In September 2024, Burdenko Voronezh State Medical University (VSMU) will celebrate the 20th anniversary of one of its divisions, the Preventive Medicine (PM) Faculty. Back in 2004, the faculty was established as a response to the demand and need for specialists in the field of general medical care and prevention specialists who could prevent the occurrence and spread of both infectious and non-communicable diseases, and control compliance with the legislation related to consumer protection.

Twenty years ago, VSMU admitted students to the PM Faculty for the first time, and six years later, in 2010, issued diplomas to the 49 educated epidemiologists and hygienists.

History of establishment of sanitary and hygienic curricula at VSMU  

The PM Faculty's roots go back far into history of the Voronezh's medical university and are closely entwined with its evolution. In June of 1930, under the Resolution of the Council of People's Commissars of the RSFSR, the medical faculty of Voronezh University was transformed into the Voronezh Medical Institute. It consisted of only two faculties, general medical care and sanitary-hygienic [1, 2].

In 1931, Tikhon Yakovlevich Tkachev, professor and doctor of medical sciences, initiated establishment of a sanitary faculty in VSMU; professor Tkachev became the dean of this faculty and remained in this capacity for over 10 years. Tikhon Yakovlevich has an outstanding record: being one of the founders of the national healthcare system, he was the head of the Department of Central Institute for Advanced Medical Training and the Department of Healthcare Organization and History of Medicine (1941–1963) at VSMU, worked as the sanitary inspector of the People's Commissariat for Healthcare of the USSR, and a member of the editorial board of the Hygiene and Sanitation journal (1939–1940), lead an active public life and participated in the Pirogov Congresses, was appointed deputy at the Supreme Soviet of the USSR, and wrote one of the country's first textbooks on social hygiene. Tikhon Tkachev published over 120 articles, monographs, and textbooks [3, 4], and supervised preparation and defense of more than 20 theses seeking the ranks of candidates and doctors of sciences. For his scientific and pedagogical achievements, professor Tkachev received two Orders of Lenin (highest awards in the USSR) and several medals.

The curriculum of the sanitary and hygienic faculty was different from that of the general medicine faculty from the very first course. The former included higher mathematics, fundamentals of technological chemistry, communal and food hygiene, occupational hygiene, and occupational diseases. The students were given knowledge enabling them to assess the impact of environmental and industrial factors on the development of occupational pathology.

The Sanitary and Hygienic faculty existed for eleven years, but with the beginning of the Great Patriotic War of 1941–1945, priorities changed. It was merged with the Medical and Pediatric faculty with the aim to provide accelerated training to surgeons, anesthesiologists, traumatologists, infectiologists - medical professionals highly sought-after during wartime. Talented scientists and teachers continued to work at the departments; their efforts not only laid the foundation of preventive medicine in the Voronezh region but also contributed to the sciences of hygiene and epidemiology.

At VSMU, the founders of the medical and preventive care discipline were distinguished scholars M.I. Shtutzer, P.P. Mufel, E.A. Shepilevsky, and V.A. Pokrovsky.

In 1921, microbiologist and epidemiologist M.I. Shtutzer established and chaired the Department of Hygiene and Microbiology at the Medical faculty of VSMU, and founded the Voronezh Bacteriological Institute. His research advanced microbiology. M.I. Shutzer authored about 80 scientific papers; the most popular of them were "A new variety of para dysentery bacilli" and "About bacterial flora of the intestinal canal of cholera patients."

P.P. Mufel, who graduated from the Medical faculty of the Yuriev (Derpt) University in 1909, became an epidemiologist, a sanitarian (1918), a doctor of medicine (1924), a professor (1936), and an honored Scientist of the RSFSR (1947). In Voronezh, he simultaneously chaired two departments, the Department of Epidemiology (1936-1943) and the Department of Infectious Siseases (1941–1942, since 1943), and was also the vice principal of the VSMU. The research efforts of P.P. Mufel were summarized in "The experience of studying the epidemiology of malaria according to the survey of the Voronezh province" (1927), "Guide to the epidemiology of malaria" (Voronezh, 1936), "Prevention of infectious diseases in rural areas" (1945).

