confirmed in the manner prescribed by the labor legislation of the Russian Federation:
from one to three years in the positions of medical and (or) pharmaceutical workers with secondary vocational education	10 points with an increase in achievement weight of 5 points for each subsequent three years of service
from nine months to two years in the positions of medical and (or) pharmaceutical workers with higher professional education	12 points with an increase in achievement weight of 5 points for each subsequent two years of service
work experience in the positions of medical and (or) pharmaceutical workers with higher professional education in medical organizations located in rural settlements or workers' settlements or urban-type settlements, from nine months	10 points for the entire period of employment in addition to the points accrued in the presence of a general work experience in the positions of medical and (or) pharmaceutical workers
Individual achievements established by the Procedure for Admission to Residency Programs (no more than 15 points in total, when providing documents on the presence of several individual achievements of the same type, points are awarded once):
Possession of a diploma of completion of an internship (residency)	3 points
Availability of publication in journals included in Web of Science, Scopus, RSCI, HAC	2 points
Availability of other publications (articles and abstracts) and poster presentations (three or more)	1 point
Participation with a report at Russian congresses, conferences, forums, associations, communities of specialists (two or more) in the medical specialty	2 points
Participation with a report at international congresses, conferences, forums, associations, communities of specialists (two or more) in the medical specialty	3 points
Winners (prize-winners) of All-Russian Olympiads and competitions (if the Olympiad or competition was held during the period of higher medical education)	3 points
Knowledge of a foreign language, confirmed by an international certificate, or knowledge of several foreign languages, confirmed by other certificates	1 point

Acceptance of documents