i. zogadi debulebebi · sisxlzarrvta qirurgebsi codnis ertnairi donisa da setanxmebuli bazisuri...

I. zogadi debulebebi 1. programis mizani da amocanebi

1.1. Sesavali

specialoba “sisxlZarRvTa qirurgia” moicavs sisxlZarRvebis da limfuri sadinarebis daavadebebis diagnostikas, marTvas da qirurgiul mkurnalobas. sisxlZarRvTa qirurgis kompetenciaSi ar Sedis qalasSida, gulis mkvebavi da gulTan anatomiurad axlos ganlagebuli magistraluri sisxlZarRvebis (aswvrivi aorta, filtvis arteria da venebi) daavadebebis qirurgiuli mkurnaloba.

saqarTveloSi sisxlZarRvTa qirurgiis specialobis maZiebeli SeiZleba iyos Sesabamisi umaRlesi samedicino ganaTlebis mqone diplomirebuli medikosi, romelsac gavlili aqvs diplomisSemdgomi ganaTlebis (profesiuli mzadebis)/rezidenturis programa sisxlZarRvTa qirurgiaSi. rezidenturis programa specialobiT “sisxlZarRvTa qirurgia”-ia momzadebulia evrokavSiris qveynebSi samedicino specialistebis mzadebis standartebis gaTvaliswinebiT, amasTan, adaptirebulia Cveni qveynisTvis.

programam rezidentebs unda Seuqmnas SesaZlebloba kurikulumze dafuZnebuli codnisa da klinikuri unar-Cvevebis siRrmiseulad SeswavlisaTvis, sabaziso da gamoyenebiTi qirurgiis aTvisebisa da klinikuri Cvevebis srulyofisaTvis. garda sisxlZarRvTa qirurgiis elementebisa, programa iTvaliswinebs daxelovnebas zogad qirurgiasa da mis momijnave dargebsa da subspecialobebSi.

rezidenturis programa specialobaSi “sisxlZarRvTa qirurgia” momzadebulia saqarTvelos angiologebis da sisxlZarRvTa qirurgebis asociaciis ganaTlebisa da mecnierebis komisiis mier da SeTanxmebulia saqarTvelos qirurgTa asociaciis gamgeobasTan. programis momzadebisas gamoyenebuli iyo Semdegi wyaroebi:

UEMS document D9421, d. d. November 1993 - “Definition and Specifications of Vascular Surgery”; “Chapter or Training of Medical Specialists in the EU. Requirements for the Specialty Vascular Surgery”,

1995 Bulletin of the American College of Surgeons Vol. 74, Vol 6, Pages 6-7, June 1989 Humphreys JW Jr: General surgery redefined in the era of specialization. Bull Am Coll Surg, 69:4-6, 1984 http://www.surgeons.org.uk/ http://journalreview.org/ http://www.americansurgical.info/ http://www.aofoundation.org/ http://www.facs.org/ http://www.uems.net/ http://www.uemssurg.org/

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1.2 mizani da amocanebi:

sisxlZarRvTa qirugiaSi diplomis Semdgomi momzadebis programis mizania

kvaificiuri eqimi – “sisxlZarRvTa qirurgis” momzadeba. Pqveynebs Soris adamianuri resursebis gazrdili mobilobis fonze mniSvnelovania

sisxlZarRvTa qirurgebSi codnis erTnairi donisa da SeTanxmebuli bazisuri standartebis qona, miuxedavad imisa, Tu romel qveyanaSi eqneba miRebuli ganaTleba sisxlZarRvTa qirurgs.yovelive zemoTqmulis gaTvaliswinebiT saqarTveloSi “sisxlZarRvTa qirurgiaSi” sarezidento programis mizania:

rezidentis codnisa da daxelovnebis harmonizacia; uzrunvelyofa imisa, rom rezidentma gaiaros stuqturirebuli treningis

programa; uzrunvelyofa sisxlZarRvTa qirurgis iseTi teqnikuri daxelovnebisa,

rom mis praqtikaSi avadobisa da sikvdilianobis done ar gansxvavdebodes normisagan;

kompetenciis im minimaluri donis garantia, romelic mniSvnelovania pacientisTvis, samkurnalo dawesebulebisa da TviT rezidentisaTvis, anu momavali sisxlZarRvTa qirurgisTvis.

“sisxlZarRvTa qirurgiaSi” sarezidento programis amocanaa specialobis SigniT srulfasovani ganaTlebis miRweva. programis ganmaxorcielebeli pirebi uzrunvelyofen sazogadoebisaTvis am momsaxurebis miwodebas.

specialistis momzadebis procesi unda warimarTos mdidari saganmanaTleblo gamocdilebisa da mravalprofiluri klinikuri bazebis pirobebSi. programas gaaCnia sami ZiriTadi komponenti: kurikulumi, samecniero saqmianoba da praqtikuli saqmianoba, romlebic struqturirebuli arian imgvarad, rom uzrunvelyon codnis, unar-Cvevebis, damokidebulebisa da klinikuri gansjis unaris Camoyalibeba, rac aucilebeli pirobaa rogorc sisxlZarRvTa, aseve zogadqirurgiuli praqtikisaTvis. programis nebismieri akademiuri komponenti SesabamisobaSi unda modiodes zemoT aRweril mizanTan da amocanebTan.

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2. saeqimo specialobis - “sisxlZarRvTa qirurgia” aRweriloba

2.1. specialobisa da specialistis gansazRvreba (definicia)

sisxlZarRvTa qirurgia ganviTarda rogorc zogadi qirurgiis erT- erTi mimarTuleba

da 60-iani wlebis bolosTvis evropaSi ukve miRebuli iyo rogorc mkafiod gansazRvruli disciplina da kerZo specialoba.

UEMS–is (medikosi specialistebis evropuli kavSiris) ganmartebiT, sisxlZarRvTa qirurgia aris “klinikuri da samecniero disciplina, romlis sagans warmoadgens arteriebis, venebisa da limfuri ZarRvebis (anu vaskulaturis) daavadebebis diagnozi, mkurnaloba da prevencia”, xolo vaskuluri qirurgi aris “vaskuluri mecnierebebis specialisti, romelic aRWurvilia, raTa vaskuluri daavadebis mqone pacients gauwios sruli menejmenti”.

specialoba “sisxlZarRvTa qirurgia” Seicavs sisxlZarRvebis da limfuri sadinarebis daavadebis diagnostikas, marTvas da qirurgiul mkurnalobas. sisxlZarRvTa qirurgis kompetenciaSi ar Sedis qalasSida, gulis mkvebavi da gulTan anatomiurad axlos ganlagebuli magistraluri sisxlZarRvebis (aswvrivi aorta, filtvis arteria da venebi) daavadebebis qirurgiuli mkurnaloba..

rezidenturis programa sisxlZarRvTa qirurgiaSi minimaluri zogadqirurgiuli komponentebis garda (rezidenturis pirveli 2 weli) moicavs minimum Semdeg ZiriTad komponentebs: emboleqtomia, Tromboemboleqtomia, endartereqtomia, plastika (maT Soris mag. profundoplastika), Suntireba (autoveniT, proTeziT), veneqtomiebi, hemodializisTvis sisxlZarRvovani midgomis (arterio-venuri fistula, arterio-venuri Suntireba) Seqmnis operaciebi, amputaciebi da operaciebi sisxlZarRvebze zewolis dros (dekompresia). bolo ramdenime wlis ganmavlobaSi ufroda ufro did mniSvnelobas iZens endovaskularuli Carevebi sixZlarRvebze, rac Tanamedrove sisxlZarRvTa qirurgiis moqmedebis sferos warmoadgens, amitom intervenciulma radiologiam ufro meti asaxva hpova rezirenturis programaSi.

2.2. specialistis profesiuli zogadi codna sisxlZarRvTa qirurgma unda icodes:

saqarTvelos kanoni “janmrTelobis dacvis Sesaxeb”

saqarTvelos kanoni “saeqimo saqmianobis Sesaxab”

saqarTvelos kanoni “pacientis uflebebis Sesaxeb”

qirurgiuli saqmianobis iuridiuli aspeqtebi;

profesiuli pasuxismgeblobis aspeqtebi, malpraqtika;

qirurgiuli praqtikis bioeTikuri sakiTxebi;

sikvdilis konstatacia da masTan dakavSirebuli administraciuli RonisZiebebi;

organoTa donaciis principebi;

pacientTa usafrTxoebis principebi;

qirurgiuli mkurnalobis xarisxi da misi kontrolis proncipebi;

qirurgiuli samuSao garemos usafrTxoeba, profesiuli mavneobis sakiTxebi;

qirurgiuli daxmarebis arsi, misi organizacia da menejmenti;

kritikul SemTxvevaTa klinikuri marTva; qirurgiis ekonomikuri aspeqtebi;

zogadi samedicino menejmenti (krizisuli situaciebis marTva, drois menejmenti, jgufuri muSaobis principebi);

qirurgiuli avadmyofis informirebuli Tanxmoba;

riskis Sefaseba da skalirebis sistemebi qirurgiul praqtikaSi, qirurgiuli gadawyvetilebis miReba;

mtkicebulebebze dayrdnobili praqtikis interpretacia;

inovaciuri teqnologiebisa da axali samkurnalo saSualebebis kritikuli analizi;

kolegebTan, pacientebTan, maT naTesavebTan da kanonier warmomadgenlebTan urTierTobis aspeqtebi;

verbaluri, werilobiTi da eleqtronuli komunikaciebi;

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konfliqtebis gadawyveta da menejmenti;

sakiTxisa da SemTxvevisadmi multidisciplinuri midgomis principebi;

monacemTa Segroveba, skrininguli programebi, statistika da sainformacio teqnologiebi qirurgiaSi;

klinikuri auditi da samedicino dokumentaciis warmoebis wesebi;

mkurnalobis uwyvetobisa da pacientTa gadacemis principebi;

samecniero principebi qirurgiaSi, klinikuri kvlevebis dizaini da analizi;

operaciis fsiqologiuri efeqtebi da mZime danakargebi, reabilitacia;

2.3. specialistis zogadi unar-Cvevebi sisxlZarRvTa qirurgs unda SeeZlos

qirurgiul mdgomareobaTa marTva, sabaziso da klinikur codnaze dafuZnebuli gamcdilebis gamoyenebiT;

uCvenos Sesabamisi unar-Cvevebi im qirurgiuli teqnikis gamoyenebiT, romelsac unda flobdes kvalificiuri qirurgi;

aCvenos kritikuli azrovnebis unari qirurgiuli gadawyvetilebebis miRebisas, gansakuTrebiT, rodesac avadmyofi imyofeba sicocxlisaTvis saSiS mdgomareobaSi;

warmarTos eTikuri, iuridiulad dasabuTebuli gansja, rac Seefereba maRali kvalifikaciis eqim specialists;

efeqturad iTanamSromlos kolegebTan da sxva specialobis eqimebTan;

aswavlos da gauziaros SeZenili codna da praqtikuli gamocdileba kolegebs, umcros rezidentebs, studentebs da jandacvis sferos sxva muSakebs;

miawodos pacients da misi ojaxis wevrebsa da axloblebs maTi janmrTelobisaTvis aucilebeli saWiro rekomendaciebi;

aCvenos mzadyofna uwyveti profesiuli ganaTlebisaTvis, rac erT-erTi mniSvnelovani momentia qirurgis kvalifikaciis mudmivi amaRlebisa da srulyofisaTvis;

aCvenos samecniero kvlevebis, naSromebis adekvaturi aRqmisa da interpretaciis unari, amavdroulad TviTonac SeeZlos samecniero kvlevis warmarTva an masSi aqtiuri monawileoba;

ganaviTaros liderobisa da administraciuli unarebi;

pativi sces pacientis da maTi ojaxis saWiroebebs, aRmouCinos da warmarTos qirurgiuli daxmareba maTi saWiroebidan gamomdinare.

arsebiTi SesaZleblobebi, romelic unda gaaCndes rezidenturis kursdamTavrebuls,

mdgomareobs akademiur da moqmedebis SesaZleblobebSi da unarebSi, rasac Tan unda erTvodes fizikuri, kogniciuri da qceviTi Taviseburebebis Camoyalibeba da ganviTareba. es ukanaskneli moicavs Semdeg komponentebs: inteleqtur SesaZleblobebs(konceptualuri, integraciuli da xarisxobrivi SesaZleblobebi, romlebic aucilebelia diagnozis dasmisa da klinikuri problemebis gadaWrisaTvis); eqimis moqmedebis qceviT da socialur aspeqtebs, komunikaciur unar-Cvevebs, motorul Tavisuflebas da sensoruli sferos specifikur ganviTarebas. zemoT CamoTvlili Cvevebi unda ganiviTaros TiToeulma rezidentma sisxlZarRvTa qirurgma, raTa adeqvaturi saSualeba mieces SeZenili profesiuli codnisa da gamocdilebis gamoyenebisaTvis.