E.A. Shepilevsky became the first head of the department of General and Experimental Hygiene of the Medical faculty of VSMU, and held the position from November 1918 through February 1920. He published over 30 studies covering various aspects of hygiene and epizootology.

V.A. Pokrovsky graduated from the Sanitary faculty of the VSMU in 1931; he was an honored worker of the occupational hygiene sector of the Institute of Social Health of the Central Black Earth Region (1931–1933), worked as an assistant at the Department of Hygiene of VSMU, fought in the Great Patriotic War as a military doctor. After the War, he chaired the Department of Hygiene of VSMU from 1948 to 1980, and after this tenure was a professor therewith. His research efforts investigated the problems of hygiene and toxicology of organic synthesis. In 1948, he founded a scientific school studying the hygienic issues of public healthcare, and was the director of this school. V.A. Pokrovsky authored over 300 scientific works, including the "Textbook of Hygiene" (1961, 1979) for medical students [5, 6].

These were the outstanding scientists who gave rise to the faculty, enduring all the difficulties of war and post-war years, all the hardships, understaffing, lack of educational materials, unavailability of lecture halls and practical classrooms, and remaining firmly convinced that they were doing something very important. Teaching doctors, these professors shared invaluable experience and knowledge in the fields of epidemiology, hygiene, and sanitation.

The Great Patriotic War set new essential tasks before the country's healthcare system: it had to provide qualified medical assistance to the wounded, sick soldiers and commanders of the Soviet Army, ensure sanitary and epidemiological well-being of the military and civilians, and protect their health [7–9].

In wartime, VSMU trained doctors at an accelerated pace both for the Soviet Army and for civilian hospitals, and worked extensively to guarantee a good sanitary and epidemiological status overall. By the beginning of the Great Patriotic War, there was a well-organized sanitary and anti-epidemic service staffed with qualified personnel in the Voronezh Oblast.

The War became a hard test for the entire Soviet healthcare system, and especially for its sanitary and epidemiological component. The sanitary units of the Voronezh Oblast, as well as those anywhere else in the country, passed this test with honor.

When the War broke out, the epidemiological situation in Voronezh Oblast became dire: many sanitary professionals were drafted into the army, and the path of mass migration of the country's population ran through this area. The roads, railway stations, and hythes of the region were crowded with people, which raised the risk of outbreaks [10].

Despite certain adverse conditions that favored the spread of various epidemic diseases, there were no severe epidemics during the War. To a large extent, this success stemmed from the preventive nature of Soviet healthcare. Sanitary and hygienic evacuation points were opened along the migration routes, and sanitary control posts worked at large railway junctions [11].

Thanks to the active participation of all medical workers, the constant assistance rendered by the local Party and Soviet authorities as well as the general public, the sanitary and epidemiological service of Voronezh Oblast successfully discharged its responsibilities during the difficult war years, even considering lack of laboratories, disinfection equipment and transport, understaffing, inadequate supply of antibacterial drugs, disinfectants, and laboratory equipment. Throughout the entire Great Patriotic War, the sanitary and epidemiological status of the region's population remained good [12].

Medical and preventive care education, research efforts, and sanitary awareness of the population: current state

The Sanitary and Hygienic faculty was closed in 1941, and, over time, the need for medical and preventive care specialists became acute. In 2004, the city of Voronezh lacked 246 such specialists, while the mean age of those who worked in this field was 50-54 years; in other regions, the situation was similar. That need made it clear the respective faculty had to resume operation.

