rezidenturis diplomissemdgomi samedicino ganatlebis programa … · 2019. 9. 17. · rezidenturis...

rezidenturis diplomisSemdgomi samedicino ganaTlebis programarezidenturis diplomisSemdgomi samedicino ganaTlebis programarezidenturis diplomisSemdgomi samedicino ganaTlebis programarezidenturis diplomisSemdgomi samedicino ganaTlebis programa

“saojaxo medicina“saojaxo medicina“saojaxo medicina“saojaxo medicina““““ xangrZlivoba - 3w. (33 Tve)

Tavi I. zogadi debulebebiTavi I. zogadi debulebebiTavi I. zogadi debulebebiTavi I. zogadi debulebebi

1.1. Sesavali:Sesavali:Sesavali:Sesavali:

winamdebare sarezidento programa aRwers specialobaSi `ojaxis eqimi~ rezidentebis

swavlebis/mzadebis procesis komponentebs, saxeldobr: logikur safuZvlebs, Sinaarss, gamosavlebs/Sedegebs, strategiebsa da resursebs. programa moicavs Sefasebis meTodebisa da procesis aRwerasac; es ukanaskneli exeba rogorc Tavad swavlebis process, ise TiToeul rezidents.

programis komponentebi esadageba struqturirebuli saganmanaTleblo programis CarCos, romlis mizania, rogorc saqarTvelos, ise Tanamedrove evropis sxva qveynebis jandacvis sistemaSi saqmianobis mosurne eqimisaTvis mravalmxrivi codnis, kompetenciebis, komunikaciis Cvevebisa da profesiuli midgomebis swavleba. programis zogadi CarCo da struqtura detalurad asaxavs zogadi praqtikis/saojaxo medicinis evropul ganmartebas (WONCA Europe [The European Society of General Practice / Family Medicine]: The European Definition of General Practice/Family Medicine; Barcelona: WONCA, 2002), romelic mocemulia ojaxis eqimTa maswavleblebis evropuli akademiis mier momzadebul saganmanaTleblo programaSi (EURACT [European Academy of Teachers in General Practice] Education Agenda; EURACT, Leuven 2005). kerZod, EURACT-is saganmanaTleblo programaSi aRwerilia evropaSi zogadi praqtikis warmoebisaTvis aucilebelad miCneuli ZiriTadi kompetenciebi. kurikulumia isea Sedgenili, rom moicas zemoaRniSnuli dokumentiT gaTvaliswinebul yvela ZiriTad sakiTxebs da daavadebebs im codnis, unar-Cvevebisa da midgomebis CvenebiT, rac SesaZleblobas miscems praqtikos ojaxis eqims specifikur (Cveni qveynisaTvis damaxasiaTebel) konteqstSi warmoaCinos ojaxis eqimis kompetenciebi.

programa moicavs intensiuri mzadebis 3 wels (36 Tve) da Sedgeba sami ZiriTadi etapisagan – (a) saojaxo medicinis Sesavali kursi (6 Tve), (b) rotaciebi saavadmyofoebSi (18 Tve) da saojaxo medicinis specializebuli kursi (12 Tve).

mzadebaSi monawileobs Tbilisis saxelmwifo samedicino universitetis saojaxo medicinis departamenti (xelmZRvaneli – Tssu sruli profesori givi javaSvili) da saojaxo medicinis centri (xelmZRvaneli – Tssu asocirebuli porfesori guram kiknaZe). mzadebaSi, agreTve, CarTulia universitetTan asocirebuli klinikebi (rogorc pirveladi jandacvis [saojaxo medicinis klinikebi da saswavlo centrebi], ise jandacvis meoreuli da mesameuli donis dawesebulebebi). zemoaRniSnuli klinikebi universitetTan TanamSromloben xelSekrulebis safuZvelze.

mzadebis ZiriTad nawils warmarTaven universitetis saojaxo medicinis departamentisa da centris TanamSromlebi da ojaxis eqimebi, agreTve sxva specialobis warmomadgenlebi romlebic TanamSromloben zemoT moxseniebul centrTan da departamentTan da aqvT saTanado momzadeba mozrdilTa swavlebis sakiTxebSi.

mzadebaSi CarTuli pirebis did nawils gavlili aqvs `zogadi praqtikis maswavlebelTa evropuli akademiis~ (EURACT), litvis ojaxis eqimTa maswavleblebis sazogadoebis, klaipedas universitetisa da Tbilisis saxelmwifo samedicino universitetis (saqarTvelos saxelmwifo samedicino akademiis) saojaxo medicinis fakultetis/departamentis mier 2005 wlis ivnis-agvistoSi organizebuli mzadebis programis sami moduli (saerTo xangrZlivoba 100 saaTi), romlis mizani iyo ojaxis eqimTa maswavleblebis momzadeba Tbilisis saxelmwifo samedicino universitetis saojaxo medicinis departamentis da centris mier, agreTve aRniSnuli struqturebis mier ojaxis eqimTa damoukideblad mzadebisaTvis saWiro programis SemuSaveba.

rezidenturaSi mzadebis procesSi monawile sxva profesionalebs gavlili aqvT ojaxis eqimTa mzadebis analogiuri kursi, romelic 2006 wels organizebuli iyo

rezidenturis (diplomisSemdgomi samedicino ganaTlebis) programa “ojaxis eqimi”

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Tbilisis saxelmwifo samedicino universitetis saojaxo medicinis departamentisa da centris mier (programis xangrZlivoba 80 akademiuri saaTi).

mzadebis garemo moicavs Tbilisis saxelmwifo samedicino universitetis saojaxo medicinis centrs da universitetTan asocirebul saojaxo medicinis klinikebsa, saswavlo centrebsa da saavadmyofoebs.

Tbilisis saxelmwifo samedicino universitetis saojaxo medicinis centrs aqvs Semdegi daniSnulebis teqnikuri resursebi (farTobi, aRWurviloba, saswavlo masalebi):

# dasaxeleba raod. SeniSvna

1. saleqcio auditoria 1 35-45 msmenilsTvis; aRWurvili ekraniT, multimedia da overhed proeqtorebiT.

2. saswavlo oTaxebi mcire jgufebSi samuSaod

5 7-15 msmenelisaTvis; aRWurvili ekraniT, multimedia da overhed proeqtorebiT da saweri dafebiT.

3. praqtikuli Cvevebis saswavlo auditoria

5 sxvadasxva mulJebiTa da simulatorebiT aRWurvili.

4. multimedia laboratoria 1 kompiuteruli klasiT, videomagnitofoniT, televizoriTa da musikaluri centriT aRWurvili.

5. biblioTeka: samkiTxveloTi da kompiuteruli darbaziT

1 Tanamedrove literaturiT, sasw. masalebiT da teqnikiT aRWurvili.

1.2. mizani da amocanebi:1.2. mizani da amocanebi:1.2. mizani da amocanebi:1.2. mizani da amocanebi:

specialobaSi òjaxis eqimi~ diplomis Semdgomi mzadebis umTavresi mizania Camoayalibos eqimi specialisti, romlis Teoriuli codna da proaqtikuli unar-Cvevebi Seesabameba ojaxis eqimis specialobis aRwerilobas, romelic, Tavis mxriv, maqsimalurad Seesabameba saqarTvelos mosaxleobis janmrTelobis interesebsa da Taviseburebebs da iTvaliswinebs Sromis bazris moTxovnebs.

winamdebare sarezidento programa aRwers specialobaSi òjaxis eqimi~ rezidentebis swavlebis/mzadebis procesis yvela ZiriTad komponents. programis amocanaa Camoayalibos rezidenti rogorc specialisti òjaxis eqimi~, am specialobis yvela ZiriTadi 12 maxasiaTeblis mixedviT (ix. specialobisa da specialistis gansazRvreba (definicia) da mzadebis amocanebi VI ZiriTad TavSi).


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2222. specialobis òjaxis eqimi~. specialobis òjaxis eqimi~. specialobis òjaxis eqimi~. specialobis òjaxis eqimi~ aaaaRweriloba/specifikacia:Rweriloba/specifikacia:Rweriloba/specifikacia:Rweriloba/specifikacia:

òjaxis eqimis~ specialobis aRwerilobis momzadebisas gamoyenebuli iqna Semdegi masalebi:

� zogadi praqtikis/saojaxo medicinis evropul ganmarteba (WONCA Europe [The European Society of General Practice / Family Medicine]: The European Definition of General Practice/Family Medicine; Barcelona: WONCA, 2002; www.wonca.org );

� ojaxis/zogadi praqtikis eqimTa maswavleblebis evropuli akademiis saganmanaTleblo programaSi (EURACT [European Academy of Teachers in General Practice] Education Agenda; EURACT, Leuven 2005; www.euract.org ).

� amerikis ojaxis eqimTa akademiis kurikulumis masalebi ojaxis eqimTa rezidenturaSi mzadebisaTvis (www.aafp.org )

� didi britaneTis zogadi praqtikis eqimTa samefo kolejis kurikulumis masalebi zogadi praqtikis eqimTa rezidenturaSi mzadebisaTvis (www.rcgp.org.uk )

Tavi I. specialobisa da specialistis gansazRvreba (definicia)Tavi I. specialobisa da specialistis gansazRvreba (definicia)Tavi I. specialobisa da specialistis gansazRvreba (definicia)Tavi I. specialobisa da specialistis gansazRvreba (definicia)

saojaxo medicinasaojaxo medicinasaojaxo medicinasaojaxo medicina – akademiuri da mecnieruli disciplina sakuTari saganmanaTleblo SinaarsiT, kvleviT, mtkicebiTi safuZvlebiT da klinikuri saqmianobiT; is pirvelad jandacvaze orientirebuli klinikuri specialobaa.

zogadi praqtikis/saojaxo medicinis evropis sazogadoebis (WONCA EUROPE) bolo ganmartebebis mixedviT (European Definition of Family Medicine, 2002) zogadi praqtikis/saojaxo medicinis rogorc disciplinis maxasiaTeblebi Semdegia:

a) Cveulebriv, samedicino personalTan pirveli Sexebis wertilia jandacvis sistemaSi; uzrunvelyofs Ria da SeduzRudav xelmisawvdomobas momxmareblisaTvis da dakavebulia misi janmrTelobis problemebiT asakis, sqesis an raime pirovnuli maxasiaTeblis miuxedavad;

b) racionalurad iyenebs jandacvis resursebs pirvelad jandacvaSi samedicino daxmarebis koordinaciis, sxva profesionalebTan erToblivi saqmianobis gziT, agreTve, sxva specialobebTan urTierTobis marTviT da advokatis rolis SesrulebiT im SemTxvevebSi, roca pacients es sWirdeba.

g) aviTarebs individze (pirovnebaze) orientirebul midgomas, orientirebuls Tavad individze, mis ojaxze da Temze.

d) aqvs unikaluri sakonsultacio procesi romelic afuZnebs droiT SeuzRudav urTierTobebs eqimsa da pacients Soris efeqturi komunikaciis gziT;

e) pasuxismgebelia gamWoli, uwyveti daxmarebisaTvis pacientis saWiroebebis Sesabamisad;

v) sargeblobs specifikuri gadawyvetilebis miRebis procesiT, rac ganpirobebulia TemSi daavadebebis gavrcelebiTa da sixSiriT;

T) erTdroulad marTavs pacientis rogorc mwvave, ise qronikul problemebs;

i) marTavs daavadebebs romelnic warmodgenilni arian aradiferencirebuli formiT, Tavisi ganviTarebis adreul etapebze, rac SeiZleba Txoulobdes gadaudebel Carevas;

k) xels uwyobs janmrTelobas da keTildReobas saTanado da efeqturi CarevebiT;

l) specifikuri pasuxismgeblobis matarebelia Temis jandacvaze;

m) exmianeba janmrTelobis problemebs maTi fizikuri, socialuri, kulturuli da egzistencialuri ganzomilebebis gaTvaliswinebiT.

ojaxis eqimiojaxis eqimiojaxis eqimiojaxis eqimi aris eqimi specialisti romelic saTanado ganswavlis gziT dauflebulia `saojaxo medicinis~, rogorc disciplinis principebs (ix. zemoT). is personaluri eqimia,


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upirveles yovlisa pasuxismgebeli yovlismomcveli da mudmivi zrunvisaTvis yovel pirze, romelsac esaWiroeba samedicino daxmareba, ganurCevlad misi asakis, sqesisa da daavadebisa. is zrunavs pirovnebaze ojaxis, Temis, kulturis konteqstSi, yovelTvis pativs scems pacientis avtonomias. is iRebs pasuxismgeblobas Temis winaSec. pacientTan samoqmedo gegmis Sedgenisas ojaxis eqimi erToblivad ganixilavs fizikur, fsiqologiur, socialur, kulturul da ezsistencialur faqtorebs, iyeneben codnasa da ndobas, rac saTaves pacientTan ganmeorebiTi kontaqtebidan iRebs. ojaxis eqimi Tavis profesiul rols asrulebs janmrTelobisaTvi xelSewyobis, daavadebaTa prevenciisa da mkurnalobis, movlisa da paliatiuri mzrunvelobis gziT. yovelive amas is an Tavad akeTebs, an iyenebs sxvebis mier gaweuli momsaxurebas janmrTelobis saWiroebebisa da arsebuli xelmisawvdomi resursebis gaTvaliswinebiT, saWiroebis SemTxvevaSi exmareba pacients am resursebis gaTvaliwinebuli momsaxurebis miRebaSi. ojaxis eqimma unda ikisros pasxuxismgebloba da ganaviTaros da SeinarCunos profesiuli Cvevebi, pirovnuli wonasworoba da faseulobebi, raTa uzrunvelyos pacientebisaTvis efeqturi da usfrTxo samedicino momsaxurebis gaweva.

Tavebi IITavebi IITavebi IITavebi II----III. specialistis òjaxis eqimi~ zogadi codna da unarIII. specialistis òjaxis eqimi~ zogadi codna da unarIII. specialistis òjaxis eqimi~ zogadi codna da unarIII. specialistis òjaxis eqimi~ zogadi codna da unar----CvevebiCvevebiCvevebiCvevebi

ojaxis eqimis, rogorc specialistis zogadi kompetencia, anu codna da unar-Cvevebi mTlianad mocemuli disciplines maxasiaTeblebidan gamomdinareobs. qvemoT mocemulia specialobis òjaxis eqimi~ maxasiaTeblebis ufro detaluri interpretacia, rac aucilebelia ojaxis eqimis kompetenciis srulyofilad daxasiaTebisaTvis:

a)a)a)a) Cveulebriv, samedicino personalTan piCveulebriv, samedicino personalTan piCveulebriv, samedicino personalTan piCveulebriv, samedicino personalTan pirveli Sexebis wertilia jandacvis sistemaSi; rveli Sexebis wertilia jandacvis sistemaSi; rveli Sexebis wertilia jandacvis sistemaSi; rveli Sexebis wertilia jandacvis sistemaSi; uzrunvelyofs Ria da SuzRudav xelmisawvdomobas momxmareblisaTvis da dakavebulia uzrunvelyofs Ria da SuzRudav xelmisawvdomobas momxmareblisaTvis da dakavebulia uzrunvelyofs Ria da SuzRudav xelmisawvdomobas momxmareblisaTvis da dakavebulia uzrunvelyofs Ria da SuzRudav xelmisawvdomobas momxmareblisaTvis da dakavebulia misi janmrTelobis problemebiT asakis, sqesis an raime pirovnuli maxasiaTeblis misi janmrTelobis problemebiT asakis, sqesis an raime pirovnuli maxasiaTeblis misi janmrTelobis problemebiT asakis, sqesis an raime pirovnuli maxasiaTeblis misi janmrTelobis problemebiT asakis, sqesis an raime pirovnuli maxasiaTeblis miuxedavad.miuxedavad.miuxedavad.miuxedavad.

`Cveulebriv~ gamoiyeneba imis aRsaniSnavad, rom zogierT situaciaSi, magaliTad didi travmis dros, ara gvaqvs saqme kontaqtis pirvel zRudesTan. amave dros, is SeiZleba iyos pirveli wertili sxva situaciebSi. ar unda arsebobdes barierebi xelmisawvdomobis gzaze; ojaxis eqimi dakavebuli unda iyos pacientebis yvela tipiT - axalgazrda Tu moxuci, mamakaci Tu qali, da maTi janmrTelobis problemebiT. zogadi praqtika pirveli da arsebiTi resursia. is moicavs saqmianobis did sferos, romelic warmodgenilia pacientis saWiroebebiTa da problemebiT. aseTi midgoma SesaZlebels xdis disciplinis mravali aspqtis gaTvaliswinebas, iZleva SesaZleblobas maTi gamoyenebisa individualuri da TemSi arsebuli problemebis gadasaWrelad.

b)b)b)b) racionalurs xdis jandacvis resursebis gamoyenebas pirvelad jandacvaSi samedicino racionalurs xdis jandacvis resursebis gamoyenebas pirvelad jandacvaSi samedicino racionalurs xdis jandacvis resursebis gamoyenebas pirvelad jandacvaSi samedicino racionalurs xdis jandacvis resursebis gamoyenebas pirvelad jandacvaSi samedicino daxmarebis koordindaxmarebis koordindaxmarebis koordindaxmarebis koordinaciis, sxva profesionalebTan erToblivi saqmianobis gziT, agreTve, aciis, sxva profesionalebTan erToblivi saqmianobis gziT, agreTve, aciis, sxva profesionalebTan erToblivi saqmianobis gziT, agreTve, aciis, sxva profesionalebTan erToblivi saqmianobis gziT, agreTve, sxva specialobebTan urTierTobis marTviT da advokatis rolis SesrulebiT im sxva specialobebTan urTierTobis marTviT da advokatis rolis SesrulebiT im sxva specialobebTan urTierTobis marTviT da advokatis rolis SesrulebiT im sxva specialobebTan urTierTobis marTviT da advokatis rolis SesrulebiT im SemTxvevebSi, roca pacients es sWirdeba.SemTxvevebSi, roca pacients es sWirdeba.SemTxvevebSi, roca pacients es sWirdeba.SemTxvevebSi, roca pacients es sWirdeba.

makoordinebeli roli xarisxiani da xarjefeqturi pirveladi samedicino daxmarebis umniSvnelovanesi maxasiaTebelia. is uzrunvelyofs pacientis Sexvedras specifikuri problemebis gadaWris saTanado unaris mqone jandacvis profesionalTan. samedicino daxmarebis sxvadasxva saxeebis gawevis unaris mqone spcieliatTa erToblioba, saTanado informaciis gavrceleba da daniSnuli mkurnalobis regulireba aucileblad moiTxovs makoordinirebel erTeuls. zogad praqtikas SeuZlia am kardinaluri rolis Sesruleba, Tu infrastruqturac iZleva amis SesaZleblobas. samedicino daxmarebis xarisxis uzrunvelsayofad gundi muSaobs pacientTan yvela sxva jandacvis profesionalTan erTad. sxva specialistebTan TanamSromlobis koordinaciiT disciplina xelmisawvdoms xdis pacientisaTvis saWiro maRalteqnologiuri, meoreul jandacvaSi ganTavsebulni momsaxurebas. disciplinis kvanZovani rolia advokatura - pacientis dacva im vnebisagan, rac mas SeiZleba moutanos arasaWiro skriningma, testirebam da mkurnalobam; agreTve megzuroba jandacvis sistemis kompleqsurobis junglebSi gasavlelad.


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g)g)g)g) aviTarebs individze orientirebul midgomas, orientirebuls aviTarebs individze orientirebul midgomas, orientirebuls aviTarebs individze orientirebul midgomas, orientirebuls aviTarebs individze orientirebul midgomas, orientirebuls Tavad individze, mis Tavad individze, mis Tavad individze, mis Tavad individze, mis ojaxze da da Temze. ojaxze da da Temze. ojaxze da da Temze. ojaxze da da Temze.

saojaxo medicina exeba adamianebsa da maT problemebs maTi cxovrebis pirobebisa da garemoebebis konteqstSi da ara `impersonalur~ paTologiuri mdgomareobebsa da klinikur SemTxvevebs. saqmianobis amosavali punqtia pacienti. mniSvnelovania imisi gageba, Tu rogor aRiqvams pacienti daavadebas da daavadebis mimdinareobas. amosavali wertilia pirovneba, misi rwmeniT, SiSiT, molodiniTa da saWiroebebiT.

d)d)d)d) aqvs unikaluri sakunsaltacio procesi romelic afuZnebs droiT SeuzRudav aqvs unikaluri sakunsaltacio procesi romelic afuZnebs droiT SeuzRudav aqvs unikaluri sakunsaltacio procesi romelic afuZnebs droiT SeuzRudav aqvs unikaluri sakunsaltacio procesi romelic afuZnebs droiT SeuzRudav urTierTobebs efeqturi komunikaciis gziT eqimsa da pacients SorisurTierTobebs efeqturi komunikaciis gziT eqimsa da pacients SorisurTierTobebs efeqturi komunikaciis gziT eqimsa da pacients SorisurTierTobebs efeqturi komunikaciis gziT eqimsa da pacients Soris

yoveli kontaqti pacientsa da ojaxis eqims Soris ayalibebs Semtania maT urTierTobas, yoveli indivivdualuri konsultacia win gadadgmuli nabijia ukve arsebuli gamocdilebis gaRrmavebis gzaze. personaluri urTierTobis fasi ganisazRvreba ojaxis eqimis sakumunikacio CvevebiT da Tavis TavSi Seicavs Terapiul komponentsac.

e)e)e)e) pasuxismgebelia gamWoli uwyveti daxmarebisaTvis pacientis saWiroebebis Sesabamisad.pasuxismgebelia gamWoli uwyveti daxmarebisaTvis pacientis saWiroebebis Sesabamisad.pasuxismgebelia gamWoli uwyveti daxmarebisaTvis pacientis saWiroebebis Sesabamisad.pasuxismgebelia gamWoli uwyveti daxmarebisaTvis pacientis saWiroebebis Sesabamisad.

zogadi praqtikis saqmianoba mudmivi da uwyveti unda iyos – dabadebidan (zogjer ki manamdec) sikvdilamde (zogjer Semdegac). is uzrunvlyofs meTvalyureobis mudmivobas/uwyvetobas mTeli cxovrebis ganmavlobaSi. samedicino Canawerebi mudmivobis/uwyvetobis kargi dadasturebaa. is konsultaciebis daiqsirebis obieqturi meTodia, magram pacientisa da eqimis urTierTobebis istoriisa mxolod erTi nawilia. ojaxis eqimi pacientis gverdiT aris misi cxovrebis yvela mniSvnelovan - avadmyofobis epizodebis periodSi. is agreTve pasxuxismgebelia imisaTvis, rom janmrTelobis dacvis SesaZlebloba uzrunvelyofili iqnes 24 saaTis ganmavlobaSi, moaxerxos misi uzrunvelyfois koordinacia, mas Tavad ar SeuZlia samedicino daxmarebis aRmoCena.

v)v)v)v) sargeblobs specifikuri gadawyvetilebis miRebis procesiT, rac ganpirobebulia TemSi sargeblobs specifikuri gadawyvetilebis miRebis procesiT, rac ganpirobebulia TemSi sargeblobs specifikuri gadawyvetilebis miRebis procesiT, rac ganpirobebulia TemSi sargeblobs specifikuri gadawyvetilebis miRebis procesiT, rac ganpirobebulia TemSi daavadebebis gadaavadebebis gadaavadebebis gadaavadebebis gavrcelebiTa da sixSiriT.vrcelebiTa da sixSiriT.vrcelebiTa da sixSiriT.vrcelebiTa da sixSiriT.

ojaxis eqims saqme aqvs problemebTan, romelnic gansxvavdebian meoreul jandacvaSi warmodgnili problemebisagan. daavadebaTa gavrceleba da sixSire gansxvavebulia stacionarebSi arsebuli situaciisagan; seriozuli daavadebebi naklebad xSiria zogad praqtikaSi, vidre stacionarebSi, vinaidan zogad praqtikaSi pacientebis SerCeva ar xdeba. es moiTxovs specifikur unars, romelic daefuZneba gadawyvetilebis miRebis process romlis drosac gamoiyeneba pacientisa da Temis Sesaxeb ojaxis eqimis xelT arsebuli informacia.Pprognozul Sefasebebs, pozitiur an negatiur klnikur niSnebs an sadiagnozo testebs saojaxo medicinaSi, SedarebiT stacionarul sistemasTan, gansxvavebuli fasi aqvT. xSirad ojaxis eqimma unda Tavi unda daizRvios im SemTxvevebSi, roca saxeze daavadebis arsebobis Taobaze SiSi da pirvelma gansazRvros, rom es daavadeba ar arsebobs.

z)z)z)z) erTdroulad marTavs pacientis rogorc mwvave, ise qronikul problemebs.erTdroulad marTavs pacientis rogorc mwvave, ise qronikul problemebs.erTdroulad marTavs pacientis rogorc mwvave, ise qronikul problemebs.erTdroulad marTavs pacientis rogorc mwvave, ise qronikul problemebs.

saojaxo medicina dakavebulia yoveli pacientis janmrTelobasTan dakavSirebuli yvela problemiT. mas ar SeuZlia SeizRudos mxolod arsebuli daavadebis marTviT, xSirad eqimma mravalferovani problemebi unda marTos. pacienti xSirad warmoadgens mraval Civils, romelTa raodenobac izrdeba asakTan erTad. erTdrouli pasuxi mravalmxriv moTxovnebze moiTxovs ierarqiis dawesebas problemebisa marTvisas, rogorc eqimis, ise pacientis prioritetebis mxedvelobaSi miRebiT.

T)T)T)T) marTavs daavadebebs romelnic warmodgenilni arian aradiferencirebuli formiT, Tavisi marTavs daavadebebs romelnic warmodgenilni arian aradiferencirebuli formiT, Tavisi marTavs daavadebebs romelnic warmodgenilni arian aradiferencirebuli formiT, Tavisi marTavs daavadebebs romelnic warmodgenilni arian aradiferencirebuli formiT, Tavisi ganviTarebis adreul etapebze, rac SeiZleba Txoulobdes gadaudebel CarevganviTarebis adreul etapebze, rac SeiZleba Txoulobdes gadaudebel CarevganviTarebis adreul etapebze, rac SeiZleba Txoulobdes gadaudebel CarevganviTarebis adreul etapebze, rac SeiZleba Txoulobdes gadaudebel Carevas.as.as.as.

pacienti xSirad momarTavs ojaxis eqims simptomebis aRmocenebisTanave; aseT adreul stadiaze diagnozis dasma Znelia. aseT SemTxvevebSi pacientisaTvis mniSvnelovani


7

gadawyvetileba miRebuli unda iqnes SezRuduli informaciis safuZvelze da, amdenad, klinikuri da paraklinikuri gamokvlevis prognozuli mniSvneloba naklebad zustia. im SemTxvevebSic ki, rodesac ama Tu im daavadebis niSnebi kargad cnobilia, am daavadebis adreul stadiaze gamoxatuli niSnebi xSirad araspecifikuria da saerToa mravali daavadebisaTvis. aseT pirobebSi riskis marTva disciplinis ZiriTadi maxasiaTebelia. meyseuli seriozuli gamosavalis gamoricxvisas gadawyvetileba saboloo ar unda iqnes – is kidev erTxel unda iqns gadamowmebuli momavalSi. mxolod erTi konsultaciis Sedegi xSirad erTi an ramdenime simptomis konstataciaa, zogjer mxolod mosazreba ibadeba daavadebis arsebobis Sesaxeb; saboloo da sruli diagnozi iSviaTad aris SesaZlebeli.

i)i)i)i) xels uwyobs janmrTelobasa da keTildReobas saTanado da efeqturi CarevebiT.xels uwyobs janmrTelobasa da keTildReobas saTanado da efeqturi CarevebiT.xels uwyobs janmrTelobasa da keTildReobas saTanado da efeqturi CarevebiT.xels uwyobs janmrTelobasa da keTildReobas saTanado da efeqturi CarevebiT.

Carevebi adekvaturi, efeqturi unda iyos da efuZnebodes saTanado mtkicebulebebs, roca ki es SesaZlebelia. Careva, romelic ar aris saWiro, SesaZloa zianis momtani da jandacviTi resursebis umizno xarjvis ganmapirobebeli gaxdes.

k)k)k)k) specifikuri pasuxismgeblobis matarebelia sazogadoebis janmrTelobis daspecifikuri pasuxismgeblobis matarebelia sazogadoebis janmrTelobis daspecifikuri pasuxismgeblobis matarebelia sazogadoebis janmrTelobis daspecifikuri pasuxismgeblobis matarebelia sazogadoebis janmrTelobis dacvaze;cvaze;cvaze;cvaze;

disciplina aRiarebs rom is pasuxsimgebelia rogorc calkeuli pacientis, ise mTlianad Temis (sazogadoebis) janmrTelobis dacvisaTvis. zog SemTxvevaSi aman SeiZleba gamoiwvios daZabuloba da interesebis konfliqti, risi mogvarebac saTanadod aris saWiro.

l)l)l)l) dakavebulia janmrTelobis problemebiT maTi fizikuri, socialuri, kulturuli da dakavebulia janmrTelobis problemebiT maTi fizikuri, socialuri, kulturuli da dakavebulia janmrTelobis problemebiT maTi fizikuri, socialuri, kulturuli da dakavebulia janmrTelobis problemebiT maTi fizikuri, socialuri, kulturuli da egzistencialuri ganzomilebebis gaTvaliwinebiT.egzistencialuri ganzomilebebis gaTvaliwinebiT.egzistencialuri ganzomilebebis gaTvaliwinebiT.egzistencialuri ganzomilebebis gaTvaliwinebiT.

disciplina yvela am ganzomilebas erTdroulad iTvaliswinebs da TiToeuls Sesabamis mniSvnelobas aniWebs. daavadebaTa Taviseburebebi da maxasiaTeblebi cvalebadia am miTiTebul sakiTxebTan kavSirSi da xSirad warumatebloba imiTia ganpirobebuli, rom Carevis samizne problemis siRrmiseuli nawili ara aris.

Tavi IV. specialistis òjaxis eqimi~ specifikuri kompetenciebi sxvadasxva daavadebebis Tavi IV. specialistis òjaxis eqimi~ specifikuri kompetenciebi sxvadasxva daavadebebis Tavi IV. specialistis òjaxis eqimi~ specifikuri kompetenciebi sxvadasxva daavadebebis Tavi IV. specialistis òjaxis eqimi~ specifikuri kompetenciebi sxvadasxva daavadebebis pppprevenciis, amocnobis, Sefasebisa da marTvis sferoSirevenciis, amocnobis, Sefasebisa da marTvis sferoSirevenciis, amocnobis, Sefasebisa da marTvis sferoSirevenciis, amocnobis, Sefasebisa da marTvis sferoSi

ojaxis eqimis specifikuri kompetenciebi calkeuli klinikuri sferoebis mixedviT detalurad aris asaxuli programis V ZiriTad TavSi (`programis etapobrivi ganxorcielebis aRweriloba [etapebis mixedviT]~).

Tavi Tavi Tavi Tavi V. sadiagnozo da samkurnalo manipulaciebiV. sadiagnozo da samkurnalo manipulaciebiV. sadiagnozo da samkurnalo manipulaciebiV. sadiagnozo da samkurnalo manipulaciebi

ojaxis eqims unda SeeZlos Semdeg sadiagnozo da samkurnalo manipulaciebis damoukideblad Catareba:

� fizikuri gasinjvis zogadi meTodebi organoTa sistemebis mixedviT (daTvaliereba, palpacia, perkusia, auskultacia);

� ZiriTadi sasicocxlo funqciebis SenarCuneba da kardiopulmonuri reanimacia (mozrdilebSi, bavSvebSi, Cvilebsa da axalSobilebSi);

� ekg-is gadaReba da interpretacia;

� fataluri ariTmiebis marTva da defibrilacia;

� axalSobilis pirveladi higienuri RonisZiebebis Catareba;

� mcireqirurgiuli manipulaciebi: Wrilobis pirveladi damuSaveba, qirurgiuli nakerebis dadeba da moxsna, infiltraciuli anesTezia (gamtareblobiTi da budobrivi), abscesebis, panariciumebis, flegmonebis gakveTa da gaxsna, Cazrdili frCxilis mocileba, rbili qsovilebis zedapirul simsivneTa inokulacia, naxvevis dadeba da sxv.;

� damwvrobisa da inficirebuli Wrilobis damuSaveba


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� zedapiruli ucxo sxeulebis mocileba;

� ineqciebi: kanSida, kanqveSa, intramuskuluri, intravenuri; intravenuri infuzia;

� mxedvelobis organis Sefaseba/gasinjva: daTvaliereba, mxedvelobis simaxvilis dadgena, ofTalmoskopia/fundoskopia,

� otoskopia, gogirdis sacobis gamoZeveba wylis WavliT;

� rinoskopia, faringoskopia, arapirdapiri laringoskopia;

� bimanualuri vaginaluri da reqtovaginaluri gamokvleva, `sarkis Cadgma~;

� garegani sameano gasinjva, nayofis guliscemis Sefaseba

� placentis mdebareobis Sefaseba

� orsulis mdgomareobis Sefaseba funqcionaluri diagnostikis meTodebiT

� fiziologiuri mSobiarobis marTva;

� Sardis buStis kaTeterizacia

� swori nawlavis da winamdebare jirkvlis gasinjva TiTiT;

� amovardnilobis koreqcia;

� satransporto imobilizacia kidurebis Zvlebisa da xerxemlis motexilobs SemTxvevaSi;

� nacxis aReba baqteriologiuri da citologiuri gamokvlevebisaTvis;

� paracentezi, plevris punqcia, daWimuli pnevmoToraqsis gadayvana Ria pnevmoToraqsSi.

3. swavlebis da 3. swavlebis da 3. swavlebis da 3. swavlebis da Sefasebis meTodebiSefasebis meTodebiSefasebis meTodebiSefasebis meTodebi

swavlebis meTodebiswavlebis meTodebiswavlebis meTodebiswavlebis meTodebi

specialobaSi òjaxis eqimi~ rezidentebis mzadebis procesSi gamoyenebuli swavlebis meTodebi damokidebulia im codnasa da unar-Cvevebze, romelic unda SeiZinos rezidentma mocemuli modulis dros. mTlianad programa orientirebulia mozrdilTa swavlebis meTodebze. gamoyenebuli iqneba mozrdilTa swavlebis yvela ZiriTadi meTodi, rac, rogorc wesi efuZneba msnelis/monawilis motivirebas, interaqtiuri swavlebasa da damoukidebel gundur da individualur muSaobas.

