An important role in the international integration of national educational standards in Russia is played by the international projects coordinating the efforts of various nations in solution of global problems of health care, the concepts determining the strategy and tactics of the nations´ health care systems perfection. The "Rational pharmaceutical management" and the concept of "Rational use of medicaments" should be referred to such projects. Their realization in Russia has changed the native health care national policy essentially, presented new requirements to the professionalism of all levels specialists working in the area of medicine and pharmacy. It couldn´t help affecting the medical and pharmaceutical education in Russia.
A certain influence on the integration of medical and pharmaceutical education has had the activity of the European regional Bureau of the World Health Organization. On its initiative the international seminar "Implementation of Rational Medication into Academic Programs of Medical Higher Educational Institutions of the CIS" (Russia, Moscow, May 21-23, 1997) was held and the internship of the Russian medical and pharmaceutical HEI faculties in the international courses "Teaching Rational Medicinal Treatment for Medical HEI students (Netherlands, Gronningen, August 21-29, 1997). A major landmark in the international integration of national educational standards has become the "International Conference on the pharmaceutical education strategy in Europe" organized within the framework of the program of cooperation between the Ministry of Health Care and Social Development of the Russian Federation and European Regional Bureau of the World Health Organization (Russia, Moscow, October 11-12, 2005).
The rational use of medications - is the carrying out of medicinal treatment adequate to the clinical state of the patient in the dosage corresponding to his individual features for a proper time period and to the keenest price. The analysis of the "Rational use of medicaments" concept testifies that there is much in common in the integration of medical and pharmaceutical education. In accord with current trends of medical and pharmaceutical help development from the position of evidence based medicine both the doctor and the pharmacist focus their professionalism on the patient, they solving the patient´s problems by means of medicaments. It is the patient´s problems that are the motivation of the professional communication of the doctor and the pharmacist, the competence of who will be determined by the knowledge and skills level acquired while studying at a basic and pharmacology HEI.
Present-day achievements of science and practice testify to the impetuous expansion rate of the extent of knowledge on pharmacological disciplines, rapid development of the pharmaceutical market and ever-increasing part of principally new medicaments. There is hardly a dare-devil, who will dare to maintain that the decades existing educational system meets modern trends of medicine and pharmacy development. The education basing on facts cognition is becoming unreasonable. The medical and pharmaceutical education reforming expediency emerges objectively.
The main principles of medical and pharmaceutical education reforming become the international community statements, one of which is that "the pharmacist occupied in a retail drugstore - is not a seller, but, first of all, a bearer of specialized knowledge, advisor of the doctor and patient" (WHO, GPP rules). Thus, the knowledge and skills level on pharmacological disciplines in a pharmacist cannot be lower that that in a doctor.
The pharmaceutical education reforming supposes the modernization of education programs, the keystones of which are:
- the correspondence to present-day practice of rational use of medicaments;
- the correspondence to the knowledge level, national health care problems;
- the teaching of problem solving skills (which do not depreciate in the course of time);
- the use of preparations, included into the national instruction for medicaments use, as the basis for pharmacists;
In spite of the fact that all these principles were put across pharmacologists and clinical pharmacologists in 1997 already at the international seminar in Moscow (1997), unfortunately, the program on pharmacology, which pharmaceutical HEIs follow, has not been modernized and doesn´t meet the international integration principles. The same problems in teaching clinical pharmacology/medicinal treatment (the Problem Committee Chairman is the Academician of RAMS Kukes V.G.) are being solved more progressively.
One of the key regulations for the rational use of medicaments is teaching pharmaceutical HEI students medicinal treatment by means of problem-based method. The HEI faculties of Moscow, Smolensk, Ryazan, Kazan and Perm have passed the internship at the Gronningen University under the auspices of the European Regional Bureau of the World Health Organization. This method has been used for 10 years at the Pharmacology Department of the Perm Pharmaceutical Academy.
The introduction of rational medications use practice into the pharmaceutical education in Perm took place in a stepwise manner. Originally it included:
- the organization and holding an interuniversity seminar for teachers on the rational medications use methodology;
- the modernization of clinical pharmacology/medicinal treatment education program;
- the development and publishing a rational medications use principles-based study guide for pharmaceutical HEI students;
- the development and publishing a clinical pharmacology/medicinal treatment study guide containing tests and problem-based assignments for pharmaceutical HEI students. The purpose of the study guide is to promote the acquisition of skills of rational medications choice at various diseases on the efficiency and safety criteria, carrying out the pharmacoeconomic analysis of advantages of a series of medicaments over the other ones, the inclusion of medicaments into logbooks of various levels, the by-effects monitoring and forecasting, the exercise of competent consultation of the preparations consumers;
- the organization of problem-based learning method training for the Pharmacology/Clinical Pharmacology Department faculty instructors;
- the organization and development of rational medications use research, holding conferences, symposia of regional and federal levels;
- the organization and carrying out the knowledge and skills quality control of rational use of medications included into the federal formulary system in students.
At the following stage the practice of rational medications use is introduced into qualified pharmaceutical chemists´ education at the extramural department, internship and the department of postgraduate professional pharmaceutical education. It should be noted that the academic process correction touched mainly the material volumes that is connected with the difference in hours. The objectives and teaching methods are identical to those defined at the intramural form of pharmaceutical education.
The experience of rational medications use concept introduction into the academic process of the Perm Pharmaceutical Academy was reported in panel sessions of the Russian Problem Educational Methodological Committee on clinical pharmacology, the International Conference on the pharmaceutical education in Europe (Moscow, 2005).
Our experience has showed that the international integration of national educational standards opens manifold possibilities for the introduction of new educational technologies, leads the pharmaceutical education quality to a principally new level, raises the prestigious value of the profession, guarantees its socially significant and economically effective realization.
The constraint of the international integration of national educational standards, in our opinion, is the teaching staff, as it is little informed about the processes taking place within the training system of high qualification cadres, and therefore, not all its representatives are ready for the pharmaceutical education modernization.
It is advisable to ease the availability of information about the features of national educational standards, new technologies of education for the teachers´ body, to make the educational internet-resources free. All this will allow understanding the essence of the education reforming, entering actively the processes of educational standards´ and technologies´ international integration.
The work is submitted to III Scientific Conference "The Problems of International Integration of Educational Standards", Czechia (Prague) - Luxembourg - France (Paris), April, 20-27, 2008. Came to the Editor´s Office on 31.12.2007.