Professor Igor Gladchuk: Simulation training is a competitive advantage of Odessa Medical University

Although gynecological diseases remain ones of the most common, the efforts of Ukrainian scientists, doctors and clinics manage to keep the overall statistics of morbidity at the European level. The urgent task is to reduce the mortality of patients from cancer and other gynecological diseases. The Department of Obstetrics and Gynecology of Odessa National Medical University purchases equipment and trains specialists who are able to respond to this and other challenges. For example, the department recently received the status of a European scientific and clinical center of endometriosis. History of the department and modern technologies in the treatment of gynecological diseases – in an interview with the head of the department, vice-president of the Association of Obstetricians and Gynecologists of Ukraine, Professor Igor Gladchuk.

How did you come to medicine and why did you choose gynecology?

I can’t say that I deliberately went to medicine. I come from a rural family that has never had a doctor. There was no one to tell me about this profession. I was 16 years old when I entered the university, so I objectively could not imagine what it was. I graduated from school with a medal, the Ternopil Medical Institute was very popular at the time, and I was satisfied with the entrance exams. So I successfully passed them and became a student. But medicine itself is a separate galaxy. Gynecology was then very prestigious and even elite, access for students wishing to master it was very limited. And I had a collision: I studied for almost a month in the 6th year, preparing to become a therapist. But it  happened that among the 12 students of the course, who were allowed to specialize in gynecology, one place became vacant. The dean asked if I had changed my mind about being a gynecologist. And no, I didn’t change my mind.

And how did you get to Odessa?

I worked in the area for three years and felt that I was getting cramped. I began to look for a place in graduate school, in the residency. In those days, it was a difficult task: making a professional scientific career was very popular. I applied to my Alma Mater, Lviv and Kyiv medical institutes, but no one could promise me support. And then during the annual Plenum of obstetricians and gynecologists in Ternopil, the associate professor who taught me told me about a young professor from Odessa who does not refuse beginners. This professor was Valerii Mykolaiovych Zaporozhan. He agreed to take me to his clinical residency. He had to look for a place for me in the ministry for a long time, because there were no vacancies in Odessa at that time. Since 1990 and until now I have been in Odessa without leaving. At first, clinical residency, PhD defense – Valerii Mykolaiovych was my supervisor. Then he offered me a job at the department. At that time, the USSR was just disintegrating, there was a difficult choice: to go to the district and become a district obstetrician-gynecologist with the degree of Candidate of Sciences or to stay in Odessa as a teacher and develop a scientific career. Valerii Mykolaiovych helped with housing, supported morally and helped to make the right choice. Today I consider myself a real resident of Odessa, here I have a favorite job and many friends.

When did you head the department and what has changed in its work over the years?

I became the head of the department in 2015. It was once formed by Valerii Zaporozhan. At first it was difficult. I showed myself more as a gynecologist-surgeon, lectured, engaged in scientific rather than administrative work. There was no understanding of how to manage the department. But later, it seems to me, it was formed. Today our department is the largest in Ukraine. We have almost 80 employees, 16 of them are professors. It is actually a scientific institute. My principle of managing the department is to delegate authority and responsibility to all who are ready and willing to take them. At each base of the department there is a responsible professor-head with great powers to ensure the pedagogical and scientific processes, medical work. It relieves me a bit and allows my colleagues to grow and express themselves more

What is the scientific profile of the department?

The work of the department, including scientific, is generally approved and supervised by the university, but each professor has the right to their own directions and develop them on their own bases. My focus is mainly on operative gynecology, improving the diagnosis of diseases and surgical treatment. It includes modern minimally invasive surgery, initiated by Valerii Mykolaiovych Zaporozhan, and classic abdominal and vaginal operations. A few weeks before the start of quarantine, we had a commission of the European Society of Endometriosis, which licensed our clinic. For the first time in Ukraine we received the status of the European scientific and clinical center of endometriosis of the highest, 4 level of accreditation and received the corresponding certificate. This is one of the main achievements of our clinic under my leadership, I am proud of it and of the whole team. There are no such centers in Ukraine. There are several of them in the post-Soviet countries.

By what criteria did the commission evaluate the department?

There were a lot of them. Among the main: the volume and quality of work, the range of services we provide to patients, scientific support of clinical work, publications, monographs, clinical trials and more. An important factor was the international image of the department. In pre-quarantine times we often had to be an expert in many countries, constantly invited foreign colleagues. This exchange contributes to the enrichment of each of us, the space for learning is unlimited. I always try to find out how others work, what techniques can be introduced in our country. For my part, I willingly share my knowledge and skills in operative gynecology – laparoscopic, vaginal surgery, plastic and reconstructive surgery. My lecture in Warsaw, where I was awarded the degree of Honorary Doctor of the Polish Association of Obstetricians and Gynecologists, was related to laparoscopic treatment of endometriosis, I  held master classes, taught to work on modern equipment. I have been an expert in Georgia, China, Germany, Kazakhstan, Kyrgyzstan and other countries.

You mentioned innovative equipment. Are there simulators at the department?

There is simulation equipment for undergraduate education, as well as for postgraduate education. If in the first case we give students a base, in the second we dive in more detail: we develop the practical skills necessary for all modern obstetricians and gynecologists. We have unique simulators that allow young professionals, interns to professionally improve in minimally invasive surgery, laparoscopic surgery. Simulators are a kind of intermediate stage of training of doctors between theory and practice. Before performing operations on patients, young professionals practice all their movements on simulators, which in fact completely simulate a variety of clinical situations. Our simulation class has been renovated, but is closed for training during the period of strict quarantine. I am a fan of simulation training. Such training is a competitive advantage of Odessa National Medical University. I hope that we will be able to restore the full work of the class as soon as possible.

Is there any equipment you are especially proud of?

3 years ago we were the first in Ukraine to receive equipment from the German company Karl Storz, which we now actively use in operative gynecology. We are actively developing the direction of isolation of sentinel lymph nodes in oncogynecological patients by staining them with a special dye. This procedure is made possible by the availability of endoscopic equipment and cameras that allow you to identify stained lymph nodes and perform more thorough and high-quality cancer surgery and, at the same time, less injury, improve recovery prognosis and shorten the rehabilitation period. This is very important in modern practice.

What are the plans for the development of the department?

My term as head of the contract will last for the next 5 years. The main tasks are to further improve the educational and scientific process and to support the medical work at the high level at which it has always been and remains. In addition, we continue to adapt to new realities, I mean the pandemic. Unfortunately, the activities of physicians in quarantine are still insufficiently regulated. We strictly adhere to all ministry requirements and safety regulations to avoid the risk of infecting our patients.