TiToeuli sakiTxis asaTviseblad SerCeulia mozrdilTa swavlebis SeZlebisdagvarad efeqturi meTodi.

mzadebis ZiriTad nawili eTmoba èrTi-erTze~ swavlebasa da mcire jgufebSi muSaobas. es ukanaskneli warmodgenili iqneba 5-6 msmeneliT. erTi-erTze swavleba gulisxmobs rezidentis muSaobas sertificirebuli eqimis zedamxedvelobis qveSi, roca rezidenti asrulebs programiT gaTvaliswinebul davalebebs.

periodulad moewyoba Sexvedrebi, diskusia da prezentaciebi SedarebiT did auditoriaSi mzadebis erT etapze myofi rezidentebisaTvis.

qvemoT mocemulia specialobaSi òjaxis eqimi~ rezidentebis mzadebis procesSi gamoyenebuli meTodebis CamonaTvali:

• interaqtiuri leqciebi/prezentaciebi;

• azrebis korianteli (“brainstorming” );

• TamaSebi;

• swavleba mcire jgufebSi;

• seminari;

• klinikuri SemTxvevebis demonstrireba da garCeva;

• diskusia saerTo jgufSi;


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• video da multimedia masalebis demonstrireba;

• rolebis TamaSi da simulirebuli (standartizebuli) pacientis gamoyeneba;

• muSaoba, simulatorebze, mulaJebsa da manekenebze praqtikuli Cvevebis gamomuSavebis mizniT;

• damoukidebeli swavla;

• problemaze orientirebuli swavleba;

• individualuri da jgufuri saSinao davalebebi;

• prezentaciebis momzadeba msmenelebis mier;

• samedicino auditi;

• proeqtze dafuZnebuli swavleba;

• kolegebis Sefaseba msmenelebis mier.

Sefasebis meTodebiSefasebis meTodebiSefasebis meTodebiSefasebis meTodebi

SefasebisaTvis gamoyenebuli iqneba ramdenime meTodi, rogorc mimdinare (`formaciuli~), ise daskvniTi (`sumaciuri~) Sefaseba.

mimdinare Sefaseba moicavs, rogorc rezidentebis Sefasebas, aseve, TviT programis Sefaseba rezidentebis mier specialuri anonimuri kiTxvarebis Sevsebis gziT.

mimdinare Sefasebis mizania erTi mxriv, zogadad swavlebis meTodebis gaumjobeseba, xolo, meore mxriv, konkretuli rezidentis mzadebis procesis efeqturobis gazrda misi kompetenciis gazrda. mimdinare Sefasebis Sedegebis miewodeba rezidents da xdeba am Sedegebis garCeva da msjeloba. aRniSnuli exmareba rogorc pedagogs, ise rezidents swavlebis/mzadebis procesis momdevno etapebis dagegmvasa da rezidentis miRwevebis gaumjobesebaSi.

mimdinare, etapobrivi da daskvniTi Sefasebisas gamoyenebuli meTodebis saxeoba damokidebulia Sesafasebel kompetenciaze (codna, unar-Cvevebi, damokidebuleba) da moicavs pirdapiri da arapirdapiri, agreTve TviTSefasebis meTodebs:

pirdapiri Sefaseba:pirdapiri Sefaseba:pirdapiri Sefaseba:pirdapiri Sefaseba:

• zepiri gamokiTxva (codna);

• gamokiTxva mravalpasuxiani kiTxvarebis saSualebiT – MCQ (codna);

• pasuxebi situaciur amocanebze (codna);

• eseis momzadeba winaswar SerCeul sakiTxze (codna);

• prezentaciis momzadeba (codna);

• konsultaciis Catareba simulirebuli pacientis daxmarebiT (codna da unar-Cvevebi);

• klinikur saqmianobaze dakvirveba (unar-Cvevebi, damokidebuleba);

• praqtikuli Cvevebis demonstrireba manekenze/mulaJze (unar-Cvevebi);

• samuSao jgufebis mier warmodgenili davalebebis Sefaseba (codna);

• amocanaze orientirebuli struqturizebuli klinikuri gamocda – OSCE (unar-Cvevebi).

arapirdapiri Sefaseba:arapirdapiri Sefaseba:arapirdapiri Sefaseba:arapirdapiri Sefaseba:

• xelmZRvanelTa daskvnebi (codna, unar-Cvevebi);

• pacientis Sefasebebi (unar-Cvevebi, damokidebuleba);

• gare auditi (unar-Cvevebi);

• Canawerebis, maT Soris, e.w. `referalebis~ Semowmeba (unar-Cvevebi).

TTTTviTSefasebaviTSefasebaviTSefasebaviTSefaseba (codna, unar-Cvevebi, damokidebuleba):

• damoukidebeli Canawerebis warmoeba, romelSic rezidenti:


10

o afiqsirebis problemas klinikuri saqmianobisas; risi gakeTeba ver moaxerxa an SeeZlo ukeTesad gaekeTebina pacientTan muSaobisas;

o gansazRvravs ra sferos, disciplinas moicavs aRniSnuli problema (profesiuli kompetenciis deficiti);

o axdens aRmoCenili profesiuli deficitis klasificirebas: codnis (klinikuri an araklinikuri/fundamenturi codna), unar-Cvevebis, damokidebulebis deficiti.

o gansazRvravs ra unda iswavlos da rogor SeiZleba misi swavla;

o aTanxmebs aRniSnul sakiTxs xelmZRvanelTan da iwyebs swavlas, romlis mizania aRmoCenili deficitis Sevseba.

4. programis xangrZlivoba4. programis xangrZlivoba4. programis xangrZlivoba4. programis xangrZlivoba

diplomis Semdgomi mzadebis (diplomis Semdgomi mzadebis (diplomis Semdgomi mzadebis (diplomis Semdgomi mzadebis (rezidenturisrezidenturisrezidenturisrezidenturis)))) programis xangrZlprogramis xangrZlprogramis xangrZlprogramis xangrZliiiivobavobavobavoba specialobaSi specialobaSi specialobaSi specialobaSi òjaxis eqòjaxis eqòjaxis eqòjaxis eqimi~imi~imi~imi~ samisamisamisami welia.welia.welia.welia.

rezidenturaSi mzadebis programa iyofa sam ZiriTad nawilad/etapad:

I. saojaxo medicinis Sesavali kursisaojaxo medicinis Sesavali kursisaojaxo medicinis Sesavali kursisaojaxo medicinis Sesavali kursi – xangrZlivoba 6 Tve;

II. rotaciebi saavadmyofoebSirotaciebi saavadmyofoebSirotaciebi saavadmyofoebSirotaciebi saavadmyofoebSi – xangrZlivoba 18 Tve;

III. saojaxo medicinis specializebuli kursisaojaxo medicinis specializebuli kursisaojaxo medicinis specializebuli kursisaojaxo medicinis specializebuli kursi – xangrZlivoba 12 Tve.

rezidenturis programis zemoT moxseniebuli 3 nawilis gavlam saSualeba unda misces rezidents etapobrivad SeiZinos is codna da unar-Cvevebi, rac òjaxis eqimis~ specialobis aRwerilobaSia mocemuli da, rac misi rogorc ojaxis eqimis profesiul kompetencias Seadgens.

� rezidenturis I etapis (pirveli 6 Tve) mizania gaacnos rezidents saojaxo medicinis principebi da strategiebi, rac sasargeblo iqneba misTvis mzadebis mTels periodSi.

� mzadebis II etapis mizania rezidentisaTvis im codnisa da unar-Cvevebis SeZena-gamomuSaveba, rac aucilebelia pirvelad jandacvaSi arsebuli specifikuri problemebis marTvisaTvis, maT Soris gansakuTrebiT im problemebisa, romlebic umniSvnelovanesia saqarTvelosaTvis.

� swavlebis periodSi rezidentma unda SeiZinos specifikuri codna, unar-Cvevebi da midgomebi, romlebic mas SesaZleblobas miscemen efeqturad marTos gavrcelebuli qronikuli da mwvave mdgomareobebi, romlebic tipuria saojaxo medicinisaTvis. dasaSvebia, rom am periodis ganmavlobaSi rezidents eqneba SesaZlebloba ganaxorcielos garkveuli kontingentisaTvis uwyveti samedicino daxmareba, eqneba damoukidebeli saqmianobis nebarTva, rogorc saojaxo medicinis specialists.

SesaZlebelia mTlian programaSi calke gamovyoT mzadebis wlebi. aseT SemTxvevaSi programa SeiZleba Semdegi saxiT warmovadginoT:

I weli:I weli:I weli:I weli:

Tveebi ITveebi ITveebi ITveebi I----VI: VI: VI: VI: saojaxo medicinis Sesavali kursisaojaxo medicinis Sesavali kursisaojaxo medicinis Sesavali kursisaojaxo medicinis Sesavali kursi

Tveebi VIITveebi VIITveebi VIITveebi VII----XII:XII:XII:XII: rotaciebi saavadmyofoebSirotaciebi saavadmyofoebSirotaciebi saavadmyofoebSirotaciebi saavadmyofoebSi

II weli:II weli:II weli:II weli:

Tveebi ITveebi ITveebi ITveebi I----XII: XII: XII: XII: rotaciebi saavadmyofoebSirotaciebi saavadmyofoebSirotaciebi saavadmyofoebSirotaciebi saavadmyofoebSi

III weli:III weli:III weli:III weli:

Tveebi ITveebi ITveebi ITveebi I----XII: XII: XII: XII: saojaxo medicinis specializebuli kursisaojaxo medicinis specializebuli kursisaojaxo medicinis specializebuli kursisaojaxo medicinis specializebuli kursi


11

5. rezidenturaSi profesiuli mzadebis meToduri uzrunv5. rezidenturaSi profesiuli mzadebis meToduri uzrunv5. rezidenturaSi profesiuli mzadebis meToduri uzrunv5. rezidenturaSi profesiuli mzadebis meToduri uzrunvelyofisa da organizaciis elyofisa da organizaciis elyofisa da organizaciis elyofisa da organizaciis wesi.wesi.wesi.wesi.

muxli 1.muxli 1.muxli 1.muxli 1. rezidenturaSi profesiuli mzadeba warimarTeba saqarTvelos kanonebis - `saeqimo saqmianobis Sesaxeb~, “janmrTelobis dacvis Sesaxeb” -Sesabamisad.

muxli 2. muxli 2. muxli 2. muxli 2. rezidenturaSi profesiuli mzadeba xorcieldeba diplomis Semdgomi ganaTlebisa (profesiuli mzadebis) da uwyveti profesiuli ganviTarebis sabWos mier akreditebuli rezidenturis programebiT saeqimo specialobaTa nusxis Sesabamisad.

muxli 3.muxli 3.muxli 3.muxli 3. rezidenturaSi profesiuli mzadebas srulad afinansebs saxelmwifo (stomatologiur specialobebSi dasaSvebia kerZo dafinanseba), saministros specialuri saxelmwifo programis _ `diplomisSemdgomi samedicino ganaTlebis saxelmwifo programis~ farglebSi. amave dros, arsebobs rezidenturis alternatiuli diplomisSemdgomi ganaTleba (profesiuli mzadeba), romelic gulisxmobs sarezidento programis yvela modulis gavlas calkeuli modulisa da mTlianad programis xangrZlivobis zustad gansazRvris gareSe da finansdeba kerZo piris mier moZiebuli saxsrebiT (“rezidenturi alternatiul diplomisSemdgom ganaTlebaSi (profesiul mzadebaSi) monawileobis, misi warmarTvisa da Sefasebis wesisa da im samedicino dawesebulebebis akreditaciis kriteriumebis da wesis damtkicebis Sesaxeb, romlebSic SesaZlebelia diplomisSemdgomi ganaTlebis (profesiuli mzadebis) kursis gavla” saqarTvelos Sromis, janmrTelobisa da socialuri dacvis ministris 2007 wlis 18 aprilis #135/n brZanebis Sesabamisad).

muxli 4. muxli 4. muxli 4. muxli 4. rezidenturaSi Caricxvis wesi ganisazRvreba saqarTvelos Sromis, janmrTelobis da socialuri dacvis ministris brZanebiT: `erTiani diplomisSemdgomi sakvalifikacio gamocdis Catarebis wesisa da rezidenturaSi Caricxvis wesis damtkicebis Sesaxeb~ (# 295/n; 3.11.2006), xolo rezidenturis alternatiuli diplomisSemdgomi mzadebis wesi: “rezidenturis alternatiuli diplomisSemdgom ganaTlebaSi (profesiuli mzadebaSi) monawileobis, misi warmarTvisa da Sefasebis wesisa da im samedicino dawesebulebebis akreditaciis kriteriumebis da wesis damtkicebis Sesaxeb, romlebSic SesaZlebelia diplomisSemdgomi ganaTlebis (profesiuli mzadebis) kursis gavla” (#135/n; 18.04.2007).

muxli 5muxli 5muxli 5muxli 5. . . . rezidenturis programis ganxorcieleba mimdinareobs sauniversiteto klinikebsa da im samedicino dawesebulebebSi, romelTac miRebuli aqvT akreditacia kanonmdeblobiT dadgenili wesiT (`rezidenturis alternatiul diplomisSemdgom ganaTlebaSi (profesiul mzadebaSi) monawileobis, misi warmarTvisa da Sefasebis wesisa da im samedicino dawesebulebebis akreditaciis kriteriumebis da wesis damtkicebis Sesaxeb, romlebSic SesaZlebelia diplomisSemdgomi ganaTlebis (profesiuli mzadebis) kursis gavla~ saqarTvelos Sromis, janmrTelobis da socialuri dacvis ministris 2007 wlis 18 aprilis #135/n brZanebis Sesabamisad).

muxli 6. muxli 6. muxli 6. muxli 6. rezidenturis kursis dasrulebis Semdeg gaicema saxelmwifo mowmoba.

muxli 7. muxli 7. muxli 7. muxli 7. rezidenturis programis xarisxis uzrunvelyofaze pasuxismgebelni arian - rezidenturis programis direqtori, programis direqtorati, lokaluri xelmZRvanelebi, rezidentebi, saministros saxelmwifo kontrols daqvemdebarebuli sajaro samarTlis iuridiuli piri.

muxli 8. muxli 8. muxli 8. muxli 8. programis direqtoris movaleobebi:


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1. misaRebi gamocdis programis Sedgena da rezidenturaSi miRebis procesSi monawileoba;

2. specialobis aRwerilobis safuZvelze Sedgenil diplomis Semdgomi profesiuli mzadebis (rezidenturis) akreditebuli programis ganxorcielebas;

3. samedicino dawesebulebis da lokaluri xelmZRvanelis miTiTebiT rezidentis individualuri gegma-grafikis Sedgena da gansazRvra Tu ramden rezidents SeiZleba zedamxedvelobdes erTi lokaluri xelmZRvaneli.

4. winaswar dadgenili individualuri grafikis mixedviT rezidentis mier Sesasrulebeli samuSaos moculobasa da Casatarebeli manipulaciebis raodenobaze kontroli.

5. direqtoratis wevrebTan erTad dadgenili wesis mixedviT yovelwliurad rezidentis muSaobis Sefaseba da saministros saxelmwifo kontrols daqvemdebarebul sajaro samarTlis iuridiuli pirisaTvisangariSis Cabareba.

6. yovelwliuri Sefasebis Sedegebis gaTvaliswinebiT rezidentisaTvis rekomendacias micema programis gagrZelebis Sesaxeb.

7. rezidentis saqmianobis aradamakmoyofilebli wliuri Sefasebisas, saministros saxelmwifo kontrols daqvemdebarebul sajaro samarTlis iuridiuli pirisaTvis dasabuTebuli moxsenebiT baraTis wardgena garicxvis Sesaxeb.

8. rezidenturis kursis warmatebuli dasrulebis Semdeg rezidentis Semajamebeli atestaciis Catareba da diplomisSemdgomi ganaTlebis (profesiuli mzadebis) da uwyveti profesiuli ganviTarebis sabWos kursis gavlis damadasturebeli saxelmwifo mowmobis gacemis Sesaxeb rekomendaciis micema.

9. lokaluri xelmZRvanelebis saqmianobis zedamxedveloba da Sefaseba.

muxli 9. muxli 9. muxli 9. muxli 9. programis direqtoratis wevrebis movaleobebi:

1. rezidentebis SerCevis procesSi monawileoba; 2. program direqtorTan erTad yovelwliurad rezidentebis muSaobis dadgenili

wesis mixedviT Sefaseba; 3. program direqtorTan erTad SeimuSaveben rezidentis atestaciis formatis

SemuSaveba; 4. rezidentis Semajamebeli atestaciis procesSi monawileoba; 5. saWiroebis SemTxvevaSi, programis direqtorisaTvis rezidenturis

programasTan dakavSirebul nebismier sakiTxebze konsultaciis gaweva.

muxli 10. muxli 10. muxli 10. muxli 10. lokaluri xelmZRvanelis movaleobebi:

1. samedicino dawesebulebaSi rezidentis muSaobis warmarTva; 2. rezidentebTan pedagogiur muSaobisaTvis Tavisi saqmianobis gansazRvruli

drois daTmoba. 3. TiToeuli modulis dasrulebis Semdeg dadgenili wesis mixedviT, program

direqtorisaTvis rezidentis mier gaweuli samuSaos Sesaxeb angariSis wardgena;

4. rezidentis dRiurSi rezidentis mier Sesrulebuli samuSaos xelmoweriT dadastureba.

muxli 1muxli 1muxli 1muxli 11. 1. 1. 1. rezidentis ufleba/movaleobebi:

1. rezidenti SeiZleba garicxuli iqnas rezidenturidan erTi Tvis ganmavlobaSi gamoucxadeblobis an programis ver daZlevis SemTxvevaSi. gadawyvetilebas rezidentis garicxvis Sesaxeb iRebs programis direqtori saministros saxelmwifo kontrols daqvemdebarebuli sajaro samarTlis iuridiuli pirTan SeTanxmebiT;


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2. rezidents ufleba aqvs programis kurikulumis darRvevis an Seferxebis Sesaxeb werilobiT acnobos saministros saxelmwifo kontrols daqvemdebarebul sajaro samarTlis iuridiuli pirs;

3. rezidents ufleba aqvs programis daubrkolebeli daZlevisaTvis moiTxovos Sesabamisi samuSao pirobebiT uzrunvelyofa (kvalificiuri xelmZRvaneli, Tanamedrove tipis klinikuri da sainformacio/sakomunikacio teqnologiebi, samuSao oTaxi);

4. rezidenti valdebulia Seasrulos rezidenturis programiT gansazRvruli kurikulumi;

5. rezidenti valdebulia programiT gansazRvruli da Sesrulebuli saqmianoba daafiqsiros personalur dRiurSi;

6. rezidenti valdebulia yoveli wlis bolos warudginos programis direqtors gaweuli muSaobis angariSi da gaiaros etapobrivi da damasrulebeli atestacia dadgenili wesiT;

7. rezidenti valdebulia daicvas samedicino dawesebulebis Sinaganawesi da Seasrulos dawesebulebis ganrigiT gansazRvruli saqmianoba.

6666. programis etapobrivi ganxorcielebis aRweriloba (. programis etapobrivi ganxorcielebis aRweriloba (. programis etapobrivi ganxorcielebis aRweriloba (. programis etapobrivi ganxorcielebis aRweriloba (etapebisetapebisetapebisetapebis mixedviTmixedviTmixedviTmixedviT).).).).

rrrrezidenturis programa specialobaSiezidenturis programa specialobaSiezidenturis programa specialobaSiezidenturis programa specialobaSi

“ojaxis eqimi“ojaxis eqimi“ojaxis eqimi“ojaxis eqimi””””

profesiuli mzadebis I etapiprofesiuli mzadebis I etapiprofesiuli mzadebis I etapiprofesiuli mzadebis I etapi modulebis raodenoba: modulebis raodenoba: modulebis raodenoba: modulebis raodenoba: sul 8 savaldebulo moduli

calkeuli modulis xangrZlivoba saSualod 2-4 kviras Seadgens.

profesiuli mzadebis I profesiuli mzadebis I profesiuli mzadebis I profesiuli mzadebis I etapisetapisetapisetapis mizanimizanimizanimizani da amocanebi:da amocanebi:da amocanebi:da amocanebi:

rezidenturis I etapis (pirveli 6 Tve) bolos rezidenti ukve icnobs saojaxo medicinis principebsa da strategiebs. mas SeuZlia msjeloba ojaxis eqimis ZiriTad kompetenciebsa da specialobis maxasiaTeblebze. flobs saeqimo konsultaciis Catarebis meTodologias da komunikaciis Cvevebs. SeuZlia msjeloba ojaxis eqimis praqtikis organizaciul aspeqtebze. icnobs mtkicebulebiTi medicinis safuZvlebsa da meTodebs. SeuZlia gaaanalizos ama Tu im sadiagnozo meTodis validuroba da samkurnalo meTodis efeqturoba arsebuli literaturis Sefasebis safuZvelze. icnobs saqarTvelos kanonmdeblobas janmrTelobis dacvis sferoSi da eqimisa da pacientis urTierTobis samarTlebriv da eTikur aspeqtebs. SeuZlia kvlevis meTodebze msjeloba pirveladi jandacvis konteqstSi.

mzadebis es nawili unda Catardes ojaxis eqimis ofisSi da universitetis saojaxo medicinis saswavlo centrSi, rezidentis personaluri xelmZRvanelis (lokaluri xelmZRvanelis) meTvalyureobiT.

mocemuli etapis specifikuri amocanebiamocanebiamocanebiamocanebi moicavs Semdegs:

1.1.1.1. pirveladi jandacvis marTva: pirveladi jandacvis marTva: pirveladi jandacvis marTva: pirveladi jandacvis marTva:

• pirvelad jandacvaSi arsebuli problemebis (maT Soris Civilebis) epidemiologiis codna;

• pirveladi jandacvisaTvis tipuri simptomebisa da Civilebis codna, gansakuTrebiT daavadebaTa adreul stadiebze; maTi mniSvnelobis codna diagnozisa da mkurnalobisaTvis (bazisuri procedurebi saojaxo medicinis praqtikaSi);

• organizaciuli midgomebis codna qronikuli mdgomareobebis marTvisaTvis (praqtikis organizacia da administrireba);

• jandacvis sistemis struqturisa da misi komponentebis funqciis codna pirvelad jandacvasTan kavSirSi;

• ZiriTadi skomunikacio unar-Cvevebi pacientisa da misi ojaxis wevrebis konsultirebisa da swavlebisaTvis, maTTan urTierTobisaTvis;


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• ZiriTadi saorganizacio unar-Cvevebi Canawerebis Senaxvis, sainformacio marTvis, gunduri muSaobis, praqtikis warmarTvisa da saqmianobis xarisxis auditisaTvis.

2.2.2.2. ppppirovnebaze koncentrirebuli daxmarebairovnebaze koncentrirebuli daxmarebairovnebaze koncentrirebuli daxmarebairovnebaze koncentrirebuli daxmareba::::

• bazisuri mecnieruli codna pirovnebis, misi ganviTarebis, miznebisa da cxovrebiseuli molodinebis gagebisaTvis;

• moZiebuli monacemebis pacientisaTvis misTvis misaRebi da gasagebi formiT Setyobinebis unari, rac, agreTve, gulisxmobs pacientisaTvis informaciis miwodebas misi mosazrebebis Taobaze da erTiani safuZvlis Camoyalibebas Semdgomi gadawyvetilebis misaRebad;

• gadawyvetilebis miReba pacientis avtonomiis gaTvaliswinebiT. 3.3.3.3. specifikuri problemebis mogvarebis unarspecifikuri problemebis mogvarebis unarspecifikuri problemebis mogvarebis unarspecifikuri problemebis mogvarebis unar----CvevebiCvevebiCvevebiCvevebi::::

• bazisuri codna daavadebebisa da paTologiuri mdgomareobebis Sesaxeb pirvelad jandacvasa da, zogadad, saqarTveloSi, zemoxsenebulTa sixSirisa da gavrcelebis specifikurobis gaTvaliswinebiT;

• anamnezis Segrovebisa da fizikuri gasinjvis, agreTve moZiebuli Sedegebis Sefasebis unar-Cveva.

4.4.4.4. yovlismomcveli midgomayovlismomcveli midgomayovlismomcveli midgomayovlismomcveli midgoma::::

• ojaxis eqimis rolis gacnobiereba TemSi janmrTelobisaTvis xelSewyobisaTvis;

• individisa da Temis moTxovnebs Soris arsebuli eTikuri winaaRmdegobebis mniSvnelobis gaTvaliswineba da Sesabamisad moqmedeba;

• gundis wevrebis gansxvavebuli SesaZleblobebisa da gansxvavebuli wvlilis Setanis unaris gacnobiereba.

5.5.5.5. Temze orientaciaTemze orientaciaTemze orientaciaTemze orientacia

• janmrTelobis dacvasa da socialur dacvas Soris urTierTkavSiris gacnobiereba;

• siRaribis, eTnikuri Taviseburebebisa da lokaluri epidemiologiuri monacemebis janmrTelobaze zegavlenis gacnobiereba;

• jandacvis sferoSi arsebuli uTanabrobis gacnobiereba; • jandacvis sistemis struqturisa da misi ekonomikuri SesaZleblobebis SezRudulobis gacnobiereba;

• gacnobiereba imisa, rogor SeiZleba iqnes gamoyenebuli jandacvis sistema pacientisa da eqimis mier (referaluri procedurebi, Tanagadaxda, saavadmyofo furceli, sakanonmdeblo sakiTxebi da a.S.) maTi problemebis konteqstSi.

6.6.6.6. holistikuri midgomaholistikuri midgomaholistikuri midgomaholistikuri midgoma

• holizmis koncefciis codna da misi gamoyeneba pacientebisaTvis daxmarebis aRmoCenisas.

mzadebis am nawilis arsebiTi maxasiaTeblebi SeiZleba gaxdes:

a) konteqstualuri:a) konteqstualuri:a) konteqstualuri:a) konteqstualuri:

• adgilobrivi Temis, ekonomikuri faqtorebis, geografiuli da kulturuli faqtorebis gavlena samuSao adgilze da pacientisaTvis daxmarebis aRmoCenis procesze;

• ra saxis finansur da sakanonmdeblo garemoSi xorcieldeba janmrTelobis dacva praqtikul doneze.

b) b) b) b) damokidebulebiTidamokidebulebiTidamokidebulebiTidamokidebulebiTi::::

• personaluri eTikis sakiTxebis gacnobiereba.


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g) mecnierulig) mecnierulig) mecnierulig) mecnieruli

• samecniero kvlevis zogadi principebis, meTodebisa da koncefciis, agreTve statistikis safuZvlebis (sixSire, gavrceleba, progrnozuli mniSvneloba da sxv.) codna.

• samedicino literaturis moZiebis, kiTxvisa da kritikuli Sefasebis unari mzadebis I etapis modulebimzadebis I etapis modulebimzadebis I etapis modulebimzadebis I etapis modulebi

moduli 1.1.moduli 1.1.moduli 1.1.moduli 1.1. `saojaxo medicinis Sesavali kursi~`saojaxo medicinis Sesavali kursi~`saojaxo medicinis Sesavali kursi~`saojaxo medicinis Sesavali kursi~

modulis xangrZlivoba: modulis xangrZlivoba: modulis xangrZlivoba: modulis xangrZlivoba: 3 kvira

modulis mizanmodulis mizanmodulis mizanmodulis mizaniiii::::

modulis mizania rezidentis mier saojaxo medicinis rogorc disciplinis maxasiaTeblebis Seswavla, maTi gaazreba da mniSvnelobis Sefaseba ojaxis eqimis yoveldRiur saqmianobaSi.

modulis amocanebimodulis amocanebimodulis amocanebimodulis amocanebi::::

modulis bolos rezidentma:

� unda icodes saojaxo medicinis Tanamedrove ganmarteba zogadi praqtikis/saojaxo medicinis evropis sazogadoebis (WONCA EUROPE) bolo ganmartebebis mixedviT (European Definition of Family Medicine, 2002);

� unda SeeZlos zemoaRniSnuli ganmartebis farglebSi ojaxis eqimis ZiriTad kompetenciebsa da maxasiaTeblebze msjeloba da maTi misadageba konkretuli SemTxvevebisadmi.

gamoyenebuli swavlebis/Sefasebis meTodebigamoyenebuli swavlebis/Sefasebis meTodebigamoyenebuli swavlebis/Sefasebis meTodebigamoyenebuli swavlebis/Sefasebis meTodebi

swavleba klinikuri praqtikis gareTswavleba klinikuri praqtikis gareTswavleba klinikuri praqtikis gareTswavleba klinikuri praqtikis gareT

• swavleba mcire jgufebSi, romlis mizania ZiriTadi informaciis miwodeba rezidentebisaTvis da maT mier aucilebeli codnis dagroveba saojaxo medicinis, rogorc disciplinis da `ojaxis eqimis~, rogorc konkretuli saeqimo specialobis Sesaxeb; monawileoba rolebis TamaSSi da klinikur garCevebSi saojaxo medicinis ZiriTadi maxasiaTeblebis gaTvaliswinebiT.

praqtikuli saqmianpraqtikuli saqmianpraqtikuli saqmianpraqtikuli saqmianoba pirveladi jandacvis dawesebulebebSioba pirveladi jandacvis dawesebulebebSioba pirveladi jandacvis dawesebulebebSioba pirveladi jandacvis dawesebulebebSi

• dakvirveba saojaxo medicinis ofisis/klinikis, misi calkeuli rgolisa da wevris saqmianobaze;

• daswreba ojaxis eqimis da jandacvis sxva profesionalebis mier Catarebul konsultaciebze;

• lokaluri xelmZRvanelis angariSi programis xelmZRvanelisadmi da swavlebis procesis gaumjobesebis sakiTxebze msjeloba;

swavlebis meTodebis CamonaTvaliswavlebis meTodebis CamonaTvaliswavlebis meTodebis CamonaTvaliswavlebis meTodebis CamonaTvali

• rolebis TamaSi;

• pirdapiri dakvirveba (ojaxis eqimis ofisis da samedicino personalis saqmianobaze);


• interaqtiuri diskusia;

• interaqtiuri prezentacia, leqcia TandarTuli saxelmZRvanelo masalebiT;

• ukukavSiri/angariSebi praqtikis maswavleblebisgan da sxva personalisagan.


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Sefasebis meTodebis CamonaTvaliSefasebis meTodebis CamonaTvaliSefasebis meTodebis CamonaTvaliSefasebis meTodebis CamonaTvali

• gamokiTxva;

• mravalpasuxiani kiTxvebi;

• esei.

saswavlo resursebi:saswavlo resursebi:saswavlo resursebi:saswavlo resursebi:

vebgverdebi:vebgverdebi:vebgverdebi:vebgverdebi:

http://www.wonca.com

http://www.euract.org

http://www.rcgp.org.uk

http://www.aafp.org

literatuliteratuliteratuliteratura:ra:ra:ra:

1. The European Definition of General Practice/Family Medicine; Barcelona: WONCA, 2002 2. The EURACT Educational Agenda of General Practice / Family Medicine; EURACT Leuven,

2005 3. Jones R (Ed). Oxford Textbook of Primary Medical Care Oxford: Oxford University Press, 2004 4. McWhinney IR A Textbook of Family Medicine Oxford: Oxford University Press, 2004 5. Rakel RE. Textbook of Family Practice 6th edition London: W.B. Saunders, 2001 6. Bordage G and Zacks R. The Structure of Medical Knowledge in the Memories of Medical

Students and General Practitioners: Categories and Prototypes. Medical Education 1984; 18: 406–16

7. Bordage G. Elaborated Knowledge: A Key to Successful Diagnostic Thinking Acad Med 1994; 69:883–5

8. Havelock P., Hasler J., Flew R., McIntyre D., Schofield T., Toby J. (1995) Professional Education for General Practice. Oxford General Practice Series 31. Oxford University Press, Oxford, New York, Toronto

9. Little M., Midtling J.E. (1989) Becoming a Family Physician. Springer – Verlag New York.

Sesasrulebeli saSesasrulebeli saSesasrulebeli saSesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba:muSaos moculoba da Casatarebeli manipulaciebis raodenoba:muSaos moculoba da Casatarebeli manipulaciebis raodenoba:muSaos moculoba da Casatarebeli manipulaciebis raodenoba:

Teoriuli kursi profesiuli unar-Cvevebi (raodenobis miTiTebiT)

davaleba

� pirveladi jandacva da sazogadoebrivi jandacva, `saojaxo medicinis~ ganmarteba; � saojaxo medicina, rogorc disciplina da specialoba `ojaxis eqimi~: specialobis ZiriTadi maxasiaTeblebi da kompetenciebi; � saojaxo medicinis Camoyalibeba da ganviTareba evropasa da msoflios ganviTarebul qveynebSi; saojaxo medicina saqarTveloSi;

� monawileoba rolebis TamaSSi;

� jgufuri da individualuri davalebebi: klinikuri SemTxvevebis garCeva saojaxo medicinis maxasiaTeblebis gamoyenebiT (specialobis maxasiaTeblebisa da `ojaxis eqimis~ ZiriTadi kompetenciebis misadageba calkeuli SemTxvevisadmi); � dakvirveba ojaxis eqimis ofisis da calkeuli ojaxis eqimis da sxva samedicino personalis saqmianobaze, misi gaanalizeba da daskvnebis momzadeba da wardgena xelmZRvanelisaTvis.


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moduli 1.2.moduli 1.2.moduli 1.2.moduli 1.2. `komunikaciis unar`komunikaciis unar`komunikaciis unar`komunikaciis unar----Cvevebi~Cvevebi~Cvevebi~Cvevebi~


modulis mizani: modulis mizani: modulis mizani: modulis mizani:

modulis mizania rezidentma gamoimuSaos pacientze orientirebuli samedicino konsultaciis Catarebis unar-Cvevebi urTierTobis (komunikaciis) iseTi efeqturi meTodebis gamoyenebis gziT, rac maqsimalurad miesadageba mis klinikur praqtikas.

modulis amocanebi: modulis amocanebi: modulis amocanebi: modulis amocanebi:

modulis bolosTvis rezidentma pacientTan komunikaciis sferoSi unda SeiZinos Semdegi kompetenciebi (codna, unar-Cvevebi, damokidebuleba) `saojaxo medicinis evropuli ganmartebis mixedviT~; kerZod, modulis bolos mas unda:

1.1.1.1. pirveladi jandacvis marTva: pirveladi jandacvis marTva: pirveladi jandacvis marTva: pirveladi jandacvis marTva:

• SeeZlos klinikur praqtikaSi profesiuli komunikaciis Cvevebis gamoyeneba (rogorc oraluri, ise weriTi) droisa da sxva resursebis efeqturi xarjvis fonze;

• SeeZlos efeqturi/adekvaturi urTierTobis damyareba jandacvis profesionalebTan organizaciiis SigniT da mis gareT;

• gamoimuSaos komunikaciis Cvevebi saeqimo konsultaciis Casatareblad, swavlebisaTvis, pacientebTan da maTi ojaxis wevrebTan urTierTobis dasamyareblad;

• gamoimuSaos partniorobaze, TanamSromlobaze dafuZnebuli urTierTobis stili pacientebTan muSaobisas.

