On the 55^th anniversary of the Faculty of pediatrics of Yaroslavl State Medical University (Institute of Pediatrics and Reproductive Health since 2025)

Introduction

The protection of motherhood and childhood, along with safeguarding children's health, interests, and rights, constitutes a strategic priority of the state's social policy in our country. Childhood is the most dynamic and vulnerable stage of ontogeny, critically influencing an individual's somatic, psychoemotional, functional, and intellectual development and health in subsequent periods of life. Many adult diseases have their origins in childhood. Consequently, the national healthcare system places significant emphasis on the sector of pediatric medicine.

The effectiveness of child healthcare is ensured not only by the material and technical condition of modern pediatric treatment, preventive, and social institutions, the advancement of pediatric science, and state support for maternal and child health, but also by the existence of specialized higher medical education in pediatrics. This refers to the concept of training pediatricians through specialized pediatric faculties. For a student of a pediatric faculty (or institute), "pediatrics is not an adjunct to a core general medical education, but from the outset becomes the primary objective of their education, their worldview, their life philosophy, and their official designation as stated in their higher education diploma" [1, 2].

In Russia, this concept has been implemented since the 1920s-1930s. In 1925, the world's first specialized pediatric higher education institution was established – the Leningrad Medical Pediatric Institute (now the St. Petersburg State Pediatric Medical University of the Ministry of Health of the Russian Federation). In 1930, the first Faculty for the Protection of Motherhood, Infancy, and Childhood in our country was founded at the Second Moscow Pirogov Medical Institute. Since 1936, this faculty has been known as the Pediatric Faculty, and today it is the Institute of Motherhood and Childhood of the Pirogov Russian National Research Medical University (RNRMU).

Currently, higher medical education in pediatrics (specialty "Pediatrics" code 31.05.02 – specialist degree level) can be obtained at 69 medical universities across Russia. The Pediatric Faculty at the Yaroslavl Medical Institute (now Yaroslavl State Medical University – YSMU) was established in 1970 in accordance with:

• Decree of the Council of Ministers of the RSFSR No. 536 of September 10, 1970, "On Further Improvement of Child Health Protection in the RSFSR" (Clause 5: The Ministry of Health of the RSFSR shall ensure the organization, in the prescribed manner, of pediatric faculties at the Orenburg, Perm, Chelyabinsk, and Yaroslavl State Medical Institutes in 1970-1972);

• Order No. 153 of the Ministry of Health of the RSFSR dated June 19, 1970.

In 2025, the faculty was reorganized into the Institute of Pediatrics and Reproductive Health.

Formation and Development of General Medical and Pediatric Education in Russia

Until the 17th century, there was no formal medical education in Russia. The influx of medical personnel was sustained through the recruitment of foreign physicians.

The first medical schools emerged in the 17th century and were associated with the military departments of the time. An example is the bone-setting school opened in 1653 under the Streltsy Prikaz (Streltsy Department), where bone-setters were trained for one year. Almost simultaneously, in 1654, a medical school was established under the Apothecary Prikaz (Apothecary Department), which trained physicians over a five-year period. From 1669, the Apothecary Prikaz began conferring the degree of Doctor of Medicine upon its graduate physicians.

In the 18th century, by decree of Emperor Peter I in 1706, the first state medical institution was opened in Moscow – the Land Hospital (now the N.N. Burdenko Main Military Clinical Hospital of the Ministry of Defense of the Russian Federation). Accompanying it in 1707 was Russia's first hospital-based medico-surgical school for 50 students, training personnel for the army and navy. It was headed by the Dutch Doctor of Medicine, Peter I's court physician, Nicholas Bidloo (1670-1733). During Peter I's reign, 10 hospitals and over 500 infirmaries were established.

Subsequently, hospital schools were organized at other major hospitals. In Moscow and St. Petersburg, they later transformed first into medico-surgical colleges and then into Medico-Surgical Academies. For instance, the Imperial Medico-Surgical Academy in St. Petersburg was established in 1798 through the transformation of a pre-existing medico-surgical college. From 1881, it became known as the Military Medical Academy (now the S.M. Kirov Military Medical Academy of the Ministry of Defense of the Russian Federation).

On April 26 (May 7), 1755, by decree of Empress Elizabeth Petrovna, Moscow University was founded, with one of its three initial faculties being the Medical Faculty (alongside Philosophy and Law). M.V. Lomonosov, describing the Medical Faculty, stated that it "...is engaged in consideration of human health and life. In it, practical and theoretical medicine, chemistry, botany, anatomy, and surgery are taught, and such individuals from among native subjects are produced who, as physicians and doctors, can assist their fellow citizens, care for their health, and thus contribute to the common good in countless instances." The successor to the Medical Faculty of Moscow University is today the I.M. Sechenov First Moscow State Medical University.

