The 25 years development of the Moscow Center for Diagnostics: through an eyewitness

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Abstract

Today, on the eve of the 25th anniversary of the leader in the Moscow radiological service, Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Healthcare Department (used to be the Research and Practical Center of Medical Radiology until 2019), the bright quarter-century history of this institution comes to life in our me-mory, day after day has passed by since the opening of the Center, our weekdays, scientific breakthroughs, and celebrations.

We would like to present to our readers a brief history of one of the aspects of the Center’s complex activities, the development of professional education of radiologists. We observe a period from its launching to its recognition as the authority in radiology. The Education Department of the Moscow Center for Diagnostics and Telemedicine Technologies is currently appointed by the Ministry of Health of the Russian Federation as an expert to participate in addressing the current challenges of professional training and certification in diagnostic radiology.

The article is devoted to well-known scientists and teachers, professors, and leading specialists in the industry, who are actively involved in the development of continuing education of radiologists and other specialists in diagnostic radiology at different stages of the center’s existence. Specialists of the Training Center strive for the compliance of the provided professional training following the Bologna Declaration (1999), thereby creating conditions for Russian professionals to obtain European diplomas.

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THE SCIENTIFIC AND PRACTICAL CENTER ESTABLISHMENT

Today, the Center for Diagnostics and Telemedicine has a fairly solid historical foundation, having evolved from the organization in 1976 in the City X-ray Radiological Department (CXRD) in Moscow, which was later transformed into the Diagnostic Center No. 3.

 

Director of the Scientific and Practical Center for Medical Radiology Professor Yu.V. Varshavsky

 

In August 1996, Professor Yuri Viktorovich Varshavsky, Director of the Diagnostic Center No. 3, announces to the employees the order of the Moscow City Health Department to rename the institution into the Scientific and Practical Center for Medical Radiology (SPC MR) and the related changes in the main tasks of the Center.

The SPC MR activities significantly expanded the organizational and methodological functions of the CXRD, that was founded and for a long time led by Georgiy Timofeevich Gureev, a long-serving employee of the Moscow X-ray and radiological service with a Ph.D. in Medicine. Professor Viktor Yuryevich Bosin was appointed Deputy Director of the SPC MR for scientific work, and Ph.D. in Engineering Mikhail Izrailevich Zelikman was appointed Associate Deputy of Yu.V. Varshavsky in the scientific and technical work.

In a short period of time, specialized scientific units were established, and prospects for individual scientific activity of employees were developed. Associate Professor Natalya Iosifovna Afanasyeva organized the work of the Academic Council, which was carried on for many years by Ph.D. in Medicine Elena Alexandrovna Pavlova.

THE ROLE OF SPC MR IN PROFESSIONAL ADVANCED TRAINING OF SPECIALISTS IN THE RADIOLOGY SERVICE

On the eve of the anniversary of the Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow City Health Department (SPCC DTT MCHD), a number of publications appeared in the press about the history of Moscow’s radiology service, as well as very significant, striking changes that have occurred in the Center over the past 5 years.

The role of the SPC MR in organizing professional advanced training for radiology service specialists in Moscow is also noteworthy. Prior to the establishment of Diagnostic Center No. 3, the Training and Advisory Center CXRD, founded in 1977 on the basis of the city polyclinic No. 186 (chief physician Vladimir Dmitrievich Fedotov), was engaged in advanced radiology training in the Moscow Health Department, the educational department of which was headed by Igor Efimovich Kagan.

 

Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow City Health Department

 

In 1996, in the established SPC MR, the tasks were defined to improve the organization of professional advanced training for specialists in the radiology service in Moscow. Professor Leonid Davidovich Lindenbraten, a well-known scientist and educator, led this field. Within the framework of the Central Certification Commission of the Moscow Health Department, a specialized certification commission was also formed to assign attestation categories to specialists in radiation diagnostics, led by a radiologist of the highest category, Maya Mikhailovna Lovkevich.

At the time of the renaming of the Diagnostic Center No. 3, Yury Viktorovich Varshavsky, Director of the SPC MR, and Professor Lyudmila Arsenyevna Nizovtsova, head of the organizational and methodological department, were employees of the Department of Radiation Diagnostics of the Russian Medical Academy of Postgraduate Education, which contributed to the joint activities of the Department and the Center, the introduction of all forms of postgraduate education of medical specialists in radiation diagnostics in the educational activities of the established SPC MR. Courtesy of the recognized professional and educator Viktor Vasilievich Kitaev, who headed the Information and Analytical Department of the SPC MR, advanced training was also organized for midlevel medical workers, X-ray technicians, and the involvement of the Center’s chief nurse, senior X-ray technician Nelly Ivanovna Solovieva in this activity.