2.2.2.2. pirovnebaze koncentrirebuli daxmareba:pirovnebaze koncentrirebuli daxmareba:pirovnebaze koncentrirebuli daxmareba:pirovnebaze koncentrirebuli daxmareba:

• SeeZlos pacientis janmrTelobis problemis mimoxilva da vizitis mizezebis gansazRvra;

• SeeZlos Seafasos da mimoixilos pacientis gaTviTcnobierebuloba da damokidebuleba sakuTari janmrTelobis problemisadmi da misi marTvis sakiTxebisadmi;

• SeeZlos Seafasos da adekvaturad upasuxos pacientis wuxils, dards misi janmrTelobis problemebisa da am problemebis marTvis sakiTxebTan dakavSirebiT;

• SeeZlos miawodos pacients Sesaferisi ganmartebebi misi janmrTelobis problemebTan dakavSirebuli mosazrebebisa da kiTxvebis Sesaxeb;

• SeeZlos gansazRvra imisa, Tu ramdenad gaigo da sworad aRiqva eqimis mier miwodebuli ganmartebebi da ramdenad moaxerxa eqimma pacientis wuxilsa da dardze adekvaturad reagireba.

3.3.3.3. specifikuri problemebis mogvarebis unarspecifikuri problemebis mogvarebis unarspecifikuri problemebis mogvarebis unarspecifikuri problemebis mogvarebis unar----Cvevebi:Cvevebi:Cvevebi:Cvevebi:

• gamoimuSaos efeqturi komunikaciis unari gansakuTrebul situaciebSi; kerZod, rezidents unda SeeZlos:

� `cudi ambebis~ (pacientisaTvis arasasiamovno ambis) Setyobineba;

� reagireba ukmayofilebze, gaRizianebasa da agresiaze;

� `rTuli~ pacientis marTva;

• SeeZlos pacientis CarTva misi janmrTelobis problemebis marTvasTan dakavSirebuli gadawyvetilebis miRebis procesSi;

• SeeZlos, warmarTos konsultacia im saxiTa da TanmimdevrobiT, rac Seesabameba pacientis saWiroebebs; amasTan, erTi mxriv, CarTos pacienti konsultaciis procesSi, xolo meore mxriv, efeqturad gamoiyenos dro.


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4.4.4.4. yovlismomcvelyovlismomcvelyovlismomcvelyovlismomcveli midgoma:i midgoma:i midgoma:i midgoma:

• gamoimuSaos unari, daarwmunos calkeuli pacienti janmrTelobisaTvis xelSewyobis aucileblobaSi TiToeuli samedicino problemis marTvisas;

• SeeZlos komunikaciis sxvadasxva meTodebisa da midgomebis saWiroebisda mixedviT gamoyeneba, zogjer erTsa da imave pacientTan urTierTobisas.


• SeeZlos, xeli Seuwyos pacientisa da samedicino personalis mier janmrTelobis dacvis sistemaSi arsebuli resursebis gamoyenebas (pacientis gagzavna konsultaciaze – `referali~, Tanagaxdis sistemebi, avadmyofobis furceli, sxvadasxva samarTlebrivi sakiTxebi da sxv.);

• axsnas, Tu rogor aris calkeuli individis saWiroeba gadajaWvuli Temis saWiroebebTan, sadac isini cxovroben.


• SeeZlos pacientTan kargi urTierTobis damyareba da mis mimarT, rogorc pirovnebisadmi, pativiscemis gamoxatva;

• iqonios pacientTan adekvaturi urTierToba pacientis faseulobebis, kulturuli Taviseburebebis, tradiciebis, gamocdilebis, rwmenisa da molodinis gaTvaliswinebiT, ramac SeiZleba gavlena iqonios samedicino momsaxurebis gawevaze.

zemoT moxseniebulTan erTad rezidenturis kursdamTavrebuls unda SeeZlos gamoimuSaos unar-Cvevebi Semdegi maxasiaTeblebis mixedviT:

a) konteqstualuri:a) konteqstualuri:a) konteqstualuri:a) konteqstualuri:

• gaiTvaliswinos pirovnebis, ojaxis, Temis Taviseburebebi da daamyaros efeqturi urTierToba pacientebTan gansxvavebuli pirovnuli da kulturuli maxasiaTeblebiT.

b) damokidebulebiTi:b) damokidebulebiTi:b) damokidebulebiTi:b) damokidebulebiTi:

• sakuTari SesaZleblobebis, faseulobebisa da eTikuri principebis gaTvaliswinebiT Seafasos da gaiazros, Tu rogoria misi SegrZnebebi da damokidebuleba gansxvavebul situaciebSi; gamoimuSaos saWiro informaciisa da mxardaWeris moZiebis unari; agreTve, gamoimuSaos Cvevebi, romelic mas daexmareba iseTi situaciebSi, sadac eqimi ganicdis Zlier emociur da fsiqologiur zewolas (mag., `rTuli pacienti~, samedicino Secdomebi).

g) mecnierulig) mecnierulig) mecnierulig) mecnieruli

• gamoimuSaos kritikuli da mecnierebaze dafuZnebuli midgoma profesiul saqmianobaSi. SeinarCunos aRniSnuli midgoma uwyveti ganaTlebis, xarisxis gaumjobesebis, samedicino literaturis moZiebis, gacnobisa da kritikulad Sefasebis gziT.


swaswaswaswavleba vleba vleba vleba klinikuri praqtikis gareTklinikuri praqtikis gareTklinikuri praqtikis gareTklinikuri praqtikis gareT

• swavleba mcire jgufebSi, romlis mizania ZiriTadi informaciis miwodeba rezidentebisaTvis da maT mier aucilebeli codnis dagroveba pacientis konsultaciisa da pacientTan urTierTobis sferoSi, agreTve, garkveuli Cvevebis gamomuSaveba klinikuri praqtikis dawyebamde; am ukanasknels rezidentebi aRweveven rolebis TamaSSi monawileobisa da masze dakvirvebis gziT, videoCanawerebis gaanalizebis safuZvelze.

praqtikuli saqmianoba pirveladi jandacvis dawesebulebebSipraqtikuli saqmianoba pirveladi jandacvis dawesebulebebSipraqtikuli saqmianoba pirveladi jandacvis dawesebulebebSipraqtikuli saqmianoba pirveladi jandacvis dawesebulebebSi

• konsultaciebis gadaReba da analizi (videoanalizi);

• konsultaciebis SemTxveviTi SerCeva da analizi;


19

• `erTi-erTze~ swavleba: daswreba ojaxis eqimis da jandacvis sxva profesionalebis mier Catarebul konsultaciebze;


• pacientebis mosazrebebi rezidentis mier Catarebuli konsultaciis Sesaxeb (mag., specialuri kiTxvaris Sevseba).

praqtikuli saqmianoba meoreuli jandacvis donezepraqtikuli saqmianoba meoreuli jandacvis donezepraqtikuli saqmianoba meoreuli jandacvis donezepraqtikuli saqmianoba meoreuli jandacvis doneze

• dakvirveba samedicino konsultaciebze meoreuli jandacvis dawesebulebebSi;

• mosazrebebis dafiqisreba jandacvis profesionalebis mier Catarebuli calkeuli konsultaciis Sesaxeb sxvadasxva specialobebSi.


• rolebis TamaSi;

• konsultaciebis videoCanawerebis demonstrireba da garCeva;

• pirdapiri dakvirveba (samedicino konsultaciaze);




• samedicino konsultacia simulirebuli pacientis daxmarebiT;



• pirdapiri dakvirveba rezidentis mier warmoebul konsultaciaze da dakvirvebis Sedegebis ganxilva rezidentTan;

• rezidentis mier warmoebuli konsultaciis gadaReba da misi ganxilva rezidentTan;


• pacientis mosazrebebi da Canawerebi.



http://www.balint.co.uk

http://www.rcgp.org.uk/exam/videoworkbook/intro.asp

literatura:literatura:literatura:literatura:

1. Mead N, Bower P. “Patient-centredness: a conceptual framework and review of the empirical literature.” Social Science & Medicine 2000; 51: 1087–1110

2. Stewart M, Brown, JB, Freeman, TR. Patient-Centered Medicine. Transforming the Clinical Method (2nd edn). Oxford: Radcliffe Medical Press, 2003

3. Silverman J, Kurtz S, Draper J. Skills for communicating with patients (2nd edition). Oxford: Radcliffe Medical Press, 2004

4. Kurtz S, Silverman J, Draper J. Teaching and learning communication skills in medicine (2nd edition). Oxford: Radcliffe Medical Press, 2004

5. Maguire P, Pitceathly C. “Key communication skills and how to acquire them.” BMJ 2002; 325: 697–700 6. BMA. Communication skills and continuing professional development London, BMA, 1998 7. Midland Faculty of the Royal College of General Practitioners Consulting: Communication skills for

general practitioners Birmingham: Midland Faculty of the Royal College of General Practitioners 2005 8. Kjeldmand D Balint training makes GPs thrive better in their job. Patient Education and Counselling 2004;

55: 2: 230-235


20

9. Smith RC, Marshall-Dorsey AA, Osborn GG, Shebroe V, Lyles JS, Stoffelmayr BE, Van Egeren LF, Mettler J, Maduschke K, Stanley JM, Gardiner JC. Evidence-based guidelines for teaching patient-centered interviewing. Patient Educ Couns. 2000 Jan; 39(1):27-36.

10. Pendleton D, Hasler J. Doctor Patient Communication, 1983 London. 11. Buckman R. How to Break Bad News, Macmillan Press, 1992. 12. Ungar L, Alperin M, Amiel GE, Beharier Z, Reis S. Breaking bad news: structured training for family

medicine residents. Patient Educ Couns. 2002 Sep; 48(1): 63-8. 13. Shapiro J, Lie D. Using literature to help physician-learners understand and manage ‘’difficult’’ patients.

Academic medicine, 2000; 75:765-768. 14. Steinmetz,D; Tabenkin,H; The difficult patient' as perceived by family physicians. Family Practice,

2001;18(5): 495-500. 15. Smith R.C. The patient's story: Integrated patient–doctor interviewing. Little, Brown and Company (now

Lippincott, Williams and Wilkins), Boston (1996). 16. Beckman HB, Frankel RM. The effect of physician behaviour on collection of data. Ann Intern Med,

1984; 101:692-6. 17. Baile,W.F.; Buckman,R.; Lenzi,R.; Glober,G.; Beale,E.A.; Kudelka,A.P. SPIKES-A six-step protocol for

delivering bad news: application to the patient with cancer. Oncologist. 2000;5(4):302-311. 18. Newman,M.C. The emotional impact of mistakes on family physicians. Archives of Family Medicine,

1996; 5(2): 71-76. 19. Rubin S.B, Zoloth L. Margin of error. The ethics and mistakes in the practice of medicine. University

Publishing group, Hagerstown, Maryland. 20. Rowland-Morin PA, Carroll JG. Verbal communication skills and patient satisfaction. A study of doctor-

patient interviews. Eval Health Prof., 1990; 13(2):168-185 Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba:Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba:Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba:Sesasrulebeli samuSaos moculoba da Casatarebeli manipulaciebis raodenoba:

Teoriuli kursiTeoriuli kursiTeoriuli kursiTeoriuli kursi profesiuliprofesiuliprofesiuliprofesiuli unarunarunarunar----CvevebiCvevebiCvevebiCvevebi davalebadavalebadavalebadavaleba � pacientze orientirebuli konsultacia; � araverbaluri komunikacia samedicino konsulaciis dros � kiTxvebis formulireba da pacientis mosmena; � pacientis mosazrebebi, Sexedulebebi da molodini samedicino konsultaciasTan dakavSirebiT; � axsna-ganmartebebis miwodeba, informirebuli Tanxmobis miReba da cxovrebis jansaRi wesis sakiTxebis ganixlva; � konsultaciis dro da urTierToba eqimsa da pacients Soris; � `cudi ambebis~ (pacientisaTvis arasasiamovno ambis) Setyobineba; � reagireba ukmayofilebze, gaRizianebasa da agresiaze; � `rTuli~ pacientis marTva; � eqimis damokidebuleba samedicino Secdomebisadmi.

pacientis konsultaciis warmarTva rolebis TamaSis farglebSi: pacientze orientirebuli konsultacia, `cudi ambebis~ Setyobineba, cxovrebis jansaRi wesi,

reagireba ukmayofilebaze (≥ 8); konsultaciis warmarTva simulirebuli pacientis

gamoyenebiT (≥ 1 an 2); konsultaciebis Catareba

ojaxis eqimis ofisSi (≥ 20);

� dakvirveba samedicino personalis mier warmoebul konsultaciaze ojaxis eqimis ofisSi; � dakvirveba samedicino personalis mier warmoebul konsultaciaze meoreuli jandacvis dawesebulebaSi; � eseis momzadeba pedagogis mier SerCeul sakiTxze; � jgufuri davalebis Sesruleba – problemaze orientirebuli swavleba (mag., `rTuli pacientis~ marTva).


21

moduli 1.3.moduli 1.3.moduli 1.3.moduli 1.3. `̀̀̀saqarTvelos saqarTvelos saqarTvelos saqarTvelos jandacvis sistema~jandacvis sistema~jandacvis sistema~jandacvis sistema~



modulis mizania saqarTvelos jandacvis sistemis, misi funqcionirebis, dagegmvisa da marTvis Taviseburebebis, saqarTvelos mosaxleobis janmrTelobis problemebis specifikurobisa da maTi gadaWris SesaZlo gzebis gacnoba rezidentisaTvis;


modulis bolos:

� rezidenti unda icnobdes saqarTvelos jandacvis sistemis ZiriTad maxasiaTeblebs, qveyanaSi avadobisa da sikvdilianobis ZiriTad mizezebs da monacemebs am mizezebiT gamowveuli xarjebis Sesaxeb, sxvadasxva paTologiuri mdgomareobebis pirvelad jandacvasa da, zogadad, saqarTveloSi sixSiresa da gavrcelebis specifikurobas;

� rezidents unda SeeZlos imsjelos saqarTvelos jandacvis ZiriTad prioritetebze, mis organizaciul safuZvlebze, pirveladi jandacvis rolze da am ukanasknelis saWiroebebsa da organizaciis Taviseburebebze.


swavleba klinikuri praqtikis swavleba klinikuri praqtikis swavleba klinikuri praqtikis swavleba klinikuri praqtikis gareTgareTgareTgareT

• swavleba mcire jgufebSi, romlis mizania ZiriTadi informaciis miwodeba rezidentebisaTvis da maT mier aucilebeli codnis dagroveba saqarTvelos janmrTelobis dacvis sistemis Sesaxeb.


• dakvirveba saojaxo medicinis ofisis saqmianobaze da janmrTelobis problemaTa Taviseburebebis warmoCena da analizi;



• pirdapiri dakvirveba (ojaxis eqimis ofisis saqmianobaze);





Sefasebis meTSefasebis meTSefasebis meTSefasebis meTodebis CamonaTvaliodebis CamonaTvaliodebis CamonaTvaliodebis CamonaTvali

• gamokiTxva;


• esei.



http://www.healthministry.ge an http://www.molhsa.ge/

http://www.healthministry.ge/eml/index.php

http://www.medportal.ge/


22

http://www.nilc.org.ge/

http://www.health.net.ge/

http://www.parliament.ge (kanonmdebloba)

http://www.ghlbs.org.ge



• saqarTvelos jandacva – yovelwliuri angariSebi;

• `saqarTvelos kanonmdebloba janmrTelobis dacvis sferoSi (mokle qronologiuri mimoxilva, ZiriTadi etapebi)~; kiknaZe, javaSvili, barkalaia; jandacvis marTvis nacionaluri centris samecniero SromaTa krebuli, tomi I, 1998, 15-20

• pacientis uflebebi da maTi ganxorcielebis meqanizmebi kiknaZe, javaSvili Tbilisi, 1999

moduli 1.4.moduli 1.4.moduli 1.4.moduli 1.4. `mtkicebulebebze dafuZnebuli medicina~`mtkicebulebebze dafuZnebuli medicina~`mtkicebulebebze dafuZnebuli medicina~`mtkicebulebebze dafuZnebuli medicina~ modulis xangrZlivoba: modulis xangrZlivoba: modulis xangrZlivoba: modulis xangrZlivoba: 4 kvira


modulis mizania gaacnos rezidentis mtkicebulebiTi medicinis safuZvlebi da gamoumuSaos mas unari gamoiyenos mtkicebulebiTi medicinis meTodebi da resursebi konkretuli samedicino problemis gadaWris procesSi


modulis gavlis Sedegad rezidentma unda icodes:

� klinikuri saxelmZRvanelo rekomendaciebis (`gaidlainebi~) da praqtikis oqmebis (`protokolebi~) arsi, mniSvneloba, SemuSavebisa da gamoyenebis gzebi da sferoebi;

� samedicino momsaxurebis procesis modelebi, daavadebaTa marTva da klinikuri literaturis kritiruli Sefaseba;

� mtkicebulebebze dafuZnebuli medicinis safuZvlebi:

• klinikur praqtikaSi mtkicebulebebze dafuZnebuli medicinis principebis gamoyeneba a. problemis da uzustobis gansazRvra b. Sesabamisi, fokusirebuli, klinikurad mniSvnelovani sakiTxebis

formulireba, romlebzec pasurxis gacema savaraudod SesaZlebelia g. mtkicebulebis moZebna da Sefaseba d. mtkicebulebebis klinikuri mniSvnelovnebis Sefaseba e. nebismieri rekomendaciisa Tu daskvnis klinikuri gamoyenebadobis

Sefaseba v. gadawyvetilebis miReba, imoqmedo Tu ara mtkicebulebebze

dayrdnobiT z. moqmedebis Sedegis Sefaseba T. momavali gamoyenebisTvis Canawerebis Sejameba da Senaxva

modulis gavlis Sedegad rezidents unda SeeZlos

� klinikuri procesis gaumjobesebis SesaZleblobis Sefaseba

� Zveli da mimdinare klinikuri praqtikis analizis unari da gamocdilebiT miRebuli momavali samedicino momsaxurebis gaumjobeseba

� sxvadasxva wyaroebidan monacemTa Segrovebisa da analizis swavla

• saTanado kiTxvis dasma


23

• literaturis Zieba nabeWdi da eleqtronuli resursebis gamoyenebiT

• literaturis gamoyeneba konkretuli pacientis klinikur problemasTan dakavSirebiT

• mtkicebulebebze dafuZnebuli medicinis monacemTa resursebidan informaciis moZiebis da amoRebis unari a. koxreinis (Cochrane) monacemTa baza da sxva bazebi, romlebic

mtkicebulebebze dafuZnebuli kvlevis masalebs aqveyneben (sistemuri mimoxilvebi, metanalizis Sedegebi, calkeuli randimizirebuli kvlevebis Sedegebi);

b. samedicino kvlevisa da xarisxis sakiTxebze momuSave organizaciebi.



• swavleba mcire jgufebSi, romlis mizania ZiriTadi informaciis miwodeba rezidentebisaTvis da maT mier aucilebeli codnis dagroveba mtkicebulebiTi medicinis sferoSi.


• problemebis identificireba damoukideblad da/an samedicino personalTan urTierTobis gziT da problemis gadaWris gzebis Zieba saTanado mtkicebulebebis moZiebisa da konkretuli SemTxvevisadmi maTi misadagebis gziT.








• gamokiTxva;


• esei.



www.acponline.org/

www.update-software.com/cochrane/default.htm www.clinicalevidence.org/ www.uptodate.com www.samed.com

www.ncbi.nlm.nih.gov/PubMed igm.nlm.nih.gov www.medmatrix.org/info/medlinetable.asp www.evidence.org www.harrisonsonline.com

www.nthames-health.tpmde.ac.uk/connect/journals.htm www.pslgroup.com/dg/medjournals.htm www.emedicine.com www.medmatrix.org/index.asp

www.shef.ac.uk/~scharr/ir/netting/


24

www.mwsearch.com

www.guidelines.gov www.cma.ca/cpgs www.mdconsult.com www.ovid.com/products/cip/ebmr.cfm


• Haynes RB, Sackett RB, Gray JMA, Cook DC, Guyatt GH. Transferring evidence from research into practice: 1. The role of clinical care research evidence in clinical decisions. ACP Journal Club. 1996 Nov-Dec;125:A-14-15.

• Guyatt GH, Sackett DL, Cook DJ for the Evidence-based Medicine Working Group. Users' guides to the medical literature. II - How to use an article about therapy or prevention. Part B. What were the results and will they help me in caring for my patients. JAMA 1994:271:59-63.

• Introduction to Research: Understanding and Applying Multiple Strategies, Elizabeth Depoy, Laura N. Gitlin , 2005, Elsevier Health Sciences

• Foundations of Clinical Research: Applications to Practice, Leslie Gross Portney, Mary P. Watkins, 1999, Pearson Education

• Interpreting the Medical Literature, Stephen H. Gehlbach 2002 McGraw-Hill Companies, The Studying a Study and Testing a Test: How to Read the Medical Evidence 5e, Richard K. Riegelman, 2004 Lippincott Williams & Wilkins

• Data Monitoring and Case Studies in Clinical Trials, David L. Demets (Editor), Lawrence Friedman (Editor), Curt D. Furberg (Editor), 2005, Springer-Verlag New York, LLC

• Basic and Clinical Biostatistics, Beth Dawson, Robert G. Trapp 2004, McGraw-Hill Companies

• Primer of Biostatistics Stanton A. Glantz 2005, McGraw-Hill Medical Publishing

• Biostatistics: A Foundation for Analysis in the Health Sciences, Wayne, W. Daniel, Noel A. C. Cressie (Editor), David J. Balding (Editor), Ian M. Johnstone (Editor) 2004, Wiley, John & Sons, Incorporated

• Evidence Based Medicine: How to Practice and Teach EBM Sharon E. Straus, R. Brian Haynes, W. Scott Richardson, Paul Glasziou 2005, Elsevier Health Sciences

• Users' Guides to the Medical Literature: Essentials of Evidence-Based Clinical Practice, Evidence-Based Medicine Working Group, Drummond Rennie, Preface by Gordon H. Guyatt 2002 American Medical Association

• Evidence-Based Medicine Guidelines, Staff of Duodecim Medical Publications, Duodecim Medical Publications Staff, Ilkka Kunnamo , 2005, Wiley, John & Sons, Incorporated

moduli 1.5.moduli 1.5.moduli 1.5.moduli 1.5. `̀̀̀ samedicino eTiksamedicino eTiksamedicino eTiksamedicino eTika ojaxis eqimis saqmianobaSia ojaxis eqimis saqmianobaSia ojaxis eqimis saqmianobaSia ojaxis eqimis saqmianobaSi~~~~



modulis mizania saeqimo saqmianobis procesSi saqarTvelos moqmed kanonmdeblobaSi gacxadebuli normebisa da Tanamedrove bioeTikis principebis Sesabamisad moqmedebisaTvis saWiro codnis SeZena da misi gamoyenebis unaris gamomuSaveba rezidentis mier;


programis amocanebia:

� profesiuli saqmianobisas konkretuli SemTxvevis samarTlebrivi da eTikuri mxareebis warmoCenis unaris gamomuSaveba rezidentisaTvis;

� yoveldRiuri profesiuli saqmianobis Tanamedrove samedicino eTikis principebisa da arsebuli kanonmdeblobis Sesabamisad warmarTvis unaris gamomuSaveba rezidentisaTvis, maT Soris, profesiuli saqmianobis procesSi


25

samarTlebrivi koliziebisa da eTikuri dilemebis gadawyvetis unaris gamomuSaveba;

� adamianze Catarebuli samedicino-biologiuri kvlevis Tanmxlebi samarTlebrivi da eTikuri mxareebis warmoCenis da analizis, agreTve, konkretul SemTxvevebSi biosamedicino eTikisa da arsebuli kanonmdeblobis Sesabamisad moqmedebis unaris gamomuSaveba rezidentisaTvis.

gamgamgamgamoyenebuli swavlebis meTodebioyenebuli swavlebis meTodebioyenebuli swavlebis meTodebioyenebuli swavlebis meTodebi::::

� msmenelTan komunikaciis interaqtiuri meTodebi, saxeldobr:

1. `kerZo SemTxvevis analizi~;

2. samedicino dawesebulebis eTikuri komisiis saqmianobis imitacia;

3. adamianze Catarebuli samedicino-biologiuri kvlevis gegmis eTikuri eqspertizis imitacia;

zemoT miTiTebulTagan pirvel da meore punqtebSi miTiTebuli saqmianobisaTvis SemTxvevebi SeirCeva specialur literaturaSi gamoqveynebulTagan, agreTve Tavad rezidentebis profesiuli saqmianobis dros maT samuSao adgilze momxdari SemTxvevebidan, romelTac rezidentebi Tavad warmoadgenen. mesame punqtSi miTiTebuli saqmianobis imitaciisaTvis gamoyenebuli iqneba saxelmwifo samedicino akademiis aspirantebisa da maZieblebis samedicino-biologiuri kvlevis gegmebi.

� interaqtiuri leqciebi - msenelisaTvis sabaziso informaciis misawodeblad;

� samedicino eTikis da samedicino-biologiuri eTikis komisiebis muSaobaze daswreba;

� werilobiTi davalebebi:

1. konkretuli SemTxvevis an zogadad qveyanaSi/dawesebulebaSi arsebuli problemis analizi;

2. referati programiT gaTvaliswinebuli sakiTxebis Sesaxeb.

SefasebaSefasebaSefasebaSefaseba

� reizedntis mier programiT gaTvaliswinebuli sakiTxebis codna Sefasdeba werilobiTi davalebebis analizis gziT da daskvniTi testirebis saSualebiT.

programiT gaTvaliwinebuli sakiTxebiprogramiT gaTvaliwinebuli sakiTxebiprogramiT gaTvaliwinebuli sakiTxebiprogramiT gaTvaliwinebuli sakiTxebi

1. kanonisa da eTikis roli samedicino momsaxurebis gawevisas.

1.1. samedicino momsaxurebis gamwevsa (eqimi) da samedicino momsaxurebis momxmarebels (pacients) Soris urTierTobis Taviseburebebi, urTierTobis modelebi.

1.2. cnebebis ganmarteba (jandacvis sferos kanonmdebloba, samedicino eTika, bioeTika).

1.3. saeqimo saqmianobis samarTlebrivi regulirebis aucileblobis damadasturebeli istoriuli magaliTebi (hamurabis kodeqsi, safrangeTis revoluciis konvencia da sxv.);

1.4. saeqimo saqmianobis eTikuri normebiT regulirebis aucileblobis damadasturebeli istoriuli magaliTebi (eTikuri kodeqsebi hipokrates ficidan moyolebuli Jenevis deklaraciamde, niurnbergis kodeqsi, tuskijis eqsperimenti, talidomidis tragedia da sxv.));

1.5. samedicino eTikis principebi:

a) pacientis da eqimis uflebebi - avtonomiis principi;

b) pacientis da eqimis pasuxismgebloba da movaleobebi;


26

g) sargebloba pacientisaTvis - maqsimaluri sargeblianobis principi;

d) pacientisaTvis zianis Tavidan acileba an misi minimumamde Semcireba - principi `ar avno~;

e) simarTlis Tqma;

v) konfidencialuroba;

z) informirebuli Tanxmoba: � eTikuri midgoma;

� samarTlebrivi midgoma;

T) samarTlianobis principi: � resursebis ganawileba konkretul SemTxvevaSi - pacientis

individualur saWiroebebze dafuZvnebuli resursebis samarTlianad ganawileba;

� resursebis ganawileba globalurad - resursebis samarTlianad ganawileba saxelmwifo da erovnul doneze.

1.6. riT aris wamodgenili saqarTvelos kanonmdebloba janmrTelobis dacvis sferoSi.

2. pacientis individualuri uflebebi, saqarTvelos kanonmdebloba pacientis individualuri uflebebis Sesaxeb

2.1. informirebuli Tanxmobis ufleba. informirebuli Tanxmobis arsi da Semadgeneli elementebi;

2.2. sakuTari janmrTelobis mdgomareobis Sesaxeb informaciis miRebis ufleba;

2.3. informaciis konfidencialuroba;

2.4. meore azris moZiebis ufleba;

2.5. samedicino dawesebulebisa da samedicino personalis arCevis ufleba;

3. informirebuli Tanxmoba

3.1. `informirebuli Tanxmobis~ istoria samedicino daxmarebis aRmoCenis da samedicino-biologiuri kvlevis dros; informirebuli Tanxmobis doqtrinis samarTlebrivi da eTikuri safuZvlebi; informirebuli Tanxmobis funqciebi _ Tavisuflebaze uflebis garantia, pacientis keTildReobis uzrunvelyofa;

3.2. informirebuli Tanxmobis elementebi, informirebuli Tanxmobis aucilebeli pirobebi;

3.3. informirebuli Tanxmobis `ganxorcielebis~ (realizaciis) meTodebi _ informirebuli Tanxmoba rogorc erTjeradi movlena, informirebuli Tanxmoba rogorc procesi; informirebuli Tanxmobis, rogorc `procesis~ modelis SezRudvebi.

3.4. gadawyvetilebis miRebis unaris Sefaseba, gadawyvetilebis miRebis unaris Sefasebis meTodi (`cvalebadi Skalis~ meTodi) _ gansxvavebuli kriteriumebi samedicino Carevis (ar Carevis) Sedegebis gansxvavebuli `seriozulobis~ SemTxvevebSi, cvalebadi Skalis meTodis SezRudvebi.

4. pacientis qmedunarianoba da mis mier gacnobierebuli gadawyvetilebis miRebis unari

4.1. cnebebis ganmarteba;

4.2. pacientis mier gacnobierebuli gadawyvetilebis miRebis unaris Sefaseba:

a) informaciis gagebis unari;

b) informaciis Sefasebis unari;


27

g) samedicino daxmarebasTan dakavSirebuli arCevanis SesaZlebloba.

4.3. vis aqvs samedicino CarevasTan dakavSirebuli gadawyvetilebis miRebis ufleba qmeduunaro da gacnobierebuli gadawyvetilebis unaris armqone pacientis SemTxvevaSi.

4.4. arasrulwlovani pacientebis uflebebi samedicino CarevasTan dakavSirebuli sakiTxis gadawyvetisas.

4.5. qmeduunarianobasTan da gacnobierebuli gadawyvetilebis miRebis unaris arqonasTan dakavSirebuli sakiTxebi saqarTvelos kanonmdeblobaSi.

5. sikvdilisa da evTanaziis samarTlebrivi da eTikuri problemebi.

5.1. cnebebis ganmarteba da terminebis aRrevis Tavidan acilebis aucilebloba - sikvdili eqimis daxmarebiT, suicidi eqimis daxmarebiT, aqtiuri evTanazia, sicocxlis SemanarCunebeli mkurnalobis ar dawyeba an SeCereba, pasiuri evTanazia;

5.2. evTanazia, misi istoria, sakanonmdeblob regulaciis magaliTebi.

5.3. eqimis daxmarebiT TviTmkvlelobis da aqtiuri evTanaziis sasargeblo da sawinaaRmdego filosofiuri da empiriuli argumentebi; gansxvaveba mokvdinebasa da bunebrivi sikvdilis `saSualebis micemas~ Soris; kanonmdebloba da sazogadoebis interesebi aRniSnuli problemebis analizis dros;

5.4. `kargi sikvdilis~ cneba, terminalur stadiaze myofi pacientis paliatiuri mkurnaloba _ eqimis daxmarebiT TviTmkvlelobis da aqtiuri evTanaziis SesaZlo alternativa, paliatiuri mkurnalobis elementebi, paliatiuri medicinis ganviTarebis aucilebloba.

5.5. `Rirseuli sikvdili";

5.6. paTologanatomiuri gakveTa;

6. mkurnalobaze uaris Tqmis samarTlebrivi da eTikuri sakiTxebi.

6.1. reanimaciuli RonisZiebebis Catarebaze uaris gacxadebis uflebamosileba;

6.2. ra formiT unda gacxaddes uari reanimaciuli RonisZiebebis Catarebaze da ras unda Seicavdes;

6.3. uari reanimaciuli RonisZiebebis ganxorcilebaze da ara `uari movlaze~

6.4. pacientis mier winaswar gacxadebuli neba;

6.5. kanonieri warmomadgenelis roli gadawyetilebis miRebisas;

7. sicocxlis SemanarCunebeli mkurnalobis Sewyvetis samarTlebrivi da eTikuri sakiTxebi

7.1. sicocxlis SemanarCunebeli mkurnalobis Sewyvetis uflebamosileba;

7.2. gansxvaveba (sicocxlis SemanarCunebeli) mkurnalobis Sewyvetasa da (sicocxlis SemanarCunebeli) mkurnalobis Catarebaze uars Soris (Catarebisagan Tavis Sekavebas Soris);

7.3. xelovnuri sunTqvis Sewyveta;

7.4. siTxeebis gadasxmis da xelovnuri kvebis Sewyveta.

7.5. sicocxlis SemanarCunebel mkurnalobaze uaris uflebis realizciis sirTuleebi konkretul klinikur SemTxvevebSi _ pacientis Rirebulebebis, survilis dadgenasTan dakavSirebuli sirTuleebi, samedicino personalsa da pacientsa (pacientis ojaxis wevrebs) Soris urTierTobis problemebi,


28

samedicino personalis fsiqologiuri barierebi da maT profesiul saqmianobaSi damkvidrebuli tradiciebi, kanonmdeblobis codnasTan dakavSirebuli problemebi.

8. adamianis organoebis gadanergvis samarTlebrivi da eTikuri sakiTxebi

8.1. cocxali donorisagan organos, qsovilis aReba;

8.2. gvamuri organoebis aReba; organoTa aRebis ZiriTadi sakanonmdeblo modelebi - `gacxadebuli Tanxmobis~ ("Opting in") da `nagulisxmebi Tanxmobis~ ("Opting out") modelebi;

8.3. Tavis tvinis sikvdili; Tavis tvinis sikvdilis arsi; Tavis tvinis sikvdilis, permanentuli vegetatiuri mdgomareobis da komis SedarebiTi daxasiaTeba; maTi aRmocenebisas samedicino daxmarebasTan dakavSirebuli eTikuri problemebi;

8.4. saqarTvelos kanonmdebloba adamianis organoebis gadanergvis Sesaxeb.

9. pediatriuli praqtikis samarTlebrivi da eTikuri sakiTxebi

9.1. bavSvis janmrTelobis interesebis Sesabamisi gadawyvetilebis miRebis sirTuleebi.