In 2004, the Preventive Medicine Faculty opened its doors at the VSMA named after N.N. Burdenko. From then on, the university has been teaching specialty 32.05.01, "Medical and preventive care." L.E. Mekhantieva, professor, Doctor of Medical Sciences, an Excellent Healthcare Worker, awardee of the Golden Fund of National Science exhibition, became the dean of the faculty. A.I. Potapov, General Director of the Erisman Federal Research Center, and A.S. Faustov, professor, head of the Department of General Hygiene, contributed immensely to its relaunch. Today, the MPC faculty of VSMU has trained several generations of epidemiologists and hygienists, specialists sought-after in different parts of our country. All professors teaching at the university participate in the education of highly qualified sanitary doctors, but those giving them most of their professional skills and abilities work at the Departments of the Preventive Medicine Faculty.

Currently, the head of the PM Faculty is N.Yu. Samodurova, Candidate of Medical Sciences, Associate Professor, accredited expert of the Federal Service for Supervision in Education and Science. She was in the first batch of graduates after revival of the faculty; today, under her leadership, it continues to expand and develop, and successfully carry out its primary tasks in the field of medical and preventive care education. There are 10 departments to the Faculty: the Department of Hygienic Disciplines, the Department of Dermatovenerology and Cosmetology, the Department of Infectious Diseases, the Department of Disaster Medicine and Life Safety, the Department of Medical Prevention, the Department of Microbiology, the Department of General Hygiene, the Department of Pedagogy and Humanities, the Department of Phthisiology, and the Department of Epidemiology.

One of the most important tasks set before the PM Faculty today is to popularize healthy lifestyle based on the meaningful attitude of students to their health, and to the health of the population in their further professional life. Every year, staff and students of the PM Faculty organize and take part in the conferences and events dedicated to the topics of health preservation.

In cooperation with public organizations and healthcare institutions, the faculty educates university students and schoolchildren about prevention of infectious and mass non-communicable diseases in the city of Voronezh and Voronezh Oblast [13–16].

The Department of Hygienic Disciplines of VSMU was opened in February of 2007. From the day of its foundation to the present, the department has been chaired by Yu.I. Stepkin, Honored Physician of the Russian Federation, professor, Doctor of Medical Sciences, and chief medical officer at the Center for Hygiene and Epidemiology in Voronezh Oblast. The opening of this Department was a step towards creating the base to train highly qualified specialists in various fields of hygiene (food hygiene, hygiene among children and adolescents, labor, communal, and radiation hygiene), study the factors of the environment and habitat, working conditions, personal hygiene, and investigate the methods of control and prevention of non-communicable and infectious diseases. The Department works only for the students of the Preventive Medicine Faculty.

Currently, the Department of Hygienic Disciplines is one of the specialization departments of the Faculty; it provides fundamental knowledge and professional skill training to the Rospotrebnadzor personnel in the region.

Working with medical professionals in the context of the general hygiene curriculum, future specialists participate in control and supervisory activities, learn the specifics of operation of enclosed spaces, buildings, and equipment in the real-life conditions of businesses selling goods and/or rendering services. In the testing laboratory center, they prepare samples and do the subsequent laboratory testing under the guidance of mentors, and perform instrumental measurements directly at the facilities.

The Department of Dermatovenerology and Cosmetology first opened in 1918. It was part of the Medical Faculty of Voronezh State University, founded on the basis of the Yuriev University, which is the predecessor of the modern VSMU named after N.N. Burdenko.

G.I. Koppel, professor, otolaryngologist, was the first head of the department. From 1919 onwards, it was chaired by professor E.F. Friedman (1919–1920), professor N.N. Burdenko (1920), assistant A.V. Rossov (1920–1925), professor V.M. Boikov (1925–1927), surgeon professor S.S. Solovyov (1927).

From 1996 to the present, the Department of Dermatovenerology and Cosmetology is managed by L.A. Novikova, Doctor of Medical Sciences, professor.

Today, the staff of the department actively participates in educational work. They continuously improve educational and methodological materials, and master the new teaching methods.

In terms of research, the department seeks to refine the protocols of pathogenetic therapy of chronic dermatoses.