2.4. daavadebebis, paTologiuri mdgomareobebis CamonaTvali, romelTa klinikas, diagnostikas, mkurnalobasa da profilaqtikasmoicavs sislZRavTa qirurgia:

sisxlZarRvTa qirurgia:

aTerosklerozi

aorto-arteriopaTiebi (marfanis sindromi, ehrler-danlosis sindromi, kistozuri medialuri nekrozi, fibrokunTovani displazia, arteriomegalia, daklakniloba (kinkingi);

aorto-arteriiti, vaskulitebi;

adventicialuri kistozuri daavadeba;

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sisxlZarRvis kedlis inficireba;

koarqtacia, anevrizma, ganSreveba;

diabeturi mikro- da makroangipaTia, arteriis media Sris kalcifikacia (menkenbergis sklerozi);

sisxlZarRvis kedlis dazianebebi sistemuri daavadebebis dros;

sisxlZarRvis kedlis sxivuri dazianebebi;

sisxlZarRvis kedlis dazianebebi intravenur narkotikebze damokidebulobis dros;

sisxlZarRvebis eqstravazaluri kompresia;

sisxlZarRvebis travmuli dazianebebi;

Tandayolili arteriuli, venuri da arterio-venuri malformaciebi;

sisxlZarRvebis Trombozebi da emboliebi;

sisxlZarRvovani simsivneebi.

hiperkoagulaciuri mdgomareobebi, memkvidruli da SeZenili hiperkoagulaciuri mdgomareobebi (Trombofiliebi);

hemostazis darRvevebi sisxlZarRvebis daavadebebis dros;

iSemiasTan dakavSirebuli organoTa disfunqcia

simptomuri hipertenziebi

kidurebis vazospasturi daavadebebi (angiotrofonevrozebi);

portaluri hipertenzia;

sisxlZarRvovani genezis mamakacTa impotencia;

mcire menjis venuri Segubebis sindromiT gamowveuli qalTa

seqsologiuri darRvevebi;

2.5. laboratoriul-instrumentuli gamokvlevebis CaminaTvali, romelTa Sedegebis interpretacia da klinikuri Sefaseba unda SeeZlos sisxlZarRvTa qirurgs:

koagulogramis maCveneblebis Sefaseba da interpretacia;

lipiduri cvlis maCveneblebis Sefaseba da interpretacia;

vazoaqtiuri hormonebis maCveneblebis Sefaseba da interpretacia;

sisxlZarRvTa anTebiTi daavadebebisaTvis damaxasiaTebeli laboratoruli testebis maCveneblebis Sefaseba da interpretacia.

transkutanuri oqsimetria;

lazeruli floumetria;

birTvul-magnitur-rezonansuli gamokvleva (angiografia) ;

spiraluri kompiuteruli gamokvleva (angiografia);

digitaluri (substraqciuli) angiografia.

2.6. diagnostikuri da samkurnalo manipulaciebi, romelTac unda flobdes sisxlZarRvTa qirurgi:

ultrabgeriTi doplerografia;

dupleqssonografia;

TcPO2-metria

standartuli angiografia:

- aorto-arteriografia;

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- flebografia.

sisxlZarRvTa palpacia;

sisxlZarRvTa auskultacia

sisxlZarRvSida intervenciebi:

1. centraluri venebis (barZayis, laviwqveSa, Sida sauRle) kaTeterizacia;

2. barZayis da mxris arteriebis kaTeterizacia;

3. kaTeteriT mimarTuli Trobmolizisi;

4. kava-filtrebis Cayeneba**;

5. sisxlZarRvebis balonuri angioplastika**;

6. sisxlZarRvovani anomaluri da SeZenili paTologiuri warmonaqmnebis embolizacia**;

7. sisxlZarRvis sanaTuris stentireba**;

8. endovaskularuli protezireba**;

9. sisxlZarRvis meqanikuri rekanalizacia**.

SeniSvna:

- meTodis sruli aTviseba aucilebelia;

** - sakmarisia meTodis principebis Seswavla.

sisxlZarRvTa qirurgiuli teqnika

sisxlZarRvebis gamoyofa da maTi sanaTuris kontroli (damWerebiT an turniketiT):

intraoperaciuli sisxldenis kontrolis meTodebi: arteriotomia/venotomia;

sisxlZarRvis nakeris teqnika:

_ “bolo boloSi”;

_ “bolo gverdSi”;

_ “gverdi gverdSi”;

kedlis gverdiTi plastika.

sisxlZarRvebis proTezireba da Suntireba auto- da sinTeturi SemcvlelebiT;

sisxlZarRvis replantacia da reimplantacia;

sisxlZarRvSida manipulaciebi sxvadasxva saxis kaTeterebiT;

sisxlZarRvis rekonstruqciis Sefaseba:

_ intraoperaciuli angiografiiT.

mikroqirurgiuli teqnikis Seswavla saoperacio lupis da mikroskopis gamoyenebiT:

_ mcire yalibis sisxlZarRvebis plastika;

_ interfascikularuli neiroplastika.

sisxlZarRvTa qirurgiis kerZo sakiTxebi:

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1. aorta-TeZos da kidurebis arteriebis maokluzirebeli daavadebebis

diagnostika da mkurnaloba; 2. aortis, magistraluri da periferiuli arteriebis anevrizmebis da ganSrevebis diagnostika da mkurnaloba; 3. aortis braqiocefaluri totebis (saZile, laviwqveSa, usaxelo da xerxemlis arteriebi) maokluzirebeli daavadebebis diagnostika da mkurnaloba; 4. Tirkmlis arteriebis maokluzirebeli daavadebebis diagnostika da

mkurnaloba; 5. simptomuri hipertenziis sxva formebis (feoqromocitoma, konis daavadeba, aortis koarqtacia, koarqtaciuli sindromi) diagnostika da mkurnaloba; 6. visceraluri iSemiis diagnostika da mkurnaloba; 7. gulmkerdidan gamosvlis sindromebis diagnostika da mkurnaloba; 8. kidurebis mwvave arteriuli gauvalobis diagnostika da mkurnaloba; 9. diabeturi angiopaTiis da diabeturi terfis diagnostika da mkurnaloba; 10. sisxlZarRvTa qirurgiis garTulebebis diagnostika da mkurnaloba; 11. sisxlZarRvebis travmuli dazianebebis diagnostika da mkurnaloba,

samxedro-savele qirurgiis principebi; 12. qveda kidurebis qronikuli venuri ukmarisobis diagnostika da

mkurnaloba;

13. Rrma venebis Trombozebis da filtvis arteriis emboliis diagnostika da mkurnaloba; 14. mwvave da qronikuli limfedemis diagnostika da mkurnaloba; 15. kidurebis amputaciis Cvenebebi da qirurgiuli teqnika;

16. sisxlZarRvis kedlis araaTerosklerozuli dazianebebis diagnostika

da mkurnaloba:






sisxlZarRvTa eqstravazaluri kompresia;

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sisxlZarRvovani simsivneebi;



17. kidurebis vazospasturi daavadebebis (angiotrofonevrozebi) diagnostika da mkurnaloba;

18. Tandayolili arteriuli, venuri da arterio-venuri malformaciebis diagnostika da mkurnaloba;

19. hemostazis darRvevebis diagnostika da mkurnaloba sisxlZarRvebis daavadebebis dros;

20. simpateqtomiebis Cvenebebi da qirurgiuli teqnika periferuli sisxlZarRvebis daavadebebis dros; 21. hemodializisTvis arterio-venuri anastomozebis da Suntebis Seqmnis qirurgiuli teqnika; 22. portaluri hipertenziisdiagnostika da mkurnaloba; 23. sisxlZarRvovani genezis mamakacTa impotenciis diagnostika da mkurnaloba; 24. mcire menjis venuri Segubebis sindromiT gamowveuli qalTa seqsologiuri darRvevebis diagnostika da mkurnaloba; 25. pacientis operaciuli riskis dadgena; 26. operaciis wina- da Semdgomi periodebis marTva;

27. kidurebis qronikuli arteriuli da kritikuli iSemiis stadiebis dadgena (fontenis klasifikaciiT) fizikaluri gasinjviT, klinikuri niSnebiT da arainvaziuri gamokvlevebis monacemebiT;

28. kiduris mwvave arteriuli gauvalobis stadiis dadgena transatlantikuri saerTaSoriso asociaciebis SemTanxmebeli komitetis (TASC) klasifikaciiT;

29. kiduris mwvave arteriuli gauvalobis gamomwvevi mizezis dadgena da misi mkurnaloba;

30. kidurebis sisxlZarRvebis maokluzirebeli procesis da travmis lokalizaciis dadgena fizikaluri gasinjviT, klinikuri niSnebiT da arainvaziuri gamokvlevebis monacemebiT;

31. kidurebis kritikuli iSemiis mkurnalobis taqtikis SerCeva; kritikuli iSemiis dros tkivilis kontroli;

32. kidurebis kritikuli iSemiisTvis saWiro samkurnalo preparatebis moqmedebis meqanizmis, dozirebis da farmakodinamikis codnis floba;

33. kidurebis kritikuli iSemiis medikamentozuri mkurnaloba;

34. kidurebis kritikuli iSemiis dros prostanoidebis intravenuri infuziis Catareba;

35. kidurebis kritikuli iSemiis antikoagulanturi da Trombolizuri Terapia hemostazis laboratoruli kontroliT;

36. iSemiuri kiduris revaskularizacis (reperfuziis an ~CarTvis~) sindromis diagnostika da mkurnaloba;

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37. kidurebis kritikuli iSemiis mkurnalobis Sefaseba fizikaluri gasinjviT, klinikuri niSnebiT da arainvaziuri gamokvlevebis monacemebiT;

38. kritikuli iSemiis dros pirveladi amputaciis Cvenebis dadgena;

39. kiduris amputaciis donis dadgena arainvaziuri sisxlZarRvovani diagnostikis meTodebiT (doplerografia, transkutanuri oqsimetria);

40. kiduris iSemiis xangrZlivobasgan damokidebuli qirurgiuli Carevis warmatebis an warumateblobis prognozireba;

41. kritikuli iSemiis da mwvave arteriuli gauvalobis dros revaskularizaciis taqtikis arCeva;

42. qirurgiuli Carevis Semdeg rekonstruirebuli arteriuli segmentis gamavlobis dadgenaarainvaziuri sisxlZarRvovani diagnostikis meTodebiT (doplerografia, dupleqssonografia);

43. qvemo kidurebis venuri ukmarisobis stadiis dadgenaCEAP-is klasifikaciis mixedviT;

44. qvemo kidurebis Rrma venebis, qvemo Rru da TeZos venebis Trombozis ganviTarebis gamomwvevi mizezebis da risk-faqtorebis dadgena, antiTrombuli profilaqtika;

45. zemo kidurebis Rrma venebis da iRliis-laviwqveSa venuri segmentis (pejet-Sreteris sindromi) Trombozis ganviTarebis gamomwvevi mizezebis dadgena, antiTrombuli profilaqtika;

46. memkvidruli da SeZenili Trombofiliebis klinikur-laboratoriuli diagnostika, Trombozebis ganviTarebis profilaqtika, mkurnalobis taqtikis SerCeva;

47. zemo Rru venis sindromis gamomwvevi mizezebis dadgena da mkurnalobis taqtikis SerCeva;

48. Rrma venebis Trombozis da filtvis arteriis emboliis ganviTarebis profilaqtika sxvadasxva klinikur situaciebSi risk-faqtorebis gaTvaliswinebiT (qirurgiuli operacia, orsuloba, onkologiuri daavadeba da sxv.);

49. qvemo kidurebis Rrma venebis Trombozis diagnostika fizikaluri gasinjviT, diferenciuli diagnostika;

50. Rrma venuri Trombozebis diagnostika ultrabgeriTi doplerografiiT da dupleqssonografiiT;

51. venis sanaTurSi ganlagebuli Trombuli masis embologenobis (“motivtive” Trombi) dadgena dupleqssonografiiT;

52. qvemo Rru venaSi filtris Cayenebis Cvenebis dadgena; barZayis, TeZos da qvemo Rru venebis mwvave Trombozis qirurgiuli mkurnalobis (Trombeqtomia, gadakvanZva, plikacia) Cvenebis dadgena;

53. Rrma venebis Trombozis da filtvis arteriis emboliis dros antikoagulanturi da Trombolizuri Terapiis Catareba hemostazis laboratoriuli kontroliT;

54. filtvis arteriis emboliis diagnostika klinikuri niSnebiT, rentgenologiuri da rentgenokontrastuli (angiopulmonografia) gamokvlevebiT;

55. kidurebis venuri flegmaziis mkurnalobis taqtikis SerCeva; kanqveSa venebis mwvave Tromboflebitis mkurnaloba;

56. didi saCino venis aRmavali Tromoflebitis qirurgiuli mkurnaloba (ligireba safeno-femoraluri SerTulis areSi).