9.2. pediatri, rogorc bavSvis interesebis damcveli;

9.3. mSoblebisaTvis rCevebis micema;

9.4. neonataluri intensiuri Terapia;

9.5. gadawyvetilebis miRebis procesSi bavSvis monawileoba.

10. usargeblo samedicino Careva/pacientis gaumarTlebeli moTxovna

10.1. pacientis uflebebi mkurnalobis procesSi; negatiuri (ufleba ganacxados uari samedicino Carevaze) da pozitiuri uflebebi (ufleba moiTxovos garkveuli saxis mkurnaloba).

10.2. gaumarTlebeli moTxovnebis variantebi;

10.3. usargeblo mkurnaloba; usargeblo mkurnalobis sxvadasxva gageba _ usargeblo mkurnaloba fiziologiuri TvalsazrisiT, sikvdilis gadavadeba, usargeblo mkurnaloba sicocxlis xarisxis TvalsazrisiT, mkurnalobis efeqturobis dabali albaToba;

10.4. usargeblo da araracionaluri mkurnalobis moTxovnis mizezebi;

10.5. gaumarTlebel moTxovnebze uaris Tqmis safuZvlebi;

10.6. samarTlebrivi da eTikuri aspeqtebi;

10.7. gansxvaveba usargeblo mkurnalobasa da racionalur mkurnalobas Soris;

10.8. eqimis reaqcia gaumarTlebel moTxovnaze.

11. reproduqtologiis samarTlebrivi da eTikuri sakiTxebi

11.1. orsulobis xelovnuri Sewyveta;

11.2. xelovnuri ganayofiereba; in-vitro xelovnur ganayofierebasTan dakavSirebuli eTikuri aspeqtebi:

a) embrionis gayinva;

b) sqesis SerCeva;

g) embrionis ganadgureba.


29

d) heterologiuri xelovnuri ganayofierebis moralurobis Sefaseba _ wyvilis, daqorwinebulTa da bavSvis Rirseba da uflebebi;

e) homologiuri xelovnuri ganayofierebis moralurobis Sefaseba.

11.3. kontracefcia;

11.4. surogatuli dedoba;

11.5. adamianis reproduqciuli klonireba.

12. tkivilis marTva/paliatiuri mkurnaloba

12.1. ufro agresiuli mkurnalobis saWiroeba;

12.2. gavrcelebuli (Cveuli) Secdomebi;

12.3. tkivilis optimaluri marTva:

12.4. tkivildamayuCebeli preparatebis dozis SerCeva;

12.5. wamalTdamokidebulebis SesaZleblobis gaTvaliswineba;

12.6. sunTqvis daTrgunva;

12.7. sedacia terminalur mdgomareobaSi.

13. specifikuri jgufebisaTvis samedicino daxmarebis –samarTlebrivi da eTikuri sakiTxebi

13.1. orsuli da meZuZuri dedebi;

13.2. patimrebi;

13.3. religiuri umciresobebi;

13.4. arasrulwlovanebi, qmeduunaro pacientebi.

14. rTuli pacienti

14.1. macdunebeli pacienti;

14.2. nevrasTeniuli pacienti;

14.3. wamlze damokidebuli pacienti;

14.4. zedmetad damokidebuli pacienti;

14.5. ukurnebeli daavadebis terminaluri stadiaSi myofi pacienti;

14.6. pacienti, romelic ar eqvemdebareba mkurnalobas;

14.7. mosazRvre mdgomareobebi;

14.8. rTuli pacientis marTvisaTvis saWiro unar-Cvevebi.

15. genuri Terapia da genetikuri konsultacia

15.1. genuri inJineria da genuri Terapia;

15.2. genetikuri konsultacia;

15.3. genetikuri informaciis moZiebasTan dakavSirebuli eTikuri problemebi;

15.4. adamianis uflebebis darRvevis riski genetikuri informaciis safuZvelze.

16. adamianze Catarebuli samedicino-biologiuri kvlevis samarTlebrivi da eTikuri sakiTxebi

16.1. samedicino-biologiuri kvlevasTan dakavSirebuli eTikuri problemebi;


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16.2. samedicino-biologiuri kvlevis gegmis Sefaseba, eTikis komisiis funqciebi samedicino-biologiuri kvlevis gegmis Sefasebisas.

16.3. samedicino-biologiuri kvlevis gegmis Sefasebis ZiriTadi elementebi - kvlevis riskisa da sargeblobis gansazRvra da urTierTSedareba, informirebuli Tanxmobis `WeSmaritebis~ Sefaseba, kvlevis subieqtis SerCeva (samarTlianobis da Tanasworobis principebis dacviT), kvlevis subieqtis piradi cxovrebis da konfidencialurobis dacva, kvlevis mimdinare Sefasebis aucilebloba;

16.4. samedicino-biologiuri kvlevis warmoeba specifikur jgufebSi. eTikuri problemebi kvlevis warmoebisas bavSvebis, orsulebis, patimrebis monawileobiT;

17. arasakmarisi resursebi janmrTelobis dacvis sistemaSi, organizaciuli eTika da marTvadi jandacvis sistema

17.1. samarTlianobis principi janmrTelobis dacvis sistemaSi;

17.2. resursebis ukmarisoba, prioritetebis gansazRvra da arCevanis problema;

17.3. marTvadi jandacvis sistema da konfliqti ekonomikuri efeqturobis moTxovnebsa da pacientis interesebs Soris;

17.4. samedicino momsaxurebisaTvis anazRaurebis sxvadasxva formebis arsebobisas eqimis finansuri motivaciis sxvadassxva variantebi da pacientis janmrTelobis interesebi, ormagi standartis dauSvebloba samedicino daxmarebis gawevisas.

18. pacientis uflebebis dacva samedicino dawesebulebaSi

18.1. samedicino dawesebulebebis Sinaganawesis roli pacientis uflebebis, samedicino daxmarebasTan dakavSirebuli eTikuri problemebis gadawyvetaSi;

18.2. samedicino dawesebulebis eTikuri standartebi;

18.3. dawesebulebis movaleoba uzrunvelyos pacientis uflebebis dacva;

18.4. pacientis uflebebis dacvis zogierTi meqanizmi samedicino dawesebulebaSi (eTikis komisiebi, ombudsmenis intituti).

18.5. samedicino eTikis komisiebis daniSnuleba, maTi warmoqmnis istoria;

18.6. samedicino eTikis komisiebis ZiriTadi funqciebi;

18.7. saqarTvelos kanonmdebloba eTikis komisiebis Sesaxeb; samedicino eTikis komisiebis sanimuSo wesdeba: samedicino eTikis organizaciasa da funqcionirebasTan dakavSirebuli sakiTxebi.

19. eqimis profesiuli pasuxismgebloba

19.1. ra SemTxvevebSi warmoiqmneba eqimis profesiuli pasuxismgeblobis problema;

19.2. saeqimo Secdoma;

19.3. saeqimo Secdomis dazRveva;

19.4. saqarTvelos kanonmdeblobiT gaTvaliwinebuli sanqciebi eqimis profesiuli pasuxismgeblobis dadgomisas.

20. eqimis uflebebi saqarTvelos moqmed kanonmdeblobaSi

20.1. xelSekruleba samedicino dawesebulebis xelmZRvanelobasTan;

20.2. saeqimo saqmianobis adekvaturi adanzRaurebis ufleba;

20.3. profesiuli saqmianobisaTvis adekvaturi samuSao garemos moTxovnis ufleba;


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20.4. uwyvet samedicino ganaTlebaSi monawileobis uzrunvelyofa;

20.5. saqarTvelos kanonmdeblobiT gaTvaliswinebuli socialuri SeRavaTebi samedicino personalisaTvis.



• “Encyclopedia of Bioethics”, Warren Thomas Reich (Ed.), Simon & Schuster Macmillan, New York, 1995 (5 Volumes);

• “Principles of Biomedical Ethics” (4th Ed.), T.L. Beauchamp, J.F. Childress, Oxford University Press, 1994;

• “Ethical Issues in Modern Medicine” (5th Ed.), John D. Arras, Mayfield Publishing Company, 1999

• “Health Law-Cases, Materials and Problems”(3rd Ed.), B.Furrow etc. West Group, St Paul. Minn, 1997

• “Legal Medicine” (4th Ed.), S.S. Sanbar etc. American College of Legal Medicine Textbook Committee; Mosby, 1998;

• `saqarTvelos kanonmdebloba janmrTelobis dacvis sferoSi (mokle qronologiuri mimoxilva, ZiriTadi etapebi)~; kiknaZe, javaSvili, barkalaia; jandacvis marTvis nacionaluri centris samecniero SromaTa krebuli, tomi I, 1998, 15-20

• pacientis uflebebi da maTi ganxorcielebis meqanizmebi kiknaZe, javaSvili Tbilisi, 1999

• “Principles of modern medical ethics and Health care professionals; Relation between health and education: from declaration to implementation (Georgian Experience)” Kiknadze, Javashvili, Barkalaia; medicinis filoso-fosTa II msoflio kongresis masalebi, krakovi, 2000, 45

• “Through doctors' glasses: The story of one article of the law on organ transplantation or how could closed eyelids of the deceased person conceal our sins”, Javashvili, Kiknadze; medicinis filoso-fosTa II msoflio kongresis masalebi, krakovi, 2000, 41

• “Patients' rights legislation in Georgia” Kiknadze, Javashvili, Barkalaia; “Journal of Health Sciences and Publlic Health”, Volume 1, Number 1, 2000, 17-26

• “Ethics committees in Georgia”; Javashvili, Kiknadze “Ethics Committees in Central and Eastern Europe”, 2000, Charis – IMEB Fdn. Bratislava, Slovakia 179-185 ISBN 80-88743-40-0

• `pacientis ombudsmeni:ideidan realizaciamde~; javaSvili, kiknaZe saqarTvelos bioeTikis da jandacvis samarT-lerivi sakiTxebis Semswavleli sazogadoeba, Tbilisi, 2001. ISBN 99928-908-1-9

• àdamianis uflebebi biomedicinis sferoSi~; javaSvili, kiknaZe, barkalaia; saqarTvelos bioeTikis da jandacvis samarT-lerivi sakiTxebis Semswavleli sazogadoeba, Tbilisi, 2001. ISBN 99928-908-0-0

• èqimis profesiuli saqmianobis samarTlebrivi safuZvlebi~; kiknaZe, javaSvili saqarTvelos bioeTikis da jandacvis samarT-lerivi sakiTxebis Semswavleli sazogadoeba, Tbilisi, 2002. ISBN 99928-908-5-1

• `jandacvis ombudsmeni:pirveli nabijebi~; javaSvili, kiknaZe saqarTvelos bioeTikis da jandacvis samarT-lerivi sakiTxebis Semswavleli sazogadoeba, Tbilisi, 2002. ISBN 99928-908-8-6

• ìeRovas mowmeTaTvis mkurnalobis mizniT sisxlis gadasxmis eTikuri da samarTlebrivi sakiTxebi~; kiknaZe, javaSvili, barkalaia; `Tanamedrove medicina~, tomi 1, #1, gv. 37-44

• “Georgian Legislation on Human Rights in the sphere of health care and biomedicine: Current trends and harmonisation with international developments”; Javashvili, Kiknadze; in “Europe and its impact on National Healthcare systems Yearbook 2001”, 2002, Erasmus University Press, Rotterdam, The Netherlands, 60-72, ISBN 90 807503 I X

• “Treatment and care at the end-of-life: Review of Georgian Legislation” Javashvili, Kiknadze; in “Ethical Eye”, 2003, Council of Europe Publishing, Strasbourg, France, In Press

• “A Clinician’s Commentary from a Post-Soviet Society on


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• Organizational Issues of Care for Alzheimer’s Disease”; Javashvili; in “Book on Alzheimers's Disease”, 2003, Johns Hopkins University Press. in press.

• `pacientis mkurnaloba da movla daavadebis terminalur stadiaze: saqarTvelos kanonmdeblobis mimoxilva~; javaSvili, kiknaZe; `Tanamedrove medicina~, tomi 1, #3.

moduli 1.6.moduli 1.6.moduli 1.6.moduli 1.6. òjaxis eqimis praqtikuli saqmianobis organizcia~òjaxis eqimis praqtikuli saqmianobis organizcia~òjaxis eqimis praqtikuli saqmianobis organizcia~òjaxis eqimis praqtikuli saqmianobis organizcia~



modulis mizania gamoumuSaos rezidents ojaxis eqimis praqtikis marTvis Cvevebi gansxvavebul garemoSi (saxelmwifo da kerZo seqtorSi, qalaqad, urbanizebul raionebSi da soflad, jandacvis ganviTarebuli infrastruqturis mqone regionebSi da mwiri resursebis pirobebSi).


modulis gavlis Sedegad rezidentma unda icodes:

� profesiuli saqmianobis saxis, adgilis, garemos Sefaseba

• adgilmdebareoba a. regioni, raioni, qalaqi/sofeli b. mosaxleobis raodenoba da tipi

• saqmianobis da dawesebulebis tipi a. `solo~ an jgufuri praqtika b. soflis ambulatoria, poliklinika d. sxva

• xelSekrulebebi/kontraqtebi TanamSromlebTan a. kompensaciebi da SeRavaTebi b. samuSao datvirTva g. profesiuli pasuxismgeblobis dazRveva d. samarTlebrivi sakiTxebi e. eTikuri aspeqtebi

� dawesebuleba

• adgilmdebareoba da marketinguli analizi

• dizaini da Sinaganawesi

• finansireba

• aRWurviloba da momsaxureba

• materialur teqnikuri uzrunvelyofa da momarageba

• daqiraveba, ijara an mflobeloba

• laboratoriebi da saxelmwifo regulacia

• radiologia da ultrasonografia

• specialuri ofisSi gansaxorcielebeli pirocedurebi � ofisis organizacia

• Sida komunikaciis jaWvi

• ganrigi

• damxmare personalis raodenoba da tipi

• kompiuteruli sistemebi

• momarageba da inventaris movla � dawesebulebis saqmianoba

• pacientebis nakadi da maTi miRebis ganrigi

• momwodebelebi

• samedicino Canawerebis organizacia


33

• Sida politika da instruqciebi

• dazRveva da mesame pirisaTvis angariSis wardgena

• farmacevtuli kompaniebis warmomadgenlebTan urTierToba

• satelefono zarebis organizacia

• satelefono da peijinguri sistemebi

• winaswari dagegmva da ganrigis Sedgena

• monacemebis da Canawerebis Senaxva

• konsultaciebis organizeba

• pacientebis ganaTlebis organizeba

• daavadebebis gamovlenis sistemebi da prevenciuli momsaxureba

• mimRebi rgolis funqciebi

� samedicino Canawerebi

• Senaxvis sistema

• indeqsireba da kodireba

• informaciis gacema

• konfidencialuroba

• auditi da Tvalyuris devneba

• Canawerebis tipebi

• Canawerebis struqtura

� TanamSromelbi da personali

• urTierToba TanamSromlebTan a. xelfasebi da SeRavaTebi b. motivacia g. daqiraveba da SenarCuneba d. gaTavisufleba (termination) e. Sefaseba v. pasuxismgebloba an angariSgeba z. samuSaos aRweriloba

• Sromis kanonmdebloba

• personaluri Canawerebi

� riskis marTva da sakanonmdeblo sakiTxebi

• eqimisa da pacientis urTierToba � gansazRvreba � terminologia � mitoveba � organizebuli (marTvadi) samedicino momsaxureba

• informirebuli Tanxmoba � komponentebi � paicentTa specifikuri jgufebi

• urTierToba � eqimi-pacienti � samedicino personalis urTierToba pacientTan � saeqimo saqmianoba da samarTlebrivi sistema � personali � sxva momwodeblebi

• samarTlebrivi gansazRvrebebi � janmrTelobis dacvis kanonmdebloba � zogadi samarTlebrivi pasuxismgebloba � samedicino momsaxurebis gawevis valdebuleba


34

� samedicino momsaxurebis gawevis saTanado standartebi � samdecino momsaxurebis standartebis darRveva � mizez-Sedegovrivi kavSiri movalebis ar Sesrulebasa da zianis

miyenebas Soris � kanoniT gansazRvruli sanqciebi

• dokumentacia (qaRaldis matarebelze an eleqtronuli) � eqimis samedicino Canawerebi � eqTnis da sxva samedicino personalis Canawerebi

• eqimis koompetenturobis sakiTxebi � uwyveti samedicino ganaTleba � samedicino praqtikis standartebi � saqmianobis Sefaseba mesame mxaris mier � alkoholizmi an wamalTdamokidebuleba eqimebs Soris

• yvelaze xSiri garemoebebi, romelTac Sedegad mohyveba pacientis saCivari eqimis profesiuli saqmianobis Sesaxeb � arasakmarisi urTierToba da komunikacia paicnetTan, urTierTobis

deficiti � araswori an dagvianebuli diagnozi � motexilobisa da travmis mcdari diagnozi da/an menejmenti � araswori farmakologiuri mkurnaloba � dagvianebuli konsultacia � procedurebis daudevrad Catareba � daudevari sameaneo praqtika � informirebuli Tanxmobis ar miReba

• profesiuli pasuxismgeblobis dazRveva � dazRvevis polisis tipebi � dazRvevis farglebi � movaleobebi � profesiuli dazRvevis `momwodebelTa~ tipebi

• organizaciebi, romelTac miewodeba informacia mcdari samedicino qmedebis Sesaxeb � saxelmwifo sertifikatis mimniWebeli sabWo � eqimTa registri � profesiuli asociaciebi an maTi gaerTianeba

• eqimebis winaaRmdeg saqmis aRZvris Sedegebi � emociuri � socialuri (ojaxi) � ekonomikuri

� kompiuteris moxmareba

• beWdviTi wyaroebi a. Jurnalebi b. saxelmZRvaneloebi g. monografiebi d. gazeTebi e. sainformacio furceli / kvlevebi

• kompiuteruli wyaroebi a. kompaqt diskebi b. literaturis saZiebeli resursebi g. internetis resursebi d. usg-is teqnologiebi e. eleqtronuli sainforacio resursebis codna

� eleqtronuli saxelmZRvaneloebi � bibliografiuli bazebi � klinikuri `imitatori~


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� eqsperimentuli teqnologiebi, rogoricaa virtuluri sistemebi

v. praqtikaze dafuZnebuli kompiuteruli sistema

• sakomunikacio teqnologiebi a. telekomunikaciebi b. xmovani Setyobineba g. elfosta d. eleqtronuli qseli samedicino dawesebulebaSi e. axali teqnologiebis gamoyenebis samarTlebrivi sakiTxebi

• interpersonuli a. sxva ojaxis eqimebi b. konsultantebi g. sxva personali d. farmaciis warmomadgenlebi

• praqtikuli gamocdileba

• mimoxilviTi statiebi

• orignaluri kvleva

• meta-analizuri mimoxilva

• praqtikuli saxelmZRvanelo principebi

• mtkiceulebebze dafuZnebuli medicinis da klinikuri Sedegebis analizi

• ojaxis eqimma unda icodes, romeli wyaroa saukeTeso informaciis misaRebad: a. pacientTan dakavSirebul kiTxvebze pasuxis gasacemad b. sakuTari codnis ganaxlebisaTvis, romelic araa dakavSirebuli

konkretul pacientTan; g. gamoyenebuli meTodis Rirebulebis da informaciis saWiroebis

dasabalanseblad;

• ojaxis eqims unda SeeZlos informaciis prioritetebis gamoyofa

• ojaxis eqims unda SeeZlos Sesabamisi klinikuri SekiTxvebis Camoyalibeba a. Sedegebisa da interesebis gansazRvra b. mniSvnelobis (Rirebulebis) gansazRvra

• ojaxis eqims unda SeeZlos literaturis moZieba � saavadmyofosTan dakavSirebuli sakiTxebi

• saavadmyofos SerCeva

• TanamSromlebTan miRebis saaTebi da privilegiebi

• samedicino personali da ganyofilebis pasuxismgeblobebi � urTierTobebi personals Soris

� dafinansebis modelebi

• centraluri da municipaluri samedicino programebi

• sadazRvevo kompaniebi

• individualuri kontraqtebi (individebi, ojaxebi)

• sxva � gadaxdis sistemebi

• winaswari gadasaxadi

• gaweuli momsaxurebis gadasaxadi

modulis gavlis Sedegad rezidents unda SeeZlos:

� piradi da profesiuli interesebis balansireba

� praqtikis tipis SerCeva (moicavs gadawyvetilebebs, romlebic dakavSirebulia cxovrebis stilTan, adgilmdebareobasTan da profesiul urTierTobebTan)


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� molaparakebis warmoeba eTikuri principebis gamoyenebiT

� konsultantebisa da momwodeblebis windaxeduli SerCeva da gamoyeneba

� kompiuteris moxmareba

� drois marTva

� komunikaciis warmoeba individebTan da organizaciebTan (sityvieri, werilobiTi)

� resursebis marTva

gamoyenebuli swavlebis/Sefasebis megamoyenebuli swavlebis/Sefasebis megamoyenebuli swavlebis/Sefasebis megamoyenebuli swavlebis/Sefasebis meTodebiTodebiTodebiTodebi


• swavleba mcire jgufebSi, romlis mizania ZiriTadi informaciis miwodeba rezidentebisaTvis da maT mier aucilebeli codnis dagroveba


• dakvirveba saojaxo medicinis ofisis saqmianobaze da janmrTelobis marTvis Taviseburebebis warmoCena da analizi;








Sefasebis meTodebis CamonaTvaSefasebis meTodebis CamonaTvaSefasebis meTodebis CamonaTvaSefasebis meTodebis CamonaTvalililili

• gamokiTxva;


• esei.

moduli 1.7.moduli 1.7.moduli 1.7.moduli 1.7. `fundamenturi medicinis Tanamedrove aspeqtebi~`fundamenturi medicinis Tanamedrove aspeqtebi~`fundamenturi medicinis Tanamedrove aspeqtebi~`fundamenturi medicinis Tanamedrove aspeqtebi~



rezidentis/specialobis maZieblisaTvis medicinis fundamenturi da klinikuri kvlevis Tanamedrove principebis Sesaxeb saWiro codnis SeZena da misi gamoyenebis unaris gamomuSaveba. programa kompleqsuria, Sedgeba oTxi - imunologiis, klinikuri farmakologiis, fiziologiis da paTfiziologiis - qvemodulisagan, Sesabamisi amocanebis Tanmimdevruli ganxorcielebiT.

modumodumodumodulis amocanebi:lis amocanebi:lis amocanebi:lis amocanebi:

fiziologiis qvemoduli:

� adaminis organizmis funqciuri sistemebis organizaciisa da centralur nervul sistemaSi mimdinare neirobiologiuri procesebis bioqimiuri safuZvlebi integraciis sxvadasxva doneze;

� calkeuli neiromediatoruli sistemis funqcionirebis (sinafsuri mediaciis) natifi molekuluri meqanizmebi; sinafsuri gadacemis sxvadasxva safexurze


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qimiuri preparetebis zemoqmedebis efeqturi gamovlinebebi da daavadebaTa koreqciis zogadi principebi;

� tkivilisa da gautkivarebis funqciuri sistemis neirobiologiuri safuZvlebi; nocicepciis periferiuli da centraluri meqanizmebis neiroqimiuri safuZvlebi; endogenuri opioiduri da sxva peptidebis receptoruli sistemis roli analgeziis ganviTarebaSi;

� motivacia da emocia. limburi sistema (hipokampi, sartylebri xveuli, nuSisebri kompleqsi), striopaliduri sistema da integraciis Talamuri done adamianis qcevis organizaciaSi. hipoTalamusis roli integraciul moqmedebaSi da ZiriTad biologiur motivaciebis formirebaSi.

� fiziologiaSi, molekulur biologiaSi da Teoriul medicinaSi ukanasknel wlebSi (2000-2005) ganxorcielebuli mniSvnelovani kvlevis Sedegebis mimoxilva da analizi;

paTfiziologiis qvemoduli:

� adaptaciis procesi. organizmis zogadi reaqcia endogenuri da egzogenuri faqtoris zemoqmedebaze. organizmis Seguebadoba Secvlil saarsebo garemosTan.

� organizmis saregulacio sistemebis roli adaptaciis ganxorcielebaSi fiziologiur da eqstremalur situaciebSi. parakrinuli regulaciis molekuluri meqanizmebi. mexsierebis roli adaptaciuri qcevis realizaciaSi.

� adapturi stres-reaqcia. stresuli da antistresuli meqanizmebi. eqstremaluri faqtoris zemoqmedebiT ganviTarebuli paTogenuri stresi. Sokuri mdgomareobis zogadi paTogenezi. organoebisa da organoTa sistemebis funqciobis da integraciis moSlis meqanizmebi Sokis dros.

klinikuri farmakologiis qvemoduli:

� kerZo klinikuri farmakologiis ZiriTadi sakiTxebi fundamenturi da klinikuri medicinis bolo miRwevebis Sesabamisad. farmakoTerapia mtkicebiTi medicinis poziciebidan.

� samkurnalod praqtikaSi gamoyenebuli samkurnalo preparatebis ZiriTadi jgufebis farmakokinetikis da farmakodinamikis Seswavla. sxvadasxva samkurnalo preparatebis urTierTdamokidebulebis da arasasurveli gverdiTi efeqtebis Seswavla. agreTve, gamoyenebuli farmakologiuri preparatebis randomizebuli kontrolirebadi kvleva.

imunologiis qvemoduli:

� fundamenturi da klinikuri imunologiis - imunuri sistemis organoebisa da ujredebis, imunoglobulinebis, antigenis gamomcnobi da warmdgeni molekulebis struqturisa da funqciis- Tanamedrove Teoriuli da praqtikuli aspeqtebi;

� daavadebaTa ganviTarebaSi imunuri meqanizmebis rolis, rogorc axali sadiagnozo da Terapiuli strategiis safuZvlebi;

Sesasrulebeli samuSaos moculoba:Sesasrulebeli samuSaos moculoba:Sesasrulebeli samuSaos moculoba:Sesasrulebeli samuSaos moculoba:

Teoriuli kursiTeoriuli kursiTeoriuli kursiTeoriuli kursi davalebadavalebadavalebadavaleba organizmis funqciebis regulacia da fiziologiuri integraciaorganizmis funqciebis regulacia da fiziologiuri integraciaorganizmis funqciebis regulacia da fiziologiuri integraciaorganizmis funqciebis regulacia da fiziologiuri integracia

neironis morfologiuri specializacia da neironTaSorisi komunikaciis safuZvlebi cns-is integraciuli moqmedebis ganxorcielebaSi. neirosekrecia, rogorc ZiriTadi biologiuri kanonzomiereba da cns-is subujreduli regulaciis elementi.


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neironTaSorisi komunikaciis safuZvlebineironTaSorisi komunikaciis safuZvlebineironTaSorisi komunikaciis safuZvlebineironTaSorisi komunikaciis safuZvlebi

neiroregulatorebis klasifikacia da maTi gansazRvris kriteriumebi. neiroregulatorebis mimarT mgrZnobiare receptorebis klasifikacia da maTi moqmedebis kanonzomierebani. “retrograduli mesenjeri”. sinafsis plastikuroba. neironuli integracia. calkeuli neiroregulatorebi (biogenuri aminebi, aminomJavebi, arapeptiduri kandidatebi, neiropeptidebi).

prezentaciebis analizi

tkivilis fiziologiatkivilis fiziologiatkivilis fiziologiatkivilis fiziologia

problemis zogadi mimoxilva. nocicepturi sistema da tkivilis sensitiuri aRmavali gzebi. endogenuri opioiduri da sxva peptidebis roli. antinocicefciuri sistema, gautkivarebis biologiuri mniSvneloba. tkivilis saxeebi. tkivilis neirobiologiuri safuZvlebi. tkivilis centraluri da periferiuli meqanizmebi. endogenuri opiatebi (opioidebi). opioidebiT gamowveuli analgeziis neirofiziologiuri meqanizmebi. substancia P da misi roli tkivilis SegrZnebaSi.


motivacia da emociamotivacia da emociamotivacia da emociamotivacia da emocia

limburi sistemis anatomiis da funqciis zogadi mimoxilva. adamianis qcevis organizacia. “motivaciis” da “emociis” mniSvneloba qcevis organizaciaSi. “fsiqoanalizis” Teoria. hipoTalamusis roli integraciul moqmedebaSi da ZiriTad biologiur motivaciebis formirebaSi. limburi sistema (hipokampi, sartylebri xveuli, nuSisebri kompleqsi) striopaliduri sistema da integraciis Talamuri done.

testireba

fiziologiaSi, molekulur biologiaSi da Teoriul medicinaSi ukanasknel wlebSi (2004-2006) ganxorcielebuli mniSvnelovani mniSvnelovani mniSvnelovani mniSvnelovani kvlevis Sedegebis mimoxilva da analizi;kvlevis Sedegebis mimoxilva da analizi;kvlevis Sedegebis mimoxilva da analizi;kvlevis Sedegebis mimoxilva da analizi;

organizmis sxvadasxva funqciurorganizmis sxvadasxva funqciurorganizmis sxvadasxva funqciurorganizmis sxvadasxva funqciur----struqturul doneze ganviTarebuli struqturul doneze ganviTarebuli struqturul doneze ganviTarebuli struqturul doneze ganviTarebuli paTologiuri procesebis urTierTobisa da integraciis paTologiuri procesebis urTierTobisa da integraciis paTologiuri procesebis urTierTobisa da integraciis paTologiuri procesebis urTierTobisa da integraciis kanonzomierebani.kanonzomierebani.kanonzomierebani.kanonzomierebani. organizmis da garemos fiziko-qimiuri da informaciuli urTierToba. reaqtiulobis roli Secvlil saarsebo garemosTan adaptaciis ganviTarebaSi.

saregulacio sistemebis roli adaptaciuri procesebis saregulacio sistemebis roli adaptaciuri procesebis saregulacio sistemebis roli adaptaciuri procesebis saregulacio sistemebis roli adaptaciuri procesebis ganviTarebaSiganviTarebaSiganviTarebaSiganviTarebaSi. parakrinul-autokrinuli regulacia. citokinebi ujredSorisi urTierTobebis peptiduri regulatorebi. azotis oqsidi da misi moqmedebis molekuluri meqanizmebi.


mexsierebis roli adaptaciuri qcevis ganxorcielebaSi. sxvadasxva tipis mexsierebis neirobiologiuri meqanizmebi. mexsierebis darRveva.


specifiuri adaptaciis meqanizmebispecifiuri adaptaciis meqanizmebispecifiuri adaptaciis meqanizmebispecifiuri adaptaciis meqanizmebi. stresstresstresstres----reaqcia. zogadi reaqcia. zogadi reaqcia. zogadi reaqcia. zogadi adaptaciuri sindromi. adaptaciuri sindromi. adaptaciuri sindromi. adaptaciuri sindromi. stresuli hormonebi. centraluri da periferiuli antistresuli meqanizmebi, stresuli cilebi.


eqstremaluri mdgomareobis zogadi paTogenezi. Soki, Sokis eqstremaluri mdgomareobis zogadi paTogenezi. Soki, Sokis eqstremaluri mdgomareobis zogadi paTogenezi. Soki, Sokis eqstremaluri mdgomareobis zogadi paTogenezi. Soki, Sokis stadiebi. neiroendokrinuli regulaciisa da organoTa sistemebis integraciis moSlis meqanizmebi. Sokuri Tirkmlis, Sokuri RviZlis, Sokuri filtvis ganviTarebis meqanizmebi. mozrdilTa mwvave respiraciuli distres-sindromi.

testireba

imunuri sistemis zogadi daxaimunuri sistemis zogadi daxaimunuri sistemis zogadi daxaimunuri sistemis zogadi daxasiaTeba. siaTeba. siaTeba. siaTeba. sakuTarisa da ucxos garCeva. Tandayolili da SeZenili imunuri pasuxi. imunuri sistemis ujredebi. imunuri pasuxis mediatorebi. ujredSida da ujredgareTa paTogenis sawinaaRmdego dacva. vaqcinacia. imunopaTologia da atopia.