The work of well-known professionals such as Professor Nikolai Nikolaevich Blinov, Eduard Georgievich Chikirdin, Vladimir Vladimirovich Stavitsky, and Mikhail Izrailevich Zelikman in the SPC MR established advanced training of the medical and technical staff of the radiation diagnostics service in the field of radiological control and radiation safety. Almost immediately, a team of highly professional employees was organized, who were actively involved in the educational activities of the SPC MR of the Moscow Health Department in addition to their main functions. In fact, SPC MR was the country’s first CXRD, combining scientific and full-fledged systematic work to improve the professional level of employees of the radiation diagnostics services in institutions subordinate to the Department of Health.

Joint work with the City Mammological Dispensary to improve the qualifications of radiologists in mammology was performed by Professor Larisa Markovna Burdina and Associate Professor Evsey Grigorievich Pinkhosevich, who was the organizer of the mammological service in Russia and the founder of the first City Mammological Dispensary in global practice (1990), which was transformed with his active participation into Women’s Health Clinic in 2004.

Professor Viktor Yuryevich Bosin, in collaboration with the Pediatric Department of Radiation Diagnostics of the Russian Medical Academy of Postgraduate Education, actively participated in the advanced training of radiologists from children’s institutions.

PROFESSIONAL EDUCATIONAL ACTIVITY OF RADIOLOGISTS

The professional educational activities of radiologists during the SPC MR period can be objectively divided into three stages, each of which corresponded to tasks assigned, created, and implemented in accordance with the plans of the administrative team.

The period 1996–2012 can be described as an active stage in the development of a new format of professional education, a network form of education. In Moscow, radiologists received primary professional education in the form of a 1-year internship or 2-year residency at the departments of universities and research institutes, and through the Department of Health, it was at the Second Moscow Medical Institute (N.I. Pirogov Russian National Research Medical University) (Head of the Department of Radiation Diagnostics Professor Andrey Leonidovich Yudin) and the N.V. Sklifosovsky Federal Research Institute of Emergency Medicine (Head of the Radiological Department was a well-known scientist and outstanding teacher Professor Era Arsenievna Beresneva).

 

Meeting of the specialized certification commission

 

Later, through the Healthcare Department, residents in the specialty “Radiology” were trained at the Research Institute of Emergency Pediatric Surgery and Traumatology (program leader Professor T.A. Akhadov) and the A.S. Loginov Moscow Clinical Research Center (program leader Professor A.B. Abduraimov). The SPC MR was tasked with supervising training in these institutions specifically designated by the Healthcare Department for groups of interns and residents.

Because of the current situation in the SPC MR, the work of the SPC staff representing the department of the Russian Medical Academy of Postgraduate Education (Yu.V. Varshavsky, L.A. Nizovtsova, M.I. Zelikman) and the Department of Radiation Diagnostics and Therapy of the Russian State Medical University (N.I. Afanaseva), there were real opportunities to conduct joint thematic cycles for residents and interns. Teachers at the N.V. Sklifosovsky Federal Research Institute of Emergency Medicine Professor Era Arsenievna Beresneva and her deputy Ph.D. in Medicine Irina Evgenievna Selina assisted in the delivery of these courses. Business and informal communication with Era Arsenievna, a wonderful teacher, a famous scientist devoted to traditional emergency X-ray diagnostics, and an amazing woman, left an indelible memory and bright warm impressions for everyone who was lucky enough to speak with her at least once.

The experience of teaching such general courses has demonstrated their effectiveness and the interest of students in taking them. Thus, in September 2000, in agreement with L.D. Lindenbraten, L.A. Nizovtsova organized the first course “Introduction to Specialty” for residents in their first year of study in all departments of radiation diagnostics of medical universities and research institutes located in Moscow. The scrupulousness of Ekaterina Sergeevna Kiseleva, an employee of the SPC MR, should be emphasized, who, in addition to her main duties, served as the dispatcher of the curriculum for these courses.

All departments were eager to hold classes at Kalitnikovskaya (audience of SPC MR). The authority in conducting these courses was created by the common interest of the curator and the teachers who fulfilled the curriculum, as well as the employees of all departments whose residents were trained on the course. Lectures by L.D. Lindenbraten in this cycle, particularly for his group seminars with residents, were held in high regard. The preparation of material for classes with residents by Leonid Davidovich, as well as his constant work to improve educational materials and manuals, left not only warm memories and pleasant impressions from communication with this amazing person but also an example of a teacher, scientist, and professional looking to the future. His constant improvement of his own publications, as well as his desire to create a new textbook for residents, sparked admiration. He stated unequivocally that a 2-year residency is insufficient time to prepare a qualified doctor with modern knowledge in this profession. His dream was to change and to reform professional education in radiology: “If I were a minister, I would restructure the specialty. It does not have to be just radiology.”

