Shevchenko Scientific Society and UMANA discuss medical education and practice in Ukraine and U. S. (02/22/04)

Shevchenko Scientific Society and UMANA discuss medical education and practice in Ukraine and U. S.

by Dr. Orest Popovych

NEW YORK - The Shevchenko Scientific Society (NTSh) jointly with the New York Metropolitan Chapter of the Ukrainian Medical Association of North America (UMANA) on February 14 hosted a roundtable comparing some aspects of medical education and practice in Ukraine and America.

Dr. Larissa Zaleska Onyshkevych, the president of NTSh, opened the program and invited Prof. Vasyl Makhno to chair the proceedings. He, in turn, started by reading greetings from the president of the UMANA Chapter, Dr. Lesia Kushnir, who was unable to attend.

First to speak was Dr. Michael Cehelsky, former chief of gynecology and obstetrics at Sydenham and Our Lady of Mercy hospitals in New York City, a professor at the New York Medical College and a full member of NTSh. Dr. Cehelsky has been involved with the UMANA program of exchanges with Ukraine since 1991. Subsequently, his individual efforts on behalf of medicine in Ukraine developed along two tracks: bringing medical students from Ukraine to New York and publishing medical literature in Ukraine.

Since 1996 Dr. Cehelsky has battled bureaucracies on both sides of the Atlantic to enable selected students from the Dnipropetrovsk Medical Institute to attend a 12-week program in the third year at the New York Medical College. He has traveled repeatedly to Dnipropetrovsk at his own expense in order to interview and select the candidates for this program.

Medical education in Ukraine lasts six years, and the students enter medical school directly from a secondary school, without receiving first a bachelor's degree, as is required in the U.S. Therefore, the students selected by Dr. Cehelsky had to be in their fifth or sixth years, and with a knowledge of English. Dr. Cehelsky was happy to report that to date 11 such students had completed his program, and all of them returned to Ukraine, except one, who got married here.

At the medical school in Odesa, where he has been lecturing to post-graduate audiences, Dr. Cehelsky has collaborated in the publication of two major works in the field of gynecology and obstetrics, namely a textbook and an atlas. It is significant that in predominantly Russian-speaking Odesa these books were published by the local medical school in Ukrainian, stressed Dr. Cehelsky. He is now preparing a Ukrainian text for the U. S. Residency Program in gynecology and obstetrics, which the Odesa Medical School would like to adopt.

Next to speak was Dr. Viktor Gribenko, formerly chief of a cardiovascular surgery department in Kyiv, and author of more than 50 articles in his field. As a practicing physician formerly in Ukraine and since 1991 in the U.S., he was able to contrast the medical experience in both countries in great detail.

One problem in Ukraine, said Dr. Gribenko, is the oversupply of physicians, dating back to the Soviet period, which results in an average pay of about $60 a month. There is also a dire shortage of modern medical equipment; for example, the city of Kyiv has no more than five or six MRI units. Free medical care does exist, but it provides only minimal care, excluding even X-rays, said Dr. Gribenko. Patients often must provide their own medical supplies, such as syringes and bandages, and are generally too poor to pay for quality drugs. Gradually, however, private clinics are developing throughout Ukraine, where one can get better care for a fee, Dr. Gribenko noted.

Having painted this dismal picture of medicine in Ukraine, Dr. Gribenko said the top priority for Ukraine's physicians is better access to medical information, which means they must, first of all, learn English. At the moment, new medical information is reaching Ukraine primarily through Russia, which is backward compared to the West, but still ahead of Ukraine in medicine, said Dr. Gribenko.

Last to speak was Dr. Daria Dykyj, professor of anatomy at the Albert Einstein Medical College and the New York College of Podiatric Medicine, as well as chair of the NTSh Membership Committee.

People arriving here with medical diplomas from the former Soviet Union, said Dr. Dykyj, make a stab at the medical exams in New York, but often fail them. As a result, they wind up in one of the related professions, such as physician's assistant or nursing.

Some of the opinions and attitudes of the physicians from the former Soviet Union, as related by Dr. Dykyj, were interesting. For example, they consider themselves to be superior to American physicians in patient diagnosis and feel that American education is excessively exam-oriented. During exams they often tend to help each other - a procedure we call cheating. They also feel that additional payments by patients to physicians in Ukraine are perfectly acceptable, even though medical care there is socialized. Considering the dismal rate of pay for medical doctors in Ukraine, such opinion seems reasonable.

In closing the program, which evoked a lively discussion from the audience, Prof. Makhno summed it up best: "In Ukraine medicine is a horror, while in America the cost of medicine is a horror."

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