The impact of virgin lands development on the organization of medical education (on the example of the Tselinograd Medical Institute, 1964 – 1965)

. The article presents the results of historical and medical research, revealing the impact of virgin and fallow lands development in Kazakhstan on the opening of a medical institute in Tselinograd in 1964. The analysis of the documents shows that the resettlement of a large number of people to the virgin land development has generated a complex of problems, primarily related to the shortage of medical workers in the Tselinny Krai. The development of the institute was slow, despite the help of the state. In general, the authors came to the conclusion that the work of state bodies on the opening of a medical institute, the creation of teaching staff and the establishment of the educational process has led to positive results. At the same time, the analysis showed that the shortage of classroom resources, understaffing of teaching staff, weak methodological base required further practical research by health and education authorities.


Introduction
The journalistic historiography dedicated to the formation and development of the Tselinograd Medical Institute is quite substantial.The issues of healthcare system development during the virgin lands campaign were studied by both foreign and Kazakhstani scholars [1][2][3][4][5][6][7][8].However, there are no special studies devoted to the analysis of the history of the emergence and formation of the Tselinograd Medical Institute.
In the 1950s, the territory of northern Kazakhstan became a place for the development of virgin and fallow lands.Future pioneers of virgin lands campaign from all the former Soviet republics started arriving in the region.The concentration of a large population on the virgin lands led to numerous problems, with environmental, socio-economic, and health-related issues at the forefront [9][10][11][12][13][14].The solution to challenging tasks involved implementing a set of measures, including the establishment of a medical institute.
On October 26, 1964, in response to the need for medical services for workers in the virgin lands, the Central Committee of the Communist Party of Kazakhstan and the Republic's Council of Ministers (in accordance with the decision of the USSR's Council of Ministers on July 31, 1964) passed a resolution to establish a medical institute in the city of Tselinograd.A plan was set for the initial admission of 300 first-year students in the 1964-1965 academic year and 100 second-year students [15].

Materials and Methods
The research is based on the principle of the historical-medical approach, which helps to establish cause-and-effect relationships, taking into account specific facts and phenomena in their movement and interrelation.Scientific objectivity has become the basic methodological principle, which makes it possible to move away from conjunctural assessments of past events and carry out an impartial analysis of the collected information.
3 Discussion of the results

Organization of the Institute's work
The state authorities of the republic, region, and city supported the young institute's staff in personnel selection, creating necessary study conditions, arranging housing for teaching staff and students, and ensuring the organized start of the first student intake.
By order of the Minister of Health of the Kazakh SSR dated December 28, 1964, Candidate of Medical Sciences S.D. Poletayev, who had previously worked as Deputy Director for Scientific Work of the Kazakh Scientific Research Institute of Tuberculosis was appointed the rector of the Tselinograd Medical Institute.Associate Professor, Candidate of Medical Sciences A.R. Rakhishev was appointed the Vice-rector of the Institute for Scientific Educational Work.Classes at the Institute began on December 22, 1964 [16].
At the time of its opening, the Institute officially had four academic buildings, with three of them partially occupied by city institutions.Only one, the former boarding school, was fully under the institute's ownership.In 1964, this 6,867 square meter building housed the following 11 departments: normal anatomy, physics, inorganic chemistry, biochemistry, foreign languages, Latin, histology, microbiology, physical education, and courses on the history of the CPSU and philosophy.The administrative apparatus of the Institute was located in the same building.Insufficient space caused serious difficulties in planning normal training sessions with students.The department teams made substantial efforts in this direction, resulting in the successful implementation of the training programs for both the first and second courses with positive results.
In 1964-1965, the recruitment plan was completed in full.The monitoring of students' progress in all departments was carried out by teachers through interviews at practical, laboratory and seminar classes.The final assessment of the students' work was the results of the winter and spring examination sessions [17].See Table 1.
At the start of the 1965-1966 academic year, the Institute's usable space had expanded with the partial release of two school buildings on Mira Street No. 49 and No. 51 by city institutions.In this regard, out of the 3 first floors in building No. 49, it was possible to accommodate 5 departments: physics, biochemistry, pathological anatomy, histology and physical education.The first three floors of building No. 51 needed reconstruction and repair.Following the renovation, the Department of Normal Anatomy partially occupied this building, and after the renovation, both the Department of Normal Anatomy and the Department of Topographic Anatomy and Operative Surgery completely relocated to this facility.The lack of sufficient space for a long time remained the main reason causing great difficulties in the deployment of full-fledged training sessions.Due to the same reason, the theoretical cycle departments and the newly established clinical departments faced challenges in initiating scientific research, despite having access to a range of modern equipment at the time.
It should be noted that the Institute's administration placed significant emphasis on ensuring the visibility of students' education.For this purpose, some departments were almost completely provided with educational and visual aids, drugs and models.Examples include the departments of normal anatomy, histology, normal and pathological physiology, and pathological anatomy.Many educational tables and diagrams were produced by the staff of these departments, which were demonstrated at lectures and practical classes.Educational museums were formed at some departments.For example, in the Museum of macropreparations at the Department of Pathological Anatomy, Biology, a significant number of preparations and models were prepared for the museum at the Department of Normal Anatomy [18].
Despite the help from the management of the Institute, some departments felt a great need to replenish equipment, primarily microscopes.So, the Department of Biology, accepting 60 students at the same time, had only 15 microscopes, the Department of Histology and Microbiology had 25 microscopes each.For this reason, practical classes at these departments were conducted in large (paired) academic groups.