We raised these concerns repeatedly during the preparation of the professional standard “Radiologist.”

 

Radiological Department of N.V. Sklifosovsky Federal Research Institute of Emergency Medicine (2004–2005)

 

In 2004, the course started to be held under the auspices of the Moscow Association of Medical Radiologists rather than the SPC MR. One of the reasons for this change was the creation in 2003 by Professor Alla Vladimirovna Zabrodina of a private educational institution Educational Center for Medical Radiology, which is located at the Scientific and Practical Center for Medical Radiology.

The educational activities of the SPC MR included not only the training of interns and residents but also advanced training courses for radiologists on a variety of topics. Nugzar Abesalomovich Shengelia, an employee of the SPC MR, actively conducted regular advanced training courses on radiation safety in X-ray examinations for both doctors and technical workers.

 

Residents after the lecture by E.A. Beresneva

 

The collaboration with V.V. Kitaev is remembered fondly for proposing a novel approach to advanced training of X-ray technicians. The work of the specialized certification subcommissions of the Central Certification Commission of the Moscow Department of Health was reorganized in 2000. Two certification subcommissions were approved in the SPC MR: for doctors (radiologists, ultrasound diagnostics and radiologists; executive secretary L.A. Nizovtsova) and paramedical workers (X-ray laboratory assistants, nurses of radiation diagnostics departments; executive secretary N.I. Solovieva). After 2012, both commissions were merged, and Yuri Yurievich Yurkin, Ph.D. in Medicine, was appointed secretary of the unified specialized certification commission. Since 2016, the structure of specialized certification commissions has changed several times. In addition, in 2000, a new approach to assessing the professional competence of specialists was developed for that time period, and test tasks and situational problems were formulated and then improved. The first situational problems for the qualification exam for X-ray technicians were created and published by V.V. Kitaev in 1998; and for the first time in 2001, tests for qualification exams for radiologists appeared not only in Moscow but throughout Russia. Everyone who knew Viktor Vasilyevich, a benevolent, sympathetic, widely erudite individual, remembered both the collaborative work and informal communication with great respect and warmth.

Since 2000, requirements for the digitalization of advanced training programs and control materials in educational and certification processes have been developed. Thus, this is a never-ending cycle of creation and improvement. Further, we must pay tribute to Yu.V. Varshavsky, who enlisted not only the staff of the Department and the SPC MR but also the highly professional specialists in practical healthcare and related specialties, to this generally unappreciated creative endeavor, namely, the compilation of educational programs and test tasks. Probably for this reason, the materials created by the Department of Radiation Diagnostics of the Russian Medical Academy of Postgraduate Education have long served as a model for other educational institutions. The SPC MR created the first database of test tasks for certification examinations of medical specialists in radiation diagnostics, differentiated not only by specialty but also by declared certification category.

The period 2012–2015 should be attributed to the next stage in the development of professional educational activities at SPC MR. Professor Alexander Igorevich Gromov, who was the director of the SPC MR at the time, had to solve a number of key tasks assigned by the Moscow Department of Health, including licensing the educational and medical activities of the SPC MR; establishing a new administrative unit within the SPC structure, namely, the Training and Advisory Center; organizing telemedicine consultations for doctors of radiology departments of institutions subordinate to the Moscow Department of Health; and monitoring the staffing of radiology departments in the medical institutions of the Department of Health, etc.

 

Seminar of Professor L.D. Lindenbraten with residents

 

Inna Vladimirovna Krinina, a highly qualified radiologist with extensive teaching experience at a medical university, took an active role in completing the tasks outlined above. She was the director of the SPC MR’s Training and Advisory Center; she actively performed basic organizational work to obtain licenses for the educational activities of the SPC, as well as the preparation of postgraduate education programs for doctors and X-ray technicians. With the team she formed, the introduction of telemedicine consultations into clinical practice, as well as the audit of the work of departments of the radiology service, started. Due to the high level of interest shown by practicing physicians in advanced training courses held at the SP MR’s Training and Advisory Department of the SPC MR, training in advanced education programs was introduced for radiation diagnostics specialists from institutions not subordinated to the Moscow Health Department, including on-site advanced training courses in other regions of the country.

