Trial by fire: results of the residents’ year of work at city polyclinics

March 14

Today, over 800 residents assist physicians at capital polyclinics. The very same day the year before, Moscow authorities decided to involve residents from Moscow medical higher education institutions in working at city polyclinics and for visiting patients at home due to the COVID-19 pandemic. This step helped physicians and medical nurses whose workload has increased significantly amid the COVID-19 pandemic.

“In this extremely difficult situation of the novel coronavirus infection, when the major load fell on the home care service, it was crucially important for us to ensure the needed availability of primary medical care for Moscow residents. At that time, hundreds of residents responded to our offer to work at city polyclinics. It is impossible to overestimate their contribution, and we want to express our sincere gratitude to each of them. Many of those who started assisting our physicians with patient attendance or visits to patients subsequently remained as of Moscow health system employees,” Elena Efremova, Deputy Head of Moscow Department of Healthcare said.

As early as in April, the first 730 young specialists, having passed preliminary training, proceeded to work. Residents partially undertook patient attendance, and joined medical teams visiting patients at home. Subsequently, the number of residents increased up to almost 1,300 people. Last autumn, over one thousand residents were working at city polyclinics. Up to date, as the disease incidence rate is reducing and polyclinics are gradually returning to their routine, over 800 residents continue assisting physicians.

This period of time became not only a serious trial for young medics but also an opportunity to get invaluable experience and a steady job. All residents obtained initial accreditation to work as district internists. They passed training in the Unified Medical Information and Analysis System (UMIAS), detailed briefing in the management of patients with suspected novel coronavirus infection and gained the right to receive patients on their own. At the same time, all possible measures were taken to mitigate the risk of infection for young specialists. All residents, like other polyclinic and hospital employees, are provided with personal protective equipment. They regularly pass coronavirus antibody tests as well.

“To let the polyclinic work on a scheduled basis”

Liliya Vershinina, the Chief Medical Officer of City Polyclinic No. 22 tells that at the very beginning of this project, in the spring of 2020, 21 residents joined the healthcare institution. All of them were chosen by the HR Centre of Moscow Department of Healthcare. According to Liliya Vershinina, all young people were ready to upcoming trials. Each resident was supervised by heads of therapeutics departments and polyclinic branches. Young specialists were able to ask their supervisors for assistance at any time.
Most residents received patients and visited them at home. They visited both patients with chronic diseases and those who had called in a doctor because of high temperature or other coronavirus infection symptoms.

Liliya Vershinina, Chief Physician of City Polyclinic No. 22

“At late 2020, we had 30 COVID-19 teams. Four physicians were working at the CT center. In addition, vaccination stations were opened. Thus, over 40 healthcare professionals – therapists and specialists – were involved at unusual positions. Attending physicians were a big help to us. It was important for the polyclinic to continue working on a scheduled basis,” Liliya Vershinina said.

38 residents had time to work at Polyclinic No. 22 from October 2020 to February 2021. 12 young specialists continue working at the healthcare facility at the moment. They are receiving patients, visiting patients with chronic diseases at home and engaged in the vaccination program.

“You’re responsible for everything”

Anna Tkachenko is one of the residents who became a full-time employee at the polyclinic. At the pandemic beginning, she was a student at A.I. Evdokimov Moscow State University of Medicine and Dentistry and a resident at the Bakhrushins Brothers City Clinical Hospital Therapeutics Department in Sokolniki.

“In early March, the institute of higher education told us that polyclinics needed assistance. Among other things, they motivated us with good wages. At first, this was about one month of work – from late March to late April. Then it was extended to late July. I thought: why not if I had a chance to accumulate experience and earn some money? I didn’t regret it. We even passed our state exams online. Staying at home while doing nothing for almost six months isn’t productive,” Anna Tkachenko tells.

Anna Tkachenko, resident of Bakhrushins Brothers Clinical Hospital

For the first month, residents were receiving patients together with physicians. Then Anna’s colleague was moved to the CT center, and the young woman was transferred to visit patients. Anna visited patients with chronic diseases, rendered palliative care among other things. She was also working at the call center for some time: she was calling people undergoing coronavirus infection treatment at home.

In October, Anna was invited to succeed a retired physician and become a general practitioner. Now the young woman is engaged in vaccination.

“Previously, I planned to work in inpatient settings. You delve into a work process every day there, and everything suited me. You can see process dynamics in inpatient settings when a severe patient is hospitalized, and then a healthy person is discharged. However I believe now that it will be a good experience to work at a polyclinic for several years. Of course, everything is somewhat different here. When you prescribe treatment, you understand that everything depends on you. As for common residency, you always have a doctor nearby who can correct your treatment. And here, you’re responsible for everything,” the healthcare professional concludes.

According to Anna Tkachenko, it was initially unusual to visit patients at home every day: not all of them were welcoming and hospitable. However communications with patients give a lot of positive emotions either.

“I asked to join a COVID team right away”

Arif Bazanaev works at City Polyclinic No. 214. The young man studied at the Peoples’ Friendship University of Russia and enrolled at N.V. Sklifosovsky Research Institute of Emergency Medicine residency.

 “The roentgen-endovascular surgery is my specialty. The quarantine was introduced amid the pandemic, and all residents were switched to remote training. I decided to turn my hands to the useful work and help Moscow struggle against the pandemic during my spare time. I managed to gain a lot of practical knowledge that will prove useful in the future, in surgery among other things,” Arif Bazanaev tells.

The young physician does not regret about this change in specialty. However he notes that it was quite difficult at first.

Arif Bazanaev, resident of N.V. Sklifosovsky Research Institute of Emergency Medicine“I asked to join a COVID-19 patient assistance team from the very beginning. I’m specialized in surgery, so I could also help coronavirus patients requiring, for example, bandaging or wound treatment. Such people are quarantined, so they cannot turn to a specialized center. They need medical assistance at home,” Arif Bazanaev tells.

He likes his colleagues very much, and he has been working as a contracted therapist, doctor on call basically at Polyclinic No. 214 since last autumn. Arif notes that patients’ gratitude is one of the most pleasant moments.

“I’ve remembered a lot of patients for this year often visited by us at home. Most of them are very grateful and welcome doctors as their friends,” Arif Bazanaev tells.
The young physician does not mention his future professional plans at the moment. For now, Arif has decided to continue working at the polyclinic to gain experience.



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