39

imunuri pasuxis regulaciaimunuri pasuxis regulaciaimunuri pasuxis regulaciaimunuri pasuxis regulacia antigeniT imunuri pasuxis regulacia. antigenwarmdgeni ujredebi. antisxeulebiT regulacia. limfocitebiT regulacia. idiotipuri modulacia. neiroendokrinuli modulacia. imunuri pasuxis genetikuri kontroli. tolerantobis induqcia eqsperimentSi. sakuTari antigenebisadmi centraluri Timusuri tolerantoba. sakuTari antigenebisadmi periferiuli – postTimusuri tolerantoba. sakuTari antigenebisadmi B-ujreduli tolerantoba. in vitro da in vivo xelovnurad inducirebuli tolerantoba. tolerantobis gamoyeneba TerapiaSi.


simsivnis imunologiasimsivnis imunologiasimsivnis imunologiasimsivnis imunologia simsivne rogorc qsovilovani transplantanti. imunuri zedamxedveloba. simsivnesTan asocirebuli antigenebi. simsivnis sawinaaRmdego imunuri pasuxi. simsivnis mier imunuri pasuxis Tavidan acileba. imunodiagnostika. imunoTerapia.


autoimuniteti da autoimunuri daavadebebiautoimuniteti da autoimunuri daavadebebiautoimuniteti da autoimunuri daavadebebiautoimuniteti da autoimunuri daavadebebi autoimunitetis kavSiri daavadebebTan. organospecifiuri da araorganospecifiuri autoimunuri daavadebebi. genetikuri faqtorebi. paTogenezi. autoimunur daavadebaTa modelebi: inducirebuli da spontanuri autoimuniteti. daavadebebi, ganpirobebuli paTogenuri autoantisxeulebiT: Tireotoqsikozi, avTvisebiani miasTenia, I tipis diabeti, mamakacis uSviloba, perniciozuli anemia, gudpasCeris sindromi, sisxlis daavadebebi. daavadebebi, ganpirobebuli paTogenuri imunuri kompleqsebiT: sistemuri wiTeli mglura, revmatoiduli poliarTriti, skleroderma, antifosfolipiduri sindromi.


imunuri sistemis klinikuri da laboratoriuli Sefasebaimunuri sistemis klinikuri da laboratoriuli Sefasebaimunuri sistemis klinikuri da laboratoriuli Sefasebaimunuri sistemis klinikuri da laboratoriuli Sefaseba humoruli imunuri pasuxis Sefaseba. ujreduli imunuri pasuxis Sefaseba. limfocitTa raodenobisa da funqciis Sefaseba: imunofenotipireba gamWoli citofluorometriiT, in vitro limfocitebis proliferacia, citokin-maproducirebeli ujredebis gansazRvra (ELISPOT meTodi), citotoqsiurobis testi. komplementis sistemis gamokvleva. fagocitebis funqciis gamokvleva. antigenis/antisxeulis aRmosaCeni reaqciebi: precipitaciis reaqcia, hemaglutinaciis reaqcia, komplementis SeboWvis reaqcia, pirdapiri da arapirdapiri imunofluorescenciis reaqcia, imunofermentuli reaqcia, imunoblotingi da imunoprecipitacia. antisxeulTa izolacia. monoklonuri antisxeulebis produqcia.

testireba

klinikuri farmakokinetikisa da klinikuri farmakodinamikis klinikuri farmakokinetikisa da klinikuri farmakodinamikis klinikuri farmakokinetikisa da klinikuri farmakodinamikis klinikuri farmakokinetikisa da klinikuri farmakodinamikis ZiriTadi principebi, racionaluri farmakoTerapia.ZiriTadi principebi, racionaluri farmakoTerapia.ZiriTadi principebi, racionaluri farmakoTerapia.ZiriTadi principebi, racionaluri farmakoTerapia.

arasasurveli wamlismieri reaqciebi. klinikuri farmakoekonoarasasurveli wamlismieri reaqciebi. klinikuri farmakoekonoarasasurveli wamlismieri reaqciebi. klinikuri farmakoekonoarasasurveli wamlismieri reaqciebi. klinikuri farmakoekonomika, mika, mika, mika, farmakoepidemiologia.farmakoepidemiologia.farmakoepidemiologia.farmakoepidemiologia. samkurnalo dozebis gaTvla Tirkmlis qr. ukmarisobiT daavadebul pacientebSi. medikamentozuli saSualebebis metabolizmi, biotransformacia.


farmakoTerapia da mtkicebiTi medicina.farmakoTerapia da mtkicebiTi medicina.farmakoTerapia da mtkicebiTi medicina.farmakoTerapia da mtkicebiTi medicina. medikamentebis Sewovisa da organizmSi ganawilebis meqanizmebi


farmakoTerapiis saxeebifarmakoTerapiis saxeebifarmakoTerapiis saxeebifarmakoTerapiis saxeebi----etiotropuli, paTogenezurietiotropuli, paTogenezurietiotropuli, paTogenezurietiotropuli, paTogenezuri

farmakoTerapiis saxeebi farmakoTerapiis saxeebi farmakoTerapiis saxeebi farmakoTerapiis saxeebi ---- simptomaturi, profilaqtikuri.simptomaturi, profilaqtikuri.simptomaturi, profilaqtikuri.simptomaturi, profilaqtikuri. racionaluri antibiotikoTerapiis sakiTxebi. medikamentozuri monitoringi (Cvenebebi, klinikuri mniSvneloba da Sedegebis interpretacia).


gadaudebel mdgomareobaTa klinikaSi gamoyenebul medikamentTa gadaudebel mdgomareobaTa klinikaSi gamoyenebul medikamentTa gadaudebel mdgomareobaTa klinikaSi gamoyenebul medikamentTa gadaudebel mdgomareobaTa klinikaSi gamoyenebul medikamentTa farmakokinetikuri da farmakodinamikuri daxasiaTebafarmakokinetikuri da farmakodinamikuri daxasiaTebafarmakokinetikuri da farmakodinamikuri daxasiaTebafarmakokinetikuri da farmakodinamikuri daxasiaTeba. arasasurveli

testireba


40

medikamentozuri efeqtebi, maTi karcenogenoba.

modulismodulismodulismodulis dasrulebis Semdeg rezidents/specialobis maZiebelma unda dasrulebis Semdeg rezidents/specialobis maZiebelma unda dasrulebis Semdeg rezidents/specialobis maZiebelma unda dasrulebis Semdeg rezidents/specialobis maZiebelma unda icodes/SeeZlos:icodes/SeeZlos:icodes/SeeZlos:icodes/SeeZlos:

� integraciis sxvadasxva doneze organizmis cxovelmoqmedebis zogadi kanonzomierebebis (molekuluridan-organizmulamde) da principebis Sefaseba;

� daavadebul organizmSi mimdinare adaptaciuri procesebis, avadmyofobis aRmocenebis, mimdinareobisa da gamosavlis zogadi meqanizmebis, paTogenezuri profilaqtikis, Terapiis principebis da meTodebis Sefaseba;

� imunopaTologiuri mdgomareobebis diagnostikuri da Terapiuli strategiis safuZvlebis Sefaseba; alergiuli daavadebebis profilaqtikisa da mkurnalobis Sesaxeb codnas;

� farmakokinetikuri da farmakodinamikuri monacemebis Sesabamisad samkurnalo saSualebebis SerCeva. individualuri mgrZnobelobidan gamomdinare, preparatis arasasurveli efeqtebis gaTvaliswineba; datvirTvisa da SemanarCunebeli dozebis SerCeva; zogierT kategoriis avadmyofTaTvis (RviZlis funqciis darRveva, Tirkmlis qr. ukmarisoba, xandazmuli da xanSisesuli pirebi, bavSvebi) samkurnalo dozis gaTvla; arasasurveli wamlismieri reaqciis profilaqtika, diagnostika da mkurnaloba; samkurnalo preparatebis zedozirebis diagnostika da mkurnaloba.

moduli 1.moduli 1.moduli 1.moduli 1.8888.... `biosamedicino kvlevis warmoeba saojaxo medicinis sferoSi `biosamedicino kvlevis warmoeba saojaxo medicinis sferoSi `biosamedicino kvlevis warmoeba saojaxo medicinis sferoSi `biosamedicino kvlevis warmoeba saojaxo medicinis sferoSi –––– Sesavali Sesavali Sesavali Sesavali kursi~kursi~kursi~kursi~



modulis mizania miawodos informacia rezidents pirveladi jandacvis sferoSi biosamedicino kvlevebis warmoebis Taviseburebebis Sesaxeb, kvlevis SesaZlo mimarTulebebis, Temebisa da midgomebis Taobaze; gamoumuSaos unari rezidents SearCios kvlevis sagani arsebuli problemebis analizis safuZvelze da miusadagos mis mier dasaxul mizans kvlevis Tanamedrove da adekavturi meTodebi



• swavleba mcire jgufebSi, romlis mizania ZiriTadi informaciis miwodeba rezidentebisaTvis da maT mier aucilebeli codnis dagroveba biosamedicino kvlevebis sakiTxebze pirveladi jandacvis sferoSi.

swavleba ojaxis eqimis praqtikaSiswavleba ojaxis eqimis praqtikaSiswavleba ojaxis eqimis praqtikaSiswavleba ojaxis eqimis praqtikaSi

• mciremasStabiani kvlevis Catareba da priveladi masalebis moZieba ojaxis eqimis ofisSi, samedicino Canawerebis sistemuri analizi da daskvnebis momzadeba;

• auditis dagegmva da ganxorcieleba rezidentis mier lokaluri xelmZRvanelis zedamxedvelobiT;






41



• gamokiTxva;


• esei;

• kvlevis da auditis Sedegebis Sefaseba



• Introduction to Research: Understanding and Applying Multiple Strategies, Elizabeth Depoy, Laura N. Gitlin , 2005, Elsevier Health Sciences

• Foundations of Clinical Research: Applications to Practice, Leslie Gross Portney, Mary P. Watkins, 1999, Pearson Education

• Interpreting the Medical Literature, Stephen H. Gehlbach 2002 McGraw-Hill Companies, The Studying a Study and Testing a Test: How to Read the Medical Evidence 5e, Richard K. Riegelman, 2004 Lippincott Williams & Wilkins

• Data Monitoring and Case Studies in Clinical Trials, David L. Demets (Editor), Lawrence Friedman (Editor), Curt D. Furberg (Editor), 2005, Springer-Verlag New York, LLC

• Basic and Clinical Biostatistics, Beth Dawson, Robert G. Trapp 2004, McGraw-Hill Companies

• Primer of Biostatistics Stanton A. Glantz 2005, McGraw-Hill Medical Publishing

• Biostatistics: A Foundation for Analysis in the Health Sciences, Wayne, W. Daniel, Noel A. C. Cressie (Editor), David J. Balding (Editor), Ian M. Johnstone (Editor) 2004, Wiley, John & Sons, Incorporated

• Evidence Based Medicine: How to Practice and Teach EBM Sharon E. Straus, R. Brian Haynes, W. Scott Richardson, Paul Glasziou 2005, Elsevier Health Sciences

• Users' Guides to the Medical Literature: Essentials of Evidence-Based Clinical Practice, Evidence-Based Medicine Working Group, Drummond Rennie, Preface by Gordon H. Guyatt 2002 American Medical Association

profesiuli mzadebis II etapiprofesiuli mzadebis II etapiprofesiuli mzadebis II etapiprofesiuli mzadebis II etapi modulebis raodenobamodulebis raodenobamodulebis raodenobamodulebis raodenoba: : : :

5 savaldebulo moduli (15 Tve) da 7 SerCeviTi (eleqtiuri) moduli (3 Tve)

profesiuli mzadebis II profesiuli mzadebis II profesiuli mzadebis II profesiuli mzadebis II etapis mizani:etapis mizani:etapis mizani:etapis mizani:

mzadebis II etapis bolosTvis rezidents gamomuSavebuli aqvs codna da unar-Cvevebi, rac aucilebelia pirvelad jandacvaSi arsebuli specifikuri problemebis marTvisaTvis, maT Soris gansakuTrebiT im problemebisa, romlebic umniSvnelovanesia saqarTvelosaTvis.

SeuZlia gavrcelebuli qronikuli daavadebebis diagnostika da marTva; icnobs gadaudebeli medicinisa da travmis marTvis principebs, SeuZlia gavrcelebuli samedicino problemebis marTva bavSvebSi, icnobs qalTa janmrTelobis dacvis ZiriTad principebs da SeuZlia specifikuri problemebis marTva sqesobrivi gziT gadamdebi daavadebebis CaTvliT; SeuZlia pacientis fsiqikuri janmrTelobis ZiriTadi maxasiaTeblebis Sefaseba da gavrcelebuli aSlilobebis amocnoba an maT arsebobaze eWvis mitana; SeuZlia garcelebuli daavadebebis amocnoba da pirveladi marTva Semdegi sferoebidan: yel-yur-cxviris daavadebebi, dermatologia, ofTalmologia, nevrologia, orTopedia, onkologia, qirurgia.

profesiuli mzadebis II etapis amocanebi: profesiuli mzadebis II etapis amocanebi: profesiuli mzadebis II etapis amocanebi: profesiuli mzadebis II etapis amocanebi:


42


1.1.1.1. pirveladi jandacvis pirveladi jandacvis pirveladi jandacvis pirveladi jandacvis marTva: marTva: marTva: marTva:

• pirveladi jandacvis sferoSi tipuri (uxSiresi) simptomebisa da Civilebis codna, gansakuTrebiT daavadebaTa adreul stadiebze; am ukanasknelTa niSnebisa da simptomebis mniSvnelobis codna sadiagnozo da samkurnalo RonisZiebebis SerCevisaTvis;

• unar-Cvevebi mwvave, qronikuli, prevenciuli, paliatiuri da gadaudebeli daxmarebis aRmoCenisaTvis;

• anamnezis Segrovebis, fizikuri gamokvlevisa da damatebiTi testebis gamoyenebis unar-Cvevebi im mdgomareobaTa sadiagnozod, romlebic aReniSnebaT pacientebs pirvelad jandacvaSi;

• mkurnalobis unar-Cvevebi, maT Soris, rogorc medikamenturi, ise aramedikamenturi midgomebis gamoyenebiT im mdgomareobebis dros, romlebic xSiria pirvelad jandacvaSi (mag., kardiovaskuluri daavadebebi, cerebrovaskuluri daavadebebi, diabeti, filtvis daavadebebi da a.S.);

• sxva specialistebTan efeqturi TanamSromlobis unari. 2.2.2.2. pirovnebaze koncentrirebuli daxmarebapirovnebaze koncentrirebuli daxmarebapirovnebaze koncentrirebuli daxmarebapirovnebaze koncentrirebuli daxmareba

• bazisuri sakomunikacio unar-Cvevebi (gagrZeleba iqneba).

3.3.3.3. specifikuri problemebis gadaWris unarspecifikuri problemebis gadaWris unarspecifikuri problemebis gadaWris unarspecifikuri problemebis gadaWris unar----CvevebiCvevebiCvevebiCvevebi

• specifikuri gadawyvetilebebis miRebis unar-Cveva, maT Soris iseTi berketebis gamoyenebis unari, rogoricaa klinikuri msjeloba da gadawyvetilebis miRebis zogadi wesebi;

• anamnezuri monacemebis moZiebisaTvis saWiro kiTxvebisa da mniSvnelovani fizikuri niSnebis codna da maTi misadageba arsebul problemasTan, yuradRebis gamaxvilebiT gadaudebeli daxmarebis saWiroebaze da piriqiT.

• pacientTan dakavSirebuli garemoebebis, maT Soris ojaxisa da socialuri faqtorebis, moZiebis codna;

• warmodgenili problemebis gadaWrisaTvis saWiro sadiagnozo da samkurnalo resursebis Sesaxeb informacis floba;

• anamnezis Segrovebisa da fizikuri gamokvlevis unar-Cvevebi, moZiebuli monacemebis Sefasebis codna;

• saqmianobisadmi midgomis iseTi maxasiaTeblebis gaTaviseba, rogoricaa codnis wyurvili, mondomeba da yuradRebianoba;

• specifikuri gadawyvetilebebis miRebis unar-Cveva urgentul situaciebSi; • specifikuri unar-Cvevebis qona gadaudebeli daxmarebisaTvis saWiro procedurebis ganxorcielebisaTvis pirveladi jandacvisaTvis damaxasiaTebel situaciebSi;

• codna imisa, rodis SeiZleba mocda/dayovneba da rodis aris saWiro damatebiTi sadiagnozo RonisZiebebi.;

• simptomebisa da niSnebis, damatebiTi gamokvlevebis monacemebis pozitiuri da negatiuri prediktuli mniSvnelobisa da `samizne~ daavadebebis dros maTi sixSiris codna;

• sadiagnozo da samkurnalo RonisZiebebis xarjefeqturobisa da xarjsargeblianobis gacnobiereba.

4.4.4.4. yovlismomcveli midgomayovlismomcveli midgomayovlismomcveli midgomayovlismomcveli midgoma

• polimorbidulobis (polinozologiurobis) koncefciisa da Sedegebis gacnobiereba;

• pacientis janmrTelobis sxvadasxva problemebis erTdroulad marTvis unar-Cveva maTi amocnobis, Seswavlis, ganmartebis micemis, saubris warmarTvisa da prioritetebis gamoyofis gziT.


43

5.5.5.5. Temze orientacia Temze orientacia Temze orientacia Temze orientacia

• jandacvasTan dakavSirebul saTemo politikaSi CarTul sxva profesionalebTan muSaoba da maTi rolis gacnobiereba.

6.6.6.6. mecnieruli gamoyenebis maxasiaTeblebi iqneba:mecnieruli gamoyenebis maxasiaTeblebi iqneba:mecnieruli gamoyenebis maxasiaTeblebi iqneba:mecnieruli gamoyenebis maxasiaTeblebi iqneba:

• srulyofili codna paTologiis, simptomebisa da diagnozis, mkurnalobisa da prognozis, epidemiologiis, agreTve, gadawyvetilebis miRebis, hipoTezis Camoyalibebisa da problemis gadaWris Teoriebis formirebisa da prevenciuli samedicino daxmarebis mecnieruli safuZvlebis Sesaxeb.

mTlianad mzadeba II etapze 18 Tves moicavs, romlis ZiriTadi nawili (15 Tve) savaldebulo modulobes eTmoba, xolo darCenili 3 Tve eleqtiur modulebs:

savaldebulo modulebi (sul 15 Tve):savaldebulo modulebi (sul 15 Tve):savaldebulo modulebi (sul 15 Tve):savaldebulo modulebi (sul 15 Tve):

1. Sinagani medicina – 4 Tve;

2. gadaudebeli medicina da travma – 3 Tve:

3. bavSvTa janmrTeloba – 3 Tve;

4. qalTa janmrTeloba da sqesobrivi gziT gadamdebi daavadebebi – 3 Tve;

5. fsiqikuri janmrTeloba – 2 Tve;

SerCeviTi (eleqtiuri) modlebi (sul 3 Tve):SerCeviTi (eleqtiuri) modlebi (sul 3 Tve):SerCeviTi (eleqtiuri) modlebi (sul 3 Tve):SerCeviTi (eleqtiuri) modlebi (sul 3 Tve):

E1. yel-yur-cxviris daavadebebi (4 kvira); E2. dermatologia (4 kvira); E3. ofTalmologia (4 kvira); E4. nevrologia (4 kvira); E5. orTopedia (4 kvira); E6. onkologia (4 kvira); E7. qirurgia (4 kvira).

yoveli rotaciis sul mcire 50%-s rezidentis gaatarebs ambulatoriul klinikaSi. specialuri/viwro sakiTxebisaTvis organizebuli iqneba moklevadiani kursebi Tssu saojaxo medicinis centrSi, centris unar-Cvevebis laboratoriasa da saojaxo meidicnis centr(eb)Si (mag. ekg, mcire qirurgia, laboratoriuli diagnostika, spirometria)


mzadebis mocemul etapze swavlebis da Sefasebis meTodebi analogiuria da TiTqmis arafriT gansxvavdeba erTmaneTisagan da efuZneba klinikuri sagnebis swavlebas calkeul specialobebSi.


• swavleba mcire jgufebSi, romlis mizania ZiriTadi informaciis miwodeba rezidentebisaTvis ama Tu im klinikuri sakiTxis Sesaxeb.

praqtikuli saqmianoba praqtikuli saqmianoba praqtikuli saqmianoba praqtikuli saqmianoba saavadmyofoSisaavadmyofoSisaavadmyofoSisaavadmyofoSi

• dakvirveba samedicino personalis saqmianobaze, daswreba samedicino konsultaciebze meoreuli jandacvis dawesebulebebSi;

• praqtikuli klinikuri saqmianoba mocemul specialobaSi lokaluri xelmZRvanelis (viwro specialisti) zedamxedvelobiT;



• dakvirveba samedicino personalis saqmianobaze, daswreba samedicino konsultaciebze ojaxis eqimis ofisSi;


44

• praqtikuli klinikuri saqmianoba ojaxis eqimis ofisSi: mocemuli specialobis farglebSi arsebuli janmrTelobis problemebis marTva lokaluri xelmZRvanelis (ojaxis eqimis) zedamxedvelobiT;



• pirdapiri dakvirveba (viwro specialistisa da ojaxis eqimis saqmianobaze);


• Cvevebis Seswavla mulaJis gamoyenebiT;





SefasebSefasebSefasebSefasebis meTodebis CamonaTvaliis meTodebis CamonaTvaliis meTodebis CamonaTvaliis meTodebis CamonaTvali

• rezidentis mier warmoebuli klinikuri saqmianobis Sefaseba rezidentis Canawerebis safuZvelze;

• pirdapiri dakvirveba rezidentis mier warmoebul saqmianobaze da dakvirvebis Sedegebis ganxilva rezidentTan;

• rezidentis mier warmoebuli profesiuli saqmianobis gadaReba da misi ganxilva rezidentTan;


• klinikuri Cvevebis demonstireba mulaJze/manekenze/simulatorze;

• rolebis TamaSi;

• klinikuri SemTxvevebis analizi (werilobiTi da zepiri);

• pacientis mosazrebebi da Canawerebi. profesiuli mzadebis II etapis modulebi (savaldebulo)profesiuli mzadebis II etapis modulebi (savaldebulo)profesiuli mzadebis II etapis modulebi (savaldebulo)profesiuli mzadebis II etapis modulebi (savaldebulo)

moduli 2.1.moduli 2.1.moduli 2.1.moduli 2.1. `Sinagani `Sinagani `Sinagani `Sinagani medicinamedicinamedicinamedicina~~~~

modulis xangrZlivoba:modulis xangrZlivoba:modulis xangrZlivoba:modulis xangrZlivoba:4 Tve


Sinagani medicinis sferoSi farglebSi arsebuli janmrTelobis gavrcelebuli mwvave da qronikuli problemebis prevencia, amocnoba da marTva;


rezidentis kompetencia Sinagani medicinis sferoSi unda moicavdes Semdeg sakiTxebs:

gulgulgulgul----sisxlZarRvTa sistemasisxlZarRvTa sistemasisxlZarRvTa sistemasisxlZarRvTa sistema

� samedicino momsaxurebis principebi samedicino momsaxurebis principebi samedicino momsaxurebis principebi samedicino momsaxurebis principebi

� gulgulgulgul----sisxlZarRvTa sistemis anatomia da fiziologia.sisxlZarRvTa sistemis anatomia da fiziologia.sisxlZarRvTa sistemis anatomia da fiziologia.sisxlZarRvTa sistemis anatomia da fiziologia.

� gulgulgulgul----sisxlZarRvTa sistemis fiziologiuri maxasiaTeblebis cvlilebebi sisxlZarRvTa sistemis fiziologiuri maxasiaTeblebis cvlilebebi sisxlZarRvTa sistemis fiziologiuri maxasiaTeblebis cvlilebebi sisxlZarRvTa sistemis fiziologiuri maxasiaTeblebis cvlilebebi asakis Sesabamisad da orsulobis dros.asakis Sesabamisad da orsulobis dros.asakis Sesabamisad da orsulobis dros.asakis Sesabamisad da orsulobis dros.

� gulgulgulgul----sisxlZarRvTa sistemis daavadebebis ganviTarebis risksisxlZarRvTa sistemis daavadebebis ganviTarebis risksisxlZarRvTa sistemis daavadebebis ganviTarebis risksisxlZarRvTa sistemis daavadebebis ganviTarebis risk----faqtorebi: faqtorebi: faqtorebi: faqtorebi:

• gulis iSemiuri daavadeba: a. hiperlipidemia b. Tambaqos moxmareba


45

g. genetikuri winaswarganwyoba d. adinamia e. hipertenzia v. Saqriani diabeti z. simsuqne T. kveba i. hormonuli statusi k. emociuri stresi.

• gulis sarqvlovani daavadebebi

� anamnezis mniSvneloba;anamnezis mniSvneloba;anamnezis mniSvneloba;anamnezis mniSvneloba;

� gulgulgulgul----sisxlZarRvTa sistemis fizikuri gamokvleva;sisxlZarRvTa sistemis fizikuri gamokvleva;sisxlZarRvTa sistemis fizikuri gamokvleva;sisxlZarRvTa sistemis fizikuri gamokvleva;

� gamokvlevis arainvazaiurgamokvlevis arainvazaiurgamokvlevis arainvazaiurgamokvlevis arainvazaiuri meTodebi:i meTodebi:i meTodebi:i meTodebi:

• eleqtrokardiografia

• gulmkerdis rentgenografia

• datvirTvis testi, rogorc tredmilis, aseve farmakologiuri saSualebebis gamoyenebiT (testirebis procedura, Sedegebis interpretacia).

• eqokardiografia/ doplerografia mosvenebul mdgomareobaSi da datvirTviT, rogorc tredmilis, aseve farmakologiuri saSualebebis gamoyenebiT

• radioizotopuri gamokvleva, mosvenebul mdgomareobaSi da datvirTviT, rogorc tredmiliT, aseve farmakologiuri saSualebebis gamoyenebiT

• ekg-monitorireba, saavadmyofoSi da ambulatoriul pirobebSi

• sisxlZarRvTa doplerografia da ultrabgeriTi gamokvleva.

� gamokvlevis invaziuri meTodebi:gamokvlevis invaziuri meTodebi:gamokvlevis invaziuri meTodebi:gamokvlevis invaziuri meTodebi:

• gulis sadiagnozo kaTeterizacia da angiografia

• karotiduli da periferiuli sisxlZarRvebis sadiagnozo angiografia

• intrakoronaruli da periferiul sisxlZarRvebis invaziuri gamokvleva saTanado aRWurvilobiT

• sisxlZarRvTa Sida monitorirebis saSualebebi: – a. centraluri venuri da periferiuli arteriuli kaTeteri b. hemodinamikis monitoringi, balonuri flotaciuri kaTeteris gamoyenebiT.

• eleqtrofiziologiuri gamokvlevebi

• samkurnalo Carevebis Cvenebebi da ukuCvenebebi: a. aortokoronaruli Suntireba b. angioplastika da stentis Cayeneba g. riTmis wamyvanis (peismeikeris) Canergva d. sarqvelis Secvla/aRdgena, balonuri valvulotomia e. eleqtrofiziologiuri ablacia.

� laboratoriuli gamlaboratoriuli gamlaboratoriuli gamlaboratoriuli gamokvlevebis, maT Soris Sratis fermentebis, izoenzimebis okvlevebis, maT Soris Sratis fermentebis, izoenzimebis okvlevebis, maT Soris Sratis fermentebis, izoenzimebis okvlevebis, maT Soris Sratis fermentebis, izoenzimebis da lipidebis gansazRvris Sedegebis interpretacia: da lipidebis gansazRvris Sedegebis interpretacia: da lipidebis gansazRvris Sedegebis interpretacia: da lipidebis gansazRvris Sedegebis interpretacia:

� specifikuri daavadebebi/mdgomareobebispecifikuri daavadebebi/mdgomareobebispecifikuri daavadebebi/mdgomareobebispecifikuri daavadebebi/mdgomareobebi

• gulis iSemiuri daavadeba a. stabiluri/arastabiluri stenokardia b. miokardiumis infarqti, garTulebuli an gaurTulebeli

� kardiogenuli Soki � ariTmia � dvrilisebri kunTis disfunqcia da gaskdoma � parkuWis gaskdoma � anevrizma


46

g. uecari sikvdili. –

• gulis wasvla

• ariTmia a. taqiariTmia:

� parkuWzeda � parkuWovani � reentri

b. bradiariTmia g. eqtopiuri ritmi:

� winagulovani � parkuWovani

• hipertenzia: a. esenciuri b. meoradi g. filtvis arteriis.

• filtvismieri guli

• gulis SegubebiTi ukmarisoba a. sistoluri disfunqcia b. diastoluri disfunqcia

• Tromboemboliuri daavadeba

• gulis sarqvlovani daavadeba a. revmatuli b. Tandayolili g. degeneraciuli d. mitraluri sarqvlis prolafsis sindromi

• gulis Tandayolili daavadebebi a. Sunti upiratesad marcxnidan marjvniv (acianozuri) b. Sunti upiratesad marjvnidan marcxniv (cianozuri) g. obstruqciiT ganpirobebuli problemebi

• ganSrevebadi anevrizma

• gulis uvnebeli (`funqciuri~) Suilebi

• periferiuli sisxlZarRvebis daavadebebi a. anevrizma b. karotiduli aTerosklerozi g. arteriebis daavadebebi d. maoblitirebeli aTerosklerozi

• kardiomiopaTiebi a. SegubebiTi (dilataciuri) b. restriqciuli g. hipertrofiuli kardiomiopaTia d. mSobiarobis Semdgomi

• perikardiumis daavadebebi

• infeqciiT ganpirobebuli daavadebebi a. virusuli miokarditi b. qvemwvave baqteriuli endokarditi g. kavasakis daavadeba

• gulis sxva– dazianebebi a. imunuri:

� mwvave revmatuli cxeleba � autoimunuri daavadebebi

b. fsiqogenuri g. travmuli d. kvebiTi e. miqsoma v. farisebri jirkvlis disfunqcia


47

z. marfanis sindromi T. medikamentebiT, kerZod kokainiT, steroidebiT da qimioTerapiuli preparatebiT gamowveuli

• kardiologiuri pacientebis gamokvleva arakardiologiuri operaciebis dros: a. kardiologiuri riskis Sefaseba operaciul Carevamde -– Sefasebis testebi b. operaciamde da operaciis Semdgomi marTva.

• sarqvlovani daavadebis saprofilaqtiko mkurnaloba antibiotikebiT

• kardiovaskuluri farmakologia

sasunTqi sistemasasunTqi sistemasasunTqi sistemasasunTqi sistema

� klinikuriklinikuriklinikuriklinikuri simptomebi da niSnebi:simptomebi da niSnebi:simptomebi da niSnebi:simptomebi da niSnebi:

• rinorea

• xvela

• qoSini

• sisxliani xvela

• tkivili gulmkerdis areSi

• apnoe

� daavadebebi:daavadebebi:daavadebebi:daavadebebi:

• mwvave respiratoruli daavadebebi

• filtvis araspecifikuri mwvave da qronikuli daavadebebi, plevritebi

• bronquli asTma

• filtvis simsivnuri daavadebebi

• tuberkulozi (filtvis, xorxis, bronqis, plevris, gulmkerdSida limfuri kvanZebis)

• spontanuri pnevmoToraqsi

• filtvis profesiuli daavadebebi

kuWkuWkuWkuW----nawlavid traqtinawlavid traqtinawlavid traqtinawlavid traqti

� klinikuri simptomebi da niSnebi:klinikuri simptomebi da niSnebi:klinikuri simptomebi da niSnebi:klinikuri simptomebi da niSnebi:

• disfagia

• gulZmarva

• dispefsia

• slokini

• Rebineba

• umadoba

• yabzoba

• diarea

• steatorea

• muclis tkivili

• muclis Seberiloba

• wonaSi dakleba

• gastrointestinuri sisxldena

• siyviTle

• RviZlis ukmarisoba

• asciti


• saylapavis daavadebebi: a. saylapavis aqalazia


48

b. diafragmis saylapavis rgolis Tiaqari g. saylapavis simsivnuri daavadebebi

• peptikuri wyluli

• kuWis simsivneebi (kibo an sxva avTvisebiani axalwarmonaqmnebi)

• duodeniti

• mwvave da qronikuli enteriti

• qronikuli araspecifikuri koliti (nawlavis anTebiTi daavadeba) a. araspecifikuri wylulovani koliti b. kronis daavadeba

• koloreqtaluri karcinoma

• gaRizianebuli nawlavis sindromi

• mwvave da qronikuli pankreatiti

• pankreasis kibo

• qolecistiti

• qolangiti

• naRvel-kenWovani daavadeba

• qronikuli hepatiti

• mwvave hepatiti

• cirozi

• RviZlis aTvisebiani axalwarmonaqmnebi, RviZlis pirveladi karcinoma

• RviZlis infecqiuri (parazituli) daavadebebi

saSarde organoTa sistemasaSarde organoTa sistemasaSarde organoTa sistemasaSarde organoTa sistema


• Tirkmlis kolika

• Sardis Seukavebloba

• ureTraluri sindromi

• nefrozuli sindromi

• Sardis Sekaveba


• mwvave da qronikuli glomerulonefriti

• mwvave da qronikuli pielonefriti

• amiloidozi

• SardkenWovani daavadeba

• Tirkmlis toqsikuri dazianeba

• Tirkmlis axalwarmonaqmnebi, Tirkmlis kibo

• mwvave da qronikuli cistiti

• ureTriti

• Tirkmlisa da saSarde gzebis Tandayolili anomaliebi

• prostatiti

• prostatis adenoma

• prostatis kibo

• Sardis buStis kibo

• fimozi, parafimozi

• kriptorqizmi

• Sardis Seukavebloba

• enurezi

• Tirkmlis mwvave da qronikuli ukmarisoba

• Tirkmlisa da saSarde gzebis tuberkulozi

sisxlisisxlisisxlisisxlissss da da da da sisxlmbadi sistemasisxlmbadi sistemasisxlmbadi sistemasisxlmbadi sistema


49

� klinikuriklinikuriklinikuriklinikuri sindromebi,sindromebi,sindromebi,sindromebi, simptomebi da niSnebi:simptomebi da niSnebi:simptomebi da niSnebi:simptomebi da niSnebi:

• anemia

• hemoragiuli diaTezi

• hematoma

• peteqia

• purpura

• limfadenopaTia


• anemiebi: a. rkina deficituri b. hemolizuri g. posthemoragiuli d. hipo da aplastikuri e. B12 da foliummJava deficituri

• agranulocitozi

• mwvave da qronikuli leikozi

• eriTremia da eriTrocitozi

• limfadenopaTia

• limfogranulomatozi

• limfoma

• mielomuri daavadeba

endokrinuli endokrinuli endokrinuli endokrinuli sistemasistemasistemasistema


• wyurvili

• kanis qavili

• poliuria

• simsuqne

• Ciyvi

• ofTalmopaTia da ofTalmoplegia


• Saqriani diabeti

• farisebri jirkvlis daavadebebi: a. Tireoiditi b. difuzuri toqsikuri Ciyvi g. farisebri jirkvlis kibo d. hipoTireozi (miqsedema)

• paraTireozi (hipo, hiper)

• kuSingis daavadeba da sindromi

• adisonis daavadeba

• feoqromocitoma

• simsuqne

• podagra

• hipo da avitaminozebi

SemarTebelqsovilovani da ZvalSemarTebelqsovilovani da ZvalSemarTebelqsovilovani da ZvalSemarTebelqsovilovani da Zval----kunTovani sistemakunTovani sistemakunTovani sistemakunTovani sistema

� normnormnormnormaluri Zvalaluri Zvalaluri Zvalaluri Zval----kunTovani sistema, misi anatomia da fiziologiakunTovani sistema, misi anatomia da fiziologiakunTovani sistema, misi anatomia da fiziologiakunTovani sistema, misi anatomia da fiziologia

� imunologiuri meqanizmis roli revmatuli daavadebebis paTogenezSiimunologiuri meqanizmis roli revmatuli daavadebebis paTogenezSiimunologiuri meqanizmis roli revmatuli daavadebebis paTogenezSiimunologiuri meqanizmis roli revmatuli daavadebebis paTogenezSi

� asakis zemoqmedeba revmatuli mdgomareobis ganviTarebazeasakis zemoqmedeba revmatuli mdgomareobis ganviTarebazeasakis zemoqmedeba revmatuli mdgomareobis ganviTarebazeasakis zemoqmedeba revmatuli mdgomareobis ganviTarebaze


50

� pacientis Sefasebapacientis Sefasebapacientis Sefasebapacientis Sefaseba

• saxsris da rbili qsovilis Sefaseba a. istoria

• fizikuri gamokvleva a. Semajamebeli gamokvleva Camweri aparaturis gamoyenebiT b. Zval-kunTovani sistemis sruli gamokvleva saTanado Cvenebis arsebobisas g. funqcionaluri Sefaseba

• laboratoriuli gamokvlevebi a. sisxlis Srati b. sinovialuri siTxe

• radiologiuri meTodebi a. rentgenologiuri gamokvleva b. arTroskopiis Cvenebebi g. saxsris punqciis Cvenebebi d. qsovilis biofsiis Cvenebebi