In 2015, Professor Sergey Pavlovich Morozov, who took over as director of the SPC MR, paid special attention to the activities of the Training and Advisory Department. Irina Anatolyevna Trofimenko, a highly qualified radiologist and an energetic, proactive specialist with experience in pedagogical work, was appointed the head of this department and currently performs these functions successfully. Currently, the training center with an advisory department is one of the major subdivisions of the Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Moscow Health Department (as the SPC MR was renamed in 2019), which actively competes with the departments of radiation diagnostics of major medical universities in Moscow and Russia.

 

Opening of a Training and Advisory Center on the M. Raskova street

 

Strategic creative collaboration of the director of the SPCC DTT MCHD S.P. Morozov and the head of the Training Center I.A. Trofimenko showed excellent results in organizing and implementing new forms of professional training for radiology specialists, specifically in preparing and conducting advanced training programs for radiology specialists of various levels, which were accredited by the Coordinating Council for the Development of Continuous Medical Education of the Ministry of Health of Russia; organizing courses of radiation diagnostics for doctors of clinical specialties; and promptly addressing the issues of distance learning for medical specialists in radiation diagnostics during the COVID-19 pandemic.

In its 5years of operation, about 900 full-time and part-time advanced training programs, master classes, webinars, and online meetups have been held at the Training Center. Thanks to the active work, more than 150,000 specialists, radiologists, ultrasound doctors, clinical specialists, X-ray technicians, and senior nurses, as well as heads of departments of radiation and ultrasound diagnostics, were able to acquire new competencies and improve their professional level within their existing qualifications.

 

Professor S.P. Morozov, Director of the Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies, President of the Moscow Regional Branch of the Russian Society of Radiologists and Radiologists

 

Head of the Training Center of the Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies Ph.D. in Medicine I.A. Trofimenko

 

The desire to comply with the provisions of the vocational training of the Bologna Agreement (1999), as well as the creation of conditions for obtaining European diplomas by Russian specialists, should be noted in the work of the Training Center. The SPCC DTT MCHD Training Center, which has earned a high reputation, is currently being involved by the Ministry of Health of Russia as an expert in resolving urgent problems of professional training and accreditation of radiology specialists.

Nowadays, the training center works with over 120 experts from Russia, neighboring countries, the USA, and Western Europe. They are all practitioners with thousands of studies under their belts who work in multidisciplinary teams.

 

Director of the Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies Professor S.P. Morozov at an open lesson at Training Center No. 1409

 

Every year, an increasing number of specialists in related specialties attend all educational events hosted by the Training Center of the SPCC DTT MCHD and the Moscow Regional Branch of the Russian Society of Roentgenologists and Radiologists (MRB RSRR).

Combining the high level of professional educational activities of the training center with the multidisciplinary scientific activities of the SPCC DTT MCHD (which should be the subject of a separate report), the progressive development of the institution as a whole can be highlighted, and we wish the staff and administration of the SPCC continued progress, new achievements, and victories.

ADDITIONAL INFORMATION

Funding source. The author declares that there is no external funding for the exploration and analysis work.

Competing interests. The author declares no obvious and potential conflicts of interest related to the publication of this article.

Author’s contribution. The author made a substantial contribution to the conception of the work, acquisition, analysis, interpretation of data for the work, drafting and revising the work, final approval of the version to be published and agree to be accountable for all aspects of the work.

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About the authors

Lyudmila A. Nizovtsova

Research and Practical Clinical Center for Diagnostics and Telemedicine Technologies

Author for correspondence.
Email: lanizo@yandex.ru
ORCID iD: 0000-0002-9614-4505
SPIN-code: 9957-8107

MD, Dr.Sci.(Med), Professor

Russian Federation, 28-1, Srednyaya Kalitnikovskaya street, Moscow, 109029

References

Supplementary files

Supplementary Files
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1. Director of the Scientific and Practical Center of Medical Radiology, Professor Yu.V. Varshavsky.

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2. Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies of the Department of Healthcare of the City of Moscow.

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3. Meeting of the profile attestation commission.

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4. Department of Radiology of the N.V. Sklifosovsky Research Institute of Emergency Medicine (2004-2005).

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5. Residents after the lecture by E.A. Beresneva.

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6. Seminar of Professor L.D. Lindenbraten with residents.

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7. Opening of the training and consulting center on M. Raskova Street.

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8. Director of the Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies, President of the Moscow Regional Branch of the Russian Society of Radiologists and Radiologists, Professor S.P. Morozov.

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9. Head of the Training Center of the Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies, Candidate of Medical Sciences I.A. Trofimenko.

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10. Director of the Scientific and Practical Clinical Center for Diagnostics and Telemedicine Technologies, Professor S.P. Morozov, at an open lesson at the Education Center No. 1409.

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