57. atravmuli qirurgiuli instrumentebis, sakeri masalis da specialuri kaTeterebis (zondebis) swori SerCeva konkretul saoperacio situaciaSi;

58. kidurebis magistraluri da periferiuli sisxlZarRvebis travmuli dazianebebis (blagvi travma, iatrogenuli dazianeba, naCxvleti da cecxlnasroli Wrilobebis)

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diagnostika fizikaluri gasinjviT da arainvaziuri gamokvlevebiT;

59. daWimuli, mopulsire hematomebis, cru da WeSmariti arteriuli anevrizmebis diferenciuli diagnostikis Catareba;

60. travmis Sedegad mwvaved ganviTarebuli arterio-venuri SerTulis diagnostika;

61. sisxlZarRvTa izolirebuli (arteriuli, venuri) da kombinirebuli (arterio-venuri) travmis diferenciuli diagnostika;

62. sisxlZarRvovan travmasTan kombinirebuli periferiuli nervis dazianebis diagnostika;

63. Zvlebis motexilobiT gamowveuli kidurebis magistraluri da periferiuli sisxlZarRvebis dazianebis diagnostika da mkurnalobis taqtikis SerCeva;

64. pacientis zogadi mdgomareobis (sisxlis danakargi, hemodinamika) da dazianebuli kiduris qsovilebis sicocxlisunarianobis Sefaseba, mkurnalobis (konservatiuli, qirurgiuli) taqtikis arCeva, Cvenebebis dadgena;

65. muclis Rrus Semavali Wrilobebis da blagvi travmis gamo warmoebuli laparatomiis dros magistraluri sisxlZarRvebis (muclis aorta, Rru vena, maTi visceraluri da parietaluri totebi), jorjlis sixlZarRvebis, mcire menjis venuri wnulebis reviziis Catareba;

66. braqiocefaluri sisxlZarRvebis travmuli dazianebis diagnostika; gulmkerdis aortis blagvi travmis klinikuri da rentgenologiuri diagnostikis Catareba;

67. dundulos arteriebis dazianebis dadgena;

68. kidurebis magistralur da periferiul sisxlZarRvebTan qirurgiuli midgomebis warmoeba;

69. TeZos magistralur sisxlZarRvebTan da dundulos arteriebTan qirurgiuli midgomebis warmoeba;

70. laviwqveSa-iRliis sixlZarRvebTan da saZile arteriebTan qirurgiuli midgomebis warmoeba;

71. intraoperaciuli angiografiis warmoeba;

72. Trombemboleqtomiis warmoeba pirdapiri meTodiT da balonuri kaTeteriT;

73. balonuri kaTeteris gamoyeneba (intraopereciulad) rogorc sisxlZarRvidan magistraluri sisxldenis SeCerebis saSualeba; didi saCino venis gamoyofa, amokveTa da damuSaveba autovenuri transplantatis damzadebis mizniT;

74. dazianebuli sisxlZarRvebis mTlianobis aRdgena sxvadasxva meTodiT: _ sisxlZarRvis kedlis defeqtze nakeris dadeba; _ anastomozebi “bolo-boloSi”,”bolo-gverdSi”, “gverdi-gverdSi”; _ arapirdapiri plastika (nafleTis Cakereba);

_ rezeqcia anastomozirebiT “bolo-boloSi”; _ rezeqcia protezirebiT (autotransplantatiT, sinTetiuri proteziT); _ Suntireba (anatomiuri, eqstraanatomiuri).

75. sxvadasxva eqstranatomiuri Suntirebis warmoeba (jvaredina barZay-barZayis , iRlia-barZayis, TeZo – barZayis damxuravi xvrelis gavliT);

76. dundulos arteriis dazianebis qirurgiuli mkurnaloba;

77. arteriis ligireba, venis ligireba an plikacia;

78. aRdgenili sisxlZarRvidan aroziuli sixldenis profilaqtika da qirurgiuli mkurnaloba;

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79. wvivis wina, ukana da lateraluri kunTovani budeebis dekompresiuli fasciotomiis Catareba (kunTebis nekrozis SemTxvevaSi maTi amokveTiT);

80. barZayis dekompresiuli fasciotomiis Catareba;

81. winamxris da mtevnis dekompresiuli fasciotomiis Catareba;

82. terfis TiTebis trans- da metatarzaluri amputaciis Catareba;

83. qvemo kiduris amputaciebis Catareba wvivis da barZayis doneze;

84. mtevnis TiTebis da metekarpaluri amputaciis Catareba;

85. zemo kiduris amputaciis Catareba winamxris da mxris doneze;

86. travmuli arteriuli da arterio-venuri anevrizmis amokveTa sisxlZarRvis aRdgeniT plastikis sxvadasxva meTodebiT;

87. menjis venuri wnulebis dazianebis dros profuzuli sisxldenis SeCereba tamponirebiT;

88. TeZos Zvlebis motexilobiT gamowveuli retroperitonealuri hematomebis mkurnalobis (konservatiuli, qirurgiuli, endovaskularuli) taqtikis SerCeva;

89. muclis Rrus magistraluri sisxlZarRvebidan (aorta, Rru vena, TeZos arteriebi da venebi) sisxldenis kontroli atravmuli damWeriT, balonuri kaTeteriT, meqanikuri zewoliT, tamponirebiT).

90. ultrabgeriTi doplerografiis da dupleqssonografiis meTodebis sruli floba;

91. birTvul-magnitur-rezonansuli da kompiuteruli tomografiuli gamokvlevebis Sedegebis wakiTxva da swori interpretacia;

92. hemostazis darRvevebis (hiperkoagulaciuri mdgomareobebi, Trombofiliebi, koagulopaTiebi, sisxlZarRvSida disiminirebuli

93. Sededebis sindromi) klinikur-laboratoruli diagnostika da mkurnaloba sisxlZarRvebis daavadebebis dros;

94. qveda kidurebis qronikuli venuri ukmarisobis diagnostika fizikaluri da arinvaziuri gamokvlevebiT, konservatiuli mkurnaloba CEAP-is klasifikaciis gaTvaliswinebiT;

95. venuri eTiologiis trofiuli wylulebis adgilobrivi mkurnaloba;

96. qveda kidurebis qronikuli venuri ukmarisobis qirurgiuli

mkurnaloba CEAP-is klasifikaciis gaTvaliswinebiT:

kroseqtomia (safeno-femoraluri SerTulis areSi didi saCino venis gadakvanZva, gadakveTa da misi Senakadebis ligireba);

stripingi (veneqstraqtoriT didi da/an mcire saCino venis amoReba);

flebeqtomia (kanqveSa venebis izolirebuli amokveTa);

kanqveSa magistraluri venebis Senakadebis amokveTa naratis meTodiT;

didi da/an mcire saCino venebis Senakadebis kanSida ligireba Sede-koxeris meTodiT;

miniflebeqtomia;

perforantuli venebis epifascialuri (koketis meTodiT) da subfascialuri (lintonis, felderis, de palmas meTodebiT) ligireba;

kanqveSa venebis skleroTerapia;

perforantuli venebis skleroTerapia dupleqssonografiis kontrolis qveS.

97. Tandayolili arteriuli, venuri da arterio-venurimalformaciebis diagnostika da

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mkurnalobis taqtikis SerCeva;

98. mwvave da qronikuli limfedemis diagnostika da mkurnaloba;

99. diabeturi angiopaTiis da diabeturi terfis diagnostika da mkurnaloba;

100. kidurebis vazospasturi daavadebebis _ angiotrofonevrozebis ( sicivis akrocianozi, periferiuli arteriospazmi, eriTromelalgia, badisebri livedo da sxv,) diagnostika da mkurnaloba;

101. reinos fenomenis gamomwvevi mizezebis klinikur-laboratoriul-instrumentuli dadgena, diferenciuli diagnostikis Catareba, mkurnalobis taqtikis SerCeva;

102. kisris da welis simpateqtomiebis Cvenebebis dadgena da maTi warmoeba;

103. gulmkerdidan gamosvlis kompresiuli sindromebis (kostoklaviku-larulis, hiperabduqciis, wina kibisebri kunTis, mkerdis mcire kunTis, kisris neknis, pankostas simsivne) klinikur-instrumentuli diagnostika diferenciuli diagnostika da mkurnalobis taqtikis SerCeva;

104. gulmkerdidan gamosvlis sindromebis qirurgiuli mkurnalobis warmoeba (pirveli neknis rezeqcia, kisris neknis rezeqcia, mkerdis mcire kunTis gadakveTa, skalenotomia);

105. sisxlZarRvis kedlis araaTerosklerozuli dazianebebis diagnostika da mkurnalobis taqtikis SerCeva:

_ aorto-arteriopaTiebi (marfanis sindromi, ehrler-danlosis

sindromi, kistozuri medialuri nekrozi, fibrokunTovani displazia,

arteriomegalia, daklakniloba (kinkingi);

_ aorto-arteriiti, vaskulitebi;

_ adventicialuri kistozuri daavadeba;

_ sisxlZarRvis kedlis inficireba;

_ sisxlZarRvis kedlis dazianebebi sistemuri daavadebebis dros;

_ sisxlZarRvTa eqstravazalaruri kompresia;

_ sisxlZarRvovani simsivneebi;

_ sisxlZarRvis kedlis sxivuri dazianebebi;

_ sisxlZarRvis kedlis dazianebebi intravenur narkotikebze

damokidebulobis dros;

106. portaluri hipertenziis diagnostika da mkurnalobis taqtikis SerCeva;

107. aorta-TeZos da kidurebis arteriebis maokluzirebeli daavadebebis diagnostika da mkurnalobis taqtikis SerCeva fontenis da transatlantikuri saerTaSoriso asociaciebis SemTanxmebeli komitetis (TASC) klasifikaciebis gaTvaliswinebiT;

108. aorta-TeZos da kidurebis arteriebis maokluzirebeli daavadebebis qirurgiuli mkurnalobis warmoeba:

_ barZay-muxlqveSa da barZay-wvivis Suntireba (reversirebuli an

arareversirebuli autoveniT in situ) an proTezireba sinTeturi

proTeziT;

_ endartereqtomia barZayis Rrma arteriidan;

_ TeZo-barZayis segmentis Suntireba an proTezireba sinteturi

proTeziT;

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_ eqstraanatomiuri Suntirebebi (jvaredina barZay-barZayis , iRlia-

barZayis, TeZo–barZayis damxuravi xvrelis gavliT);

_ TeZos arteriebis Ria, naxevrad daxuruli da daxuruli

endartereqtomiebi;

_ TeZos arteriebis proTezireba;

_ aorta-TeZos segmentis proTezireba.

109. aortis, magistraluri da periferiuli arteriebis anevrizmebis da

ganSrevebis diagnostika da mkurnalobis taqtikis SerCeva;

_ periferiuli arteriebis aTerosklerozuli da Travmuli

anevrizmebis amokveTa arteriis proTezirebiT/SuntirebiT.

_ muclis infrarenaluri nawilis anevrizmeqtomia proTezirebiT.

110. aortis braqiocefaluri totebis (saZile, laviwqveSa, usaxelo da xerxemlis arteriebi) maokluzirebeli daavadebebis diagnostika da mkurnalobis taqtikis SerCeva mastenozirebeli procesis xarisxis da Tavis tvinis iSemiuri insultis ganviTarebis riskis gaTvaliswinebiT;

111. aortis braqiocefaluri totebis maokluzirebeli daavadebebis qirurgiuli mkurnalobis warmoeba:

_ saZile arteriis endartereqtomia;

_ saZile arteriis reimplantacia laviwqveSa arteriaSi;

_ jvaredina laviwqveSa-laviwqveSa Suntireba.