Regarding secondary medical education, it was only on April 16 (28), 1838, that the "Regulation on Military Feldsher Schools" was issued, laying the foundations for systematic feldsher education in Russia. Feldsher schools played a particularly important role during the development of zemstvo (local district) medicine in Russia.

The first elements of pediatric medical education appeared in the curricula of midwifery schools organized within the Moscow and St. Petersburg Foundling Homes. The initiator of establishing these Foundling Homes in Moscow (1764) and St. Petersburg (1770) – charitable educational and custodial institutions for "the reception and care of foundlings and homeless children" – was Ivan Ivanovich Betskoy, the personal secretary of Empress Catherine II.

In 1801, the Midwifery Institute (now the D.O. Ott Research Institute of Obstetrics, Gynecology, and Reproductology) was opened at the Moscow Imperial Foundling Home – the first maternity and educational institution in Russia for training midwives from among the most capable pupils. An obstetrics school was established at the St. Petersburg Foundling Home in 1784. One of the founders of Russian obstetrics, Nestor Maksimovich Maksimovich-Ambodik (1744-1812), taught there. He authored the first domestic manual on obstetrics, "The Art of Midwifery, or the Science of the Woman's Business" (1786), which included a section (Part 5) on child care from birth to adolescence.

In Europe, by this time, the "Guide to the Knowledge and Treatment of Infant Diseases" by Nils Rosén von Rosenstein (1706-1773) had already been prepared and published in 1764. This work included 28 chapters on various branches of pediatrics. It was translated into Russian and published in Moscow only 30 years later, in 1794 [3].

The founder of practical pediatrics (the St. Petersburg Pediatric School) is recognized as Stepan Fomich Khotovitsky (1796-1885), to whom the first domestic comprehensive work on pediatrics, "Pediatrics" (1847), is attributed. He wrote: "...a child is a being that grows and develops only according to its own inherent laws. A child is not a miniature copy of an adult." He was the first to separate a children's department from an obstetrics clinic. In 1836, S.F. Khotovitsky began delivering a full course of lectures on pediatrics (36 lectures), including the anatomical and physiological peculiarities of the child's organism, diseases of children of all ages, and acute childhood infections. He defined the goals and objectives of pediatrics as an independent branch of medicine and developed the first curriculum on childhood diseases.

However, the full-fledged development of pediatric education and the first pediatric schools, where physicians intended specifically for providing medical care to children were trained, is associated with the opening of the first children's hospitals and the first well-baby clinics. The world's first children's hospital opened in Paris in 1802, and the first in Russia (also the second in the world) opened in St. Petersburg in 1834. The first children's hospital in Moscow opened in 1844. Well-baby clinics for infants opened much later – in 1903 in Paris and in 1908 in Moscow on the initiative of Professor Georgy Nestorovich Speransky (1873-1969). At this time, special attention in the training of future pediatricians was paid to issues of child nutrition and the analysis of the causes and nature of various childhood diseases.

The first Department of Pediatrics in St. Petersburg was organized in 1865 at the Imperial Medico-Surgical Academy, where a systematic course of lectures on pediatrics was delivered by Adjunct Professor of Obstetrics, Vasily Markovich Florinsky (1841-1906). From 1870, the department was headed by Nikolai Ivanovich Bystrov, who in 1885 organized the Society of Pediatricians of St. Petersburg.

In Moscow, a course of lectures on pediatrics from 1861 was delivered by Professor of Obstetrics Nikolai Alekseevich Tolsky (1830-1891) within the Faculty Therapeutic Clinic of the Medical Faculty of Moscow University. He created a small pediatric clinic (with 11 beds), and five years later, on the basis of this clinic, he managed to open the first Department of Pediatrics in Moscow, almost simultaneously with St. Petersburg.

The first Russian pediatricians – Nils Fedorovich Filatov (1847-1902), Karl Andreevich Rauchfus (1835-1915), Nikolai Petrovich Gundobin (1860-1908), Alexander Nikolaevich Shkarin (1876-1921), Alexander Andreevich Kisel (1859-1931), Vladimir Ivanovich Molchanov (1868-1959), Mikhail Stepanovich Maslov (1885-1961), and others – laid the foundation for practical and scientific pediatrics (the study of the child) and established the structure of child healthcare.