� etiologia, paTofiziologia, epidemiologia, klinikuri monacemebi da etiologia, paTofiziologia, epidemiologia, klinikuri monacemebi da etiologia, paTofiziologia, epidemiologia, klinikuri monacemebi da etiologia, paTofiziologia, epidemiologia, klinikuri monacemebi da kriteriumebi diagnozisTviskriteriumebi diagnozisTviskriteriumebi diagnozisTviskriteriumebi diagnozisTvis

• osteoarTriti a. pirveladi b. meoradi

• revmatoiduli arTriti a. artikularuli b. eqstra-artikularuli

• iuveniluri arTriti a. iuveniluri arTriti b. sistemuri (stilis daavadeba) g. poliartikularuli

• wiTeli mglura a. sistemuri b. diskoiduri g. wamlismieri

• skleroderma a. lokalizebuli b. sistemuri g. wamlismieri

• polimioziti/dermatomioziti

• nekrozuli vaskuliti a. kvanZovani poliarteriti b. alergiuli angiiti

� Sratismieri daavadeba � Sonlain-henoxis daavadeba

g. granulomatozuri arTriti � vegeneris � safeTqelis

d. kavasakis daavadeba e. behCetis daavadeba

• siogrenis sindromi

• spondiloarTriti a. maankilozebeli b. reiteris g. fsoriazuli d. nawlavis anTebasTan asocirebuli arTriti

• infeqciebi


51

a. pirdapiri � baqteriuli � virusuli � sokovani � spiroqetuli � riketsiozuli

b. reaqtiuli � mwvave revmatuli cxeleba � qvemwvave baqteriuli endokarditi � postdizenteriuli � sxva saxis baqteriuli da virusuli � imunizaciis Semdgomi

• metaboluri arTropaTia a. podagra

� memkvidreobiTi � SeZenili

b. kalciumis pirofosfat dihidrati (fsevdo podagra) g. hidroqsiapatitis Calageba

� steroidis saxsarSi SeyvaniT gamowveuli arTriti

• neoplaziiT gamowveuli arTriti

• neirovaskuluri a. kompresia

� periferiuli dazianeba, mag. majis arxis � radikulopaTia � spinaluri stenozi

b. reinos daavadeba

• Zvlis da xrtilovani darRvevebi a. osteoporozi b. osteomalacia c. pejetis daavadeba d. avaskuluri nekrozi e. osteoqondrozi v. kviristavis qondromalacia

• eqstraartikuluri a. bursiti b. tendiniti g. tkivili zurgis qveda areSi

• fibromialgiis sindromi

• wamlismieri arTralgia

• sxva a. revmatuli polimialgia b. recidivuli panikuliti (veber-kristianis daavadeba) g. kvanZovani eriTema

� farmakologiafarmakologiafarmakologiafarmakologia

• anTebis sawinaaRmdego wamlebi (arasteroiduli anTebis sawinaaRmdego wamlebi, aspirini)

• nela moqmedi antirevmatuli wamlebi a. malariis sawinaaRmdego b. sulfasalazini g. oqros preparatebi (oraluri an intramuskuluri) d. penicilamini e. citotoqsikuri preparatebi v. metotreqsati z. uaxlesi saSualebebi

• kortikosteroidebi


52

a. sistemuri b. lokaluri

• podagris sawinaaRmdego wamlebi a. mwvave Seteva b. SardmJavas donis daqveiTeba

• antibiotikebi

� reabilitaciareabilitaciareabilitaciareabilitacia

� Cvenebebi qirurgiuli CarevisTvCvenebebi qirurgiuli CarevisTvCvenebebi qirurgiuli CarevisTvCvenebebi qirurgiuli CarevisTvis arTritis drosis arTritis drosis arTritis drosis arTritis dros

� xSirad gamoyenebuli aratradiciuli saSualebebi xSirad gamoyenebuli aratradiciuli saSualebebi xSirad gamoyenebuli aratradiciuli saSualebebi xSirad gamoyenebuli aratradiciuli saSualebebi

alergologia da imunologiaalergologia da imunologiaalergologia da imunologiaalergologia da imunologia

� imunuri pasuxi da zemgrZnobelobiTi reaqciebiimunuri pasuxi da zemgrZnobelobiTi reaqciebiimunuri pasuxi da zemgrZnobelobiTi reaqciebiimunuri pasuxi da zemgrZnobelobiTi reaqciebi

• imunuri pasuxis biologia: a. T limfocitebi b. B limfocitebi g. T da B limfocitebis funqciebi d. citokinebi

• IgEE-s imunologia • poxieri ujredebi da bazofilebis/mediatorebis gamoTavisufleba

• komplementi

• imunuri dazianebis klasifikacia: a. I tipi dauyovnebeli (anafilaqsiuri) reaqcia b. II tipi - citotoqsikuri reaqcia g. III tipi - artiusis reaqcia d. IV tipi - dayovnebuli reaqcia e. V tipi - antireceptoruli reaqcia (vkiTxo maia goTuas)

� imunodeficiti imunodeficiti imunodeficiti imunodeficiti ----–––– pirveladi da meoreuli pirveladi da meoreuli pirveladi da meoreuli pirveladi da meoreuli

� asTma:asTma:asTma:asTma:

• ganmarteba da simZimis Sefaseba

• pacientisa da Temis/sazogadoebis cxovrebis xarisxze da finansur mdgomreobaze gavlena

• sasunTqi gzebis obstruqciis ZiriTadi paTologiuri faqtorebi (adreuli da gviani fazebi): a. lorwovani garsis anTebiTi SeSupeba b. bronqokonstriqcia (gluvi kunTebi) g. naxvelis sekrecia (lorwovani sacobebi) d. sasunTqi gzebis remodelireba.

• simptomebis trigerebi (gamSvebi faqtorebi): a. infeqcia b. gamaRizianebeli faqtorebi:

� Tambaqos kvamli � haeris dabinZureba.

g. fizikuri datvirTva d. alergenebi g. medikamentebi e. gastro-ezofaguri refluqsi v. mwvave emociuri stresi.

• anTebis trigerebi (gamSvebi faqtorebi): a. alergenebi b. profesiuli zemoqmedeba d. infeqcia.

• diagnozi da diferencialuri diagnozi:


53

a. anamnezi da fizikuri gamokvleva b. testebi filtvebis funqciuri mdgomareobis Sesafaseblad g. alergiis Sefaseba d. meTilqolinis testi

• paTofiziologiuri meqanizmebi a. genetikuri faqtorebi (IgE) b. avtonomiuri disfunqcia (adrenerguli da qolinerguli) g. bronquli hiperreaqtiuloba (qimiuri mediatorebis gamoTavisufleba)

• meTvalyureoba - pikfloumetria

• saprofilaqtiko mkurnaloba: a. gamomwvevi faqtorebis Tavidan arideba b. imunoTerapia.

• farmakoTerapia: a. B2 - agonistebi b. meTilqsantinebi (Teofilini) g. antiqolinerguli preparatebi d. poxieri ujredebis mastabilizebeli preparatebi d. sainhalacio steroidebi e. sistemuri steroidebi v. leikotrienebi z. sxva anTebis sawinaaRmdego preparatebi

• asTmuri statusis mkurnaloba

• asTmis marTva Tanmxlebi daavadebis arsebobis dros (mag. orsuloba, hipertenzia, gulis daavadeba, qirurgiuli Careva, Saqriani diabeti)

• rCevebi pacientisaTvis, misi Tanamonawiled qceva a. ganaTleba (gansakuTrebiT inhalatoris gamoyeneba) b. maprovocirebeli garemo faqtorebi (mag., Tambaqos kvamlisaTvis Tavis arideba) d. adreuli Careva socialur da qceviT komponentebSi

• avadoba da sikvdilianoba

� riniti:riniti:riniti:riniti:

• simptomebi, niSnebi, paTofiziologia, cxovrebis xarisxi a. sezonuri alergiuli riniti b. qronikuli alergiuli riniti g. qronikuli araalergiuli riniti d. vazomotoruli riniti e. medikamenturi riniti.

• maprovocirebeli faqtorebi: a. inhalaciuri alergenebi (saojaxo, sacxovreblis gare) b. gamaRizianebeli faqtorebi (iritantebi) g. fiziologiuri faqtorebi d. endokrinuli faqtorebi e. profesiuli faqtorebi.

• diagnozi: a. cxviris Rrus nacxi b. kanis sinjebi g. in vitro testireba.

• marTva: a. garemo b. farmakoTerapia:

� antihistaminuri preparatebi � simpaTomimeturi preparatebi � poxieri ujredebis mastabilizebeli preparatebi � sainhalacio steroidebi � sistemuri steroidebi


54

� sxva anTebis sawinaaRmdego preparatebi � antiqolinerguli preparatebi

g. imunoTerapiis Cvenebebi: 5. Tanmxlebi mdgomareobebi:

a. sinusitebi b. orTodonturi g. Sua yuris anTeba, Sua yuris serozuli anTeba, polipebi, anosmia, alergiuli koniunqtiviti d. Zilis darRvevebi.

� medikamentebis, sakvebis da biologiuri nivTierebebis arasasurveli medikamentebis, sakvebis da biologiuri nivTierebebis arasasurveli medikamentebis, sakvebis da biologiuri nivTierebebis arasasurveli medikamentebis, sakvebis da biologiuri nivTierebebis arasasurveli zemoqmedeba zemoqmedeba zemoqmedeba zemoqmedeba

• medikamentebi a. klasifikacia

� toqsikuroba � autanloba � gverdiTi efeqtebi � alergiuli zemoqmedeba � urTierTqmedeba � genetikuri, fermentuli Taviseburebebi � idiosinkrazia

b. diagnozi � anamnezi da fizikuri gamokvleva � kanis testebi:

- penicilini (IgE) - adgilobrivi saanesTezio saSualebebi.

g. marTva � mwvave reaqciebis farmakoTerapia � Tavidan acileba � Terapiuli desensibilizacia.

• sakvebi a. klasifikacia:

� toqsikuroba � autanloba � fiziologiuri reaqciebi � genetikuri, fermentuli Taviseburebebi � alergiuli zemoqmedeba � sakvebi danamatebi � kanismxrivi alergia.

b. diagnozi � anamnezi da fizikuri gamokvleva � kanis testebi � in vitro testireba � eliminaciuri dieta � maprovocirebeli dieta

� dermatitidermatitidermatitidermatiti

• etiologia/paTofiziologia alergiuli kontaqturi dermatiti atopiuri dermatiti

• gavrceleba da klinikuri daxasiaTeba

• ubnobrivi testireba

• marTva a. garemo faqtorebis kontroli/Tavidan acileba b. safenebi/abazanebi g. malamoebi


55

d. steroidebi e. qavilis sawinaaRmdego saSualebebi v. antihistaminuri preparatebi (H1, H 2) z. dieta

� anafilaqsiaanafilaqsiaanafilaqsiaanafilaqsia

• precipitaciuri faqtorebi a. mwerebis nakbeni b. lateqsi g. medikamentebi

• paTofiziologia

• niSnebi da simptomebi a. kani b. sasunTqi sistema d. kuW-nawlavis traqti e. gul-sisxlZarRvTa sistema

• diagnostika

• mkurnaloba a. epinefrini b. siTxeebi g. antihistaminuri preparatebi (H1, H 2) d. steroidebi e. vazopresorebi v. endotraqeuli intubacia

• profilaqtika a. pacientebis ganaTleba

� anafilaqsiuri `nakrebi~ (kompleqti) � mwerebis kbenisTvis Tavis arideba � alergiis wyarosaTvis Tavis arideba (mag., lateqsi,

medikamentebi, sakvebi) b. imunoTerapiis Cvenebebi

� urtikaria/angioedemaurtikaria/angioedemaurtikaria/angioedemaurtikaria/angioedema

• klasifikacia a. mwvave urtikaria/angioedema b. SebrunebiTi mwvave urtikaria d. qronikuli urtikaria e. memkvidreobiTi angioedema

• buStukovani gamonayari da hiperemia

• imunuri meqanizmebi

• araimunuri meqanizmebi

• diagnozi

• marTva a. garemo faqtorebi b. dieta d. antihistaminuri preparatebi e. simpaTomimeturi preparatebi v. steroidebi z. doqsepini

� kanis testebikanis testebikanis testebikanis testebi

• Cxvleta

• intradermuli testi

• Carevis an medikamentebis gamoyenebis aucilebloba

� in vitro gamokvlevebigamokvlevebigamokvlevebigamokvlevebi


56

• IgEE gamokvlevis teqnika • angariSis Sedgenis meTodebi

• interpretacia, mgrZnobeloba, specifikuroba

� filtvis funqciuri testebifiltvis funqciuri testebifiltvis funqciuri testebifiltvis funqciuri testebi

• rutinuli testebi a. amosunTqvis moculobiTi siCqaris piki b. spirometria

� forsirebuli amoxunTqvis moculoba (fam) � filtvebis forsirebuli sasicocxlo tevadoba (ffst);

forsirebuli amosunTqvis moculoba pirvel wamSi (fam 1); filtvebis forsirebuli amosunTqvis moculoba pirvel wamSi Sefardebuli filtvebis sasicocxlo tevadobasTan (fam 1/ffst)

g. gamokvlevebis tipuri Sedegebi sxvadasxva mdgomareobebis dros d. fizikuri datvirTvis testi

moduli 2.2.moduli 2.2.moduli 2.2.moduli 2.2. `gadaudebeli medicina da travma~`gadaudebeli medicina da travma~`gadaudebeli medicina da travma~`gadaudebeli medicina da travma~

modulmodulmodulmodulis xangrZlivoba: is xangrZlivoba: is xangrZlivoba: is xangrZlivoba: 3 Tve


modulis mizania rezidentma gamoimuSaos gadaudebeli mdgomareobebis, maT Soris travmis, amocnobis, Sefasebisa da marTvis Cvevebi prehospitalur etapze; agreTve, aiTvisos gadaudebeli mdgomareobebis prevenciis efeqturi meTodebi.


modulis bolos rezidentma unda icodes:

� samedicino momsaxurebis principebi samedicino momsaxurebis principebi samedicino momsaxurebis principebi samedicino momsaxurebis principebi

• prehospitaluri da hospitaluri gadaudebeli samedicino daxmareba: a) gadaudebeli samedicino daxmarebis sistema b) komunikaciis sistema da standartebi (protokolebi)

• prioritetebis gansazRvra da SerCeva (triaJi)

• reanimacia da stabilizacia

• kooridinacia, komunikacia, Canawerebi

• Sefaseba da monitoringi

• konsultacia

• ganTavseba

� Sefaseba da marTvaSefaseba da marTvaSefaseba da marTvaSefaseba da marTva

• sicocxlisaTvis saSiSi mdgomareobebis amocnoba;

• kardiopulmonuri reanimaciis principebi;

• ZiriTadi sasicocxlo funqciebis SenarCunebis da kardiopulmonuri reanimaciis teqnika: a. ZiriTadi sasicocxlo funqciebis SenarCunebis RonisZiebebis

dawyebis Cveneba da Tanmimdevroba; b. kardiopulmonuri reanimaciis teqnika; g. kardiopulmonuri reanimaciis warmoeba erTi da ori piris mier; d. zeda sasunTqi gzebis ucxo sxeuliT obstruqciisgan

gaTavisufleba;

• travma a. pirveladi da meoreuli Sefaseba b. dazianebis meqnizmis gansazRvra:

� daxuruli travma (mag., guli, filtvi, muclis Rrus organoebi)


57

� gamWoli (penetrirebuli) travma (tyvia, daniT miyenebuli Wriloba)

• dazianebis adgilis mixedviT a. Tavi da kiseri b. xerxemali da xerxemlis malebi g. saxe d. rbili qsovili e. gul-mkerdi v. muclis Rru z. kidurebi T. genitaliebi/ Sardis gamomyofi organoebi

• nevrologiuri gadaudebeli daxmareba a. darRveuli cnobiereba/koma b. cerebrovaskularuli daavadebebi

� insulti (gardamavali iSemiuri darRveva, hemoragiuli/iSemiuri insulti)

� anevrizma g. kranialuri nervebis dazianeba d. infeqciuri/ anTebiTi daavadebebi, meningitis CaTvliT e. gulyra v. mwvave Tavis tkivili z. xerxemlis malebis kompresia

• fsiqiatriuli gadaudebeli daxmareba a. azrovnebis moSla/mwvave gamovlinebebi b. guneb-ganwyobis moSla/ TviTmkvlelobis akviateba/ mkvlelobis

akviateba g. gamwvavebuli SiSis SegrZneba/panika d. somatoformuli aSliloba/isteria/hipoqondria e. narkomania/Warbi doza/ narkotikis Zieba v. deliriumi/demencia/Secvlili fsiqikuri statusi z. riskis Sefaseba da iZulebiT hospitalizacia

• garemos faqtorebTan dakavSirebuli darRvevebi a. damwvroba (qimiuri, Termuli, eleqtruli) b. sasikvdilo eleqtrotravma, mexis dacema g. sicxe da sicive d. nakbeni, adamianisa da cxovelis nakbenis marTva e. Sxamiani mcenareebi v. anafilaqsia

• toqsikologiuri gadaudebeli daxmareba

• sameano-ginekologiuri gadaudebeli daxmareba a. sqesobrivi agresia b. eqtopiuri orsuloba g. mosalodneli an spontanuri aborti d. naadrevi mSobiaroba/preeklamfsia/eklamfsia e. vaginaluri sisxldena v. saswrafo kontracefcia

• Zaladobis msxverpli

• mwvave sicocxlisTvis saSiSi mdgomaareobis identificireba da menejmenti a. mwvave respiratoruli daavadebebi

� mwvave respiratoruli distresi � filtvis arteriis embolia � pulmonaruli infeqciebi � gamonaJoni plevris RruSi, empiema, pnevmoToraqsi � filtvebis obstruqciul, restriqciuli daavadebebi (asTma,

filtvebis qronikuli obstruqciuli daavadeba)


58

b. gul-sisxlZarRvTa mwvave daavadebebi � sicocxlisTvis saSiSi ariTmia � gulis gaCereba � gulis iSemiuri daavadeba (stenokardia, mwvave infarqti) � gulmkerdisa da muclis aortis anevrizma � mwvave Trombolizuri Terapia

g. saswrafo toqsikologiuri daxmareba � mwvave Warbi doza/ farmakokinetika � SemTxveviTi mowamvla/peroruli miReba � monacemebis xelmisawvdomoba/mowamvlis kontroli � mkurnaloba da antidotebi

d. masobrivi katastrofa � garemosTan dakavSirebuli/ bunebrivi kataklizmebi � birTvuli � biologiuri � qimiuri

e. gansakuTrebuli garemoebebi � wyalSi daxrCoba � Cvilis uecari sikvdilis sindromi

v. metaboluri daavadebebi/ mJava-tutovani wonasworoba z. Soki (hipovolemiuri, neirogenuli, kardiogenuri, septikuri) T. gadaudebeli daxmareba mwvave infeqciebis dros

• sadiagnozo gamokvlevebis Catarebis Cvenebebi maTi interpretacia a. eleqtrokardiograma b. radiologiuri gamokvleva

� Tavis qalas da xerxemlis da mwvave dazianebebi � gul-mkerdis paTologia � muclis Rrus mwvave paTologia � menjisa da kidurebis dazianeba

• samrTlebrivi sakiTxebi a. informirebuli Tanxmoba da gacnobierebuli gadawvetilebis miRebis

unari b. mkurnalobis ar dawyeba, mkurnalobis Sewyveta g. Sesabamisi kanonmdebloba d. profesiuli pasuxismgebloba

• urgentuli mdgomareobebis prevencia modulis bolos rezidents unda SeeZlos:

� kardiopulmonuri kardiopulmonuri kardiopulmonuri kardiopulmonuri reanimaciareanimaciareanimaciareanimacia

• kardiopulmonuri reanimaciis warmoeba erTi da ori piris mier;

• sunTqvis marTva a. sasunTqi gzebis gamavlobis gaumjobeseba, b. haimlikis manevri g. ventilacia ambus parkiT d. oraluri da nazotraqeuli intubacia e. meqanikuri ventilaciis dawyeba z. nemsiT Torakostomia T. krikoTireoidotomia

• sisxlis mimoqcevis aRdgena/SenarCuneba a. sisxlis mimoqcevis Sefaseba b. gulis garegani masaJi g. defibrilacia

• gardacvlili pacientis axlobelTan urTierToba

� anesTeziis teqnikaanesTeziis teqnikaanesTeziis teqnikaanesTeziis teqnika

• adgilobrivi anesTezia


59

• regionuli da TiTebis nervebis anesTezia

• intravenuri sedacia da analgezia

� hemodinamikuri procedurebihemodinamikuri procedurebihemodinamikuri procedurebihemodinamikuri procedurebi

• periferiuli venebis kaTeterizacia

• centraluri venebis kaTeterizacia

• venaseqcia

� sadiagnozo da samkurnalo procedurebisadiagnozo da samkurnalo procedurebisadiagnozo da samkurnalo procedurebisadiagnozo da samkurnalo procedurebi

• cxviridan sisxldenis SeCereba (wina da ukana tamponada)

• nazogastraluri zondireba da lavaJi

• Sardis buStis kaTeterizacia

� ConCxTan dakavSirebuli procedurebiConCxTan dakavSirebuli procedurebiConCxTan dakavSirebuli procedurebiConCxTan dakavSirebuli procedurebi

• xerxemlis pirveladi imobilizacia

• motexilobis an amovardnilobis pirveladi imobilizacia

� infuziuri Terapiainfuziuri Terapiainfuziuri Terapiainfuziuri Terapia

� sxvasxvasxvasxva

• masobrivi katastrofebis daSavebulTa `triaJi~

• erTdorulad ramdenime pacientis marTva

• gardacvlili pacientis axlobelTan urTierToba

• kritikul incidentTan dakavSirebuli stresis marTva

moduli 2.3.moduli 2.3.moduli 2.3.moduli 2.3. `̀̀̀bavSvTa janmrTeloba (pediatria)bavSvTa janmrTeloba (pediatria)bavSvTa janmrTeloba (pediatria)bavSvTa janmrTeloba (pediatria)~~~~

modulis xangrZlivoba: modulis xangrZlivoba: modulis xangrZlivoba: modulis xangrZlivoba: 3 Tve


modulis mizania rezidentma gamoimuSaos bavSvTa janmrTelobis problemebis marTvis unari (ganviTarebis Sefaseba, daavadebaTa prevencia, janmrTelobis mwvave da qronikuli problemebis marTva), bavSvis ganviTarebis yvela etapze.



� fetalurfetalurfetalurfetaluri da neonataluri periodii da neonataluri periodii da neonataluri periodii da neonataluri periodi

• orsulobis vadis Sesabamisi risk-faqtorebi

• dedis daavadebebis, orsulobisa da mSobiarobis gavlena Cvilze

• adaptacia saSvilosnos gare cxovrebasTan

• qvemoT CamoTvlili mdgomareobebis diagnostika da marTva: a. mekoniumis Semcveli amnionuri siTxe b. perinataluri asfiqsia g. respiratoruli distresi d. cianozi e. apnoe v. krunCxvebi z. hipoglikemia T. sefsisis ganviTarebis riskis Sefaseba i. displaziuri menj-barZayis saxsari k. samSobiaro travma l. anemia m. sisxlis SeuTavsebloba (rezus-faqtoris, jgufis mixedviT) n. policitemia o. siyviTle


60

p. naadrevi da dagvianebuli mSobiaroba

� janmrTeli axalSobilis da bavSvis movlajanmrTeli axalSobilis da bavSvis movlajanmrTeli axalSobilis da bavSvis movlajanmrTeli axalSobilis da bavSvis movla

• dabadebidan 12 wlis asakamde rekomendebuli gasinjvebi da maTi Catarebis vadebi

• asakisa da ganviTarebis etapis Sesabamisi meTvalyureoba a. windacveTa b. kveba

� ZuZuTi kveba � boTlidan kveba � mSralis sakvebis damateba � alergiis prevencia

g. temperamenti da qceva d. ganviTarebis stadiebi

� ganviTarebis skrininguli testebi e. ojaxi da socialuri urTierTobebi

� dRenakli axalSobilidRenakli axalSobilidRenakli axalSobilidRenakli axalSobili

• dRenakli bavSvis movlisa da meTvalyureobis Taviseburebebi

� fizikuri ganviTarebafizikuri ganviTarebafizikuri ganviTarebafizikuri ganviTareba

• kveba

• zrda da kaloriebis moTxovnileba

• normaluri zrda da misi variantebi a. kbilebis ganviTareba

� daavadebebisa da travmebis prevenciadaavadebebisa da travmebis prevenciadaavadebebisa da travmebis prevenciadaavadebebisa da travmebis prevencia

• saavtomobilo avariebi

• wyalSi daxrCoba

• moxrCoba/asfiqsia

• mowamvla

• cecxlsasroli iaraRi

• waqceva

• usafrTxoeba velosipediT mgzavrobisas

• damwvroba

• Zaladoba bavSvis mimarT

• fToris preparatebis gamoyeneba

• rkinadeficituri anemiis skriningi

• imunizaciis kalendari

• garemo mavne faqtorebi

� Cvilis uecari sikvdilis sindromiCvilis uecari sikvdilis sindromiCvilis uecari sikvdilis sindromiCvilis uecari sikvdilis sindromi

� fsiqolofsiqolofsiqolofsiqologiuri darRvevebigiuri darRvevebigiuri darRvevebigiuri darRvevebi

• ojaxebis identifikacia sadac arsebobs mometebuli riski mSobelsa da bavSvs Soris urTierTobisaTvis an fsiqiatriuli problemebi

• qvemoT CamoTvlili mdgomareobebis Sefaseba, mkurnaloba da konsultaciaze gagzavna a. kvebis, Wamis da monelebis problemebi b. somaturi da Zilis darRvevebi g. akviatebisa da kompulsiuri sindromi d. guneba-ganwyobilebis darRveva e. hiperaqtiuri/impulsuri da uyuradRebo qceva

� socialuri da eTikuri sakiTxebisocialuri da eTikuri sakiTxebisocialuri da eTikuri sakiTxebisocialuri da eTikuri sakiTxebi

• Svilad ayvana


61

• ganqorwineba, mSoblebis calke cxovreba, sikvdili

• ojaxuri Zaladobis, wamalze da alkoholze damokidebulebis zegavlena

• Zaladoba bavSvebis mimarT

• uari sicocxlis SemanarCunebeli RonisZiebebis Catarebaze an maTi Sewyveta

� genetikagenetikagenetikagenetika

• skrininguli testebi

• genetikuri darRvevis diagnostikis an konsultaciis mizniT Sesabamisi specialistis gamoyeneba

� ganviTarebis darRvevasTan dakavSirebuli invalidobaganviTarebis darRvevasTan dakavSirebuli invalidobaganviTarebis darRvevasTan dakavSirebuli invalidobaganviTarebis darRvevasTan dakavSirebuli invalidoba

� Cvilebis da bavSvebis samedicino problemebi:amocnoba, marTva da Sesabamis Cvilebis da bavSvebis samedicino problemebi:amocnoba, marTva da Sesabamis Cvilebis da bavSvebis samedicino problemebi:amocnoba, marTva da Sesabamis Cvilebis da bavSvebis samedicino problemebi:amocnoba, marTva da Sesabamis specialistebis gamoyenebaspecialistebis gamoyenebaspecialistebis gamoyenebaspecialistebis gamoyeneba

• alergiuli darRvevebi a. asTma b. atopia

• anTebiTi daavadebebi a. iuveniluri revmatoiduli arTriti b. vaskulitis sindromebi

• Tirkmlis anomaliebi

• urologiuri problemebi a. saSardi gzebis infeqciebi, pielonefriti b. Sardis buSt-SardsawveTis refluqsi g. hipospadia, Sarsadenis prolafsi, sasqeso bageebis Sexorceba d. sazardulis Tiaqari e. enurezi v. kriptorqizmi

• endokrinuli/metaboluri da kvebiTi problemebi a. hipo- da hiperTireoidizmi b. I tipis Saqriani diabeti g. simsuqne d. zrdis darRveva e. anomaluri zrda: maRali an dabali tani

• nevrologiuri problemebi a. krunCxvebi b. Tavis tkivili g. gulis wasvla d. CabJireba e. fsiqomotoruli darRvevebi/ cerebruli dambla v. sensoruli deficiti z. tiki da moZraobis darRvevebi

• xSiri dermatologiuri darRvevebi a. atopiuri dermatiti b. virusuli egzanTemebi da enanTemebi g. nakbenebi da naCxvletebi d. baqteriuli da sokovani infeqciebi e. tilebi da muni v. safeniT gamowveuli gamoyelva z. akne T. urtikaria da multiformuli eriTema i. damwvroba

• orTopediuli problemebi a. terfmrudoba b. displaziuri menj-barZayis saxsari


62

g. rotaciuli problemebi � rotacia SigniT da gareT � Metatarsus adductus

d. skoliozi: idiopaTiuri da SeZenili e. barZayis Tavis aseptikuri nekrozi v. barZayis Tavis epifizeolizi z. daWimva, amovardniloba da motexiloba

• saWmlis momnelebeli sistema a. diarea, virusuli da baqteriuli gastroenteriti b. parazituli invazia g. yabzoba/ganavlis Seukavebloba d. hepatiti e. kolika v. gastroezofaguri refluqsi z. sakvebis autanloba da malabsorbcia T. pilorusis stenozi i. invagianacia k. apendiciti/peritoniti l. SebrunebiTi/qronikuli tkivili muclis areSi

• guli

a. gulis Tandayolili daavadeba b. asimptomuri Suilis Sefaseba g. tkivili gulmkerdis areSi

• sasunTqi sistema

a. zemo sasunTqi gzebis virusuli infeqcia b. sasunTqi gzebis reaqtiuli daavadeba/asTma g. kisturi fibrozi d. bronqioliti e. ucxo sxeulis aspiracia v. virusuli da baqteriuli pnevmonia z. yivanaxvela T. tonziliti/faringiti/sinusiti/xaxis ukana abscesi i. epiglotitis da krupis diferencireba

• yuri

a. Sua yuris anTeba:mwvave, gamonadeniT b. gareTa sasmeli milis anTeba g. smenis dakargva d. gogirdis sacobi da ucxo sxeuli yurSi

• Tvali a. ambliopia b. strabizmi g. sacremle sadinaris stenozi d. daqveiTebuli mxedvelobis simaxvile

• bavSvTa sxvadasxva infeqciebi

a. baqteriuli infeqciebi � difTeria � Cutyvavila

b. virusuli infeqciebi � wiTela � ybayura � wiTura � Cutyvavila

• seriozuli infeqciebi


63

a. sefsisi da sefsisis sindromi b. meningiti, encefaliti g. streptokokuli da stafilokokuri infeqcia d. osteomieliti e. adamianis imunodeficitis virusi v. reis sindromi z. ucnobi etiologiis cxeleba

• neoplazia bavSvebSi

a. vilmsis simsivne b. retinoblastoma g. neiroblastoma

modulis bolos rezidents unda SeeZlos:

• asakis Sebamisad anamnezis Sekreba da fizikuri gamokvleva

� simaRlis, wonis da Tavis garSemowerilobis aRniSvna zrdis baraTze

• apgaris SkaliT Sefaseba

• yuradRebis darRvevis Sesafasebeli standartuli kiTxvarebis gamoyeneba da Sefaseba

• smenisa da mxedvelobis darRvevebis skrininguli testebi, agreTve, timpanogramebis interpretacia

• skoliozis skriningi da xerxemlis rentgenogramebis Sefaseba

• axalSobilebis, Cvilebis da bavSvebis reanimacia

• venapunqcia

• gadasasxmeli siTxis da eleqtrolitebis gamoangariSeba


1. Bannon M, Carter Y (Eds). Protecting Children from Abuse and Neglect in Primary Care Oxford: Oxford

2. University Press, 2003 3. British Medical Association, Royal Pharmaceutical Society of Great Britain, Royal College of

Paediatrics 4. and Child Health, The Neonatal and Paediatric Pharmacists Group BNF for Children London:

BMA, 2005 5. Chambers R Licence K, Looking after children in primary care Oxford: Radcliffe Medical Press,

2004 6. Cohen BA Paediatric Dermatology London: Elsevier Mosby, 2005 7. Donovan C, Suckling H Difficult Consultations with Adolescents Oxford: Radcliffe Medical

Press, 2004 8. Harndon A Sheikh A (Eds) Promoting Child Health in Primary Care London: RCGP, 2002 9. Hall D, Elliman D. Health for All Children (4th Ed) Oxford: Oxford University Press, 2003. 10. Jones R, Britten N, Culpepper L, Gass DA, Grol R, Mant D, Silagy C (eds). Oxford Textbook of

Primary 11. Medical Care Oxford: Oxford University Press, 2004 12. Keeley D Cot Death London: RCGP, 1995 13. Lissauer T, Clayden G Illustrated Textbook of Paediatrics (2nd Ed) London: Mosby, 2001 14. McPherson A, Donovan C, McFarlane A Healthcare of Young People: Promotion in Primary

Care Oxford: Radcliffe Medical Press, 2002 15. Valman HB ABC of the first year London: BMJ Books, 2001


64

16. Valman HB ABC of One to Seven London: BMJ Books, 2002 17. Viner R (Ed) ABC of Adolescence London: BMJ Books, 2002

moduli 2.4.moduli 2.4.moduli 2.4.moduli 2.4. `qalTa janmrTeloba da sqesobrivi gziT gadamdebi daavadebebi~`qalTa janmrTeloba da sqesobrivi gziT gadamdebi daavadebebi~`qalTa janmrTeloba da sqesobrivi gziT gadamdebi daavadebebi~`qalTa janmrTeloba da sqesobrivi gziT gadamdebi daavadebebi~

modulis xangrZlivoba: modulis xangrZlivoba: modulis xangrZlivoba: modulis xangrZlivoba: 3 Tve


modulis mizania rezidentma gamoimuSaos qalTa janmrTelobis problemebis marTvis unari, normaluri orsulobis warmarTvis da sqesobrivad gadamdebi daavadebebis amocnobisa da marTvis CaTvliT.