112. Tirkmlis arteriebis maokluzirebeli daavadebebis diagnostika da mkurnalobis taqtikis SerCeva (qirurgiuli, endovaskularuli, konservatiuli);

113. Torakoabdominaluri midgomebis Catareba;

114. simptomuri hipertenziis sxva formebis (feoqromacitoma, konis daavadeba, aortis koarqtacia, koarqtaciuli sindromi) diagnostika da mkurnalobis taqtikis SerCeva;

115. muclis Rrus visceraluri organoebis mwvave da qronikuli iSemiis diagnostika da mkurnalobis taqtikis SerCeva (qirurgiuli, endovaskularuli, Trombolizuri);

116. sisxlZarRvTa qirurgiis garTulebebis (proTezis inficireba, Trombozi, sisxlZarRvovani nakeridan aroziuli sisxldena, aorta-nawlavis fistula) diagnostika da qirurgiuli mkurnaloba;

117. pacientis operaciuli da anesTeziologiuri riskis dadgena;

118. operaciis wina- da Semdgomi periodebis marTva;

3. profesiuli mzadebis struqtura da sarezidento programis Sinaarsi

3.1. programis aRweriloba programa iTvaliswinebs sakiTxisadmi jgufur midgomas da gadawyvetas, programaSi

monawile TiToeul klinikur bazaze. avadmyofTa mkurnalobis procesSi monawileoba, sxvadasxva donis (etapis) rezidentTa mier sxvadasxva moculobiT xorcieldeba. rezidentebs Soris wesdeba ”piramiduli ierarqiuloba”, rac uzrunvelyofs yvela maTganis monawileobas swavlisa da swavlebis procesSi. anu, ufroskurseli rezidenti, programis farglebSi valdebulia gauwios saganmanaTleblo da praqtikuli daxmareba

14

masze erTi doniT qveviT myof rezidents sakuTari kompetenciisa da uflebamosilebis farglebSi. amgvarad, garda programaSi monawile maswavleblebisa, TiToeuli donis rezidents hyavs maswavlebeli – zemdgomi etapis rezidentic. bolo etapis rezidenti – ufrosi rezidenti, garkveul makoordinirebel rols TamaSobs programis sxva monawileTa Soris da saganmanaTleblo da klinikur-profesiul daxmarebas uwevs umcros kolegebs. swavlebis pirveli ori wlis ganmavlobaSi rezidentebi asruleben ZiriTad savaldebulo rotaciebis seriebs modulebis mixedviT, romelTa ganrigi mtkicdeba individualuri saswavlo gegmis Sesabamisad. aRniSnulis Semdeg, rezidenti agrZelebs specializacias sisxlZarRvTa qirurgiaSi. sisxlZarRvTa qirurgiaSi sruli, xuTwliani specializaciis Semdeg, rezidentebi zedmiwevniT iTviseben programas da maTi pasuxismgebloba etapobrivad izrdeba, romlis kulminacias warmoadgens ufrosi rezidentis statusi, romlis drosac isini praqtikulad warmarTaven avadmyofTa mkurnalobas da administrirebas.

rezidents saSualeba unda mieces Seasrulos rTuli procedurebis sakmarisi raodenoba, raTa SeiZinos adekvaturi qirurgiuli teqnika da SeeZlos sxvadasxva gansxvavebul situaciebSi marTebuli klinikuri gadawyvetilebis miReba.

programis xelmZRvaneli unda darwmundes, rom rezidentma ara marto Seasrula, aramed aiTvisa programiT gaTvaliswinebuli sakiTxebi da CamonaTvalis Sesabamisi Cvevebi. aqedan gamomdinare, Sesrulebuli operaciebis raodenoba TiToeuli rezidentisaTvis SesaZloa ar iyos zustad identuri.

rodesac Sesrulebuli operaciuli aqtivoba ganisazRvreba saswavlo rolis mqone intervenciebad, rezidents SeuZlia Seudges gamocdilebis gaziarebas misi umcrosi kolegebisaTvis da amgvarad gadasces sakuTari codna maTac.

3.2. modulebi / rotaciebi: modulebis/rotaciebis ganrigi SesaZlebelia Seicvalos rezidentis individuri

samuSao gegmis Sesabamisad. aRniSnuli sakiTxis mogvarebaze pasuxismgebelia programis fakulteti da uSualod programis xelmZRvaneli.

saswavlo gegma - rezidenturis programa “sisxlZarRvTA qirurgia” 55Tve.

PGY I

zogadi qirurgia I 10 Tve

laparaskopiuli qirurgia (bazisuri nawili) 1 Tve

PGY II

zogadi qirurgia II (zog.qir 3Tve + onkoqirurgia 2 Tve)

5 Tve

დამწვრობა 1 Tve

ყბა-სახის ქირურგია 1 კვირა

სასამართლო მედიცინა 3 კვირა

რადიოლოგია 1 Tve

ტრავმატოლოგია - ორთოპედია 1 თვე

პლასტიკური ქირურგია 1 თვე

თორაკალური ქირურგია 1 თვე

VS I sisxlZarRvTa qirurgia (gadaudebeli) 3 Tve

უროლოგია, ნეფროლოგია 2 თვე

ტრანსპლანტოლოგია 1 Tve

ბავშვთა ქირურგია 1 Tve

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sisxlZarRvTa qirurgia 2 Tve

გინეკოლოგია 1 თვე

ნეიროქირურგია 1 თვე

VS II sisxlZarRvTa qirurgia (gegmiuri) 5 Tve

კარდიოქირურგია 2 Tve

ინტენსიური თერაპია 2 Tve

ინტერვენციული რადიოლოგია 2 Tve

VS III

intervenciuli radiologia 3 Tve

sisxlZarRvTa qirurgia 8 Tve

3.3. rezidentis samuSao ganrigi da konferenciebi rezidentis samuSao grafiki ganisazRvreba 40 saaTiT kviris samuSao dReebis

ganmavlobaSi anu rezidentis oficialuri samuSao dRe orSabaTi-paraskevis CaTvliT Seadgens 8 astronomiul saaTs. garda amisa, rezidenti valdebulia yovel me-4 dRes imorigeos oficialuri samuSao dRis dasrulebidan, momdevno dRes samuSao dRis dawyebamde. SabaT kviras (aseve dasvenebis dReebSi) 24 saaTis ganmavlobaSi. rezidents damoukideblad morigeobis ufleba swavlis arc erT etapze ar aqvs. rezidenti aseve programis xelmZRvanelobis an sakuTari Sexedulebidan gamomdinare, klinikaSi muSaobs SabaT-kviras da dasvenebis dReebSic. rezidentis samuSao dRe iwyeba 9 saaTisaTvis. Sesabamisad sruldeba 5 saaTze. rezidents ufleba aqvs rezidenturis yoveli wlisperiodSi gamoiyenos Svebuleba 30 kalendaruli dRis ganmavlobaSi. Svebulebis ganrigi Tanxmdeba da mtkicdeba programis xelmZRvanelis mier. gansakuTrebul SemTxvevebSi, rezidents SeuZlia mimarTos programis xelmZRvanels misTvis Svebulebis dReebis ganrigis gareSe gamoyenebis uflebis micemis Sesaxeb.

saganmanaTleblo konferenciebi adekvaturi unda iyos, rogorc xarisxiT, ise sixSiriT. am Sexvedrebze rezidentebma unda SeZlon ara marto klinikuri qirurgiuli SemTxvevebis ganxilva, aramed, qirurgiis bolo miRwevebis gacnoba. konferenciebis ganrigi winaswar unda iyos damtkicebuli da cnobili, raTa rezidentebma SeZlon maTze regularuli daswreba. konferenciebs unda eswrebodnen rogorc rezidentebi, aseve maTi maswavleblebi, rac dokumenturad unda iyos dadasturebuli. programis mimdinareobisas SesaZlebelia Semdegi tipis konferenciebis mowyoba:

1. sikvdilobisa da garTulebuli SemTxvevebis yovelkvireuli garCeva, maT Soris SemTxvevaTa radiologiuri da paTologanatomiuri Sesabamisobis gacnoba qirurgiuli klinikisa da seqciis Sedegebis Sepirispireba;

2. konferenciebis struqturuli seriebis cikli raTa daifaros programiT gaTvaliswinebuli klinikuri da sabaziso sakiTxebi (ix. CamonaTvali kurikulumSi). am dros SexvedraTa momzadebis Sinaarsi unda efuZnebodes qirurgiis saxelmZRvaneloebs;

3. regularulad mowyobili klinikuri saswavlo konferenciebi, magaliTad: klinikuri garCevebi da mrgvali magidebi sxvadasxva mowveul profesionalTa monawileobiT.

programis xelmZRvanelma unda Seqmnas iseTi garemo, romelic optimaluri iqneba rogorc samkurnalo, ise akademiuri procesisaTvis. konferenciebis TvalsazrisiT, klinikuri rotaciebis dros SesaZlebelia dawesdes gansxvavebuli modelebi, vinaidan sxvadasxva specialobebi moiTxoven sxvadasxva samuSao saaTebsa da midgomebs. aqedan gamomdinare, zogadad programa unda iyos moqnili da advilad Tavsebadi TiToeul modulTan/rotaciasTan. amasTan, yovelTvis unda iyos gaTvaliswinebuli is garemoeba, rom rezidenti es aris srul Statze momuSave piri.

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qirurgiuli codnis centraluri nawili jamdeba swored zemoT aRniSnul yovelkvireul sabaziso konferenciebze, romlebic interaqtiulia da didaqtikur xasiaTs atarebs. qirurgiuli mrgvali magidebi da avadoba-sikvdilobis konferenciebi warmoadgenen forums, sadac rezidentma unda aCvenos fundamenturi codna; rezidents saSualeba eZleva, gadaxedos sabaziso qirurgiul safuZvlebs, aqtiuri monawileoba miiRos SemTxvevaTa prezentaciebSi da gaarCios da daamuSaos Tanamedrove literatura. konferenciebze ufroskurseli rezidentebi asruleben warmmarTav rols da xels uwyoben maTi umcrosi kolegebis ganaTlebas.

3.4. samecniero-kvleviTi muSaoba samecniero-kvleviTi muSaobis komponenti miCneulia programis integralur nawilad da

misi warmarTva sasurvelia programis monawile yvela rezidentisaTvis. programis samecniero-kvleviTi sakiTxebis koordinatori iZleva meTodur miTiTebebs da rekomendaciebs am sferoSi, aseve saWiroebis SemTxvevaSi daxmarebas uwevs rezidentebs proeqtis dagegmvis da ganviTarebis sakiTxebSi, awvdis informacias ZiriTad resursebze, exmareba donorebTan urTierTobaSi. rezidenti unda eswrebodes erovnul profesiul forumebsa da RonisZiebebs qirurgiis sakiTxebze, aseve, SeZlebisdagvarad, monawileobas Rebulobdes saerTaSoriso profesiul da samecniero forumebSi. rezidentebi, romlebic CarTulni arian samecniero saqmianobaSi, valdebulni arian sakuTari kvlevis Sedegebis Sesaxeb moxsenebiT warsdgnen programisa da farTo qirurgiuli sazogadoebis winaSe.

3.5. profesiul konferenciebsa da forumebze daswreba rezidenti unda daeswros adgilobriv, regionul da erovnul profesiul forumebs,

rac gaTvaliswinebuli unda iyos programis xelmZRvanelisa da fakultetis mier. programam aseve unda uzrunvelyos aseT RonisZiebebSi monawileobis mizniT rezidentis finansuri uzrunvelyofa, rogorc qveynis SigniT, ise sazRvargareT. daswreba profesiul RonisZiebebze, gansakuTrebiT mniSvnelovania ufrosi rezidentebisaTvis, ris gamoc, SerCevis dros maT garkveuli upiratesoba unda mieceT. konferenciis daswrebis gamo gacdenili periodi aucileblad unda iqnas gaTvaliswinebuli da kompensirebuli saswavlo individur programaSi.

3.6. praqtikuli saqmianoba: rezidentTa praqtikuli saqmianoba gaSlilia programaSi monawile klinikur bazebze.

saWiroebis SemTxvevaSi aseve damatebiT SesaZlebelia sxva akreditebuli samedicino dawesebulebis CarTva. rezidents SeuZlia romelime modulis / blokis gavla sazRvargareTis romelime wamyvani klinikis bazaze, ris Sesaxebac informirebuli unda iyos programis administracia, romelic aTanxmebs aRniSnul sakiTxebs ucxoeTis samedicino dawesebulebasTan. rezidentis qirurgiuli praqtika vrceldeba rogorc hospitalur, ise ambulatorul/poliklinikur doneze. ambulatoruli qirurgiis Seswavla warmoadgens qirurgiuli mzadebis ganuyofel komponents qirurgiuli avadmyofis marTvis erTobaSi. rezidents unda hqondes saSualeba, uSualod gasinjos avadmyofi hospitalizaciamde. aseve monawileoba miiRos mis mkurnalobasa da marTvaSi operaciis Semdgom, gaweris momdevno periodSi, maT Soris avadmyofis binaze mkurnalobis etapze (Tu aseTi mizanSewonilia). postoperaciuli mkurnalobis dros, rezidenti uflebamosilia poliklinikur dawesebulebaSi miiRos vizitad myofi pacienti, gasinjos da gaataros Sesabamisi klinikuri RonisZiebebi mis meTvalyure eqimTan erTad.

3.7. uwyveti ganaTleba: rezidenti unda eswrebodes universitetisa da Sesabamisi klinikebis konferenciebs da

sxvadasxva xasiaTis RonisZiebebs (samecniero, klinikuri, Tematuri statistikuri da sxv). ufroskurseli rezidenti exmareba mis umcros kolegebs aseT RonisZiebebze warmoadginon

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moxsenebebi, angariSi da meTodur koordinacias uwevs maT. garda sauniversiteto ZiriTadi RonisZiebebisa, rezidentebi unda eswrebodnen im klinikuri bazis analogiur Sexvedrebs, romlebSic mocemul momentSi isini swavlebas gadian.