Through the years, the team of the department has prepared and defended seven doctoral and more than 40 candidate theses, published five monographs, over 40 methodological manuals (five of them approved by the Curriculum Division), and five collections of scientific papers. Every year, the results of the fundamental and practical research efforts are published and reported at conferences, congresses, forums of various levels, including international events. The department maintains close scientific and practical ties with the leading research institutions of the country. 

The Department of Infectious Diseases has grown from the infectious diseases course lectured at the infectious diseases division of Voronezh State University in 1921. In 1923, the division was reorganized into the Department of Infectious Diseases; the first head thereof was M.I. Shtutzer, professor, who identified a new type of dysentery bacteria, subsequently named after him.

From 2003 to 2021, the department was chaired by Yu.G. Pritulina, professor, Doctor of Medical Sciences, Honored Physician of the Russian Federation, Honorary Professor of the VSMU named after N.N. Burdenko (2022). Under her leadership, the team was actively studying the immunological aspects of infectious diseases, the results of this work reflected in three candidate theses and over 350 scientific papers.

In 2021, by the decision of the Academic Council of VSMU, the Department of Infectious Diseases was merged with the Department of Pediatric Infectious Diseases, the latter launched in 1953 as an independent unit operating in the 7th Children's Clinical Hospital of Voronezh. V.N. Goldina, professor, was the first head of the new structure. The staff of the department studied the impact of infectious diseases on the development of somatic pathology in children and reported the results of this work in five collections of scientific papers and over 127 other publications.

S.P. Kokoreva, associate professor, Doctor of Medical Sciences, became the head of the joint Department of Infectious Diseases. Over the years, the unit prepared three candidate theses, published collections of scientific papers, organized an ongoing research workshop for students, and has been fostering academic competitions, including international ones. The department continues to develop its cooperation with the leading universities of the country, and its staff ceaselessly integrates advanced scientific achievements into the treatment process, and formulates clinical innovations within its specialization.

The Department of Disaster Medicine and Life Safety (DM and LS) is the oldest among the departments of this profile in the country. The unit, which studies the medical and sanitary aspects of disaster relief efforts (both peacetime and wartime), is an integral part of military medical science and practice. The highly qualified staff of the department has been continuously working to further refine the educational process and improve the quality of training of specialist doctors; here, they are taught in the traditions founded by outstanding Russian scientists, prominent figures in the fields of military and civilian healthcare: N.I. Pirogov, N.N. Burdenko, N.I. Leporsky, N.A. Kurshakov, A.I. Pokrovsky, E.A. Shepilevsky, D.M. Lavrov, A.A. Afanasyev, A.G. Rusanov, etc.

In 2008, medical universities of the country launched the mobilization training departments covering general healthcare and disaster medicine in lieu of the closed military training departments. At VSMU, this mobilization training department was named the Department of Disaster Medicine and Life Safety in 2014 [17].

The staff of the department organizes scientific and practical conferences at the university on a regular basis. These conferences are attended by the students from all medical faculties and courses, as well as residents of the Department of Anesthesiology, Intensive Care, and Emergency Medicine of the VSMU's Continued Professional Education Institute. Such professional exchange enables development and adoption of various approaches to emergency medical care in the context of simulated terrorist attacks, hostage situations, etc. [18].

The Department of Medical Prevention opened its doors in June 2021. From the beginning and to the present day, it has been chaired by T.N. Petrova, Doctor of Medical Sciences. The establishment of a department of this profile is the first step towards creating a unique platform for training preventive medicine specialists.

Currently, the department is an actively developing system of fundamental and practical medical and preventive education, paying special attention to instilling moral values and personal qualities, since character building is one of the most important elements of the pedagogical activity at a university. The staff of the department constantly takes students on tours to the patriotic and most significant places of Voronezh.

Today, educating and shaping a competent, highly educated doctor is not easy, but doable. The staff of the Department of Medical Prevention is ready to work tirelessly to help students make the right choice, find the right guidelines, and live a life benefiting themselves and others.

