Department of Propaedeutics Of Internal Medicine № 1
History of the department
The official chronology in department of propedeutics of internal medicine as introduction into clinic of internal diseases starts since 1928 when the department of medical diagnostics and special pathology and therapy, which were separate structural subdivisions of medical faculty in Saint Volodymyr University in Kyiv, were united.
The significant role in establishing the department of propedeutics of internal diseases was played by classics of clinical medicine; founders of Kyiv therapeutic school V.P. Obraztsov, F.G. Yanovskyy, M.D. Strazhesko.
First of all their ideas and methodological practice on clinical examination of patient and diagnostics of diseases became the theoretical and practical basis to form the primary academic course for future medical students. Newly established department, being the only one in the world training system of medical staff, received the name – propedeutics of internal diseases. Its first head was famous clinical physician and scientist, pupil of V.P. Obraztsov – professor M.M. Gubergryts, who managed it during 23 years in succession – since 1928 until his death in 1951.
Under the guidance of M.M. Hubergritz the clinical base of the department was reorganized and expanded. Already in 1935 the clinic, which was located in the 6 th building of present Oleksandrivska clinical hospital in c. Kyiv, had 103 stationary beds. At the same time the department was the clinical division of endocrinology and institute of nutrition.
The scientific and pedagogical activity of M.M. Gubergryts assisted to implementation of the newest methods for examination and diagnostics into clinic. One of the first in the country he began applying the method on electrocardiography in the general clinical practice, paid the great attention to issues on pathology of cardiovascular system. His works, devoted to angina pectoris, painless forms of myocardial infarction, mechanisms for heart pain, clinic of dying heart, are topical until now. The works of scientist, devoted to mechanisms for origin of gallop rhythm and physiological third heart sound, were of outstanding importance in semiotics. M.M. Gubergryts has the original scientific works in the sphere of physiology and pathology of digestive organs. Thirty of forty years in medical activity of M.M. Gubergryts were connected with his pedagogical activity. His general educational and professional erudition, great clinical experience, brilliant declamatory skills, great scientific achievements, talent of teacher attracted not only students but numerous practicing physicians to his lectures. M.M. Gubergryts – founder and constitutor of the newest direction in clinical training of medical staff. At his initiative reading lectures and performing practical classes was transformed from theoretical teaching to practical clinical training, which basis was demonstration of patients during lecture process and while performing practical classes – directly near the bed of patient.
In 1935 he was awarded with the honored title of Honorary scientist for outstanding achievements in the sphere for solution of scientific problems in internal medicine and in 1949 he was elected as an academician in Academy of sciences of Ukraine. He was awarded two orders of the Red Star and medal “For brave work during the Great Patriotic War in 1941- 1945” for merits in development of national medicine. His name was conferred to clinic in the 6th building in Kyiv city clinical hospital in order to memorialize this outstanding teacher due to decision by government of Ukrainian SSR.
After death of M.M. Gubergryts (in May 1951) the department was headed by professor F.Ya. Prymak. As a clinical physician and teacher, he always followed to the famous aphorism of his teacher F.G. Yanovskyy: “Closer to patient”. The pedagogical activity of department, headed by F.Ya. Prymak, continued the traditions, based on reading lectures and performing practical classes with participation of theme-based patients and independent participation of students in clinical examination of patients.
Pursuant to studies by M.D. Strazhesko about hematoparenchymal barrier, by O.O. Bogomolets about connective tissue and M.M. Syrotinin about oxygen insufficiency, F.Ya. Prymak worked out the original concept about hypoxia-dystonic syndrome in clinic of internal diseases. For the first time in national clinical science he grounded the concept on hypoxidosis as a universal pathogenic mechanism for numerous diseases that are accompanied by oxygen insufficiency. During those years the scientific research of clinic and diagnostics of toxic myocarditis, efficiency of oxygen therapy at diseases of cardiovascular system, respiratory and digestive organs was continued under his supervision. 6 doctoral and 27 candidate’s dissertations were made under his supervision. During many years F.Ya. Prymak was a member in all-Union and Kyiv city societies of physicians, member in editorial council of journal “Medical care”, member in expert therapeutic commission at Higher attestation commission, chief physician at MHC of Ukraine. F.Ya. Prymak was conferred with honored title of Honorary scientist in Ukrainian SSR for great merits to the national medicine; he was awarded the order of Lenin, two orders “Badge of Honor”, many medals. During some years he was a member in delegation of Ukraine at United Nations Organization.