In the 20th century, active reform of medical, and particularly pediatric, education unfolded in our country after 1917. In the 1920s-1930s, many medical faculties of universities were transformed into independent medical institutes. Their clinical departments invariably included a Department of Pediatrics (or "Childhood Diseases"). Since 1925, postgraduate clinical training (aspirantura and ordinatura) in pediatrics, among other disciplines, was introduced in medical institutes.

During those years, infant, child, and maternal morbidity and mortality rates in Russia remained high. In December 1917, a board was created under the Commissariat of Social Security to "carry out urgent measures for the protection and support of motherhood as a fundamental social function of women and for the protection of infancy as a direct state obligation." The first People's Commissar of Health, Nikolai Alexandrovich Semashko, stated in 1926: "We must seize with both hands the most crucial link – the protection of motherhood and infancy – and then we will pull the entire network and improve the health of the entire population." In January 1918, all institutions serving children were transferred to the jurisdiction of the "Department for the Protection of Motherhood and Childhood," and a decree on combating child mortality was issued. In Yaroslavl, the Board for the Protection of Motherhood and Infancy under the Social Insurance Department was established in October 1918 [4].

Thus, based on the principle of state support and interest, a unique system of child healthcare was created in our country, pediatric science developed, and pediatric education was refined.

Medical Faculty of Yaroslavl State University (1919-1924)

Thus, by a decree of the Council of People's Commissars of the RSFSR, Yaroslavl State University was established in Yaroslavl through the transformation of the Demidov Law Lyceum, which had existed under various names since 1803. In 1919, a Medical Faculty was opened at the University, operating until 1924 with a five-year program.

The establishment of the Medical Faculty at Yaroslavl University occurred during the most difficult period of the Civil War. Yaroslavl had not yet recovered from the consequences of the 1918 uprising, during which the city, including University buildings, was practically destroyed. At that time, the entire Yaroslavl University was housed in a single building. Epidemics (typhus, smallpox) were rampant. There was a shortage of teaching staff, support personnel, and equipment for laboratories and classrooms. Professors from Moscow and St. Petersburg medical universities were invited to deliver lectures and head departments. In particular, lectures on pediatrics and general pathology were given by Professor Vasily Pavlovich Zhukovsky (St. Petersburg Medico-Surgical Academy), a student of Professor N.I. Bystrov. The conditions and resources for adequately maintaining medical faculties were clearly insufficient.

Furthermore, after the Civil War and the demobilization of Red Army soldiers, some provinces even experienced a surplus of doctors. The question of closing some universities and/or medical faculties arose. On April 29, 1924, following a preliminary analysis of academic activities, material base, student body, and teaching staff, the Board of the People's Commissariat for Education of the RSFSR decided to close the medical faculties of the Crimean, Nizhny Novgorod, Samara, Ural, and Yaroslavl Universities. By a decree of the Council of People's Commissars of the RSFSR dated August 8, 1924, "On Changes in the Network of Higher Educational Institutions," prompted by funding shortages, Yaroslavl State University was closed, with its Pedagogical Faculty transformed into the Yaroslavl Pedagogical Institute as of October 1, 1924. Eighty-eight students who graduated from the Medical Faculty in 1924 received the title of physician. Most of them subsequently worked in medical institutions of Yaroslavl Province. Those who had not completed their studies were transferred to other universities [5, 6].

The Faculty of Pediatrics of Yaroslavl State Medical University (Institute of Pediatrics and Reproductive Health since 2025)

The Pediatric Faculty at the Yaroslavl Medical Institute (now Yaroslavl State Medical University – YSMU) was established in 1970 in accordance with:

• Decree of the Council of Ministers of the RSFSR No. 536 of September 10, 1970, "On Further Improvement of Child Health Protection in the RSFSR" (Clause 5);

• Order No. 153 of the Ministry of Health of the RSFSR dated June 19, 1970.

In 2025, the faculty was reorganized into the Institute of Pediatrics and Reproductive Health (see figure).

Fig. The Institute of Pediatrics and Reproductive Health was established at Yaroslavl State Medical University (2025)

Since the opening of the Yaroslavl Medical Institute in 1944 (following the re-evacuation of the Belarusian Medical Institute), a Department of Childhood Diseases had been functioning, headed until 1952 by Professor Esfir Markovna Kaplan, who was invited from the First Moscow Medical Institute. From 1952, the department was led by Honored Scientist, Professor Alexandra Ivanovna Titova. It was from this pediatric school of Alexandra Ivanovna Titova that the teaching staff of the Pediatric Faculty was largely formed in its early years [7].