3.8. kurikulumi: sisxlZarRvTa qirurgma unda aiTvisos da ganaviTaros specializebuli codna, raTa

moaxdinos sisxlZarRvTa daavadebebis diagnostika, preoperaciuli, perioperaciuli da postoperaciuli marTva, specialoba moicavs sisxlZarRvebis mwvave da qronikul daavadebebsa da dazianebebs; aseve yvela asakis pacientTa mwvave da eleqtiur procedurebs. mzadebis dros, fokusur mimarTulebad aris miCneuli diagnostika da mkurnaloba. es ukanaskneli moicavs yvela saxis instrumentul da arainstrumentul meTodebs, maT Soris radiologiur kvlevebs (angiografias, sonografias, kompiuterul tomografiasa da birTvul magnitur rezonanss). qirurgs unda SeeZlos gamoiyenos Sesabamisi teqnika rogorc sadiagnozo, ise samkurnalo daniSnulebiT, ris gamoc momzadebis dros unda mieces saSualeba SeiZinos da ganaviTaros codna da unarebi teqnikuri meTodebis dasaufleblad.

qirurgiuli aqtivoba moicavs pre-, peri-, da postoperaciul periods; aseve periods pacientis gaweris Semdeg. specialoba aseve moicavs individur da zogadprevenciul saqmianobas.

specialoba gansakuTrebiT fokusirebulia periferiuli arteriuli daavadebebis marTvaze, aseve venuri Trombozebis marTvasa da venuri Tromboemboliebis prevenciaze.

codna da unar-Cvevebi, romlebic sisxlZarRvTa qirurgs esaWiroeba, mWidrodaa dakavSirebuli da moiTxovs mis TanamSromlobas medicinis sxva dargebTan. garda amisa, sisxlZarRvTa qirurgs moeTxoveba icodes anatomia, fiziologia, mikrobiologia, paTologia, bioqimia da sxva sabaziso disciplinebi, rac mas saSualebas miscems Cawvdes daavadebebisa da dazianebebis arss rogorc organizmis normaluri funqciobisas, aseve sxvadasxva paTologiuri mdgomareobebis dros. sisxlZarRvTa qirurgs unda SeeZlos im ZiriTadi farmakologiuri saSualebebis moqmedebis da toqsikuri efeqtebis arsSi garkveva, romlebic gamoiyeneba sisxlZarRvTa qirurgiaSi. sisxlZarRvTa qirurgs unda hqondes garkveuli safuZveli aseve zogad paTologiaSi, maT Soris imunologiis safuZvlebSi da mikrobiologiis sakiTxebSi, romlebic dakavSirebulia qirurgiul praqtikasTan.

sisxlZarRvTa qirurgis momzadebis dros mas aucileblad unda mieces codna jandacvis ekonomikis, samecniero-kvleviTi meTodologiebis, eTikuri da iuridiuli sakiTxebis sferoebSi. mzadebis periodSi qirurgi unda eweodes samecniero aqtivobas, amzadebdes samecniero publikaciebs da amiT imzadebdes safuZvels Semdgomi klinikuri saqmianobis warmatebulad ganxorcielebisaTvis.

sisxlZarRvTa qirurgis momzadebis gegma unda moicavdes Teoriul codnas da praqtikul Cvevebs. pirveli komponenti unda Sefasdes gamocdis gziT, xolo meore – Sesruldes CamonaTvalis Sesabamisad, Sedegebi dokumenturad aisaxos saregistracio JurnalSi da Sefasdes klinikuri gamocdis gziT.

Teoriuli codna specialoba – sisxlZarRvTa qirurgia moiTxovs codnis ganviTarebas, dokumentirebasa

da Sefasebas ramdenime ZiriTadi mimarTulebiT. upirveles yovlisa qirurgs unda gaaCndes zogadsamedicino da zogad-biologiuri generiuli codna, romelic man unda gamoiyenos klinikur praqtikaSi; sisxlZarRvTa qirurgma unda warmarTos Tvisobrivi klinikuri procesi da unda aiTvisos ZiriTadi teqnikuri/operaciuli Cvevebi.

saswavlo programaSi sisxlZarRvTa qirurgis momzadeba ganxorcieldeba modulebis mixedviT. upirveles yovlisa sisxlZarRvTa qirugisaTvis aucilebelia diplomamdeli ganaTlebis etapze miRebuli codnis gaRrmaveba da sxva WrilSi ganxilva. aRniSnuli aucileblobis gamo sisxlZarRvTa qirurgis kvalifikaciis maZiebeli, programaSi monawileobis dros gaivlis Sesabamis modulebs sabaziso mecnierebebSi da gaiRrmavebs codnas Semdegi mimarTulebebiT:

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1.anatomia

1.1 magistraluri, periferiuli da organoTa sisxlZarRvebis topografiuli anatomia:

1.2 magistraluri, periferiuli da organoTa sisxlZarRvebis qirurgiuli anatomia:

qirurgiuli midgomebi;

magistraluri, periferiuli da organoTa sisxlZarRvebis anatomiuri variantebi;

magistraluri, periferiuli da organoTa sisxlZarRvebis Tandayolili anomaliuri ganviTareba;

1.3 magistraluri, periferiuli da organoTa sisxlZarRvebis rentgenanatomia. 2. hemodinamika

hidrodinamikis da hemodinamikis ZiriTadi fizikuri kanonebi;

gulisSida hemodinamika;

arteriuli hemodinamika;

venuri hemodinamika;

limfodinamika;

mikrocirkulatoruli hemodinamika;

sxvadasxva organoTaSida hemodinamika;

sisxlis nakadis da periferuli winaamRdegobis ganawileba did da mcire sisxlis mimoqcevis wreebSi;

sisxlis nakadi da wneva normalur da stenozirebul sisxlZarRvebSi;

kritikuli arteriuli stenozi;

arterio-venuri fistulis hemodinika;

“dasesxebis” da “gaqurdvis” hemodinamikuri fenomenebi.

3. sisxlZarRvis kedlis biologia

embriologia;

morfologia;

bioqimia;

endoTeliumis funqcia/disfunqcia;

sisxlZarRvis kedlis tonusi da misi regulacia. 4. aTerosklerozi (zogadi sakiTxebi)

eTiologia;

paTomorfologia;

paTogenezi;

risk-faqtorebi, skriningi, prevencia. 5. sisxlZarRvis kedlis araaTerosklerozuli dazianebebi

(zogadi sakiTxebi)





koarqtacia, anevrizma, ganSreveba;

diabeturi mikro- da makroangipaTia, arteriis media Sris kalcifikacia (menkenbergis sklerozi);

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sisxlZarRvebis eqstravazaluri kompresia;

Tandayolili arteriuli, venuri da arterio-venuri malformaciebi;

sisxlZarRvebis Trombozebi da emboliebi;

sisxlZarRvovani simsivneebi. 6. hemostazi

fiziologiuri funqcionireba;

hiperkoagulaciuri mdgomareobebi, memkvidruli da SeZenili hiperkoagulaciuri mdgomareobebi (Trombofiliebi).

7. iSemiasTan dakavSirebuli organoTa disfunqcia 8. farmakologia da farmakoTerapia.

vazotropuli preparatebi;

antiTrombuli preparatebi;

antilipidemuri preparatebi. 9. biologiuri da xelovnuri masalebi sisxlZarRvTa qirurgiaSi.

10. sisxlZarRvTa daavadebebis epidemiologia.

11. sisxlZarRvSida intervenciebi:

centraluri venebis (barZayis, laviwqveSa, Sida sauRle) kaTeterizacia;

barZayis da mxris arteriebis kaTeterizacia;

kaTeteriTmimarTuli Trobmolizisi;

kava-filtrebis Cayeneba**;

sisxlZarRvebis balonuri angioplastika**;

sisxlZarRvovani anomaluri da SeZenili paTologiuri warmonaqmnebis embolizacia**;

sisxlZarRvis sanaTuris stentireba**;

endovaskularuli protezireba**;

sisxlZarRvis meqanikuri rekanalizacia**.

SeniSvna:

- meTodis sruli aTviseba aucilebelia;

** - sakmarisia meTodis principebis Seswavla.

12.sisxlZarRvTa qirurgiuli teqnika

sisxlZarRvebis gamoyofa da maTi sanaTuris kontroli (damWerebiT an turniketiT):

intraoperaciuli sisxldenis kontrolis meTodebi: arteriotomia/venotomia;

sisxlZarRvis nakeris teqnika:

_ “bolo boloSi”;

_ “bolo gverdSi”;

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_ “gverdi gverdSi”;

kedlis gverdiTi plastika.

sisxlZarRvebis proTezireba da Suntireba auto- da sinTeturi SemcvlelebiT;

sisxlZarRvis replantacia da reimplantacia;

sisxlZarRvSida manipulaciebi sxvadasxva saxis kaTeterebiT;

sisxlZarRvis rekonstruqciis Sefaseba:

_ eleqtromagnituri floumetriiT;

_ intraoperaciuli angiografiiT.

mikroqirurgiuli teqnikis Seswavla saoperacio lupis da mikroskopis gamoyenebiT:

_ mcire yalibis sisxlZarRvebis plastika;

_ interfascikularuli neiroplastika.

sisxlZarRvTa qirurgia: 1. aorta-TeZos da kidurebis arteriebis maokluzirebeli daavadebebis diagnostika da mkurnaloba; 2. aortis, magistraluri da periferiuli arteriebis anevrizmebis da ganSrevebis diagnostika da mkurnaloba; 3. aortis braqiocefaluri totebis (saZile, laviwqveSa, usaxelo da xerxemlis arteriebi) maokluzirebeli daavadebebis diagnostika da mkurnaloba; 4. Tirkmlis arteriebis maokluzirebeli daavadebebis diagnostika da mkurnaloba; 5. simptomuri hipertenziis sxva formebis (feoqromocitoma, konis daavadeba, aortis koarqtacia, koarqtaciuli sindromi) diagnostika da mkurnaloba; 6. visceraluri iSemiis diagnostika da mkurnaloba; 7. gulmkerdidan gamosvlis sindromebis diagnostika da mkurnaloba; 8. kidurebis mwvave arteriuli gauvalobis diagnostika da mkurnaloba; 9. diabeturi angiopaTiis da diabeturi terfis diagnostika da mkurnaloba; 10. sisxlZarRvTa qirurgiis garTulebebis diagnostika da mkurnaloba; 11. sisxlZarRvebis travmuli dazianebebis diagnostika da mkurnaloba, samxedro-savele qirurgiis principebi; 12. qveda kidurebis qronikuli venuri ukmarisobis diagnostika da mkurnaloba; 13. Rrma venebis Trombozebis da filtvis arteriis emboliis diagnostika da mkurnaloba; 14. mwvave da qronikuli limfedemis diagnostika da mkurnaloba;

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15. kidurebis amputaciis Cvenebebi da qirurgiuli teqnika; 16. sisxlZarRvis kedlis araaTerosklerozuli dazianebebis diagnostika da mkurnaloba:






sisxlZarRvTa eqstravazaluri kompresia;

sisxlZarRvovani simsivneebi;



17. kidurebis vazospasturi daavadebebis (angiotrofonevrozebi) diagnostika da mkurnaloba; 18. Tandayolili arteriuli, venuri da arterio-venuri malformaciebis diagnostika da mkurnaloba; 19. hemostazis darRvevebis diagnostika da mkurnaloba sisxlZarRvebis daavadebebis dros; 20. simpateqtomiebis Cvenebebi da qirurgiuli teqnika periferuli sisxlZarRvebis daavadebebis dros; 21. hemodializisTvis arterio-venuri anastomozebis da Suntebis Seqmnis qirurgiuli teqnika; 22. portaluri hipertenziisdiagnostika da mkurnaloba; 23. sisxlZarRvovani genezis mamakacTa impotenciis diagnostika da mkurnaloba; 24. mcire menjis venuri Segubebis sindromiT gamowveuli qalTa seqsologiuri darRvevebis diagnostika da mkurnaloba; 25. pacientis operaciuli riskis dadgena; 26. operaciis wina- da Semdgomi periodebis marTva; uro-genitaluri traqti: Sard sasqeso sistemis qirurgiuli anatomia, gamoyenebiTi fiziologia da paTologia, romelic aucilebelia klinikuri kvlevebisaTvis, specifikur kvlevaTa interpretirebisaTvis, moSlili funqciis aRqmisaTvis da uro-genitaluri daavadebebisa da dazianebebis qirurgiuli mkurnalobisaTvis.

urinaruli traqtis infeqciebi; hematuria; Sardovani kenWebi; Sardis retencia; Tirkmlis qronikuli ukmaroba: principebi da dializis teqnika;

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Tirkmlis gadanergvis principebi; saTesle parkis tkivili da SeSupeba; saTeslis Semogrexa; winamdebare jirkvlis daavadebebi; muclis mwvave tkivilis ginekologiuri mizezebi; menjis anTebiTi daavadebebi; uro-genitaluri traqtis avTvisebiani daavadebebi.

centraluri nervuli sistema (neiroqirurgia):

Tavis da zurgis tvinis daxuruli travmis zogad nevrologiuri Sefaseba;

periferiuli nervebis travmuli dazianebis diagnostika;

neirorafiis Catareba;

kidurebis centraluri da periferiuli parezis/plegiis dros ganviTarebuli sisxlZarRvovani distoniis Sefaseba fizikaluri da instrumentuli (doplerografia) gamokvlevebiT;

kidurebis Rrma venebis Trombozis antiTrombuli profilaqtika da mkurnaloba pacientebSi spinaluri travmiT da insultis Semdgom periodSi;

Tavis qalis dekompresiuli trepanaciis Catareba;

lumbaluri punqciis Catareba.

