Jean Chappell Dean, Allied Health and Life Sciences Marshall Community and Technical College

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1 Jean Chappell Dean, Allied Health and Life Sciences Marshall Community and Technical College Clark Egnor Executive Director Center for International Programs Marshall University

2 Key points Challenges to the Russian Healthcare System People to People Ambassador Program Russian Healthcare Education System Lessons Learned from Collaboration

3 Once Upon a Time..

4 Russia s Challenge Vast size 6.6 million miles of country 11 time zones Mountainous areas (Urals and Caucasus) Coastline Arctic Tundra Diverse climate

5 Russia s Challenge 149 million people ~75% live in large cities of Western Russia Extreme diversity in cultures and traditions Covers 2 continents: Asia and Europe

6 Russia s Healthcare crisis Heart Disease, infectious disease, accidents Declining birthrate Increase HIV/AIDS Increase TB Average lifespan of males = 58 yo. Easing of emigration policy (1990) = Brain Drain

7 Reforming the Healthcare System Decentralization of Management Creation of Health Service Market Multi channeling of financial support for medical enterprises Transition to a financial scheme in which payment depends on quality and quantity of services provided

8 Reforming the Healthcare System Obligatory medical insurance for all Development of voluntary insurance scheme and fee for service ( direct pay ) for health services Estimated 2007 budget for healthcare reform = 87.7 million roubles from the federal government.

9 Opening Doors to Collaboration American Society for Clinical Laboratory Sciences People to People Ambassador Program

10 I have long believed, as have many before me, that peaceful relations between nations require mutual respect between individuals. ~President Dwight D. Eisenhower~ Founder of People to People

11 P2P Ambassador Program the world s most recognized and respected educational travel provider. Founded in 1956 by Dwight D. Eisenhower Purpose is to build peace by bridging cultural and political differences through the open exchange of ideas and people. ASCLS sponsored P2P delegation (2008) to exchange mutually beneficial information on healthcare education.

12 P2P Professional Itinerary Day 1 Sklifosovaskly Research Institute for Emergency Medicine (Moscow) Day 2 Moscow Medical College #1 (Moscow) Day 3 Clinical Research Laboratory of Pavlov STP State Medical University (St. Petersburg) Day 4 Leningradsky Oblast (Regional) Hospital (St. Petersburg)

13 Education System Educational structure of Russia Healthcare education structure of Russia Healthcare education levels of practice

14 Healthcare Education Education of laboratory professionals includes three paths/types: 1) 4 years Technologists (same number of years as nurses) 2) 6 years Doctor of clinical chemistry includes medical education and specialty training in clinical chemistry. 3) 5 years Biologists (use for difficult analyses, e.g. flow cytometry, manual differentials, bone marrow slides)

15 Medical Technologist Education (4 years +2; microbiology is not included) 1 st level (after 4 years of school) Clinical immunology 30 hours Hemostasis 2 nd level (to work) Diagnosis of different kinds of pathology Primary and secondary disorders of hemostasis Pharmacology for lab (18 hours) Immunology(48 hours) Oncomarkers(18 hours) Biosafety in hospitals(18 hours)

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17 Healthcare Education The technicians are responsible for running analyzers and processing specimens Specialists (biologists) are involved with difficult analyses Doctors make interpretations and are supervisors of each of the laboratories, according to specialty. Only technicians may be generalists.

18 Certification Specialists recertify every 5 years Specialists are encouraged to participate in ongoing research and to have this work published Recertification examinations are administered by the Russian Ministry of Health Technicians are also encouraged to interact with the laboratory team and to maintain competency.

19 Clinical Laboratory Looking to standardize laboratory testing External proficiency testing CLSI standards New educational course for training MLT/MT currently 3 in country. MLT 2 year curriculum MT 2+2 curriculum with MLT No integration between Clinical Chemistry and physician training. Laboratory personnel responsibility (no pathologists)

20 Common Concerns Nosocomial infections MRSA and VRE Funding being channeled away from laboratory services Direct Access Testing (double edged sword) Critical shortage of laboratory personal Low wages compared to other professions

21 Dr. Alexander Petrov, Regional Clinical Hospital in St. Petersburg we need more space for our laboratories,.government funding seems to go to everything except our patient s healthcare needs,..staffing shortages are at a critical low.

22 Continued work Curriculum Development Personnel Exchange Plans for a return trip

23 Questions