A special role in the establishment of the faculty belongs to Professor V.D. Surkov. In 1974, the Department of Faculty Pediatrics with a course in Propaedeutics, the Department of Hospital Pediatrics, the Department of Surgical Diseases, and the Department of Internal Medicine began functioning at the faculty. In September 1975, the Department of Pediatric Surgery and the Department of Childhood Infections were created. A significant role in the future development of the faculty belongs to its staff who dedicated themselves to medical-pedagogical activities.

In 2019, a reorganization of the pediatric departments was carried out. As a result of structural transformations, the number of teaching staff at the Pediatric Faculty increased significantly. The Departments of Hospital Pediatrics and Faculty Pediatrics with Propaedeutics of Childhood Diseases were substantially reformed. Their merger resulted in the formation of the Department of Pediatrics No. 1. The Department of Childhood Diseases of the Medical Faculty was renamed the Department of Pediatrics No. 2 and began participating in teaching. Furthermore, the Department of Pediatrics of the Institute of Continuing Professional Education (INPO) became a graduating department for students.

The organizational work of the faculty was carried out by the Dean's Office. Over the years, the deans were Associate Professor Anatoly Dmitrievich Khrustalev, Associate Professor Yuri Alexandrovich Burov, Associate Professor Leonid Fedorovich Shmonin, and, from 2018, Associate Professor Evgeny Stanislavovich Uglov.

In 2024, in the run-up to the anniversary of the Pediatric Faculty, preparations began for its reorganization into the Institute of Pediatrics and Reproductive Health of Yaroslavl State Medical University. The Dean's Office was reorganized into the Directorate of the Institute. The Director of the Institute became Associate Professor Evgeny Stanislavovich Uglov. The Directorate formed three departments: for Medical Activity and Mentoring, Academic Affairs, and Scientific Work.

The main functions of the Directorate are organizing the educational process for the "Pediatrics" specialty and developing the scientific base of the profile departments. Currently, students of the Institute are trained at 44 departments of the university. The number of specialized departments has increased. Thus, the specialized departments now include 11 chairs, aimed not only at teaching but also at developing scientific potential at the Russian and international level.

As of September 1, 2025, the student body of the Institute comprises 950 students, the largest number in recent decades.

In accordance with the University Charter, the governing body of the Institute is its Academic Council, chaired by the Director. The Council plans the Institute's work and is focused on improving the quality management system of the educational, scientific, and educational processes at the Institute.

The Directorate monitors the work of the departments related to the main activities of the university. In recent years, emphasis has been placed on improving knowledge assessment, introducing active and interactive teaching methods, and publishing educational materials. Since 2010, unified principles of rating assessment for student academic achievement have been introduced. The faculty's educational program in pediatrics was included in the "Best Educational Programs of Innovative Russia" in 2013 and 2014.

Teaching for the first three years is conducted mainly in seven university buildings. Senior students study at clinical bases. To improve practical training, the multi-profile accreditation and simulation center "SimClinic" was created, where students develop and refine practical skills from the first year. Great attention is paid to students' research work. Representatives of the Institute regularly win prizes at all-Russian inter-university student scientific conferences and Olympiads. Since 2020, the Institute has been conducting the annual All-Russian Student Olympiad in Pediatrics and Neonatology.

In recent years, the conclusions of the State Examination Commission (SEC) have reflected that the professional training and ethical-cultural level of graduates meet modern requirements. Since 2011, a rating system for assessment has been used in the SEC, which is unique in Russia [8, 9]. Employers show great interest in the Institute's graduates. A survey conducted by the University's Department of Education Quality and Innovations indicated high satisfaction with the competencies of the Institute's graduates. The Institute's significant contribution to staffing medical institutions in Yaroslavl, Vologda, and Kostroma regions is also evident.

Over the years of its existence, the Institute has trained over 7,500 pediatricians. Many university teachers are also graduates of the Pediatric Faculty.

Conditions have been created at the Institute for enhancing the cultural and ethical level of students, their harmonious comprehensive development, and socially responsible and patriotic education. Students are actively involved in extracurricular activities. A spirit of patriotism has always been present at the Pediatric Faculty, and students and graduates are distinguished by their active civic stance.

Thus, the 55-year experience of the Pediatric Faculty demonstrates that the content, level, and quality of training in the "Pediatrics" specialty comply with the requirements of the federal state educational standard. The reorganization of the faculty into the Institute of Pediatrics and Reproductive Health opens a new chapter of strategic development opportunities for what is currently the largest institute of Yaroslavl State Medical University. The Institute possesses a strong teaching staff with good prospects for professional development through the increase in specialized departments and inter-departmental collaboration. Graduates of the Institute are in demand in the healthcare job market and worthily represent Yaroslavl State Medical University across the entire territory of the Russian Federation.