Torakaluri qirurgia :

gulmkerdis organoebis rentgenogramebis da rentgenotomogramebis wakiTxva da Sedegebis swori interpretacia;

gulmkerdis yafazis, plevris Rrus da filtvebis dazianebebis diagnostika da konservatiuli an qirurgiuli mkurnalobis Cvenebebis dadgena;

plevris Rrus punqciisa da drenirebis warmoeba;

plevris Rrus gamonadenis aqtiuri amoqaCvis warmoeba;

sxvadasxva saxis Torakotomiuri midgomebis Catareba;

pnevmorafiis warmoeba;

zemo Rru venis sindromis gamomwvevi onkologiuri mizezebis (Suasayaris simsivneebi, filtvis kibo) diagnostika da mkurnalobis SerCeva;

gulis kunTis Wrilobis gakervis (kardiorafia) qirurgiuli principebis floba. praqtikuli unar-Cvevebi mosalodneli Sedegebi

sisxlZarRvTa qirurgiis programaSi swavlebis dasrulebis Semdeg, sisxlZarRvTa qirurgis kvalifikaciis maZiebelma kursdamTavrebulma unda SesZlos:

qirurgiul mdgomareobaTa marTva, sabaziso da klinikur codnaze dafuZnebuli gamcdilebis gamoyenebiT;

uCvenos Sesabamisi unar-Cvevebi im qirurgiuli teqnikis gamoyenebiT, romelsac unda flobdes kvalificiuri qirurgi;

aCvenos kritikuli azrovnebis unari qirurgiuli gadawyvetilebebis miRebisas, gansakuTrebiT, rodesac avadmyofi imyofeba sicocxlisaTvis saSiS mdgomareobaSi;

warmarTos eTikuri, iuridiulad dasabuTebuli gansja, rac Seefereba maRali kvalifikaciis eqim specialists;

efeqturad iTanamSromlos kolegebTan da sxva specialobis eqimebTan;

aswavlos da gauziaros SeZenili codna da praqtikuli gamocdileba kolegebs, umcros rezidentebs, studentebs da jandacvis sferos sxva muSakebs;

miawodos pacients da misi ojaxis wevrebsa da axloblebs maTi janmrTelobisaTvis aucilebeli saWiro rekomendaciebi;

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aCvenos mzadyofna uwyveti profesiuli ganaTlebisaTvis, rac erT-erTi mniSvnelovani momentia qirurgis kvalifikaciis mudmivi amaRlebisa da srulyofisaTvis;

aCvenos samecniero kvlevebis, naSromebis adekvaturi aRqmisa da interpretaciis unari, amavdroulad TviTonac SeeZlos samecniero kvlevis warmarTva an masSi aqtiuri monawileoba;

ganaviTaros liderobisa da administraciuli unarebi;

pativi sces pacientis da maTi ojaxis saWiroebebs, aRmouCinos da warmarTos qirurgiuli daxmareba maTi saWiroebidan gamomdinare.

arsebiTi SesaZleblobebi, romelic unda gaaCndes rezidenturis kursdamTavrebuls

mdgomareobs akademiur da moqmedebis SesaZleblobebSi da unarebSi, rasac Tan unda erTvodes fizikuri, kogniciuri da qceviTi Taviseburebebis Camoyalibeba da ganviTareba, imgvarad, rogorc aRwerilia winamdebare programaSi. diplomisSemdgomi ganaTlebis programa specialobaSi “sisxlZarRvTa qirurgia” moiTxovs Semdeg komponentebs: inteleqtualur SesaZleblobebs(konceptualuri, integraciuli da xarisxobrivi SesaZleblobebi, romlebic aucilebelia diagnozis dasmisa da klinikuri problemebis gadaWrisaTvis); eqimis miqmedebis qceviT da socialur aspeqtebs, komunikaciur unar-Cvevebs, motorul Tavisuflebas da sensoruli sferos specifikur ganviTarebas. zemoT CamoTvlili Cvevebi unda ganiviTaros TviToeulma rezidentma qirurgma, raTa adekvaturi saSualeba mieces SeZenili profesiuli codnisa da gamocdilebis gamoyenebisaTvis.

inteleqturi SesaZleblobebi

rezidents unda SeeZlos srulyos an SeiZinos faqtobrivi codna kiTxvisa da didaqtikuri konferenciebis gziT, damoukideblad Seagrovos informacia, moaxdinos Seswavlili masalis analizi da sinTezi da bolos gamoiyenos arsebuli codna konkretul klinikur situaciaSi. rezidentma unda gamoimuSaos uwyveti ganaTlebis Cvevebi, igi Tavidanve unda Seeguos im azrs, rom misi ganaTleba da profesiuli ganviTareba gagrZeldeba mudmivad, karieris dasrulebamde. rezidentma unda ganiviTaros adekvaturi klinikuri gansjisunarianoba da warmoaCinos kargad integrirebuli codna nozologiaTa diagnostikis, mkurnalobisa da prevenciis Sesaxeb, maTi praqtikuli moRvaweobis CarCoebSi. rezidenti Tavs komfortulad da damajereblad unda grZnobdes, araorazrovnad moqmedebdes klinikur situaciebSi da saWiroebis SemTxvevaSi unda SeeZlos moisminos da gaiziaros alternatiuli mosazreba kolegebisagan.

qceviTi, socialuri da profesiuli SesaZleblobebi

rezidenti unda flobdes emociur simwifes da stabilurobas, Tundac stresuli

situaciebis dros moqmedebis dros, rac arc Tu iSviaTia qirurgiul praqtikaSi, man unda SesZlos advili adaptacia iseT situaciebSi, romlebic gauTvaliswineblad viTardeba an swrafad dgeba. rezidents unda SeeZlos produqtiuli interaqcia sxvebTan, TanamSromlobis tipis urTierTobebis damyareba kolegebTan, SeeZlos procesis advilad daregulireba, unda uCvenos jgufuri muSaobis SesaZlebloba, da rac mTavaria TviT am gundis Seqmna da Seneba. rezidentma unda SeZlos pacientis marTvis dros prioritetTa amocnoba da rigiTobis gansazRvra. igi unda iyos punqtualuri da droulad Seasrulos dakisrebuli valdebuleba. rezidenti unda iyos tolerantuli, zogierTi pirovnebis mier gamovlenil empaTiur qmedebebTan da mgrZnobiare socialuri da kulturuli mravalgvarobis sakiTxebTan dakavSirebiT. man unda aCvenos profesiuli eTikuri qceva, maT Soris sxvisi gasaWirisaTvis upiratesobis miniWebis unari. rezidentma unda gamoavlinos TanagrZnoba, empaTia, altruizmi, samarTlianoba, pasuxismgebloba da tolerantoba; aseve uCvenos rom Seswevs unari gamoavlinos srulyofili da sayovelTaod aucilebeli Sefaseba da gansjisunarianoba saeqimo praqtikis dros.

komunikaciuri Cvevebi

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samedicino praqtika moicavs eqimTa Soris urTierTTanamSromlobas. aseve urTierTobas jandacvis sxva muSakebTan da pacientebTan. rezidents unda SeeZlos efeqturi urTierToba daamyaros pacientebTan, Sekribos informacia, auxsnas samedicino monacemebi da sakiTxebi pacients misTvis gasageb da aRsaqmel doneze, mousminos sxvas, Seicnos, pativi sces da upasuxos emociebs, gamoavlinos sensitiuroba socialur da kulturul mravalgvarobasTan dakavSirebiT. rezidents unda SeeZlos efeqturi kavSiri daamyaros da iTanamSromlos mis uZualo xelmZRvanelTan da zedamxedvelTan, sxva rezidentebTan da samedicino jgufis yvela sxva wevrTan.

motoruli unarebi

rezidents unda gaaCndes saTanado fizikuri monacemebi raTa ganaviTaros da daxvewos pacientis mkurnalobasTan da movlasTan dakavSirebuli teqnikuri da proceduruli Cvevebi. mas unda hqondes sakmarisi Zala da gamZleoba Seasrulos dakisrebuli movaleobebi gamomdinare specialobis specifikidan da gaaCndes adekvaturi fizikuri maragi da energia gadaitanos xSiri da xangrZlivi morigeobebi.

sensoruli SesaZleblobebi

rezidentma unda gamoimuSaos informaciis Segrovebis gansakuTrebiT gamaxvilebuli meTodi yvela grZnobiT, gansakuTrebiT mxedvelobiTi, smeniTi, ynosviTi da SexebiTi. es yvelaferi aucilebelia zusti samedicino da fizikuri anamnezis,fizikuri gasinjvis, diagnostikisa da mkurnalobis saTanadod warmarTvisaTvis.

garda zemoT ganxiluli saganmanaTleblo da interpersonuli Taviseburebisa,

programis dasrulebis Semdeg rezidents ganviTarebuli unda hqondes sabaziso eTikuri proncipebis gamoyenebis unari, man unda ucodes da icavdes pacientis uflebebs, unda hqondes gaTviTcnobierebuli misi movaleoba sazogadoebis mimarT da kargad erkveodes bio-samedicino kvlevis eTikur aspeqtebSi. rezidenturis kursdamTavrebuls unda SeeZlos samedicino statis kritikuli ganxilva, samecniero saqmianobis Tavadve warmarTva, unda hqondes gamomuSavebuli pedagogiuri unar-Cvevebi, SeeZlos Semdgomi personaluri da profesiuli ganviTareba. mas aseve kargad unda esmodes profesiuli saqmianobis ara marto mediko-biologiuri aramed iuridiuli standartebic; jandacvis menejmentis, ekonomikis da biznes aspeqtebi

4. programis marTva da administrireba da swavlebis/Sefasebis meTodebi

4.1. rezidentze zedamxedveloba TiToeuli rezidenti asrulebs garkveul saqmianobas. Teoriuli programis Sesruleba da

mravlobiTi rotaciebi gamiznulia imisaTvis, rom rezidentma SesZlos avadmyofTa farTo speqtris gansxvavebuli SemTxvevebis naxva, Seswavla da marTva; miiRos saganmanaTleblo gamocdileba, romelic gaTvaliswinebulia winamdebare sarezidento programiT. am procesis dros rezidentebze zedamxedveloba xorcieldeba ufroskurseli rezidentisa da zogierT SemTxvevaSi am mizniT specialurad daniSnuli eqimebis mier. TiToeul rezidentze zedamxedvelobisa da misi saqmianobis monitoringi xorcieldeba werilobiTi angariSis saxiT. saWiroa gakontroldes rezidentis mier misi individuri gegmis Sesruleba, rezidentis wasvla-mosvlis ganrigi, sxva valdebulebani, romlebic programiT aris gaTvaliswinebuli. zedamxedvelobis tipi (fizikuri daswreba, saxlSi gadarekva da ase Semdeg) rezidentisagan moiTxovs gansxvavebul damokidebulebas, qirurgiuli specializaciis sxvadasxva etapze. aRniSnuli gamowveulia im faqtiT, rom zeda safexurebze mimaval rezidents, kompetenciasTan erTad, proporciulad ezrdeba pasuxismgebloba da movaleobebi, maT Soris avadmyofTa mkurnalobasa da movlasTan dakavSirebiT. saboloo pasuxismgebloba yvela pacientis mkurnalobasTan an samedicino momsaxurebis sxva saxeebTan dakavSirebiT ekisreba damamTavrebeli kursis rezidentsa da rezidentTa zedamxedvelobis mizniT daniSnul eqimebs, romelic uSualod adevnebs Tvalyurs rezidentTa klinikur aqtivobas.