� normaluri zrdanormaluri zrdanormaluri zrdanormaluri zrda----ganviTarebis varganviTarebis varganviTarebis varganviTarebis variantebiiantebiiantebiiantebi

� ginekologiuri Semowmebaginekologiuri Semowmebaginekologiuri Semowmebaginekologiuri Semowmeba

• pediatria

• mozardi

• geriatria

� ciklicikliciklicikli

• ciklis fiziologia

• dismenorea

• ciklis wina sindromebi

� reproduqciuli traqtis infeqciebi/ daavadebebireproduqciuli traqtis infeqciebi/ daavadebebireproduqciuli traqtis infeqciebi/ daavadebebireproduqciuli traqtis infeqciebi/ daavadebebi

• sqesobrivi gziT gadamdebi daavadebebi

• menjis anTebiTi daavadebebi

• endometriozi

• qalis genitaluri traqtis keTilTvisebiani da avTvisebiani daavaadebebi. a. sarZeve jirkvlis fibrokisturi daavadebebi da avTvisebiani simsivneebi b. saSvilosnos simsivne g. endometriuli simsivne d. saSvilosnos yelis prekancerozuli da avTvisebiani daavadeba

• dieTilstilbestrolis efeqti (vnaxoT ra wamalia)

• mcire menjis qronikuli tkivili

• adamianis imunodeficitis virusiT inficireba

• vaginiti

� reproduqciareproduqciareproduqciareproduqcia

• normaluri fiziologia

• unayofoba

• kontracefcia a. mudmivi b. Seqcevadi

� oraluri � ineqcebi � implantacia � bunebrivi � barieris meTodebi � saSvilonos Sida kontracefcia

g. RU-486 (mefiprestoni)


65

• Svilad ayvana an Svilobiloba

• aborti

� seqsualurobaseqsualurobaseqsualurobaseqsualuroba

• normaluri sqesobrivi aqtiuroba

• sqesobrivi disfunqciis diagnozi da mkurnaloba

� cxovrebis jansaRi wesi, prevencia, daavadebaTa adreuli amocnobacxovrebis jansaRi wesi, prevencia, daavadebaTa adreuli amocnobacxovrebis jansaRi wesi, prevencia, daavadebaTa adreuli amocnobacxovrebis jansaRi wesi, prevencia, daavadebaTa adreuli amocnoba

• simsivnis skriningi a. papanikolaus (PAP) testi b. mamografia g. ginekologiuri gasinjva

• kvebis Taviseburebebi

• varjiSi

• osteoporozi

• Tambaqos moxmareba

• gulis iSemiuri daavadeba

• usafrTxoeba transportiT mgzavrobisas

� menopauzamenopauzamenopauzamenopauza

• normaluri fiziologia

• hormonebis Canacvleba

• klimaqsis periodis gavlena emociuri da seqsuluri sferoebze

• menopauzasTan asocirebuli daavadebebi

� fsiqosocialuri sakiTxebifsiqosocialuri sakiTxebifsiqosocialuri sakiTxebifsiqosocialuri sakiTxebi

• Zaladoba ojaxSi

• gaupatiureba

• sqesobrivi devna

• sqesobrivi Zaladoba

• bavSvis movlasTan dakavSirebuli sakiTxebi

• ojaxis struqturis cvla

• siRaribis zegavlena qalsa da bavSvze

� fsiqikuri janmrTelobafsiqikuri janmrTelobafsiqikuri janmrTelobafsiqikuri janmrTeloba

• sqesobrivi Zaldobis zegavlena

• depresiis ganmapirobebeli daavadebebi, mSobiarobis Semdgomi depresiis CaTvliT

• SiSi

• TviTSefasebis problema

• kvebis problema

• sxvadasxva nivTierebebis aradaniSnulebisamebr agamoyeneba (toqsikomania, wamalTadmokidebuleba da sxva)

• abortis emociuri zegavlena

� jandacvis politikis sakiTxebi jandacvis politikis sakiTxebi jandacvis politikis sakiTxebi jandacvis politikis sakiTxebi

• jandacvis xelmisawvdomoba qalTaTvis

• prenataluri samedicino momsaxurebis da Cvilis sikvdilobis epidemiologia

• qali da aiv infeqcia

• arasrulwlovanTa fexmZimobis prevencia

� orsuloba da mSobiarobaorsuloba da mSobiarobaorsuloba da mSobiarobaorsuloba da mSobiaroba

a. orsulobis dagegmva da konsultacia b. orsulobis marTva, riskis Sefaseba


66

g. orsulobis garTulebebi d. mSobiaroba, nayofis miReba e. mSobiarobis Semdgomi movla v. janmrTeli axalSobilis movla z. dRenakli axalSobilis movla T. zogadi neonataluri problemebi i. analgeziisa da anesTeziis ZiriTadi principebi mSobiarobisa da

nayofis miRebisas k. sakeseisro kveTis Cvenebebi l. mSobiarobis garTulebebi da gadaudebeli daxmareba mSobiarobisas m. mSobiarobis Semdgomi samedicino momsaxureba n. laqtacia

zogadi samedicino problemebizogadi samedicino problemebizogadi samedicino problemebizogadi samedicino problemebi

• gulis iSemuri daavadeba

• arteriuli hipertenzia

• farisebri jirkvlebis daavadeba

• SemaerTebeli qsovilis daavadeba

• Tavis tkivili

• filtvebis simsivne

• saSarde gzebis infeqcia

• qolecistiti

• wonasTan dakavSirebuli problemebi

• Saqriani diabeti

• sasunTqi gzebis qronikuli obstruqciuli daavadeba

• kanis dazianeba modulis bolos rezidents unda SeeZlos:modulis bolos rezidents unda SeeZlos:modulis bolos rezidents unda SeeZlos:modulis bolos rezidents unda SeeZlos:

� ginekologiaginekologiaginekologiaginekologia

• qalis saTanado skrininguli Semowmeba, sarZeve jirkvlebis Semowmebis CaTvliT

• vaginaluri da cervikaluri nacxis aReba citologiuri gamokvlevisaTvis

� ojaxis dagegmva da kontracefciaojaxis dagegmva da kontracefciaojaxis dagegmva da kontracefciaojaxis dagegmva da kontracefcia

• konsultacia kontracefciis sxvadasxva formebis Taobaze, kontracefciuri meTodis SerCeva;

• oraluri kontraceptivebis Taobaze rCeva-darigebis micema, maTi gamowera;

• saSvilosnos Sida kontraceptivebis gamoyenebis Taobaze rCeva-darigebis micema, maTi Cadgma da amoReba;

• diafragmis morgeba, rCeva-darigebis micema.

� orsulobaorsulobaorsulobaorsuloba da mSobiarobada mSobiarobada mSobiarobada mSobiaroba

• prenataluri konsultacia normaluri orsulobis, mSobiarobisa da ojaxis adaptaciis sakiTxebis Taobaze;

• Sefaseba orsulobamde;

• viziti orsulobis sawyis periodSi;

• orsulobis xandazmulobisa da menjis adekvaturobis Sefaseba;

• nayofis Sefaseba;

• riskis Sefaseba;

• anamnezi, samedicino Semowmeba, laboratoriuli monitoringi da konsultaciebi orsulobis ganmavlobaSi;

• gestaciuri asakis Sefaseba;

• mSobiarobis marTva;

• nayofis Sefaseba mSobiarobamde da mSobiarobis procesSi;


67

• mSobiarobis dros aRmocenebuli problemebis marTva (mag., arteriuli hipertenzia, msubuqi preeklamfsia, cxeleba, infeqcia, nayofis saeWvo mdgomareoba, placentis xeliT gamoReba);

• saSos, saSvilosnos yelis, saSvilosnos Semowmeba;

• gareTa sasqeso organoebis adgilobrivi ansTezia;

• neonataluri reanimacia;

• mSobiarobis Semdgomi problemebis marTva (ma., sisxldena, endometriti).

moduli 2.moduli 2.moduli 2.moduli 2.5555.... `̀̀̀fsiqikuri janmrTelobafsiqikuri janmrTelobafsiqikuri janmrTelobafsiqikuri janmrTeloba~~~~

modulis xangrZlivobmodulis xangrZlivobmodulis xangrZlivobmodulis xangrZlivoba: a: a: a: 2 Tve


modulis mizania rezidentma gamoimuSaos fsiqikuri janmrTelobis Sefasebis, fsiqikuri janmrTelobis sferoSi aRmocenebuli problemebis droulad amocnobis da pirveladi Sefasebis, drouli da adekvaturi mimarTvis da fsiqikuri daavadebebis xangrZlivi marTvis Cvevebi fsiqiatrTan mWidro TanaSmromlobis gziT.



� bazisuri codnabazisuri codnabazisuri codnabazisuri codna

• normuli fsiqosocialuri ganviTareba cxovrebis ciklis ganmavlobaSi, misi variantebi da gadaxrebi

• biologiuri, fsiqologiuri da socialuri faqtorebis urTierTkavSiri

• mwvave da qronikuli daavadebebis gavlena pacientze da mis ojaxze

• faqtorebi, romlebic zegavlenas axdenen mkurnalobis gegmis Sesrulebaze

• ojaxis funqiebi da zogadi interaqtiuli modeli stresTan gamklavebisas

• piradi damokidebulebebisa da faseulobebis Secnoba, rac zegavlenas axdens eqimis moqmedebis efeqturobaze da eqimiT kmayofilebaze

• eqimze zemoqmedi stresuli faqtorebi da maTi efeqtis Tavidan acilebis gzebi

• eTikuri sakiTxebi samedicino praqtikaSi, informirebuli Tanxmobis, pacientis avtonomiis, konfidencialurobisa da sicocxlis xarisxTan dakavSirebuli sakiTxebis CaTvliT

� fsiqikuri janmrTelobis moSlafsiqikuri janmrTelobis moSlafsiqikuri janmrTelobis moSlafsiqikuri janmrTelobis moSla

• pirvelad gamovlinebuli fsiqikuri aSliloba Cvilebs, bavSvebsa da mozardebs Soris a. gonebrivi CamorCeniloba b. daqveiTebuli swavlis unari g. motoruli darRvevebi d. komunikaciis unaris darRveva e. ganviTarebis darRvevebi v. yuradRebis deficiti da qcevis darRvevebi z. kvebasTan dakavSirebuli darRvevebi Cvilebsa da adreuli asakis

bavSvebs Soris T. tikebi i. sxva saxis aSlilobebi Cvilebs, bavSvebsa da mozardebs Soris

• deliriumi, demencia, amnezia da cnobierebis sxva darRvevebi

• nivTierebebis arasworad gamoyenebasTan dakavSirebuli darRvevebi a. alkoholi


68

b. amfetamini g. kofeini d. haSiSi e. kokaini v. halucinogeni z. inhalatorebi T. nikotini i. opioidebi k. fenciklidini l. sedaciuri, hipnozuri, SfoTvis momxsneli saSualebebis

gamoyenebasTan dakavSirebuli aSlilobebi m. polinarkomania

• Sizofrenia da sxva fsiqikuri aSlilobebi a. paranoia b. dezorganizebuloba g. katatonia d. aradiferencirebuli mdgomareoba e. narCeni movlenebi

• guneba-ganwyobis aSla a. didi depresia b. disTimia g. bipolaruli aSliloba hopomaniis, maniis, Sereuli da depresiuli

mdgomareobis CaTvliT

• SfoTva a. panika b. fobia g. akviateba, kompulsiuri aSliloba d. posttramvuli stresuli aSliloba e. mwvave stresuli aSliloba v. generalizebuli SfoTva

• somatoformuli aSlilobebi a. somatizacia b. konversia g. tkivili d. hipoqondiria

• xelovnuri aSliloba

• disociaciuri aSliloba

• seqsualuri da sqesobrivi identurobis aSliloba a. aSliloba, dakavSirebuli sqesobrivi kontaqtis survilTan b. sqesobrivi kontaqtis zizRi g. aSliloba, dakavSirebuli orgazmTan e. sqesobrivi disfunqciebi dakavSirebuli zogad samedicino

mdgomareobasTan v. parafilia z. genderuli identurobis aSliloba

• kvebasTan dakavSirebuli aSlilobebi a. anoreqsiuli nevrozi b. bulimia

• Zilis darRveva a. uZiloba b. Warbi Zili g. narkolefsia d. sunTqvasTan dakavSirebuli Zilis darRveva e. Zilis cirkaduli riTmis darRveva v. parasomnia

• impulsis kontrolis darRveva (iam unda hkiTxos rezo korinTels)


69

• garemosTan Seguebis aSliloba a. depresiuli ganwyoba b. SfoTva g. Sereuli SfoTvisa da depresiis ganwyoba d. qceevis darRveva

• personalurobis darRveva a. paranoiduli b. Sizoiduri g. Sizotipuri d. antisocialuri e. mosazRvre v. narcisuli z. Tavis TavSi Caketiloba T. damokidebuli i. akviateba, kompulsiuri aSliloba

• Zaladobasa da gulgrilobasTan dakavSirebuli problemebi

• sxva mdgomareobebi a. daumorCilebloba b. avadmyofobis simulacia g. zRvruli inteleqtualuri funqcionireba d. gonebrivi SesaZleblobebis asakTan dakavSirebuli daqveiTeba e. mZime danakargi v. akademiuri problemebi z. profesiuli problemebi T. identurobis problema i. religiuri problema k. ukulturobis problema l. cxovrebis fazis (stadiis) problema

modulis bolos rezidents unda SeeZlos:

� Sefasebis unarSefasebis unarSefasebis unarSefasebis unar----CvevebiCvevebiCvevebiCvevebi

• intervius aRebis unari, rac ganapirobebs monacemTa Segrovebas drois mokle periodSi da xels Seuwyobs eqimisa da pacientis urTierTobas.

• vizitis garemos Sesaqmneli teqnika ( mag fonis, efeqtis, problemis, situaciasTan gamklaveba da empaTia an sxva teqnika)

• gonebrivi statusis Semowmeba.

• fsiqikuri aSlilobis diagnozis dasadgenad specialuri procedurebis Catarebis Cvenebebi, maT Soris fsiqologiuri testirebis, laboratoriuli testirebis da skanirebis.

• punqtSi `codna~ mocemuli aSlilobis zogadi niSnebisa da simptomebis gamovlena da amocnoba

• depresiis Sefaseba (saTanado Skalebis gamoyenebiT)

• Cvenebebi fsiqiatris konsultaciisaTvis

� Terapiuli unarTerapiuli unarTerapiuli unarTerapiuli unar----CevevebiCevevebiCevevebiCevevebi

• arafsiqiatriuli aSlilobis emociuri aspeqtebis marTva

• unar-Cvevebi smedicino mkurnalobis reJimis Sesrulebis gasaumjobeseblad

• fsiqiatriuli gadaudebeli daxmarebis pirveladi organizeba: suiciduri pacienti, mwvave fsiqikuri pacienti

• fsiqofarmakologiuri meTodebis swori gamoyeneba: a. diagnostikuri Cvenebebi da winaaRmdegCvenebebi b. dozireba, gamoyenebis xangrZlivoba, reaqciis monitoringi, verdiTi

efeqtebi da Segueba g. wamalTa urTierTqmedeba


70

d. sxva problemebi

• ojaxis Tanadgoma

• qcevis modifikaciis teqnika a. stresis kontroli

� sunTqva � kunTebis relaqsacia � warmosaxviTi � gonebrivi rekonstruireba

b. Tambaqos moxmarebis Sewyveta, simsuqnis kontroli da sxva clilebebis nirSi

g. qronikuli tkivilis marTva

• sazogadoebrivi resursebis gamoyeneba a. sazogadoebrivi resursebi b. sxva fsiqikuri momsaxurebis profesionalebis jgufis CarTva

pacientis meTvalyureobaSi

• rCevis micemis Cveva krizisis SemTxvevaSi

• pacientis garemos Secvla

• mkurnalobis Secvlis unari pacientis pirovnuli maxasiaTeblebis, cxovrebis stilisa da ojaxuri garemos gaTvaliswinebiT

• identifikacia, Careva da mkurnaloba narkotikisa da alkoholis araswori moxmarebisas

• fsiqopaTologis meTvalyureobis gamoyenebis SesaZleblobis gansazRvra

• referaluri sistema mkurnalobis uwyvetobis uzrunvelsayofad, informaciis gaziarebis mizniT da pacientze zemoqmedebis gasaumjobeseblad a. Cvenebebi b. procesi g. Semdgomi dakvirveba da Sefaseba

profesiuli mzadebis II etapis modulebi (SerCeviTi profesiuli mzadebis II etapis modulebi (SerCeviTi profesiuli mzadebis II etapis modulebi (SerCeviTi profesiuli mzadebis II etapis modulebi (SerCeviTi ----eleqtiuri)eleqtiuri)eleqtiuri)eleqtiuri)

moduli moduli moduli moduli 2.E1.... `̀̀̀yelyelyelyel----yuryuryuryur----cxviris daavadebebicxviris daavadebebicxviris daavadebebicxviris daavadebebi~~~~



yel-yur-cxviris gavrcelebuli mwvave da qronikuli daavadebebis prevencia, amocnoba da marTva pirveladi jandacvis doneze;


rezidentis kompetencia yel-yur-cxviris daavadebebis sferoSi unda moicavdes Semdeg sakiTxebs:

• yel-yur-cxviris da saxis prbolemebis marTva, roca aRniSnuli problemebiT pacienti pirvelad mimarTavs eqims (pirveli kontaqtis marTva);

• amocnoba im simptomebisa, romlebic normis farglebs ar cildeba da ar saWiroebs mkurnalobas (mag., seniluri rinorea, mcired gadidebuli limfuri jirkvlebi janmrTel bavSvSi, cxviris perioduli gaWedva da a.S.);

• yel-yur-cxviris specialistTan referalis Cvenebebi (mag., ganmeorebiTi, xSiri tonziliti, dafis apkis perforacia);

• referalis ganxorcielebis meTodologia;

• simptomebi:

− smenis daqveiTeba;

− gogirdis sacobi yurSi;

− yuris tkivili;


71

− gamonadeni yuridan;

− Suli yurebSi;

− sisxldena cxviridan;

− yelis tkivili;

− xmis CaxleCa;

− disfagia;

− krupi;

− farisebri jirkvlis gadideba;

− limfuri jirkvlebi da sxva warmonaqmnebi kisris areSi;

− saubris gaZneleba;

− ucxo sxeulebi;

• gavrcelebuli mdgomareobebi:

− Sua yuris anTeba;

− gareTa sasmeni milis anTeba;

− dafis apkis perforacia;

− qolesteatoma;

− vertigo, menieris daavadeba;

− belis dambla, tempero-mandibuluri tkivili, trigeminiuri nevralgia;

− faringiti, tonziliti, laringiti, jirkvlovani cxeleba (glandular fever) piris Rrus kandidozi, herpesi, sanerwyve jirkvlebis qva, gastroezofaguri refluqsi (GERD);

− infeqciuri da alergiuli riniti, sinusiti, cxviris polipebi;

− cxviris motexiloba, yuris hematoma;

− xvrinva da Zilis apnoe;

− eWvi Tavis da kisris koboze;

− smenis calmxrivi daqveiTeba gare yuris paTologiis an sxva aSkara mizezis ararsebobisas;

• gamokvlevebi:

− otoskopia;

− testebi kamertoniT;

− interpretacia, codna: audiograma, audiometria;

• mkurnaloba:

− dakvirveba, usargeblo referalis Tavidan acileba;

− cxviris kauterizacia;

− gogirdis sacobis gamoZeveba;

• gadaudebeli mdgomareobebis marTva:

− septaluri hematoma;

− sisxldena cxviridan;

− mwvave tonziliti;

− gareTa yuris anTeba;

− ucxo sxeuli;

− aurikuluri hematoma an periqondriti.

• prevencia:

− smenis daqveiTebis skriningi bavSvebsa da mozrdilebSi;

− ototoqsiurobis iatrogenuri mizezebis codna da amocnoba;

moduli moduli moduli moduli 2.E2.... `dermatologia~`dermatologia~`dermatologia~`dermatologia~

modulis modulis modulis modulis xangrZlivoba: xangrZlivoba: xangrZlivoba: xangrZlivoba: 4 kvira



72

dermatologiaSi gavrcelebuli mwvave da qronikuli problemebis prevencia, amocnoba da marTva pirveladi jandacvis doneze;


rezidentis kompetencia dermatologiis sferoSi unda moicavdes Semdeg sakiTxebs:

• dermatologiis ZiriTadi Semadgenlebi

− normaluri anatomia, ganviTareba da fiziologia

− riskfaqtorebi a. Tandayolili b. SeZenili g. asakobrivi

− prevencia: a. pacientis ganaTleba b. Tanxmoba

− sadiagnozo saxelmZRvanelo rekomendaciebi a. dazianebis lokalizacia, tipi da xasiaTi b. dazianebis tipi: pirveladi/meoreuli makularuli/papularuli/vezikuluri/kvanZovani simsivne g. dazianebis specifikuri lokalizacia d. sezonuri variacia/dasawyisi

− mkurnaloba

− sistemuri gamokvleva (Cvenebis mixedviT)

• xSiri dermatologiuri problemebi

− kanis paTologiebi a. papuloskvamozuri daavadebebi seborea da qertli

fsoriazi

vardisferi pitiriazi

miliumi

brtyeli liqeni

liqeni

b. vezikulobulozuri daavadebebi 1. impetigo

2. martivi herpesi

3. herpes zosteri

4. wiTela

5. pemfigoidi

6. pemfigusi

7. dishidrozi

8. multiformuli eriTema

9. hermetoformuli dermatiti

10. epidermuli nekrolizi

11. bulozuri epidermolizi

g. dermatiti 1. kontaqturi

2. atopiuri

3. generalizebuli exqsfolaciuri

4. numularuliNegzema

5. stazdermatiti


73

6. safeniT gamowveuli gamoyelva

d. makularuli gamonayari 1. virusuli egzanTema 2. wamlismieri reaqcia

ე. urtikariuli gamonayari 1. WinWris cieba 2. dermografizmi

v. kvanZebi kvanZovani eriTema

dermatofibroma

beWdiseburi granuloma

sarkoidi

kistebi

z. qaviliT Tanxlebuli sxva mdgomareobebi 1. zogadi a. muni b. kanis simSrale (asteatozi) g. meoradi sistematuri daavadeba 2. lokalizebuli a. qronikuli martivi liqeni (lokalizebuli neirodermatiti) b. analuri qavili g. pedikulozi (datilianeba) d. rwyilis da sxva mwerebis nakbeni

T. kanis infeqciebi baqteriuli

a. impetigo b. wiTeli qari g. limfangiti d. celuliti

e. furunkuli (mag Zirmagara,, pustula, folikuliti, abscesi, karbunkuli, eqtima) v. eriTrazma

2. mikobaqteriuli

a. atipuri mikrobaqteria 3. sokovani

a. sada kanis sokovani infeqcia b. Rrma mikozi

virusuli

a. martivi herpesi b. herpes zosteri g. meWeWi d. kontagiozuri moluski

riketsiozuli

a. laimis daavadeba b. tkipismieri cxeleba (Rocky Mountain spotted fever)

i. kompleqsuri da kosmetikuri problemebi

1. vulgaruli akne 2. rozeuluri gamonayari 3. cximiani kani 4. gafarTovebuli forebi 5. naofli 6. vaskularuli paTologia 7. naoWebi


74

8. keloidi 9. hiperhidrozi

k. kanis dazianeba 1. damwvroba a. Termuli b. qimiuri g. mziT 2. buStukebi 3. nakawri 4. kanis naxeTqi 5. daJeJiloba a. tramva b. spontanuri purpura 6. nakbenebi l. pigmenturi darRvevebi 1. hiperpigmentacia 2. hipopigmentacia a. TeTri pitiriazi b. vitiligo 3. dermatomikozuri gamonayari m. axali warmonaqmnebi 1. keTilTvisebiani a. anTebiTi dazianeba

aknes gamonayari

furunkuli

hidradentiti

piogenuri granuloma

b. hiperplazia meWeWi

kontagiozuri moluski

koJiJi

epidermuli kista

akroqordoni

qsanTelazma

g. neoplazia

seboreuli keratozi

xali, nevusi (intradermuli, Serwymuli da sxva)

lipoma

dermatofibroma

keloidi

hemangioma

neirofibroma

2. simsivnis winare a. skvamozuri ujredovani karcinoma in situ (bouenis daavadeba) b. aqtinuri keratozi g. zedapiruli gavrcelebuli aqtinuri prokeratozi d. leikoplakia e. keratoakanToma v. eriTroplakia z. premelanoma

i. avTvisebiani lentigo


75

ii. giganturi Tandayolili xali iii. displaziuri xalis sindromi

T. radiaciuli efeqtebi 3. avTvisebiani a. bazalurujredovani karcinoma b. skvamozur ujredovani karcioma g. melanoma

i. ZiriTadi klinikuri kategoriebi ii. prognozuli da Terapiuli saxelmzRvanelo

rekomendaciebi d. pejetis daavadeba e. kanis limfoma v. kapoSis sarkoma z kanis metastazebi

n. sistemuri daavadebis kanismieri manifestaciebi, aiv-is da aTaSangis CaTvliT o. kanis profesiuli daavadebebi 1. Tmis problema a. sokovani daavadebeibi b. alopecia, romelic ar aris dakavSirebuli nawiburTan

i. androgenetika (mamrobiTi saxis) ii. alopecia budobrivi/totaluri/universaluri iv. traqciuli alopecia da triqotilomania v. endokrinuli efeqtebi vi. diskoiduri wiTeli mglura vii. folikuluri keratozi g. Cazrdili Tma (fsevdokolikuliti) d. hipertriqozi i. lokalizebuli ii. virilizaciiT gamowveuli hirsutizmi e. struqturis cvla (Tmis distrofia)

2. frCxilis problema a. travma b. dermatozebTan asocirebuli paTologiebi g. sxva sistemur daavadebebTan asocirebuli paTologiebi d. struqturis cvla e. sokovani infeqciebi v. frCxilis budisa da frCxilqveSa aris mdgomareoba

i. Cazrdili frCxili ii. paroniqia iii. hematoma

z. feradi frCxili T. axali wamonazardebi i. keTilTvisebiani

i. anTebiTi ii. neoplazia

k. avTvisebiani i. melanoma ii. skvamozurujreduli karcinoma 3. lorwovani garsis dazianeba 4. piris Rrus dazianeba

a. rZiana

b. piris Rrus afTebi

g. piris simSrale

d. geografiuli ena

e. Savi Tmiani ena


76

v. leikoplakia

z. xeiliti

T. brtyeli liqeni

• unarunarunarunar----CvevebiCvevebiCvevebiCvevebi sadiagnozo unar-Cvevebi

1. samedicino baraTis Sevseba da samedicino Semowmeba, diferenciuli diagnozi 2. laboratoriuli sinjebisaTvis masalis aReba, sinjebis Sedegebis interpretacia

a. biofsia

b. mikroorganizmebis kultura

g. anafxeki

3. kanis testebis Catarebis teqnika da Sedegebis interpretacia 4. meqanikuri xelsawyoebis gamoyeneba

5. sistemuri Sefaseba (Cvenebis mixedviT) 6. dazianebis gavrcelebis da xasiaTis aRwera problemis marTva

genetikuri konsultacia

konsultacia kvebis Taobaze

prevenciuli RonisZiebebi

a. kanis yoveldRiuri movla b. garemos zemoqmedebis acileba

g. mzisgan damcavi ekranebi (minebi) d. receptis gareSe gasayidi losionebis saTanadod gamoyeneba

janmrTelobisaTvis xelSewyoba

pacientis ganaTleba

dinamikis dokumentirebisaTvis fotografiis gamoyeneba

Skalis/indeqsebis gamoyeneba daavadebis simwvavis gansazRvrisTvis

konsultaciebisa da mimarTvebis gamoyeneba

samkurnalo unar-Cvevebi 1. konservatiuli

a. adgilobrivi b. sistemuri g. ultraiisferi sxivebiT mkurnalobis principebi

2. qirurgiuli a. dazianebul ubanSi kortikosteroidebis Seyvana b. gakveTa da drenireba g. Cazrdili fexis frCxilis mkurnaloba

moduli moduli moduli moduli 2.E3.... `̀̀̀ofTalmologiaofTalmologiaofTalmologiaofTalmologia~~~~



ofTalmologiaSi gavrcelebuli mwvave da qronikuli problemebis prevencia, amocnoba da marTva pirveladi jandacvis doneze;


rezidentis kompetencia ofTalmologiis sferoSi unda moicavdes Semdeg sakiTxebs:

codnacodnacodnacodna


77

• normaluri anatomia, fiziologia, Tvalis da mxedvelobis asakobrivi ganviTareba

• mxedvelobis darRvevis mqone pacientebis fiziologiuri da adaptaciuri saWiroebebi

• wamlebisa da toqsinebis gavlena mxedvelobaze da Tvalis daavadebebze

• ofTalmologiuri preparatebis gavlena sistemur funqciebze

• xanSiSesuli pacientebis mxedvelobis daqveiTebis da mxedvelobiTi funqciis regularuli Sefasebis da SenarCunebis mniSvnelobis gacnobiereba

• mxedvelobis dazianeba sxva organoTa sistemebis daavadebebis dros

• mxedvelobis Semowmebis saxelmZRvanelo principebi sxvadasxva asakobriv jgufebSi

• pirveladi diagnozi, marTva da konsultantTan gagzavnis kriteriumebi xSiri paTologiebis dros

• refraqciis darRvevebi a. axlomxedveloba (miopia) b. Sorsmxedveloba (hiperopia) g. presbiopia

kanis da mimdebare qsovilebis paTologia

a. infeqciuri hordeolumi

orbitaluri celuliti

dakriocistiti

blefariti

kavernozuli sinusis Trombozi

b. egzofTalmozebi greivsis daavadebis

arteriul-venuri anevrizma

karotiduli kavernozuli fistula

g. quTuTos daavadebebi entropioni da eqtropioni

qalazioni

ptozi

d. sacremle aparatis daavadeba dakriostenozi

e. keTilTvisebiani simsivneebi 1. papiloma 2. keratoakanToma 3. nevusi 4. qsanTelazma 5. dermoidi

v. avTvisebiani simsivneebi 1. bazalurujredovani karcinoma 2. sqvamozurujredovani karcinoma 3. limfoma 4. avTvisebiani melanoma 5. retinoblastoma

koniunqtivis daavadebebi

a. koniunqtiviti

virusuli koniunqtiviti

martivi herpesiT gamowveuli koniunqtiviti

herpes-zosteriT gamowveuli koniunqtiviti da keratiti


78

baqteriuli koniunqtiviti

alergiuli koniunqtiviti

b. koniunqtivis xali

pterigiumi

pinguekula

g. koniunqtivis simsivneebi

rqovanas daavadebebi

a. zedapiruli travma da infeqciebi

rqovanas abrazia

keratiti

rqovanas wyluli

mSrali Tvali da masTan dakavSirebuli daavadebebi

b. keratokonusi

iriti

a. araTanabari gugebi b. gugis aferentuli defeqti g. adies guga d. horneris sindromi

kataraqta

glaukoma

baduras daavadebebi

a. asocirebuli mxedvelobis dakargvasTan 1. baduris centraluri venis okluzia

2. badurs venis totis okluzia

3. baduris centraluri arteriis okluzia

4. baduras CamoSla da sisxlCaqceva minisebr sxeulSi

b. dakavSirebuli sxva daavadebebTan 1. arteriuli hipertenzia

2. Saqriani diabeti

g. yviTeli xalis degeneracia d. asakobrivi cvlilebebi

mxedvelobis nervis paTologiebi

garegani kunTovani darRvevebi

a. kranialuri nervis dambla

travma

a. daxuruli b. Semavali

damwvroba

• specialuri ofTalmologiuri da ofTalmoradiologiuri procedurebis Cvenebebi

− fluorescentuli angiografia

− Tvalis ultrabgeriTi gamokvleva

− mxedvelobis velis gansazRvra

− Tvalis magnitur-rezonansuli gamokvleva/kompiuteruli tomografia

• Tvalis refraqciis qirurgiuli koreqciis Cvenebebi

− Tvalis dazianebis da mxedvelobis dakargvis prevencia unarunarunarunar----CvevebiCvevebiCvevebiCvevebi


79

• gamokvleva:gamokvleva:gamokvleva:gamokvleva: 1. specifikuri procedurebis Catareba da Sedegebis interpretacia

a. mxedvelobis simaxvilis, mxedvelobis velis da Tvalis mamoZravebeli funqciis gamokvleva b. pirdapiri ofTalmoskopia g. mxedvelobis gamokvleva sinaTlis sxiviT d. rqovanas SeRebva fluoresciniT e. tonometria

2. yvela asakis pacientis fizikuri gamokvleva, yuradRebis gansakuTrebuli gamaxvilebiT nevrologiur da motorul reaqciebze

3. klinikuri gamokvlevis Catareba problemis lokalizaciisaTvis, diferencialuri diagnostikisaTvis da marTvis dagegmisaTvis

4. gamokvlevebis da marTvis gegmis Camoyalibeba, maT Soris mdgomareobis simZimis Sefaseba da specialistis gadaudebeli daxmarebis saWiroebis gansazRvra

• marTvamarTvamarTvamarTva 1. marTvis, gamokvlevis da specialistis konsultaciebis gegmis Camoyalibeba,

gamokvlevis riskis, fasisa da miRebuli informaciis Rirebulebis gaTvaliswinebiT.