Since 1973 until 1988 the head at department was professor B.M. Shchepotin – pupil of famous Ukrainian clinical physicians O.M. Ziukov, F.A. Udintsev, V.S. Nesterov. B.M. Shchepotin in his scientific activity continued the researches of pathogenesis and clinic of cardiovascular diseases. His main scientific activity was aimed to study the non-coronarogenic injury of myocardium, problems of oxygen insufficiency and disorders of hemostasis at myocardial infarction and arterial hypertension.
The original scientific researches, which found out clinical and biochemical evidences for chronic syndrome of disseminated intravascular microclotting, were held under his supervision, as well the indications for combined antihypertensive therapy at different clinical pathophysiological, in particular, hemodynamic evidences for hypertensive disease were grounded, regional disorders of hemocirculation at patients with arterial hypertension were studied. During this period the pupil of F.Ya. Prymak assistant professor I.M. Shchulipenko performed the researches, devoted to study of role and efficiency for phytotherapy in rehabilitation treatment of arterial hypertension. Later the original concept on modern scientific Phytotherapy was defined and formed pursuant to recent researches.
The significant role at department was paid to improvement of pedagogical process. The methodological developments for almost all lectures and practical classes were worked out in the new wording in order to optimize lecture and practical courses. The store of illustrative materials and technical means that are used at lecturing was significantly increased. The typical program and theme-based plan for new academic discipline – care for patients in therapeutic divisions – was developed. The academic methodological complex on propedeutics of internal diseases was worked out. The learning film on medical care for patients was made. Assistant professor I.M. Shchulipenko worked out the admission ritual of medical student into clinical physician with presentation of special note “To student-beginner in clinical study” and implemented it into academic activity of medical schools in the country.
Since 1988 the department is managed by corresponding member in NAMS of Ukraine, professor V.Z. Netiazhenko – pupil of corresponding member in AMS of USSR, professor O.Y. Grytsiuk, famous scientist-clinical physician, cardiologist and teacher. The traditions of Kyiv therapeutic school, which clinical pedagogical and scientific ideas have now transformed in the general state, national scale, continue developing during management of department by professor V.Z. Netiazhenko. The activity of department is directed to multiply the achievements in scientific, pedagogical activity and clinical diagnostic work, made by departmental collectives during previous years.
Significant achievements of professor V.Z. Netiazhenko in scientific, pedagogical, medical consulting work, as well as public activity were honored in 2001 by awarding the honored title “Honorary scientist and technician of Ukraine” to him.
In 2002 he was elected to the post of corresponding member in AMS of Ukraine. The diverse activity of V.Z. Netiazhenko also covers the work at the post of chairman in specialized academic council on defense of candidate’s and doctor’s dissertations, expert in Republican task group “Therapy”, member in Academic council at MHC of Ukraine.
In organizing and implementing different activities, the department adheres to the traditions that were initiated by the classics of propedeutic therapy: clinical training of the student with obligatory participation of the patient, combination of physical, instrumental and laboratory methods of examination in clinical training of the physician, as well as symptomatic syndrome approach pathology in the propaedeutic cycle, the formation of aesthetic and deontological principles, the development of clinical thinking based on the manifestation of the disease, the introduction of new methods of diagnosis and treatment into practical medicine.
