Education of a plastic surgeon in Ukraine: features and challenges of the market

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For many years, there have been discussions about the specialized education of plastic surgeons in Ukraine. Every year, the number of such specialists increases, but in fact, most Ukrainian specialists do not have a highly specialized higher education in their field.

In 2020, the Order of the Ministry of Health of Ukraine approved changes to the Handbook of Qualification Characteristics of Employees’ Professions and added an item about a plastic surgeon. That is, we can say that this was the beginning of the development of highly specialized higher education for such specialists in Ukraine.

Prerequisites for creating the specialty of plastic surgeon

A little earlier in Ukraine, specialized plastic surgery courses were already created in post-graduate medical education institutions, where training for improving the qualifications of doctors is still being conducted. In fact, such courses give the legal right to specialists of various surgical specialties to perform plastic surgery.

Unfortunately, currently in Ukraine, quite little time is allocated for studying the profession. For example, previously, in order to become a plastic surgeon, it was enough to obtain a surgeon’s education and complete 144 hours of the above-mentioned special advanced training courses. That is, people who used to be doctors of other fields – otolaryngologists, traumatologists, gynecologists, etc. – now work as plastic surgeons.

Fortunately, over the past few years, a separate educational program has emerged that allows training qualified plastic surgeons. The duration of such preparation takes about 6 months. However, this is not enough.

Foreign colleagues do not understand such an intensive period of study and, accordingly, do not perceive our specialists abroad. Because it is impossible to get enough practical skills in all the necessary areas of specialization in 6 months. For example, the training period of such specialists abroad lasts about 3 years.

To improve the educational component in Ukraine, it is necessary to fundamentally change the system of highly specialized education. At this point, there is already a statement that a plastic surgeon can be a specialist who has acquired full specialization in general or pediatric surgery.

Currently, on the initiative of the Ministry of Health of Ukraine, a pilot project is being planned and discussions are ongoing regarding the creation of a residency (specialization option abroad) in Ukraine. This approach will be more thorough. A similar duration of specialist training will meet European requirements much more, since the vector of development of our country has long been chosen.

Now in Ukraine, they are working on creating bases for residency in several clinics to ensure a possible rotation of applicants, which would take into account all the classic areas of plastic surgery. That is, for half a year, the resident acquires a specialty in one clinic, and for the next six months in another. Undoubtedly, every future doctor must pass all the main directions and acquire certain skills.

International recognition of Ukrainian specialists

Provided that high-quality professional training is implemented, the market of plastic surgery in Ukraine will have every opportunity to match the European standards of providing relevant services.

Undoubtedly, the first step towards this will be the accession of Ukraine to the European Union. This will be an impetus for the recognition of basic medical education abroad. However, there may be some debate regarding highly specialized education because, firstly, the field is currently experiencing a shortage of qualified doctors. Secondly, there is a lack of appropriate harmonization with European legislation.

In 2019, students of Ukrainian medical educational institutions were allowed to take the International Foundations of Medicine (IFOM) exam for the first time. This test is developed by the US National Board of Medical Examiners (NBME).

Currently, the conditions have not changed, but the level of results of passing such a test by Ukrainians would like to be better. Many countries have been using the IFOM exam for decades, often even instead of the national one. Because of this, several years ago, the Ministry of Health of Ukraine included it in the Unified State Qualification Examination (USQE).

Foreign experience

There is even a separate diary of the educational-scientific and operational activity of each future doctor, which is called a “logbook”, for submitting an application for taking an exam abroad. It used to be in written form, but now it is in electronic form. In particular, there is a necessary list and number of operations that a resident needs to perform in order to be allowed to take the test.

This does not include assisting others, but only the direct independent performance of surgical interventions or manipulations. In some countries, they even require videos of the necessary operations so that the manager can actually evaluate the work of the future doctor.

If appropriate training of personnel takes place in Ukraine and applicants can confirm their knowledge with the help of such a test, and at that moment our country will be a member of the European Union, then our specialists will be perceived at a higher level abroad. For this purpose, appropriate steps are already being taken to bring the desired result closer.

Few people understand that a plastic surgeon goes through a long training course abroad, during which he must learn how to treat burns, perform microsurgical operations, reconstruction after oncological problems, etc.

The part of aesthetic surgery takes up no more than one fifth of the total number of operations. The rest of the operations are based precisely on the ability to return people to the correct forms and perform reconstructive manipulations, since they are basic. It is difficult to imagine a specialist who performs certain operations with complications and then decides how to eliminate them.

Conclusion

After the introduction of narrow specialization, the market will become more regulated. The very next step will be the creation of rates at large clinics, where a plastic surgeon will work in the staff and will cover a number of other issues. The need for reconstructive surgery for our country will only increase because our patients now have fairly recent injuries and many have not yet fully recovered.

First of all, the victims should be restored to full functioning of body parts and health. However, there will come a time when there will be many requests to restore the appearance of certain areas of the body. Plastic surgery is one of those tools that help fight psychological disorders, low self-esteem and thus help better socialization of the wounded and military during the war.

Dmytro Slosser, plastic surgeon, honored doctor of Ukraine, specially for UP. Life

Publications in the “View” section are not editorial articles and reflect exclusively the author’s point of view.

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