Creation of departments
In 1965, the Institute had 19 departments, of which 120 people provided the educational process, which includes 71 faculty members (84 by staff) and 45 teaching and support staff (45 by staff).See Table 2 Russian female Ukrainians female As can be seen from Table No. 2, the number of Kazakhs among the teaching staff was 12 people (including 2 women), Russians -34 people, Ukrainians -10 people, others -12 people [19].
More than half of the total number of teaching staff were members and candidates for members of the CPSU and members of the Komsomol (38 people in total), non-party 30 people.See Table 3 Accordingly, most of the teaching staff had less than 5 years of experience at the university, with 44 individuals falling into this category, while 24 people had over 5 years E3S Web of Conferences 462, 03050 (2023) AFE-2023 https://doi.org/10.1051/e3sconf/202346203050 of experience.Many of the assistants and teachers in the departments were young workers who, understandably, lack sufficient experience in both teaching and research.
For this reason, at the departments of the Institute, along with the training of students, a lot of work was done to improve the pedagogical skills of the teaching staff.Heads of departments and associate professors conducted demonstration practical classes with the participation of young assistants.At the department meetings, the methods of conducting classes were described in detail and methodological developments for each lesson were compiled in accordance with the program.
In February 1965, 100 people were transferred from Alma-Ata, Karaganda, Semipalatinsk and other medical institutes to the second course of Tselinograd State Medical Institute.In connection with the beginning of classes in the second year, the following departments were organized: histology (Associate Professor F.S. Balakin), normal physiology (Associate Professor R.D. Kolesinskaya), Philosophy (Candidate of Legal Sciences N.S.Gagarin), Microbiology (Candidate of Medical Sciences V.A. Feinschmidt), Biochemistry (associate professor V.K. Zakharova) [20].
By the order of the Ministry of Health of the Kazakh SSR dated June 22, 1965, the composition of the Academic Council of the Institute was approved, the functions of which were previously performed by the interdepartmental meeting.On July 13, 1965, the first meeting of the Academic Council was held, at which heads, associate professors, senior lectures, assistants of functioning departments were elected.
In the formation and development of the young institute, in the training of its scientific and pedagogical staff, the leading medical universities of the country provided great assistance.For instance, medical institutes in Moscow, Leningrad, Kiev, Alma-Ata, Saratov, Kemerovo, Kursk, Novosibirsk, and the Military Medical Academy named after S.M. Kirov contributed essential equipment for outfitting laboratories and offices, along with a substantial collection of medical literature to augment the Institute's library.
After some time, the Academic Council of the Institute awarded the first scientists the titles of professors: V.R. Feitelberg-Blank, V.M. Udod, E.V. Gurova is the head of the Department of Normal Physiology. In