Significantly improved system and structure of teaching the basics of medical care for patients, which is dialectically combined with the basics of diagnostics and nosological therapy. An extremely important area of this work is the professional orientation of young people through the Lyceum system. Since 1991, the Department has started teaching valeology and nursing care at a medical lyceum, founded at the Bogomolets National Medical University.
Under the leadership of V.Z.Netiazhenko, the structure of teaching the subject was significantly improved; a radical reorganization of the forms of intermediate and examination control was carried out, with the introduction of computer-based testing in the pedagogical process. The teaching of internal medicine propedeutics with the departments of theoretical and clinical profile has been deepened and expanded.
With the introduction of module-module training, the department developed and introduced into the educational process typical curricula and plans on internal medicine, nursing practice, nursing practice, elective courses “Deontology in medicine” and “Life safety”. In 2008, the department was renamed to the Department of Propaedeutics of Internal Medicine № 1.
The department supports great work as a support among the HEIs of Ukraine in the field of integration and optimization of the propaedeutic training of medical personnel. The Department of Propaedeutics of Internal Medicine №1 actively develops algorithms for preparation and holding of students of the professional-oriented examination of OSCE-1.
To improve the assimilation of theoretical and practical training material, video lectures have been created and are available on Facebook and YouTube. Such novel implementations are freely available, which is extremely important for students who gain new experience.
One of the priority areas of V.Z. Netiazhenko’s scientific school is the problem of thrombogenesis – arterial and venous thrombosis, hemostasis, thromboembolic complications, resistance to antiplatelet drugs. V.Z. Netiazhenko’s initiated the establishment of a hemostasis laboratory for the first time in Ukraine to evaluate thrombophilic changes not only in diseases of internal organs, but also in pregnant women, evaluation of the effectiveness of antiplatelet and anticoagulant therapy. Among the main scientific directions of the department: prediction of the course of unstable forms of ischemic heart disease, substantiation of pathogenetic role and establishment of etiological mechanisms in stable coronary heart disease and its destabilization, arterial hypertension, heart failure, as well as the development of clinical pharmacovigilance issues, of life-threatening arrhythmias, study of the etiological and prognostic role of changes of the autonomic nervous system in patients with supraventricular and heart rhythm disorders, comorbid patient treatment strategy.
The scientific achievements of the department are 650 scientific works (25 monographs, inventions, educational programs, textbooks and teaching aids for doctors, interns and students). At the department having received training in magistracy, postgraduate studies, 8 doctoral and 30 PhD theses are defended. The staff of the department annually replenishes with new employees-graduates of the Bogomolets National Medical University and other universities.
The staff of the department under the leadership of Netiazhenko V.Z. carries out educational work among doctors of Ukraine. The staff of the department actively participated in the implementation of the national program “Available medicines” in the treatment of hypertension, during the annual scientific and practical conferences familiarize the medical community with the basic standards of treatment in the clinic of internal diseases.
The department provides medical consultative assistance to healthcare institutions in the diagnosis and treatment of patients with complicated course of acute myocardial infarction, pulmonary embolism, cardiac arrhythmias, heart failure, diabetes, comorbid conditions.
The staff of the Department of Propaedeutics of Internal Medicine № 1 (2019)
Bottom row from left to right: Associate Professor N.V. Gorach, Associate Professor L.A. Didkivska, Professor V.Z. Netiazhenko, Professor T.Y. Malchevskaya, Professor L.V. Shkala, Associate Professor O.M. Plenova.
Top row from left to right: Assistant A.V. Lyakhotska, Assistant N.M. Bazhenova, Assistant O.P. Gavriluk, Assistant M.S. Valigura, Assistant Yu.V. Kovbasniuk, assistant T.V. Kozmik, assistant O.V. Tkachishin, assistant V.V. Taranchuk, laboratory assistant P.P. Smolovik, laboratory assistant V.V. Borsuk, graduate student I.S. Bogdan, graduate student N.I. Kozachishin
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