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4.2. rezidentTa Sefaseba

rezidenturis programis xelmZRvaneli atarebs rezidentis mier Catarebuli saqmianobis (a) periodul da (b) Semajamebel Sefasebas. rezidenti movalea awarmoos rezidentis saregistracio Jurnali, romelSic unda iyos asaxuli mis mier Catarebuli yovelkvireuli muSaoba (gatarebul pacientTa raodenoba stacionarSi da ambulatoriul pirobebSi, diagnostikuri da samkurnalo procedurebis Catareba an asistencia, monawileoba praqtikumebSi Teoriul da eqsperimentul bazebze, paTologanatomiur gakveTebSi, klinikisa da asociaciis samecniero-praqtikul konferenciebSi da sxva. Canawerebi unda iyos damowmebuli modulze pasuxismgebeli pirebis (lokaluri klinikuri xelmZRvanelebis) mier yovelkvireul Semajamebel klinikur seminarze. yoveli rotaciis ciklis dasrulebis Semdeg rezidenti amzadebs referats an Tanamedrove klinikur-samecniero literaturis mimoxilvas garkveul Temaze. perioduli Sefaseba tardeba rezidentis mzadebis yoveli rotaciis ciklis dasrulebis Semdeg, mis mier am ciklis periodSi CatarebulimuSaobis Sedegebis analizis safuZvelze. rezidentis periodul Sefasebas atarebs programis xelmZRvaneli modulze pasuxismgebel pirebTan (lokalur klinikur xelmZRvanelebTan) erTad. rezidenturis programis dasrulebis Semdeg, programaSi monawile dawesebulebebis modulze pasuxismgebeli pirebis (lokaluri klinikuri xelmZRvanelebis) gaerTianebul krebaze programis xelmZRvanelis mier Catardeba rezidentebisSemajamebeli Sefaseba, romelic werilobiTi formiT egzavnebaprogramis ganmaxorcielebel dawesebulebas/saswavlebels. rezidenturis programiT profesiuli mzadebis Sedegebis Sefasebisprocedura iTvaliswinebs rezidentis mier pirad monawileobas: - pacientTa kurirebaSi, arainvaziur da invaziur gamokvlevebSi, qirurgiuli Cvenebebis da saoperacio riskis dadgenaSi; - klinikuri dokumentaciis da gamokvlevebis protokolebis SedgenaSi; - pacientis operaciis wina momzadebis da operaciisSemdgom mkurnalobis marTvaSi; - qirurgiul operaciebSi da manipulaciebSi; - gamsvleli sakonsultacio-qirurgiuli brigadis moRvaweobaSi;

- qirurgiuli teqnikis da sisxlZarRvSida manipulaciebis daxelovnebaSi eqsperimentuli bazis pirobebSi; - klinikuri SemTxvevebis aRweraSi da maT wardgenaSi asociaciis winaSe; - klinikis samecniero moRvaweobaSi; - klinikuri da samecniero literaturis mimoxilvebis SedgenaSi; - paTologanatomiur gakveTebSi;

- leqciebisa da seminarebis daswrebaSi rezidentis profesiuli momzadebis raodenobrivida qulobrivi Sefaseba xdeba specialuri

Sevsebuli formebis analizis Sedegad. rezidentis moRvaweobis Sefasebisas gaTvaliswinebuli iqneba calkeul samedicino dawesebulebebSi Tu ganyofilebebSi modulze pasuxismgebeli pirebisagan (lokaluri klinikuri xelmZRvanelebisagan) miRebuli daxasiaTebebi, romlebSic codnisa da profesiuli unarCvevebis SefasebasTan erTad aucileblad unda iyos aRniSnuli misi Sesabamisoba saeqimo eTikis normebTan. programis xelmZRvanelobis wardginebisa da dadebiTi Semajamebeli daxasiaTebis safuZvelze, dawesebuleba/saswavlebeli ganixilavs konkretuli rezidentis mzadebis Sedegebs da iRebs gadawyvetilebas Sesabamis specialobaSi profesiuli mzadebis damadasturebeli dokumentis gacemis Sesaxeb, ris Semdeg mas eZleva ufleba miiRos monawileoba sasertifikacio gamocdaSi. rezidentis mier Catarebuli muSaobis aradamakmayofilebeli Sefasebis SemTxvevaSi mas eZleva ufleba, 1 wliT gaugrZeldes swavlebis kursi. modulze pasuxismgebel pirs (lokalur xelmZRvanels) gaaCnia rogorc iuridiuli, ise eTikuri pasuxismgebloba individualuri pacientis mkurnalobasa da movlaze, amave dros misi zedamxedvelobis qveS myofi piris saqmianobaze da ganaTlebaze. amasTan, ufroskursel rezidents, aRniSnuli zedamxedveloba ufro naklebi xarisxiT esaWiroeba, vidre swavlebis sawyis safexurze myof pirebs (Tumca ufroskurseli rezidentic moiTxovs zedamxedvelobas ama Tu im xarisxiT). miTiTebebis jaWvi iTvaliswinebs etapobrivi pasuxismgeblobis zrdas. uflebamosilebis gadacemis sazRvrebi, konkretul SemTxvevaSi ganisazRvreba modulze pasuxismgebeli piris (lokaluri xelmZRvanelis)mier, gamomdinare rezidentis akademiuri momzadebisa da teqnikuri mzaobis aspeqtebidan. amgvari midgoma unda gamomdinareobdes modulze pasuxismgebeli piris (lokaluri

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xelmZRvanelis)piradi/uSualo xangrZlivi dakvirvebidan, romelic garkveulwilad pasuxismgebeli unda iyos rezidentis mier qirurgiuli unar-Cvevebis aTvisebaze da am ukanasknelis xarisxze. am pasuxismgeblobis SesrulebisaTvis, momzadebis programa unda moicavdes zedamxedvelobis ganxorcielebis Semdeg principebs: 1. rezidentze zedamxedvelobis formebi SesaZlebelia ganisazRvros SinaganawesiT,

politikiT an sxva raime proceduruli normiT klinikaSi an konkretul romelime departamentSi;

2. rezidentze zedamxedvelobis formebi da wesebi periodulad mowmdeba programis xelmZRvanelobis mier;

3. saTanado zedamxedveloba xels ar unda uSlides progresul da SedarebiT ufro damoukidebel gadawyvetilebaTa miRebas rezidentTan dakavSirebiT; amgvarad, zedamxedvelobis tipi SesaZlebelia varirebdes klinikuri situaciebisa da rezidentis momzadebis etapisa da donis Sesabamisad. miuxedavad amisa, xelmZRvanelobis wevri an modulze pasuxismgebeli piri (lokaluri xelmZRvaneli) nebismier dros unda iyos xelmisawvdomi rCevis micemis, daxmarebis an konsultaciuri mxardaWerisaTvis. sisxlZarRvTa qirurgiis specialobis maZieblebi, rezidenturis programaSi momzadebis

dros unda akmayofilebdnen dadgenil akademiur kriteriumebs. wlidan wlamde, rezidentTa akademiuri kompetenciisa da klinikuri unar Cvevebis progresis raodenobrivi da xarisxobrivi Sefaseba xorcieldeba rezidentTa Sefasebis politikis saSualebiT. rezidentTa ganviTarebis da moqmedebis progresis monitoringi etapobrivad xorcieldeba TiToeuli rotaciis dasrulebis Semdeg. meores mxriv, rezidentis Sefaseba SesaZlebelia moxdes xelmZRvanelobis mier gamocdis tipiT mowyobili gamokiTxviT: zepiri, testuri, werilobiTi da Cvevebze uSualo zedamxedvelobis saxiT. Sefasebis yvela tipis dasrulebis Semdeg dgeba erTiani angariSi, romelic gadaegzavneba programis xelmZRvanels gansaxilvelad da xelmowerisaTvis. rezidents, romlis saboloo Sefasebis reitingi dabalia (Sefasebis sistema SesaZlebelia iyos - mZime - deficituri, mkveTrad deficituri, misaRebi, damakmayofilebeli, kargi, warmatebuli), dauyovnebliv egzavneba Sefasebis asli. imavdroulad asli igzavneba programis xelmZRvanelTan. am SemTxvevaSi, rezidents ufleba aqvs, werilobiT gamoxatos Tavisi Tanxmoba an winaaRmdegobrivi aspeqtebi mocemuli Sefasebis mimarT. rezidenti unda Sexvdes modulze pasuxismgebeli piris (lokalur xelmZRvanels), raTa ganixilon samomavlo strategia (swavleba, interpersonuli, komunikaciuri da a.S.) identificirebuli susti mxareebis aRmosafxvrelad. rezidentTa Sefasebis politika mniSvnelovania aseve programis promociis, srulyofis, gamosworebis da sxva mniSvnelovani sakiTxebis TvalsazrisiT.

specialoba – sisxlZarRvTa qirurgia moiTxovs Sefasebul da dokumentirebul codnas da amasTan erTad kargad ganviTarebul praqtikul unar-Cvevebs. sisxlZarRvTa qirurgis kvalifikaciis maZiebelma unda aCvenos saTanadod ganviTarebuli unarebi da maTi praqtikuli Sesruleba yvela zemoT CamoTvlil sferoSi. 4.3. Sefasebis meTodi: 80%-iani wesi sisxlZarRvTa qirurgis kvalifikaciis maZieblisaTvis wayenebuli minimaluri moTxovna moicavs

sul mcire 557 ჩatarebul intervenciasa da proceduras, 20ინტერვენციულ რადიოლოგიას da 40

operacias (operatori) სისხლძარღვთა ქირურგიაში. saerTo jamSi savaldebuloa სისხლძარღვთა

ქირურგიაში299 operaciis (operatori + asistencia) warmoeba swavlebis periodSi. sxvadasxva operaciisTvis gamonaklisis saxiT, operaciaTa sruli raodenoba unda aRwevdes sul mcire 80%-s. erT an ramdenime regionSi raodenobrivi deficiti unda gadaifaros da kompensirdes sxva jgufis operaciaTa raodenobiT, raTa saboloo jamSi Sesrulebuli iyos sruli minimaluri moculoba

(იხ. დანართი N2).

rezidentis mier monacemTa Segroveba da dafiqsireba unda xdebodes programiT dadgenili

wesiT, anu nebismieri Sesrulebuli samuSao saTanadod unda aisaxos rezidentis saregistracio JurnalSi. SesaZlebelia rezidentis saqmianobis registraciis eleqtronuli sistemis SemoReba, ris Semdegac SesaZlebeli gaxdeba rezidentis koduri sityviT dacul angariSze, nebismieri personaluri kompiuteridan informaciis Seyvana.

garda sakuTari saregistracio Jurnalis warmoebisa, rezidenti valdebulia dadgenili wesiT awarmoos samedicino Canawerebi, klinikur bazaze warmarTul saeqimo saqmianobasTan

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dakavSirebiT. Tu rezidentis mier, pacientTa mkurnalobasa da movlasTan dakavSirebuli Canawerebi ar iqneba ganaxlebuli pacientis klinikidan gaweridan 24 saaTis Semdeg, rezidents disciplinuri sanqciis saxiT SesaZloa moexsnas morigeoba.

programis xelmZRvanelis mier rezidents SesaZlebelia daumtkicdes (programis monawile yvela maTgans) yovelwliuri operaciuli aqtivobis (datvirTvis) minimaluri normebi.

4.4. rezidentTa mier programis Sefaseba rotaciebis ganmavlobaSi, rezidentebi afaseben diplomis Semdgomi mzadebis sarezidento

programas. Sefasebis dros gaTvaliswinebulia maTi operaciuli aqtivobis xarisxi, avadmyofis sawolTan palataSi muSaobis xarisxi, fakultetis SesaZleblobebi, programis Sesrulebis realuroba; aseve miuTiTeben maT survilebsa da mosazrebebs programis Semdgom srulyofasTan dakavSirebiT. programis romelime fragmentis maTi mxridan uaryofiTad Sefasebis SemTxvevaSi, maT sTxoven aseve warmoadginon problemis gamosworebis sakuTari xedva. Sefasebis dros garantirebulia sruli anonimuroba. Sedegebi muSavdeba da xelmisawvdomi xdeba Sefasebis dasrulebidan mokle vadebSi. Sefasebis Sedegebze dayrdnobiT, programis xelmZRvanelobaadgens rekomendaciebs, swavlebis xarisxis daxvewisa da gaumjobesebis TaviseburebebTan dakavSirebiT. sayovelTao Sefasebis dadebiTi Sedegebis arsebobis SemTxvevaSi, Tu amgvari warmateba sistematuria, programis xelmZRvaneloba aRZravs saTanado Suamdgomlobas, aRniSnuli tendenciis mxardasaWerad da waxalisebis Taobaze. programis monitorings axorcielebs “sisxlZarRvTa qirurgiaSi” sarezidento programis xelmZRvaneloba, romlis SemadgenlobaSi Sedis programis xelmZRvaneli, programis xelmZRvanelis moadgile, programaSi monawile klinikuri bazebis warmomadgenlebi – modulze pasuxismgebeli pirebi (lokaluri xelmZRvanelebi, modulebis mixedviT), sisxlZarRvTa qirurgTa erovnuli profesiuli da samecniero gaerTianebebis warmomadgenlebi.