The Department of Microbiology consists of 16 professors lead by A.M. Zemskov, Honored Scientist of the Russian Federation, Academician of the Russian Academy of Sciences, professor, Doctor of Medical Sciences. A.M. Zemskov chaired the department in 1985, continuing the VSMU's glorious traditions microbiology research. Over the years, the department's team prepared more than 100 candidate and doctoral theses, made three scientific discoveries, registered over 20 patents for inventions, published over 60 monographs, 32 textbooks and confidential guides, 11 encyclopedias, manuals, reference books, submitted more than 700 articles to journals, with over 70 of them published in international press.  A school of clinical immunology has been established on the basis of the department.

The list of achievements of the department includes the development and testing of mathematical methods of interpretation of immunograms; clinical assessment of the immune status involving lesser immunotherapy; optimization of targeted correction protocols based on the inversion analysis of immunograms; approbation of stepwise mono-, combined, alternative, complex, immuno-metabolic therapy; approbation of a simplified multilevel method of assessment and treatment of immunopathology (electronic physician assistant) using proprietary computer programs.

The Department of General Hygiene, like the university, has a 105-year history.    

The academic and educational traditions that have developed in the course of the university's evolution enabled creation of a well-established hygiene school of thought. At different times, the department, its heads and staff alike, did everything in their power to carry out relevant scientific research, and the results of their efforts are inscribed in the pages of the history of national hygiene and preventive medicine. A special note should be made about the thrice-republished Hygiene textbook and the Geohygiene fundamental work by V.A. Pokrovsky, Honored Scientist of the RSFSR, professor. A significant contribution to occupational hygiene was made by Professor A.S. Faustov [19], who continued investigation of the influence of harmful production factors at the Sintezkauchuk plant. There has been written a number of specialized textbooks for students. In 2007, the department opened a new page: then, the position of its head was taken by Faustov's student V.I. Popov, professor, corresponding member of the Russian Academy of Sciences, Honored Worker of Higher Education of the Russian Federation (2022), Deputy Chairman of the Expert Council of the Higher Attestation Commission under the Ministry of Education and Science of the Russian Federation (medical prevention problems), member of two theses examination councils for specialization 3.2.1 "Hygiene," Deputy Editor-in-Chief of the peer-reviewed scientific and practical journal "Russian Bulletin of Hygiene", member of the editorial boards and councils of eight scientific journals.

The department began to address new scientific problems, including aging, students' health, and modern health-saving and health-shaping technologies. The staff developed Standards for Assessment of Physical Development of Children and Adolescents in the Russian Federation; since 2019, 10 monographs have been published on this topic. Professional burnout among medical workers was another subject investigated, with formulation of the basis thereof. In the field of bibliography, the department has published indexes of abstracts of hygiene-related theses defended from 1985 to 2010. Together with other educational organizations and scientific institutions, the team works on the development of products with therapeutic and preventive properties, and those possessing pre-designed functional characteristics. The Voronezh Nutrition Monitoring Center has been established at the department.

Today, the Department of General Hygiene is a well-coordinated group of like-minded people who fully devote themselves to the education and training of students. Their pedagogical work is characterized by continuity, which allows claiming establishment of the Voronezh hygiene school of thought. The department has strong ties with the leading Russian research institutes and centers, and participates in the work of the Federal and local problem commissions, and theses review councils. Specialists of the department hold positions at the editorial boards of peer-reviewed journals; they actively participate in the work of the Voronezh regional branch of the Society of Hygienists, Toxicologists, and Sanitary Doctors, a Russian national non-governmental organization.

The Department of Phthisiology, like many other VSMU's oldest departments, originates in the Yuriev University, which was evacuated to Voronezh. Professor P.I. Filosofov was the founder of this department.

In 1969, Therapy Department of VSMU launched a tuberculosis course, and in 1970, it became an independent structural unit, the Department of Tuberculosis, chaired by N.S. Tyukhtin, who remained in this capacity 2002. Through these years, the team investigated pleural diseases, with the results of the respective efforts presented in two doctoral and five candidate theses, and 265 scientific papers of different levels.

