Faculty therapy is one of the main clinical courses. It combines medical theory and practice and introduces students to the big sport - a real clinic. The main task of all departments of faculty therapy at medical universities is to teach students the most important medical competence - clinical thinking. Without the ability to think from a high clinical point of view, it is impossible to make a diagnosis, a correct prognosis and adequate treatment.
The format of training students in the clinic
The algorithm for making a clinical diagnosis at the department of faculty therapy is always about the same:
- collection of information about the patient - comprehensive information for compiling a medical history;
- collection and analysis of laboratory and instrumental research results;
- comprehensive examination of the patient using verbal, sensory, manual methods;
- the main stage in the diagnosis is a comparison of everything received with the disease “from the textbook”.
All these actions are carried out in the framework of the "supervision of the patient" - an independent observation by the student of the patient. Students conduct examination and interviews with patients, collect and analyze additional laboratory and instrumental information, after which the proposed diagnosis and treatment protocol are discussed in a practical lesson.
Course Features
Faculty therapy is studied in the fourth year - a turning point in the transformation of schoolchildren with the primitive propaedeutics of internal diseases behind them into clinical doctors. Everyone needs it in full - regardless of what specialization the student will choose in the future. Therefore, the main and only form of training in this case is the observation of a patient by a student under the guidance of a teacher with periodic discussion in practical classes.
In addition to clinical experience, students learn to draw up medical documents, the main of which, of course, is the medical history. Everything is worked out in faculty therapy: from international classifications of nosological units to the rules for issuing an epicrisis.
The Big Clinical Three
If you add the propaedeutics of internal diseases and hospital therapy, you get the "Big Clinical Three", which is mandatory for the medical faculties of domestic medical universities.
At propaedeutics, third-year students learn to act with their hands, hear with their ears and see with their eyes like doctors - everything for a patient to be diagnosed is “see, hear, feel.”
At the department of faculty therapy in the fourth year, everything is adult. Students already belong to older students, they are trusted to supervise patients on their own in order to learn the main thing: to identify and summarize the signs that are significant for the diagnosis of the disease. This means being able to think clinically. This is the stage of accumulating clinical knowledge - all about internal diseases, their diagnosis and treatment.
It should be noted that at other medical faculties, students study the bulk of clinical knowledge in the same "sister" departments: faculty surgery, faculty pediatrics. The principle of training and the tasks they have are exactly the same.
The difference between the departments of faculty and hospital therapy
As for hospital therapy, which takes place in the fifth year, it is intended to reveal to the young doctors the whole variety of manifestations of diseases in different patients. There are no patients, as in a textbook, in nature. Someone's symptoms are more pronounced, in others the clinical picture of the disease is blurred and proceeds almost secretively. Hospital therapy can be called the jazz stage in the development of clinicians. Here, students learn to make clinical decisions. This is a polishing of knowledge and experience, these are nuances and subtleties.
Faculty Therapy Tasks
Without a doubt, the number one task is to develop students' clinical thinking: the ability to think, analyze, compare with laboratory data, compare with information from lectures and textbooks. To see among many diagnostic signs those that are significant for this patient at the moment. No wonder the most famous lecturers at medical universities taught precisely at the departments of faculty therapy. Their lectures were then published in the form of textbooks on clinical disciplines. We can say that as a science, faculty therapy is a classic, the main clinical baggage.
In addition to diagnosis and clinical considerations, students should fully master all standardized types of therapeutic care for the patient, which are included in the standards of the Russian healthcare system.
Emergency conditions and syndromic therapy
Emergency conditions and emergency therapy occupy a special place in the clinical training of students. The ability to quickly and correctly assess the emergency condition of a patient who is in a grave condition is more an art than a skill. Here, knowledge alone is not enough, you need experience, a faithful doctor’s eye, a sensitive ear and skillful hands. Talent for short.
One of the most interesting sections of faculty therapy is syndromes, or the so-called syndromic treatment. Typically, this approach is used in intensive care units. But it should be owned by all self-respecting clinicians.
