[The gender and age characteristics of general practitioners in Moscow].

The feminization and middle age decreasing in general practitioner profession is a worldwide trend.Purpose of the study is to explore gender and age structure, professional characteristics of general practitioners in Moscow.The retrospective analysis of personal records of students of the Chair of General Medical Practice of the Institute of Professional Education of the The I. M. Sechenov First Moscow State Medical University trained from 2016 to 2020 (n = 400).It is established that women made 80.5% out of them. The average age was 50.7 ± 0.7 years; average general professional experience - 28.8 ± 0.8 years, in general medical practice - 9.7 ± 0.3 years. The internship/residency in therapy was graduated by 84.2% of students. Up to 96.3% worked in state medical organizations. The majority (97.0%) had no academic degree. Indicators with positive dynamics: share of women, physicians with internship/residency in therapy, employees of state medical organizations, without an academic degree. Indicators with negative dynamics: age, professional experience. Differences between men and women were established for residency and professional experience in general medical practice.The average social and professional portrait of general practitioner in Moscow: woman 50 years old graduated internship/residency in therapy, professional experience of more than 20 years, with professional retraining about 10 years ago, working in state medical organization, no academic degree.The activities were proposed considering gender and age specifics, professional characteristics of general practitioners, directed to increasing efficiency and comfort of training.

[The development and enhancement of general medical practice as major condition of successful modernization of primary health care].

The need for changes in the primary health care system in the Russian Federation that is based on the principles of general medical practice is without any question. But, even after more than thirty years, there is no full-fledged reform still. THE OBJECTIVE: To assess the state of general medical practice in the Russian Federation to identify its strengths and weaknesses, and to determine further ways of its development. The tasks. To analyze the volume and pace of development of general medical practice; to identify its impact on key demographic, medical and social indices; to assess foreign experience in this field; to elaborate proposals on intensifying process of its development in the Russian Federation. MATERIAL AND METHODS: The analytical, sociological (n=1,573) and statistical methods were applied. THE RESULTS: Since 2007, the number of general practitioners in the Russian Federation and corresponding support of the population increased. During the same time period, population size, natality, mortality, morbidity of tuberculosis, essential hypertension and cataract had positive dynamics. The morbidity of malignant neoplasms, diabetes type II, glaucoma, coronary heart disease and cerebrovascular diseases had negative dynamics. The strong negative relationship of the population's general practitioners support was established only in case of all-cause mortality and morbidity of lungs tuberculosis. The population was more satisfied with support of general practitioner than district physician. DISCUSSION: The general practitioner support of the population of the Russian Federation continues to be insufficient and its role in public health management insignificant. The proposals are formulated to improve primary health care and its further development based on the principles of general medical practice on the basis of corresponding best international experiences and national specificity. Hence, in Russia, the national health care requires a set of measures targeted to strengthen the position of general medical practice system throughout ll territories.

[The patients' evaluation of medical service at the out-patient level].

The article presents the results of questionnaire survey of patients' opinions about out-patient medical care. The survey was carried out using the Doctors' Interpersonal Skills Questionnaire during 12 months. The sampling consisted of 14.712 respondents. The lowest rates out of 11 parameters analyzed received parameters Q5 (Could the doctor reassure you?) and Q7 (Did the doctor help you to express your feelings and fears?). Such a situation was common for all medical specialties. Unexpectedly, combination of low estimate of mentioned parameters with their low correlation and resultant satisfaction with medical care was established. The resultant satisfaction with medical service by general practitioners (family doctors) was less dependent from physician's respectful attitude to patient than attention of physician to personal circumstances of patient choosing treatment. The patients of endocrinologists noted that the least input into resultant satisfaction with medical care was related to ability of physician to assist them to express their fears, and the greatest input was given to first impression from manner and mode of how physician received patient. The least input into resultant satisfaction of patients with medical services by cardiologists was made by respectful attitude of physician and the most input was attributed to way of how physician considers patient's personal circumstances in treatment selection. The patients of gastroenterologists mentioned physician's ability to reassure patient as least input into resultant satisfaction with medical care, and attention to way of how physician considers patient's personal circumstances in treatment selection as most input.

[The intraorganizational training in ambulatory polyclinic organizations].

The intraorganizational training can be an efficient addition to modern system of continuous medical education. The purpose of study is to theoretically substantiate and to develop an intraorganizational system of continuous professional education of medical personnel, to implement intraorganizational system of continuous professional education of medical personnel into medical organizations providing out-patient medical care and to assess its efficiency. The study was organized at the base of three non-state medical organizations of Moscow providing out-patient medical care. Two out of them had net organizational structure, one was represented by single medical organization. The study implemented such research methods as organizational experiment, expertise, sociological survey, test control, analytical and statistical methods. The system of continuous professional education of medical personnel including "Adaptation", "Correction" and "Development" levels was developed and tested. The system of continuous professional education of medical personnel comprises intraorganizational training center, intraorganizational system of remote training, form of long-term cooperation with educational organization, application of target training programs focused on adjustment of deficiency of knowledge and skills and acquirement of new professional competences by medical personnel. The intraorganizational system of continuous professional education of medical personnel can be used as an addition to modern form of continuous medical education. It can be used in state and non-state medical organizations. The study proved positive effect of intraorganizational training on the level of professional qualification, increase of satisfaction of medical personnel and increase of quality of medical care.