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Universitetet i Tromsø

Institutt for Samfunnsmedisin

The POMOR program in Primary Health Care Education.

The POMOR Program of Primary Health Care Education is developed on the basis of The Russian Health Reform, stating that the new Russian health system should gradually be turned from the hospital outpatient clinics into a system based on primary health care outside the old institutions, closer to the people. A systematic educational program has been initiated, based on a close cooperation between the Regional Health Ministries of Murmansk and Arkhangelsk, the University of Tromsø (UiT), The Northern universities of Sweden, The Northern State Medical University of Arkhangelsk and the Norwegian Medical Association.

A pre-project has been used to develope the comprehensive program with support from the Barents Health Program. A steering group is established and the program is developed as an activity under the Norwegian National Centre of Rural Medicine (NCRM) at UiT with Svein Steinert as responsible person. Two tutors were appointed in both Norway and Russia, and the first 8 colleagues in each county were selected in autumn 2008. The formal program started in March 2009. A two years education program was created, leading up to a formal accreditation of the 8 x 2 colleagues in June 2011. An important part of the GP trainee contracts was to be tutors for new groups of Russian colleagues from 2011/2012.

Phase 1

The POMOR program was implemented as planned and performed as described in the Norwegian 2-year education program in general practice. The two groups in Arkhangelsk and Murmansk have completed 20 meetings of 8 hours until June 2011. A Norwegian textbook ("Handbok for spesialistutdanning i allmennmedisin", Getz L, Westin S, 1996) was translated to Russian before the program started (norwegian link).  To a large degree the program is based on  self- learning by the trainee GPs, and the problems discussed started with the experiences from their own practices. One or more specific topics were selected for each meeting. Some of the GP trainees were responsible for presentations on the chosen topics. Group discussions and consultation of  international guidelines have resulted in  improvement of local guidelines.

Link to pictures taken during a trip tp Arkhangelsk June 2008.

The POMOR Program phase 1 was completed with participation at the Nordic Congress in General Practice in Tromsø 14 - 17 June 2011, Caring for people where they are. The possibility to participate in this congress has been a great motivation factor for the work in the tutorial groups, and two presentations from the POMOR-program were accepted for oral presentation at the congress.

Phase 2

The planning of phase 2 of the program started already in the beginning of 2011 with the translation of two education books that will be important in the future POMOR program; "Allmennmedisinsk gruppereise - møteopplegg for veiledningsgrupper" and "To aar sammen". Written permission for the translation was given by The Norwegian Medical Association. The work is nearly completed by the Russian MD, MPH, PhD Oleg Sidorenkov. He is speaks Norwegian  fluently after many years as a MPH and PhD student at the University of Tromsø. The translation has been done in cooperation with professor Vladimir Popov and associate professor Elena Andreeva, Northern State Medical University, Arkhangelsk. We are planning to print both books in Russia in the spring of 2012.

The two parts of the book are  now fully re-translated and finished printing (fall 2012) ( Вместе два года (“To år sammen" ) and Групповой тур по семейной медицине (“Allmennmedisinsk gruppereise”). The books are both included in the educational program.

In collaboration with the Health Ministries in Arkhangelsk and Murmansk we recruited 10 of the 18 Russian GPs that completed the education program in June 2011 as tutors for the next phase of the POMOR program.  Our plan is to start 5 new tutorial groups in the spring of
2012 with two Russian tutors and 8 GP trainees in each group, one urban and one rural group in Murmansk oblast, and one urban and two rural groups in Arkhangelsk oblast. The Norwegian mentors will have meetings with the 10 Russian tutors 4 times a year, and also support them by using email, SKYPE and video meetings.  Professor Vladimir Popov and assistant professor Elena Andreeva at The Northern State Medical University of Arkhangelsk will play an important role as coordinators in Russia, and Oleg Siderenkov will be a part of the Norwegian group. Professor Hasse Melbye at the GP research unit, UiT, will  continue to support the POMOR program with a new clinical research project on respiratory disease.