Prevention and youth
Another area of growing importance and importance every year in the course is the prevention of internal diseases in faculty therapy. This direction has existed for a long time, but recently, serious and very positive changes have been taking place among the population. This is especially true for young people. People began to relate to their health in a different way. They are ready to take responsibility for their physical well-being, come to regular preventive examinations, talk and make decisions on changes in their diet, diet or lifestyle. Such advanced patients require special attention and comprehensive reliable medical information. So the boring words "prevention of internal diseases" are no longer boring. Now everything is interesting, and a lot is changing.
Doctoral Communications
This course package also includes the modern professional ethics of the doctor, which has changed dramatically lately: doctors learn to treat the patient as a client and consumer of medical services. This is not always easy, because sometimes the stereotypes of Soviet medical settings continue to “work” in their heads. Sensitivity, attentiveness not only to the patient, but also to his relatives, communicative communication skills in difficult situations are included in medical deontology today. Properly communicate and have an effective relationship is necessary not only with patients, but also with colleagues in the workshop and the surrounding medical staff. Without communication skills, today you cannot become a good clinical doctor.
The amount of clinical skills in the course
The volume is huge, only the most important in the sequence of the diagnosis algorithm are given here.
- A thorough survey and collection of patient complaints. Full inspection.
- Planning for additional laboratory and instrumental examinations based on the received primary data from the patient and his examination.
- Analysis of the obtained medical history data and clinical and laboratory studies for the differential diagnosis. The rationale for the final clinical diagnosis.
- The choice of treatment protocol.
- Monitoring and evaluation of the clinical version and course of the disease in the patient, severity, stage, complications and prognosis in the future.
- Maintaining a clinical history of the disease with all standard forms for filling in and related documents, including statistical data.
- Filling out any other medical documents, including VTEK certificates, outpatient medical records, referrals for spa treatment, etc.
Training technology in the clinic today
If you look at modern teaching aids and gadgets for studying clinical disciplines at medical universities, it’s simply breathtaking. They are built with clear logic and sophisticated new learning technology.
Let’s take a conditional chapter from a conditional modern textbook on faculty therapy on liver cirrhosis, for example. If you think that it contains classification, symptoms, laboratory tests, differential diagnosis, treatment and prognoses in the usual sequence, then you are mistaken. All of the above is there and is located in the "Preparation for the lesson" section. The main role in the chapter belongs even to non-test tasks of the primary level, although they are perfectly formulated and are an excellent filter for those who really worked and taught. Today these are situational tasks, that is, a whole set of clinical cases with a detailed description of conditional patients for analysis in a practical lesson.
Or, for example, bronchitis. The faculty therapy conducts an analysis of modern bronchitis with an analysis of clinical cases. Extensive classification is fully consistent with international protocols for diagnosis and treatment. This is a layer of comprehensive information that will help to deal with the most complex variants of the disease. Provided that you are well versed in this very information
In the course of faculty therapy, peptic ulcer occupies a special place due to its prevalence and severity of the course of this disease in Russia. A lot has changed here: starting with the protocol of basic treatment, ending with preventive measures among all layers of youth, including girls. Everything has changed, and these are very positive changes. The classification and the huge number of clinical variants of the course of the disease are neatly arranged in clinical “shelves” - cases with nuances and versions of patient management with a variety of additional details and details. An amazing quest, there is no other name.
Conclusion
If you want to become a great clinical doctor, you can not do without the huge amount of knowledge and skills offered by the course of modern faculty therapy. There will be more than enough difficulties. And mistakes. And swotting by heart. And sleepless nights - all as expected.
But then you can enjoy your own understanding of the complex syndromes and conditions in patients. You will be able to deal with the most confusing medical history and non-standard laboratory tests. You can save lives and give a recovery. You will become a real clinician, because you will pass and pass the course of the famous faculty therapy in a cool way - this will be your main medical course.