- Currently, Arsen Askеров heads the Scientific Center for Maternal and Child Health named after A. Tashieva.
According to him, medical education in these fields is undergoing changes against the backdrop of the implementation of new technologies and the transition to competency-based educational models. Important aspects of this process include simulation training, the development of narrow specialties, and the enhancement of clinical practice. However, successful implementation requires systemic investments in educational institutions.
Here is the text:
“Given the rapid progress in medical knowledge and technologies, educational programs are becoming increasingly complex. Creating effective education in obstetrics, gynecology, and pediatrics that can prepare specialists in a short time is a global challenge. In our country, programs in these areas strive for standardization by integrating core competencies; however, clinical practice remains underdeveloped.
In the context of the transition to competency-based medical education (CBME), the focus is on developing surgical skills, patient management, and diagnostics, rather than just the number of years of practice. Global practices actively incorporate simulation training, virtual reality, and specialized internships (in areas such as perinatal medicine, pediatric gynecology, reproductive medicine), which help ensure the necessary clinical competence.
The American Board of Obstetrics and Gynecology (ABOG) recognizes such narrow specialties as perinatal medicine, reproductive endocrinology and infertility, oncology, and reconstructive surgery for women.
Training in surgical skills, including laparoscopy and hysteroscopy, as well as managing emergency obstetric situations such as shoulder dystocia and postpartum hemorrhage, plays a significant role in enhancing students' confidence. Specialized courses for managing reproductive health from early childhood to puberty are emerging.
There is a lack of in-depth training in these areas, which includes a three-year residency followed by three years of internships (for example, in pediatrics—pediatric cardiology, neonatology). The training program for general practitioners in the first year covers more issues of therapy and family medicine, which occupies the first year of clinical residency for all specialties. However, clinical bases for family medicine profiles leave much to be desired.
There are also unresolved issues regarding the transition from theoretical training (as a specialist doctor) to clinical internships and continuous education. For example, such specialties as managing high-risk patients in obstetrics, complex gynecological surgeries, and pediatric subspecialties are poorly developed, as well as the use of digital health tools.
Overall, the educational process in obstetrics, gynecology, and pediatrics is in a state of transformation, accompanied by the introduction of technologies and standardization; however, there are significant differences, especially in resource-limited settings.
It is important to note that training in modern clinical bases can help identify residents who need additional support in specific areas and provide them with a broader skill set by the end of their training. Educational sessions in emergency obstetric care (for example, in cases of postpartum hemorrhage, eclampsia, or shoulder dystocia) are rarely conducted in interdisciplinary groups involving residents, midwives, nurses, and anesthesiology interns. Research shows that team simulation training improves not only technical skills in managing emergencies but also communication and teamwork, which are critically important for patient safety.
Simulation of surgical procedures is also of great importance in training for obstetrics and gynecology. Due to limited time and safety considerations, residents have fewer opportunities to practice complex surgeries on patients. To address this issue, simulations based on anatomical models, virtual laparoscopic simulators, and laboratories using cadaveric or animal tissues for training in surgical procedures in gynecology and perinatology are being applied.
Although common scenarios (such as natural childbirth or vacuum extraction) are practiced in simulations, critical situations such as cesarean sections due to obstructed labor, amniotic fluid embolism, and maternal cardiac arrest are not accounted for. This has led to recommendations for developing simulation training that includes high-severity events to better prepare graduates for such emergency situations.
Rapid changes in obstetrics and gynecology, neonatology, and pediatrics—from new surgical techniques to modern medications—require physicians to continuously update their knowledge and skills. Continuing education in these areas is not limited to lectures and reading literature. There is a growing recognition that experienced specialists benefit from periodic continuing education using simulation methods, especially in emergency obstetric situations.
Modern hospitals and healthcare systems regularly conduct drills for interns and medical staff. These drills aim to maintain continuous education, reinforce best practices, and coordinate teamwork. Research shows that even low-quality simulations combined with e-learning can significantly enhance the knowledge and skills of medical students and nurses in obstetrics and gynecology.
In well-developed infrastructure conditions, simulation training programs correlate with a decrease in the number of lawsuits and adverse outcomes in obstetric-gynecological and pediatric practice. However, issues of scaling these methods remain relevant—problems of cost, instructor time, and ensuring the accuracy of simulations require constant attention. The growing interest in virtual and augmented reality, as well as artificial intelligence in education, is promising; however, these tools must be carefully evaluated to determine their added value.
Thus, investments in educational infrastructure and the adaptation of educational programs play a key role in training medical professionals. Modern educational strategies emphasize practical skills and validated competencies, using simulation and technology to prepare physicians who possess both technical skills and an understanding of the humanistic and social aspects of women's and children's health.”