In 1977, N.S. Tyukhtin founded the first specialized department of pleural pathology in the USSR on the basis of the Voronezh City Clinical Tuberculosis Dispensary, where patients with pleural effusions were diagnosed and studied, and students and doctors received extensive training.

Subsequently, from 2002 to 2008, the Department of Tuberculosis was headed by N.A. Stogova, Doctor of Medical Sciences, professor; after her tenure, by the decision of the Academic Council of VSMU, the Department of Tuberculosis was merged with the Department of Epidemiology. The new department was named the Department of Epidemiology and Tuberculosis, with a phthisiology course for the university's Continued Professional Education Institute. N.P. Mamchik, Doctor of Medical Sciences, was the gead of this department.

 On September 1, 2011, the Department of Phthisiology was made a separate structural unit, chaired by O.V. Velikaya, Doctor of Medical Sciences, associate professor, author of over 100 scientific papers, and holder of seven patents for inventions. Two candidate theses were defended under her guidance.

For excellence in the field of national education, President of the Russian Academy of Natural Sciences awarded VSMU's Department of Phthisiology with a diploma and the Golden Department of Russia medal. Apart from educational and research activities, the Department of Phthisiology introduces advanced methods of anti-tuberculosis care into practice.

The Department of Epidemiology was established on December 29, 2005. The main task of the department was to train specialists (epidemiologists) for Rospotrebnadzor institutions, the Center for Hygiene and Epidemiology in the Voronezh Region, and medical organizations. The department began teaching on September 1, 2006. The head of the department is N.P. Mamchik, a doctor of the highest qualification category, Honored Doctor of the Russian Federation, Excellent Healthcare Worker, Excellent Worker of the State Sanitary and Epidemiological Service of Russia, Honorary Professor of the Burdenko Voronezh State Medical University, Honorary Professor of the F.F. Erisman Federal Scientific Center for Hygiene.

Currently, the Department of Epidemiology is a structural unit of the Preventive Medicine Faculty, a specialization department that trains epidemiologists. It caters to students of the said faculty and other faculties of VSMU.

The department is actively involved in research activities, the results of which are reflected in many publications; it also organizes conferences, intra- and interuniversity competitions. The main areas of scientific research are ensuring the sanitary and epidemiological well-being and safety of the population, health risks assessment, epidemiology and prevention of infectious and non-communicable diseases. The results of these efforts are reported in nine candidate and one doctoral theses, eight textbooks, more than 50 educational and methodological manuals, and 31 collective monograph.

CONCLUSION

The joint activity of the departments forming the Preventive Medicine Faculty adequately fulfills the main task thereof, which is to train highly qualified personnel to federal educational standards and professional standards, capable of responding to the current challenges demands of the society. From 2011 to 2022, more than 108 graduates of the faculty were employed at the Center for Hygiene and Epidemiology in the Voronezh Oblast and its branches, and 99 were invited to work in the regional Rospotrebnadzor body; 81% of them continue working, with some having joined the faculty and, ensuring continuity through generations. The feedback from the employer received through a dedicated survey allows assessing satisfaction with the hires, and factor in the specifics thereof into the curricula. Graduates of the faculty have increased the staffing rate of Rospotrebnadzor institutions in the Voronezh Oblast to 90.4%, reduced the share of employees of retirement age from 34% to 16%, and raised the proportion of employees under the age of 35 from 6% to 48%.

The data and information on the establishment and development of the Preventive Medicine Faculty of VSMU given in this article confirm the significance of this discipline in the structure of medical education, adequate level of training and high qualifications of the graduates, and the demand for them not only in the institutions of Voronezh Oblast but in the Russian Federation on the whole.

The development of the departments constituting the Preventive Medicine Faculty through improvement of the equipment and material supply, educational and methodological base, advanced training of researchers and professors, and continued cooperation between clusters contribute to the faculty's growth and development evolution. And whatever difficulties may stand in the way, the close-knit team thereof will overcome.