College of Medicine helps Kazakhstan modernize medical systems

The College of Medicine’s mission – which includes training physicians to practice culturally relevant and sensitive primary care – doesn’t stop in Florida, or even at U.S. borders.

For more than two years, the college has worked with Kazakhstan to help improve the republic’s medical education and research systems. In June, three faculty members journeyed more than 7,000 miles to work with 25 associate deans and deputy directors for research from Kazakhstan’s six medical schools and several national research centers. Through intensive, all-day tutorials, these professionals learned the ins and outs of writing internationally competitive research grant proposals and articles.

The partnership officially began in May 2007 when assistant professor Askar Chukmaitov, who’s a Kazakhstani native and director of the College of Medicine’s new Center on Global Health, and Robert Brooks, then the associate dean for health affairs, established a formal working relationship with the country. Before he joined the College of Medicine, Chukmaitov had co-written Kazakhstan’s official strategy to modernize its medical education system, which had been based on the former Soviet Union’s organizational model, so he knew what needed to be done.

On that first official trip, Chukmaitov and Brooks met with Kazakhstan’s vice minister of health, deans of the country’s medical and public health schools, and hospital administrators to discuss possible projects.

In early 2008, funded by Kazakhstan’s Ministry of Health, four Kazakh health specialists came to Tallahassee for a month of intensive programs at the college, designed to familiarize them with the U.S. health system, education system and research methods. According to Chukmaitov, these specialists enjoyed the training and were able to implement what they had learned. For example, an e-mail he received from a participant indicated they’ve put together a computer lab, with an e-library that has access to major international medical journals, for the faculty and staff of their National Research Center of Urology and have had the first meeting of their Internal Review Board from the center, among other steps. As a result, the Ministry of Health requested another training in Kazakhstan.

“This way,” Brooks explained, “they were able to bring more people from all over their country.”

This summer, for two weeks Brooks, Chukmaitov and Les Beitsch, director of the college’s Center on Medicine and Public Health, lectured and held workshops for the prestigious group of 25. Chukmaitov taught research methods, research design and academic writing. Beitsch went over various public health topics, as well as how to apply for funding from major international grant organizations. Brooks provided a thorough overview of the U.S. health-care and medical-education systems, as well as how universities are relevant to scientific research.

“We have the sophisticated National Institutes of Health and other agencies that have very educated, carefully instructed people who review grants and know how to grade and rank them,” Brooks said. “The simple infrastructure needed to set up a grants system – things we take for granted as being fair or organized or orderly – just didn’t exist.”

Chukmaitov mentioned that a previous Soviet health research model was based on a planned and noncompetitive allocation of limited resources among universities and research centers. Currently, Kazakhstan’s Ministry of Health is developing a new system that will award grants to those researchers whose work is likely to get recognized and published in international peer-reviewed journals.

Brooks and Chukmaitov noted that the participants were motivated and have the talent necessary for Kazakhstan to succeed in building their new research system and be competitive on the international stage in certain biomedical and applied research areas.

“It was a very hands-on experience for them,” Chukmaitov said. “We had two big projects for them to work on in groups. During the first week they had to come up with a grant proposal that would be interesting, and on an area of research that can be generalizable, something not only relevant in Kazakhstan but that would also interest the broader international research community.

“The second week’s project was to write a paper. They had to come up with a good research question, write an introduction, then come up with a detailed outline of the methods section, of the results section, of the discussion section, of the conclusion section. The idea was to give them something they can work on after the seminar is done.”
Brooks explained why Kazakhstan’s medical community is relevant here: “The College of Medicine has a unique mission that includes not only developing a special educational model focused on primary care but, in addition, primary care that’s culturally relevant and sensitive. Even though here in Florida we don’t deal with a lot of people from the former Soviet Union, such as Kazakhs or Russians, by dealing with them as students or faculty you learn to be more culturally sensitive in caring for other peoples.”

In addition, the college shares with Kazakhstan a focus on rural health. The country boasts a total area equal to all U.S. land east of the Mississippi River – yet has a population only the size of Florida’s. Developing a primary care system for those vast underpopulated areas is difficult.

More training is planned. This fall, the college and the Center on Global Health plan to host several Kazakh medical experts, who will study the processes that major grant organizations use to score proposals and decide which applicants receive funding.