5. programis xangrZlivoba

sisxlZarRvTa qirurgiaSi diplomis Semdgomi mzadebis periodi moicavs minimum xuT wels. programis mimdinareobis dros, kvalifikaciis maZiebels sxvadasxva obieqturi mizezebidan gamomdinare swavlebis Sewyveta ar SeuZlia erT welze meti periodis xangrZlivobiT. momzadebis periodSi resursebis simciris, programis uwyvetobisa da mimdinareobis xarisxis uzrunvelyofisaTvis SesaZlo risk-faqtorebis gaTvaliswinebiT, Tu kvalifikaciis maZiebeli ver Seasrulebs rezidenturis programiT gaTvaliswinebul klinikur unar-CvevaTa minimalurad sakmaris raodenobas, programis xelmZRvaneloba ganixilavs sakiTxs programis xangrZliobis gazrdasTan dakavSirebiT.

6. rezidenturaSi profesiuli mzadebis meToduri uzrunvelyofisa da organizaciis wesi

6.1. programis organizacia da meToduri uzrunvelyofa sisxlZarRvTa qirurgiaSi diplomisSemdgomi momzadebis programis marTvas

axorcielebs “sisxlZarRvTa qirurgiaSi” diplomisSemdgomi ganaTlebis programis fakulteti, romelic iqmneba akreditebul dawesebulebaSi/saswavlebelSi. fakultetis SemadgenlobaSi Sedian: programis xelmZRvaneli/xelmZRvaneli, programis xelmZRvanelis/xelmZRvanelis moadgile, programis mdivani, programaSi monawile klinikuri bazebis warmomadgenlebi (modulebis da blokebis mixedviT), maT Soris modulebze pasuxismgebeli pirebi (zogadi qirurgia, gulmkerdis qirurgia, sisxlZarRvTa qirurgia, kardioqirurgia, radiologia, bavSvTa qirurgia, klinikuri anatomia, otorinolaringologia, intensiuri Terapia da sxv), qirurgTa erovnuli profesiuli da samecniero gaerTianebebis warmomadgenlebi. fakulteti qmnis programis ganxorcielebisaTvis aucilebel infrastruqturas, romelic efuZneba modulebis da blokebis princips. departamentis mizania programis mimdinareobaze mudmivi meTvalyureoba, programis mimdinareobis xarisxis

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uzrunvelyofa, programis calkeuli komponentebis Sesrulebis harmonizacia analogiur evropul struqturebTan, programis ganxorcielebisaTvis aucilebeli resursebis uwyvetobis uzrunvelyofa, sisxlZarRvTa qirurgiaSi kvalifikaciis maZieblisaTvis xelSewyoba rogorc saorganizacio, ise profesiuli aspeqtebis mxriv. fakulteti monawileobs programisaTvis saWiro klinikuri bazebis SerCevisa da Sida Sefasebis procesSi.

programisdizainiimgvaradaakonstruirebuli, romswavlebis 2 an 3 wlisSemdeg, programaSimonawilepirssaSualebamieces,swavlagaagrZelossxvaqirurgiulimomijnave specialobisanalogiurdiplomisSemdgomimzadebissaganmanaTlebloprogramaSi. programismarTvazepasuxismgebelipiriaprogramisxelmZRvaneli, romelicaxdensakademiuridaadministraciuliuflebebisdelegirebasmodulebisxelmZRvanelebze.

6.2. rezidentebisSerCeva

programis departamenti da dawesebulebebi erToblivad monawileoben programaSi monawileobis msurveTa SerCevaSi. sisxlZarRvTa qirurgiis sagnobrivi specifikidan gamomdinare, programa moiTxovs solidur resursebs da multidisciplinur midgomas. aRniSnulidan gamomdinare, kvalifikaciis maZieblis SerCevas metad mniSvnelovani roli gaaCnia. SerCevis procedura ganisazRvreba saqarTveloSi moqmedi regulirebisa da normebis, aseve konkretuli akreditebuli dawesebulebis/saswavleblis mier dadgenili wesis Sesabamisad. SerCevisproceduraundaiyosgamWirvale, daTanasworadxelmisawvdomi. programisdepartamenti, SerCevissabolooetapzeawyobsSexvedraskandidatebTan.

rezidentebis SerCevis procesSi aucileblad unda monawileobdes rezidenturis fakultetis warmomadgenlebi. rezidenturaSi misaReb specialobis maZiebelTa SerCevis dros dauSvebelia piris diskriminacia raime niSniT.

moTxovnebi – “sisxlZarRvTa qirurgis” kvalifikaciis maZieblisadmi:

gamocdileba saswavlo programSi monawile pirs unda gaaCndes sabaziso samedicino ganTleba, romelsac man unda daaSenos programis farglebSi SeZenili codna da praqtikuli unar-Cvevebi. aRniSnulidan gamomdinare, programaSi monawile pirs unda SeeZlos bejiTi da dakvirvebuli muSaoba rogorc saavadmyofos, ise poliklinikis (ambulatoriis) da dRis stacionaris pirobebSi. isini yoveldRiurad unda asrulebdnen minimalurad aucilebel procedurebs mainc. aRniSnul proceduraTa raodenoba da saxeebi gansazRvrulia aRniSnuli programiT da mtkicdeba programis departamentis mier individuri samuSao gegmis saxiT. saswavlo programaSi momzadebis ena saswavlo programaSi monawile pirebi aucileblad unda flobdnen saxelmwifo enas, programaSi monawile ucxoeli moqalaqeebisaTvis dawesebuli unda iyos saxelmwifo enis codnis garkveuli moculoba da swavlebis procesSi maT unda ganaviTaron aRniSnuli lingvisturi SesaZleblobebi. programaSi monawile pirebisaTvis sasurvelia aseve inglisuri da/an sxva romelime ucxo enis codna Tanamedrove samedicino literaturisa gacnobis aucileblobis proncipidan da ucxoel kolegebTan urTierTobis interesebidan gamomdinare. katalogi (atlasi) programis monawileebi valdebulni arian dadgenili wesiT awarmoon da Seinaxon klinikuri unar-Cvevebis katalogi da sxva saWiro dokumentacia, romelic ukavSirdeba maT saswavlo programaSi monawileobas.

rezidentTa xelSewyobis politika sisxlZarRvTa qirurgis momzadeba klinikuri praqtikisaTvis moicavs sabaziso sagnebis

swavlebas, kogniciuri da teqnikuri Cvevebis aTvisebas, klinikuri codnis ganviTarebasa da profesiul simwifes, qirurgiuli msjelobis unaris Camoyalibebas, sakomunikacio unar-Cvevebis daxvewas, praqtikaze dafuZnebuli codnis ganzogadebas (gamocdilebas) da sistemaze dafuZnebuli codnis ganzogadebas. programis xuTwliani mimdinareobis periodSi TiToeul maZiebels moeTxoveba zemoT CamoTvlili mimarTulebebis da kompetenciebis swrafi da gegmazomiero progresis dadastureba. Semdgomi sarezidento donis (modulis) promocia (magaliTad PGY-1 –sa PGY-2-is mier) efuZneba rezidentis miRwevebs qirurgiul da

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zogadklinikur kompetenciebSi da moqmedebaSi, maT Soris gasaTvaliswinebelia kogniciuri, teqnikuri, profesiuli, eTikuri Cvevebi, romlebic adekvaturad unad ganizomos Sefasebis procesis dros. fakultetis mier mowyobili Sefasebebi gamiznulia imisaTvis rom rezidentis mier zemoT CamoTvlili kompetenciebis ganviTarebas mieces dokumenturi saxe, Tumca perioduli pirispir Sexvedrebi da uSualo Sefasebebi gacilebiT ufro metis momtania, Tundac im TvalsazrisiT, rom Sefaseba iyos ormxrivi da amocnobil iqnes yvela is riski da susti mxare, rac xels uSlis rezidentis kompetenciisa da moqmedebis adekvatur ganviTarebas. aseTi “pirispir” uSualo Sefasebebis dros SesaZlebelia zustad dadgindes rezidentis mier miRweuli akademiuri kompetenturoba, akademiuri saWiroebebi da moqmedebis axleburi standartebi. Tu Sefasebis dros dadgindeba, rom rezidentis moqmedeba mniSvnelovan deficits ganicdis da saWiroa damatebiTi dro am naklovanebaTa aRmosafxvrelad, programis xelmZRvanelma SesaZlebelia moiTxovos rotaciis xangrZliobis gazrda an momzadebis sistemis imgvari droebiTi modificireba, romelic am susti mxaris gamosworebas uzrunvelyofs. msgavsi xasiaTis rekomendaciebiT, programis xelmZRvanels SesaZloa mimarTos Tbilisis saxelmwifo samedicino universitetis xarisxis uzrunvelyofis samsaxurmac.

rezidenturis Sewyvetisa da rezidentis garicxvis politika

rezidenturis programis Sewyvetisa da rezidentis garicxvis Sesaxeb (swavlebis aRdgenis uflebis gareSe) gadawyvetilebas iRebs, sisxlZarRvTa qirurgiaSi sarezidento programis fakulteti. gadawyvetilebis miRebis safuZveli SesaZlebelia gaxdes rezidentis mier ganviTarebis (progresis) demonstrirebis SeuZlebloba, im kompetenciebis sazRvrebSi, romelic gansazRvrulia am programiT. gadawyvetilebis gasaCivreba SesaZlebelia programis fakultetis zemdgom struqturebSi. rezidentis garicxvis gadawyvetilebis miRebamde, fakulteti valdebulia werilobiTi gafrTxileba misces rezidents da SesTavazos misi aRmofxvris garkveuli modeli, risTvisac gansazRvravs garkveul periods. anu, winamdebare politika miznad isaxavs rezidentis garicxvis dauSveblobas, probaciuli periodis micemis gareSe. rezidentis garicxvis gadawyvetilebis miRebis safuZveli, garda akademiuri problemebisa, aseve SesaZlebelia gaxdes: toqsikuri an narkotikuli nivTierebebis zemoqmedebis qveS yofna, sxva personalis mimarT araeTikuri saqcieli da mopyroba, romelsac sistematuri xasiTi aqvs, sxva pirisaTvis mZime fizikuri an fsiqikuri zianis miyeneba, sqesobrivi iZuleba samsaxureobrivi movaleobis Sesrulebis dros da ase Semdeg. rezidentis garicxvis SemTxvevaSi, am ukanasknels, apelaciis aRZvris ufleba zemdgom struqturul erTeulebSi unarCundeba gadawyvetilebis gamoqveynebidan mxolod 30 dRis periodSi. apelacia unda iyos motivirebuli da exebodes garicxvis dadgenilebaSi moyvanili faqtebis gaqarwylebas. apelaciis daukmayofileblobis SemTxvevaSi, sakiTxi unda gadawydes saqarTvelos kanonmdeblobiT dadgenili wesiT. sisxlZarRvTa qirurgiis sabaziso momzadeba sabaziso momzadeba sisxlZarRvTa qirurgiaSi, gaTvaliswinebuli unda iyos saswavlo gegmis yvela etapze. mzadebis pirveli wlebis ganmavlobaSi, kvalifikaciis maZiebelma unda daasrulos momzadeba zogadi qirurgiis sabaziso sakiTxebSi rac moicavs: qirurgiul anatomias, gamoyenebiT fiziologias, metabolizms, imunologias, nutriciologias, travmis marTvas, paTologias, Wrilobebis qirurgias, Soks, reanimacias, intensiur Terapiasa da zogad onkologias. aRniSnuli aucilebloba garkveulwilad ganpirobebulia qirurgiis sxva specialobebis diplomis Semdgomi momzadebis programebSi, sisxlZarRvTa qirurgiis kvalifikaciis maZieblis SesaZlo gadasvlis sakiTxis interesebidan gamomdinare. garda aRniSnulisa, saswavlo programa SeZlebisdagvarad harmonizebuli unda iyos evropuli saganmanaTleblo sivrcis wevr qveyanaTa analogiur programebTan, rac xels Seuwyobs eqimTa (maT Soris diplomisSemdgomi ganaTlebis etapze) Tavisufal mobilobas erTiani saganmanaTleblo sivrcis farglebSi. saswavlo programa da klinikuri Cvevebis katalogi (atlasi) sisxlZarRvTa qirurgiaSi kvalifikaciis maZieblebma unda SeiZinos programaSi mocemuli gamocdileba da aiTvisos unar Cvevebis is CamonaTvali, romelic amave dokumentiTaa gansazRvruli, programis departamentis mier damtkicebuli (individuri) saswavlo gegmis Sesabamisad. operaciuli gamocdileba saTanado wesiT struqturirebulad unda iqnes registrirebuli da asaxuli programis maZieblis klinikuri Cvevebis katalogSi. mkurnalobis

i. zogadi debulebebi · sisxlzarrvta qirurgebsi codnis ertnairi donisa da setanxmebuli bazisuri...

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