Educational process
Just as large factories consist of separate workshops united by a single factory-wide rule, so the medical institute consisted of separate departments, each of which had its own specific tasks related to the education and consistent training of students.The department is an independent educational and scientific foundation, which is the main structural and organizational unit of the institute and unites teachers of one or more closely related scientific disciplines included in the curriculum for study.
During the first years of its existence, 39 departments worked fruitfully at the Institute.In the first two courses, these are only theoretical departments, and since the third year, students have been trained on the basis of clinical departments, i.e. in hospitals, at the bedside of patient.
A large share in the doctor's education system was occupied by disciplines taught at the departments of medical and biological profile: biology, normal and pathological anatomy, normal and pathological physiology with a course in biophysics; histology, microbiology with virology, topographic anatomy and operative surgery, pharmacology.All these departments taught disciplines that are theoretical basement of medical education.
The departments of therapeutic profile contributed to the formation of clinical thinking among students, taught to identify the causes and mechanism of development of the main, most common diseases, as well as their manifestation, diagnosis, prevention and treatment.It was not possible to study such a large amount of material for one year.Therefore, students received the basic, solid foundation of knowledge on internal diseases in three senior courses.Three departments were engaged in this: Propaedeutics of internal diseases (3rd year), faculty therapy (4th year) and hospital therapy (5th year).The same group of departments could include the Department of Radiology, Tuberculosis, infectious Diseases, skin and venereal Diseases, psychiatry.The clinical departments of this group were located mainly on the bases of city and regional hospitals, they had quite modern equipment for that time and equipment for the diagnosis and treatment of patients, and were also adapted to conduct training sessions with students [20].
Those diseases for the treatment of which surgical methods had to be used were studied at the departments of surgical profile.These included, first of all, the Department of General Surgery (Head -Doctor of Medical Sciences, Prof. B.M. Udod), Department of Faculty Surgery (Head Doctor of Medical Sciences, Prof. Yu.A. Volokh) and the Department of Hospital Surgery.The same group of departments included: Departments of Neuropathology, Neurosurgery (head -Doctor of Medical Sciences, Prof. A.V. Chevalier), obstetrics and gynecology, ear-throat-nose diseases, eye diseases, traumatology and orthopedics, docent course of urology.These departments were located on the basis of hospitals, in which a large volume of complex surgical operations was performed annually.The clinical departments carried out a lot of work to improve surgical and specialized services not only in the Tselinograd region, but also in other regions of Northern Kazakhstan.The departments were equipped with modern equipment, and the Department of Faculty Surgery had an internal television system that allowed 200 students to simultaneously show the operation that was currently being performed in the operating room in the lecture hall.
In his practical work, a doctor always has to solve a wide variety of issues related to expert activities, hygiene issues, healthcare organization, and the treatment of not only adult In the sixth year, students specialized in subordination, i.e. they studied in depth one of the main medical specialties (therapy, surgery, obstetrics and gynecology) [20].
In the medical education system, much attention was paid to practical skills.Along with performing various laboratory work and medical manipulations in the course of practical training, in the summer after the 3rd, 4th, 5th courses, students had a practical training in hospitals of the city and region for 4-6 weeks.
After passing the state exams, graduates received a diploma and a badge (on a diamond of scarlet blood, a gilded snake is a symbol of the wisdom of a doctor).
Graduates of the Institute were assigned to work in rural local and district hospitals of the virgin land regions of Kazakhstan.During the first year of medical activity, young specialists improved their knowledge of their chosen specialty in clinical or large regional and city hospitals.This year of specialization was called internship.After completing the internship, doctors were assigned to work in those local or district hospitals where they received a referral.Thus, the full cycle of study at the institute was coming to an end.

Conclusion
The analysis of the available materials indicates that since the mid-1960s, the issue of providing workers of virgin lands with medical care has become acute in the republic, which in turn has actualized the problem with medical personnel.In this regard, the state authorities of the republic decided to open the Tselinograd Medical Institute in 1964.It can be stated that the Institute's initial challenges related to opening, staffing, and student recruitment were resolved within the first months of its operation.At the same time, the analysis revealed that additional efforts were needed to enhance the institution's material and technical resources and improve the educational and methodological support for various disciplines to ensure a fully functional educational process.

E3S
Web of Conferences 462, 03050 (2023) AFE-2023 https://doi.org/10.1051/e3sconf/202346203050patients, but also children.Students received appropriate training in the course of their studies at the Department of Forensic Medicine, Departments of hygienic profile and children's diseases.

Table 1 .
Results of the session.

Table 2 .
. Characteristics of the teaching staff of the Institute.

Table 3 .
. Party affiliation of the teaching staff.The data on the age composition are of interest (TableNo.4).The majority of teachers, totaling 56 individuals, were between 30 and 40 years old, with only 12 people aged 41 and older.

Table 4 .
The age composition of the teaching staff.