2. TavSi ~codna~ CamoTvlili gavrcelebuli da gankurnebadi daavadebebis gamovlena da marTva

3. fsiqosocialuri da ojaxuri sakiTxebis marTva da koordinacia, maT Soris Tvalis `damaZabunebeli~ daavadebebis xangrZlivi marTva - garemoSi adaptacia da sazogadoebrivi resursebis gamoyeneba

4. saTanado medikamentebis gamoyeneba 5. sadiagnozo da samkurnalo saSualebebis swori gamoyeneba

a. midriazuli saSualebebi

b. adgilobrivi saanesTezio saSualebebi

g. kortokisteroidebi

d. antibiotikebi

e. glaukomis samkurnalo saSualebebi

moduli moduli moduli moduli 2.E4.... `nevrologia~`nevrologia~`nevrologia~`nevrologia~



nevrologiaSi gavrcelebuli mwvave da qronikuli problemebis prevencia, amocnoba da marTva pirveladi jandacvis doneze;


rezidentis kompetencia nevrologiis sferoSi unda moicavdes Semdeg sakiTxebs:


• normaluri anatomia, fiziologia da anatomiuri principebi, romlebic nevrologiuri daavadebis lokalizaciis saSualebas iZleva

• nervuli sistemis normaluri zrda-ganviTareba da dabereba

• paTologiuri nevrologiuri darRvevebi, romlebic moicaven: 1. motoruli funqciis darRvevebs

a. zeda da qveda motoruli neironebis darRvevebi b. koordinaciis darRveva g. moZraobiTi darRvevebi

1. hipokineziuri

a. parkinsonis daavadeba b. parkinsonizmis sindromi


80

2. hiperkineziuli

a. aTetozi b. qorea g. distonia d. tikebi e. tremori

2. mgrZnobelobis darRvevebi a. centraluri b. periferiuli

3. mxedvelobis darRveva a. mxedvelobis velis defeqtebi b. monokularuli an binokularuli sibrmave g. diplopia da mzeris SezRudva d. nistagmi e. gugis anomaliebi

4. cerebrovaskularuli daavadebebi a. iSemiuri insulti

1. Trombolizuri saSualebebi a. Cveneba da gamoyeneba b. riski da sargebeli

b. hemoragiuli insulti g. vaskulitebi d. gardamavali iSemia e. simptomuri/asimptomuri karotiduli stenozi v. anevrizma

5. Tavis da zurgis tvinis travma a. Sefaseba b. marTva g. Sedegebi da prognozi

1. gafantuli sklerozi

a. sadiagnozo kriteriumebi b. paraklinikuri gamokvlevebi g. marTva

2. Tavbruxveva da smenis darRvevebi

a. centraluri da periferiuli genezis smenis dakargva 1. mwvave 2. qronikuli

b. centraluri da periferiuli genezis vertigo 1. mwave 2. qronikuli 3. gaRizianebiT testireba 4. Suili yurebSi

3. SemecnebiTi funqciis da komunikaciis darRvevebi

a. demencia 1. diferciuli diagnozi 2. Sefaseba 3. marTva

b. encefalopaTia (mwvave, qronikuli) 1. toqsikuri 2. metaboluri

g. afazia, apraqsia 4. cnobierebis darRvevebi

a. gulis wasvla b. epilefsia

1. krunCxvebi generalizebuli dasawyisiT


81

2. martivi parcialuri krunCxvebi 3. rTuli parcialuri krunCxvebi 4. mkurnaloba

a. krunCxvis medikamenturi mkurnaloba b. qirurgiuli marTva g. vagusis stimulacia

g. momatebuli qalasSida wnevis gamovlena da mkurnaloba d. stupori da koma

1. toqsikuri, metaboluri 2. struqturuli daavadeba 3. CaWedvis sindromi

e. Tavis tvinis sikvdili 5. Tavis tkivili

a. Sakiki da mis variantebi b. klasteruli tkivili g. wnevasTan dakavSirebuli Tavis tkivili d. struqturul dazianebasTan dakavSirebuli Tavis tkivili e. keTilTvisebiani intrakranialuri hipertenzia v. qronikuli tkivilebi dRis ganmavlobaSi z. Tavis tkivili gadaudebeli mdgomareobebis dros

1. subaraqnoiduli sisxlCaqceva 2. meningiti 3. giganturujredovani arteriti/safeTqlis midamos arteriti

6. Tavis tvinis simsivneebi

a. wina da ukana foso 1. pirveladi

a. keTilTvisebiani b. avTvisebiani

2. metastazuri 7. infeqciebi (meningiti da encefaliti)

a. baqteriuli b. virusuli an retrovirusuli (adamianis imunodeficitis virusi) g. sokovani d. tuberkulozi e. prionis ciliT gamowveuli daavadebebi

8. zurgis tvinis daavadebebi

a. anatomia da procesis lokalizacia b. garegani kompresiuli dazianeba g. Sinagani dazianeba

9. Zilis darRveva

10. periferiuli nervebis, nerv-kunTovani gadacemis da kunTebis dazianebebi

a. kunTovani distrofia b. periferiuli neiropaTia g. mravlobiTi mononevriti d. miopaTia e. gilen-bares sindromi v. didi miasTenia z. pleqsopaTia T. radikulopaTia i. diagnostikuri gamokvlevebi (mag., nervSi impulsis gatarebis siCqare, eleqtromiografia, kunTis biofsia)

11. Tandayolili daavadebebi

a. Tavis da zurgis tvinis ganuviTarebloba


82

1. arnold-Ciaris daavadeba 2. meningomielocele 3. Tavis tvinis qerqis ganuviTarebloba

b. qromosomuli anomaliebi (mag., daunis sindromi) g. Tavis zrdis anomalia

1. mikrocefalia

2. makrocefalia (hidrocefaliis CaTvliT)

d. ganviTarebis darRveva 1. dagvianebuli ganviTareba

2. gonebrivi CamorCena

3. neirodegeneraciuli daavadebebi

12. umaRlesi nervuli moqmedebis ganviTarebis darRvevebi

a. gonebrivi CamorCena b. metyvelebis darRveva g. swavlis uuanroba (mag., disleqsia) d. yuradRebis deficitis sindromi hiperaqtiurobiT an mis gareSe e. ganviTarebis gavrcelebuli darRvevebi (mag., autizmi)

13. fsiqiatriuli darRvevebi, romlebic nevrologiuri daavadebebis imitacia axdenen

a. araepilefsiuri Setevebi (mag., fsevdokrunCxvebi) b. depresiasTan dakavSirebuli demencia (mag., fsevdodemencia) g. konversia d. simulacia e. somatizacia da ipoqondria

14. tkivilis marTvis principebi

a. farmakologiuri preparatebi b. qirurgiuil marTva

d. pacientis marTvis fsiqologiuri aspeqtebi da reabilitacia, gansakuTrebiT qronikuli an xangrZlivi nevrologiuri daavadebebis dros. e. zogierTi nevrologiuri daavadebis genetikuri safuZveli da ojaxis ganaTleba genetikuri konsultaciis mniSvnelobis Sesaxeb v. xanSiSesul pacientebs Soris nevrologiuri uuanrobis gacnobiereba da maTi funqciuri SesaZleblobebis Sefasebis, aRdgenis da SenarCunebis mniSneloba z. sistemuri daavadebebis nevrologiuri garTulebebi T. nervuli daavadebebis prevencia unar Cvevebiunar Cvevebiunar Cvevebiunar Cvevebi

• sadiagnozo unar-Cvevebi 1. nevrologiuri problemis gamovlena da gansazRvra 2. anamnezis Sekreba da sruli nevrologiuri da gonebrivi statusis gansazRvra 3. klinikuri codnis gamoyeneba dazianebis lokalizaciis dasadgenad da diferenciuli diagnostikisaTvis 4. klinikuri problemis simZimis da prognozis Sefaseba, ramdenad aucilebelia gadaudebeli daxmareba da specialistis Careva 5. Semdgomi gamokvlevebisa da marTvis gegmis Camoyalibeba 6. qvemoT CamoTvlili gamokvlevebis Cvenebebis, ukuCvenebebis, riskisa da mniSvnelobis codna

a. lumbaluri punqcia, misi Catarebis codna b. eleqtroencefalograma g. vizualuri, Tavis tvinis Reros da somatosensoruli sapasuxo

potencialebi d. nervis gamtareblobis gamokvleva da eleqtromiografia e. kunTis da nervis biofsia


83

v. kompiuteruli tomografia kontrastirebiT an mis gareSe z. magnitur-rezonansuli gamokvleva kontrastirebiT an mis gareSe T. magnitur rezonansuli angiografia i. angiografia k. mielografia l. karotiduli sinusis ultrabgeriTi gamokvleva m. Zilis gamokvleva n. genetikuri testireba o. pozitronul-emisiuri tomografia (PET) p. SPECT skanireba

• marTva 1. sadiagnozo da marTvis gegmis formulireba da specialistis konsultacis

saWiroebis Sefaseba konsultaciis riskis, sargeblis da Rirebulebis gaTvaliswinebiT

2. specialisti nevrologis rolis gacnobiereba 3. `codnis~ nawilSi CamoTvlili xSiri da gankurnebadi davadebebis marTva,

saWiroebis SemTxvevaSi, konsultantis monawileobiT 4. qvemoT CamoTvlili gadaudebeli nevrologiuri mdgomareobebis marTva

Sesabamis specialistTan TanamSromlobis gziT: a. insulti b. koma g. meningiti da encefaliti d. epilefsiuri statusi e. centraluri nervuli sistemis travmuli dazianeba v. momatebuli qalasSida wneva z. mxedvelobis mwvave dakargva T. swrafad progresirebadi nevrologiuri deficiti i. mwvave sisuste k. Secvlili gonebrivi statusi

5. ojaxuri da fsiqosocialuri sakiTxebis marTva, rac Tan axlavs xangrZlivi drois ganmavlobaSi nevrologiuri daavadebiT Sepyrobili pacientis movlas da rac moicavs saojaxo movlas, sazogadoebis (Temis) resursebis gamoyenebas, mravalprofiluri gundis monawileobas, romelSic ojaxis eqims xangrZlivi movlis koordinatoris roli ekisreba.

6. samkurnalo saSualebebis urTierTqmedebis da maTi gverdiTi moqmedebis codna, gansakuTrebiT xanSiSesul pacientebSi.

moduli moduli moduli moduli 2.E5.... òrTopedia~òrTopedia~òrTopedia~òrTopedia~



orTopediaSi gavrcelebuli mwvave da qronikuli problemebis prevencia, amocnoba da marTva pirveladi jandacvis doneze;

modulmodulmodulmodulis amocanebi: is amocanebi: is amocanebi: is amocanebi:

rezidentis kompetencia orTopediis sferoSi unda moicavdes Semdeg sakiTxebs:

• terfmrudoba

• displaziuri menj-barZayis saxsari

• rotaciuli problemebi

− rotacia SigniT da gareT − Metatarsus adductus

• skoliozi: idiopaTiuri da SeZenili

• barZayis Tavis aseptikuri nekrozi

• barZayis Tavis epifizeolizi


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• daWimva, amovardniloba da motexiloba

• orTopediuli aparatebi

• orTopediaSi gadaudebeli mdgomareobebis gamovlena da stabilizacia

− “Compartment” sindromi − barZayis Tavis amovardniloba

− muxlis amovardniloba

− menjis Zvlebis motexiloba

− xerxemlis kisris aris motexiloba

− zurgis tvinis dazianeba

moduli moduli moduli moduli 2.E6.... ònkologia~ònkologia~ònkologia~ònkologia~



onkologiaSi gavrcelebuli mwvave da qronikuli problemebis prevencia, amocnoba da marTva pirveladi jandacvis doneze;

mmmmodulis amocanebi: odulis amocanebi: odulis amocanebi: odulis amocanebi:

rezidentis kompetencia onkologiis sferoSi unda moicavdes Semdeg sakiTxebs:

• gavrcelebuli onkologiuri daavadebebis epidemiologia, riskfaqtorebi (cxovrebis wesis CaTvliT);

• skriningis programebis principebi;

• referalis organizeba;

• paliatiuri RonisZiebebi onkologiuri daavadebebis dros;

• kibos adreuli sipmtomebisa da niSnebis amocnoba;

• eWvis mitana da diagnozis dasma kibos ganviTarebis adreuli etapze;

• adekvaturi gamokvlevebis Catareba kiboze eWvis dros;

• tkivilis marTva;

• onkologiuri daavadebebis dros aRmocenebuli paliatiuri RonisZiebebis saWiroeba:

− sisxldena;

− hiperkalcemia;

− zeda Rru venis obstruqcia;

− zurgis tvinis kompresia;

− Zvlebis paTologiuri motexilobebi;

moduli moduli moduli moduli 2.E7.... `qirurgia~`qirurgia~`qirurgia~`qirurgia~



qirurgiaSi gavrcelebuli mwvave da qronikuli problemebis prevencia, amocnoba da marTva pirveladi jandacvis doneze;


rezidentis kompetencia qirurgiis sferoSi unda moicavdes Semdeg sakiTxebs:


• qirurgiuli diagnostikis ZiriTadi principebi

− qirurgiuli anatomia

− Wrilobis fiziologia, movla da Sexorcebis procesi


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− klinikuri Sefaseba, rac moicavs qirurgiuli mdgomareobebis dros anamnezis Sekrebas, fizikur gamokvlevas, laboratoriul gamokvlevas da ZiriTadi niSnebisa da simptomebis diferenciul diagnostikas

− invaziuri da arainvaziuri sadiagnozo testebi

− anesTezia a. premedikacia b. preparatebi g. Seyvanis gzebi d. toqsikuroba e. reanimaciuli RonisZiebebi

− gadaudebeli qirurgiuli mdgomareobebis identifikacia

− eTikuri da samarTlebrivi sakiTxebi a. informirebuli Tanxmoba b. cxovrebis xarisxi g. sikvdilis wina mdgomareobasTan dakavSirebuli problemebi

• operaciamdeli gamokvleva

− operaciis riskis Sefaseba

− Tanmxlebi daavadebebi

− antibiotikebis saprofilaqtiko daniSvna

− pacientis momzadeba (nawlavebis momzadeba da sxva)

• movla operaciis msvlelobisas

− aseptikisa da sterilobis ZiriTadi principebi

− pacientis monitoringi

− siTxeebis gadasxma

− sisxlis saWiroebis gansazRvra

− sxeulis temperaturis kontroli

− ZiriTadi qirurgiuli instrumentebis gamoyeneba

• postoperaciuli movla

− rutinuli a. Wrilobis movla b. pacientis fizikuri gaaqtiureba g. kveba d. tkivilis marTva e. drenaJebi

− xSiri garTulebebi a. cxeleba da misi marTva b. Wrilobis gaxsna g. Sardis Sekaveba d. sisxldena e. pnevmonia v. ateleqtazi z. siTxeebiT gadatvirTva T. posttransfuziuli reaqciebi i. Tromboflebiti k. filtvis arteriis embolia l. oliguria m. sunTqvis ukmarisoba n. nawlavTa gauvaloba o. infeqcia p. Soki

− xangrZlivi meTvalyureoba

• ambulatoriuli qirurgia

− pacientebis SerCeva

− sedacia cnobierebis SenarCunebiT


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− postoperaciuli dakvirvebis principebi

− xangrZlivi meTvalyureoba

• xSiri mdgomareobebis ofisSi movla

− Sesiveba da kopi

− nafleTi Wrilobebi

− zedapiruli damwvroba

• xSiri qirurgiuli mdgomareobebis movla

− abscesi

− aortis anevrizma

− apendiciti

− arteriuli ukmarisoba

− keTilTvisebiani simsivneebi

− nawlavis obstruqcia

− moculobiTi warmonaqmnebi sarZeve jirkvalSi

− majis arxis sindromi

− msxvili nawlavis kibo

− gulis iSemiuri daavadeba

− kista da hematoma

− divertikuli

− naRvlis buStis daavadeba

− ganglionebi

− sisxldena kuW-nawlavis traqtidan

− buasili

− Tiaqari

− malTaSua diskis CaWedva

− filtvis kibo

• xSiri qirurgiuli mdgomareobebis erToblivi marTva

− swor nawlavis fistula, naxeTqi an perianaluri abscesi

− karcinoma

− saylapavis venebis varikozi

− asciti

− CaWedili Tiaqari

− invaginacia

− malabsorbcia

− obstruqcia

− pankreasis daavadebebi

− polipozi

− regionuli enteriti

− Sinagani organos perforacia

− wylulovani koliti

• organoebis donoroba da transplantacia unar Cvevebiunar Cvevebiunar Cvevebiunar Cvevebi

• operaciamdeli gamokvleva

− operaciis riskis Sefaseba

− fizikuri gamokvleva

− radiologiuri gamokvleva

− arainvaziuri sadiagnozo procedurebi

− invaziuri sadiagnozo procedurebi a. nazogastruli lavaJi b. Sardis buStis gamorecxva

• gadaudebeli qirurgiuli procedurebis Catareba


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− kriko Tireoidotomia

− nemsiT Torakostomia

• postoperaciuli movla

− nakeris moxsna

− naxvevis Secvla

− drenaJis amoReba

• mcire qirurgiuli operaciebis Catareba

− adgilobrivi anesTezia

− martivi ganakveTi

− kistisa da abscesis gakveTa da drenireba

− aspiracia

− yuris bibilos gaxvreta

− ucxo sxeulis amoReba

− mcire damwvroba

− Wrilobis sanacia

− zedapiruli Wrilobis gakerva

profesiuli mzadebis III etapiprofesiuli mzadebis III etapiprofesiuli mzadebis III etapiprofesiuli mzadebis III etapi modulebis raodenobamodulebis raodenobamodulebis raodenobamodulebis raodenoba::::

mzadebis III etapi moicavs 10 moduls.

profesiuli mzadebis III profesiuli mzadebis III profesiuli mzadebis III profesiuli mzadebis III etapisetapisetapisetapis mizani:mizani:mizani:mizani:

specialobaSi `ojaxis eqimi~ rezidentebis mzadebis III etapis dasasrulisTvis rezidents aqvs specifikuri codna, flobs unar-Cvevebsa da midgomebs, romlebic mas SesaZleblobas miscemen efeqturad marTos gavrcelebuli qronikuli da mwvave mdgomareobebi, romlebic tipuria saojaxo medicinisaTvis. mocemuli droisTvis rezidetnts Seswevs unari ganaxorcielos damoukidebeli uwyveti samedicino daxmareba garkveuli kontingentisTvis.

profesiuli mzadebiprofesiuli mzadebiprofesiuli mzadebiprofesiuli mzadebis III etapis amocanebi: s III etapis amocanebi: s III etapis amocanebi: s III etapis amocanebi:


1.1.1.1. pirveladi jandacvis marTva:pirveladi jandacvis marTva:pirveladi jandacvis marTva:pirveladi jandacvis marTva:

• im midgomebis codna, romelic uzrunvlyofs pacientisaTvis araseleqciuri problemebis mqone pacientisaTvis momsaxurebis advilad xelmisawvdomobas;

• qronkuli mdgomareobebis marTvis organizaciuli midgomebis codna; • im prevenciuli RonisZiebebis codna, rac moeTxoveba praqtikas pirvelad jandacvaSi;

• problemebis prioritetulobis gansazRvris unari; • pirveladi jandacvis dawesebulebis (klinikis) organizaciis codna; • gundis sxva wevrebTan efeqturi komunikaciis damyareba; • gunduri muSaobis Cveva; • sxva specialistebTan efeqturi TanamSromlobis unari; • konsultaciis, pacientisa da misi ojaxis wevrebis ganaTlebisaTvisaTvis saWiro sakomunikacio Cvevebi;

• Canawerebis Senaxvis, sainformacio menejmentis, gunduri muSaobis, praqtikis warmmarTvisa da momsaxurebis xarisxis auditirebisaTvis saWiro saorganizacio Cvevebi;

• pacientTan partnioruli kavSiris damyarebisaTvis saWiro urTierTobisa da komunikaciis unar-Cvevebis ganviTareba da SenarCuneba;

• efeqturi liderobis, molaparakebisa da kompromisebis Cvevebi.


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2.2.2.2. pirovnebaze koncentrirebuli daxmarebapirovnebaze koncentrirebuli daxmarebapirovnebaze koncentrirebuli daxmarebapirovnebaze koncentrirebuli daxmareba

• koncefciuri midgoma ojaxis da Temis faqtorebisadmi; pirovnebis damokidebulebis, faseulobebisa da rwmenis socialuri da kulturuli koneqstis gageba;

• avadmyofi pacientisa da zogadad daavadebis koncefciis Camoyalibeba; • pacientze orientirebuli sakonsultacio modelis ganxorcielebis unari, pacientis Taviseburebebis/damokidebulebis gaazrebisa (magaliTad, yinulis galRoba, ideebi, interesi da molodinebi) da masTan maswavleblis damokidebulebis integrirebiT, saerTo safuZvlebis Camoyalibebisa da erTiani samomavlo gegmis formirebisaTvis;

• eqimisa da pacientis urTierTobis subieqturi komponentis codna, rogorc pacientis (misi SegrZnebebi, Rirebulebebi da warmodgenebi), aseve rezidentis Tvalsawieridan (faseulobebis, midgomebisa da SegrZnebebis TviTanalizi);

• pacientTan partnioruli urTierTobebis damyarebisaTvis saWiro unar-Cvevebi da midgomebi;

• unar-Cvevebi da midgomebi pacientTan distancirebisa da axlo urTierTobebis dasabalanseblad;

• uwyvetobis sami aspeqtis gageba/SeTviseba: pirovnuli urTierTobis uwyvetoba mTeli cxovrebis ganmavlobaSi (midgoma xangrZlivi urTierTobis Camosayalibeblad erT pirovnebasTan), informaciis miwodebis uwyvetoba – konkretuli pacientisaTvis saWiro samedicino informaciis xelmisawvdomobis uzrunvelyofa yovel saWiro momentSi, (informaciis miwodeba personalurad da eleqtronuli sistemis saSualebiT), movlis uwyvetoba mTeli dRe-Ramis ganmavlobaSi (samuSao da arasamuSao saaTebSi).

3.3.3.3. specifikuri problemebis specifikuri problemebis specifikuri problemebis specifikuri problemebis gadawyvetis unargadawyvetis unargadawyvetis unargadawyvetis unar----CvevebiCvevebiCvevebiCvevebi

• marTvis gegmaSi pacientis CarTvis survili ; • samedicino gadawyvetilebis nabij-nabij miRebis unari, drois, rogorc sadiagnozo da samkurnalo berketis gamoyenebiT ;

• pirvelad jandacvaSi problemebis gadawyvetis procesSi gaurkveveli, saeWvo situaciebis aRmocenebis garduvalobis gageba da mis mimarT tolerantobis gamomuSaveba.

4.4.4.4. yovlismomcveli midgomayovlismomcveli midgomayovlismomcveli midgomayovlismomcveli midgoma

• polinozologiurobis koncefciisa da Sedegebis misadageba yoveli calkeuli pacientisaTvis;

• pacientis janmrTelobasTan dakavSirebuli yvela problemis erTdroulad marTvis unar-Cveva maTi identificirebis, Seswavlis, cnobis, prioritetulobis gansazRvris gziT;

• samedicino Canawerebisa da sxva informaciis saTanadod gamoyenebis unar-Cveva;

• saukeTeso mtkicebulebebis moZiebisa da maTi praqtikaSi gamoyenebis unari; • janmrTelobis koncefciis gageba mTlianobaSi, misi mravalsaxovnebis gaTvaliswinebiT;

• janmrTelobisaTvis xelSewyoba yoveli individis doneze, rogorc yoveldRiuri saqmianobis nawili;

• janmrTelobisaTvis xelSewyobisa da prevenciis ganxorcieleba saTanado programebis meSveobiT;

• sxvadasxva midgomebis gamoyenebis unari calkeuli pacientis mimarT; • praqtikis gundis saqmianobis koordinaciis unari; • Temis janmrTelobis saWiroebebis gageba populaciis epidemiologiuri maxasiaTeblebis mixedviT.


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• Temis jandacvis politikasTan dakavSirebul sxva profesionalebTan erToblivi saqmianoba da maTi rolis gacnobiereba;

• praqtikaze da Temze dafuZnebul informaciis mniSvnelobis gacnobiereba praqtikis xarisxis uzrunvelyofisaTvis;

• individebisa da Temis saWiroebebis SesabamisobaSi moyvana.


• pacientis, rogorc bio-fsiqo-socialuri mTlianobis gageba; • holistikuri gagebis praqtikul ganzomilebebSi transformaciis unar-Cveva; • samedicino daxmarebasTan mimarTebaSi pacientis kulturuli da egzistencialuri safuZvlebis codna;

• tolerantoba da pacientis gamocdilebis, rwmenis, faseulobebisa da molodinebis gageba, rasac SeuZlia gavlena moaxdinos momsaxurebis miwodebaze.

treningis am nawilis maxasiaTeblebi SeiZleba iqnes:treningis am nawilis maxasiaTeblebi SeiZleba iqnes:treningis am nawilis maxasiaTeblebi SeiZleba iqnes:treningis am nawilis maxasiaTeblebi SeiZleba iqnes:

1. konteqstualuri: 1. konteqstualuri: 1. konteqstualuri: 1. konteqstualuri:

• codna imisa, Tu ra gavlenas axdens mTlianad samuSaos moculoba mis mier konkretuli pacientisTvis gaweul samedicino daxmarebis xarisxze;

• gageba imisa, Tu ra gavlenas axdens eqimis sacxovrebeli da samuSao pirobebi mis mier gaweul samedicino momsaxurebis xarisxze.

2. midgomiTi:2. midgomiTi:2. midgomiTi:2. midgomiTi:

• codna imisa, ra SesaZleblobebi da faseulobebi gaaCnia eqims – eTikuri aspeqtebis identificireba klinikur praqtikaSi (prevencia/diagnozi/Terapia/cxovrebis stilze gavlenis momxdeni faqtorebi)

• sakuTari Tavis Secnoba: imisi gacnobiereba, rom sakuTari midgomebi da SegrZnebebi praqtikis mniSvnelovani ganmsazRvreli faqtorebia;

• piradi cxovrebasa da profesiul saqmianobas Soris kavSiris arsebobis gacnobiereba maT Soris saTanado balansis damyareba.

modulebis CamonaTvali, aRweriloba da daxasiaTeba:modulebis CamonaTvali, aRweriloba da daxasiaTeba:modulebis CamonaTvali, aRweriloba da daxasiaTeba:modulebis CamonaTvali, aRweriloba da daxasiaTeba:

sul dagegmilia 10 modulis ganxorcieleba, romelTa xangrZlivoba ZirTidad 4 kviras Seadgens:

1. janmrTelobisaTvis xelSewyoba da prevenciuli programebi pirvelad jandacvaSi;

2. qronikuli daavadebis marTva: a. diabeti; b. kardiovaskuluri da cerebrovaskuluri daavadebebi; g. filtvebis qronikuli daavadebebi.

3. ojaxi, rogorc zrunvis/daxmarebis erTeuli; 4. wamlis racionaluri gamowera; 5. moxucebis samedicino momsaxureba; 6. paliatiuri mzrunveloba; 7. xarisxis uzrunvelyofa; 8. Temze orientirebuli pirveladi jandacva; 9. komunikacia ,,rTul pacientebTan”; 10. samecniero kvleva.

imdenad, ramdenadac mzadebis mesame wlisaTvis rezidentebs ukve SeZenili aqvT specialobis kompetenciiT gansazRvruli ZiriTadi codna, maTi mzadebis ZiriTadi formaa intensiuri muSaoba pacientebTan saojaxo medicinis centrebSi (klinikebSi) ojaxis eqimis (maswavleblis) zedamxedvelobis qveS. muSaoba rezidenturis mesame wels standartulia da moicavs Semdeg saqmianobas:


90

1. modulis ganxorcielebis I dRe daeTmoba saerTo Sekrebas Tssu saojaxo medicinis centrSi, sadac programis direqtori an mis mier SerCeuli piri rezidentebs gaacnobs moduls da gaanawilebs mzadebis bazebze (saojaxo medicinis centrebsa da klinikebSi); amave dros rezidentebs miecemaT saerTo davaleba;

2. modulis pirvelsave dRes Tssu saojaxo medicinis centrSi Catardeba interaqtiuli prezentacia/leqcia yvela rezidentisaTvis Sesabamis Temaze (janmrTelobisaTvis xelSewyoba da prevenciuli programebi pirvelad jandacvaSi, qronikuli daavadebis marTva (diabeti, kardiovaskuluri da cerebrovaskuluri daavadebebi, filtvebis qronikuli daavadebebi), ojaxi, rogorc zrunvis/daxmarebis erTeuli, wamlis racionaluri gamowera,moxucebis samedicino momsaxureba, paliatiuri mzrunveloba, xarisxis uzrunvelyofa, Temze orientirebuli pirveladi jandacva, komunikacia ,,rTul pacientebTan”, samecniero kvleva). leqcia/prezentacia saWiroebisas SeiZleba Catardes kviraSi erTxel, romelic daeTmoba mocemuli momentisaTvis arsebul siaxleebs (daavadebaTa marTvis axal erovnuli gzamkvlevebs, klinikur protokolebs, kanonmdeblobas, jandacvis politikis sakiTxebs, siaxleebs sxva qveynebis gamocdilebidan).

3. modulis calkeuli kviris pirvel dRes rezidenti miiRebs davalebas lokaluri xelmZRvanelisagan. kviris bolo dRes pirispir Sexvedraze lokaluri xelmZRvaneli afasebs rezidentis mier gaweul samuSaos da aZlevs rekomendaciebs.

4. meore kviris bolos (saWiroebisas, ufro xSirad) rezidentebi ikribebian Tssu saojaxo medicinis centrSi, sadac diskusias moduliT gaTvaliswinebul sakiTxebze, rezidentebis miRwevebze da sirTuleebze warmarTavs Tssu saojaxo medicinis centris da/an departamentis warmomadgeneli.

5. modulis bolo dRe, saWiroebisas 2 dRe daeTmoba modulis Sefasebas, romelic moicavs rezidentis mier gaweuli samuSaos analizs da lokaluri xelmZRvanelis daskvnas. modulis bolos Tssu saojaxo medicinis centrSi tardeba Semajamebeli Sexvedra yvela rezidentTan.

III etapis modulebis ganxorcielebis adgiIII etapis modulebis ganxorcielebis adgiIII etapis modulebis ganxorcielebis adgiIII etapis modulebis ganxorcielebis adgilililili

programis es nawili ganxorcieldeba saojaxo medicinis centrebSi. TiToeuli rezidentisTvis gamoyenebul iqneba ori an sami saojaxo medicinis dawesebuleba, romlebic gansxvavebul pirobebSi muSaoben (magaliTad, soflad, SedarebiT qalaqTan an dedaqalaqTan). aRniSnulis mizania, residents mieces saSualeba iswavlos da imuSaos sxvadasxva garemoSi, momsaxurebis gansxvavebuli modelebis arsebobis pirobebSi.

programis am nawilis mimdinareobisas daigegmeba vizitebi sxva samedicino dawesebulebebSic (tubdispanseri, onkologiuri dispanseri, hospisi), agreTve daigegmeba sxvadasxva mokle kursebi rezidentis saWiroebebis gaTvaliswinebiT (mag., praqtikuli unar-Cvevebis daxvewa Tssu saojaxo medicinis centris unar-Cvevebis laboratoriaSi).

swavlebis meTodebiswavlebis meTodebiswavlebis meTodebiswavlebis meTodebi

ZiriTadi meTodi misaRebi da gamosadegi unda iyos rogorc maswavleblisaTvis, ise praqtikaSi saqmianobisaTvis; swavlebis meTodebidan am etapze ZiriTadi aqcenti ojaxis eqimis (lokaluri xelmZRvanelis) zedamxedvelobiT warmarTul klinikur saqmianobaze keTdeba da gulisxmobs rezidentis mier Catarebul konsultaciaze zedamxedvelobas. konkretuli


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miznebidan gamomdinare swavleba, agreTve moicavs sxvadasxva meTodebs: leqciebs, mcire jgufebSi diskusias, davalebebis Sesrulebas da sxva meTodebs. vizitebi klinikebSi da sxva instuticionalur dawesebulebebSi organizebuli iqneba rezidentebis saWiroebebis gaTvaliswinebiT, mas Semdeg, rac ganisazRvreba es saWiroebebi.

7. saswavlo gegma7. saswavlo gegma7. saswavlo gegma7. saswavlo gegma

rezidenturaSi mzadebis I etapirezidenturaSi mzadebis I etapirezidenturaSi mzadebis I etapirezidenturaSi mzadebis I etapi

modulimodulimodulimoduli ########

modulis dasaxelebamodulis dasaxelebamodulis dasaxelebamodulis dasaxeleba xangrZlivobaxangrZlivobaxangrZlivobaxangrZlivoba

1.1.1.1.1.1.1.1. saojaxo medicinis Sesavali kursi 3333 kvirakvirakvirakvira

1.2.1.2.1.2.1.2. komunikaciis unar-Cvevebi 4 kvira4 kvira4 kvira4 kvira

1.3.1.3.1.3.1.3. saqarTvelos jandacvis sistema 4 kvira4 kvira4 kvira4 kvira 1.4.1.4.1.4.1.4. mtkicebulebebze dafuZnebuli medicina 4 kvira4 kvira4 kvira4 kvira 1.5.1.5.1.5.1.5. samedicino eTika ojaxis eqimis saqmianobaSi 3 kvira3 kvira3 kvira3 kvira 1.6.1.6.1.6.1.6. ojaxis eqimis praqtikuli saqmianobis organizcia 4 4 4 4 kvirakvirakvirakvira 1.7.1.7.1.7.1.7. fundamenturi medicinis Tanamedrove aspeqtebi 2 kvira2 kvira2 kvira2 kvira

1.8.1.8.1.8.1.8. biosamedicino kvlevis warmoeba saojaxo medicinis sferoSi – Sesavali kursi

2 kvira2 kvira2 kvira2 kvira

rezidenturaSi mzadebis II etapirezidenturaSi mzadebis II etapirezidenturaSi mzadebis II etapirezidenturaSi mzadebis II etapi

moduli moduli moduli moduli

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2.1.2.1.2.1.2.1. Sinagani medicina 4 Tve4 Tve4 Tve4 Tve

2.2.2.2.2.2.2.2. gadaudebeli medicina da travma 3 Tve3 Tve3 Tve3 Tve

2.3.2.3.2.3.2.3. bavSvTa janmrTeloba 3 Tve3 Tve3 Tve3 Tve

2.4.2.4.2.4.2.4. qalTa janmrTeloba da sqesobrivi gziT gadamdebi daavadebebi 3 Tve3 Tve3 Tve3 Tve

2.5.2.5.2.5.2.5. fsiqikuri janmrTeloba 2 Tve2 Tve2 Tve2 Tve

2.6.2.6.2.6.2.6. eleqtiuri modulebi 3 Tve3 Tve3 Tve3 Tve

rezidenturaSi mzadebis III etaprezidenturaSi mzadebis III etaprezidenturaSi mzadebis III etaprezidenturaSi mzadebis III etapiiii

moduli moduli moduli moduli

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3.1.3.1.3.1.3.1. janmrTelobisaTvis xelSewyoba da prevenciuli programebi pirvelad jandacvaSi;

4 kvira4 kvira4 kvira4 kvira

3.2.3.2.3.2.3.2. qronikuli daavadebis marTva 4 kvira4 kvira4 kvira4 kvira

3.3.3.3.3.3.3.3. ojaxi, rogorc zrunvis/daxmarebis erTeuli; 4 kvira4 kvira4 kvira4 kvira

3.4.3.4.3.4.3.4. wamlis racionaluri gamowera; 4 kvira4 kvira4 kvira4 kvira

3.5.3.5.3.5.3.5. moxucebis samedicino momsaxureba; 4 kvira4 kvira4 kvira4 kvira

3.6.3.6.3.6.3.6. paliatiuri mzrunveloba; 4 kvira4 kvira4 kvira4 kvira

3.7.3.7.3.7.3.7. xarisxis uzrunvelyofa; 4 kvira4 kvira4 kvira4 kvira

3.8.3.8.3.8.3.8. Temze orientirebuli pirveladi jandacva; 4 kvira4 kvira4 kvira4 kvira

3.9.3.9.3.9.3.9. komunikacia ,,rTul pacientebTan”; 4 kvira4 kvira4 kvira4 kvira

3.10.3.10.3.10.3.10. samecniero kvleva. 4 kvira4 kvira4 kvira4 kvira

rezidenturis diplomissemdgomi samedicino ganatlebis programa … · 2019. 9. 17. · rezidenturis...

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