Introduction. The medical education system requires modernization and adaptation to the needs of modern society. The dissatisfaction of the population with the low professional competence of doctors at the rising cost of medical services requires new principles for tuning the educational system of medical workers. The topical question is whether the medical education system should be changed with the account of not only teachers’ vision but students’ requests as well. The purpose of the article is to reveal the perceptions of students of medical universities in Russia about quality medical education, to identify the attitudes to the existing forms and methods of learning, expectations from the a dministration and teaching staff. Materials and Methods. The research design is based on a combination of quantitative and qualitative methods. A survey of 3 249 students representing 45 universities subordinate to the Ministry of Healthcare of Russia was conducted. To increase the reliability of the results and the interpretation of quantitative data at the second stage, the interviews with students, clinical residents and graduate students of medical institutions of higher learning were conducted. Results. The article defines the dependence of assessing the quality of education on attitudes toward academic mobility: the higher students evaluate the experience of participating in academic mobility, the higher they assess the quality of Russian medical education. Russian medical education, possessing institutional autonomy, which allows for modernization of the content and methods of implementing educational programs, comes across restrictions caused by oversupply of students to the universities in the situation of undersupply of facilities, and the underdevelopment of norms regulating the participation of medical students in medical activities. Discussion and Conclusion. The results can be used by university leadership in determining the directions of development of educational activities with a focus on student-centered learning in order to increase students’ motivation and commitment to quality education.

Aim. To assess the effects of acquired social status, neurotic conditions, type D personality, cognitive functions, quality of life and adherence to treatment on psychosocial adaptation of patients with coronary heart disease (IHD) to chronic heart failure (CHF), depending on the severity of decompensation. Methods. 87 patients with coronary artery disease and chronic heart failure aged between 55 and 72 years were examined. All patients were divided into two groups depending on the functional class of chronic heart failure [New York Heart Association (NYHA) class IIV]. The first group included 41 patients with NYHA functional class III, the second group 46 patients with NYHA functional class IIIIV. For a comprehensive study of the psychosocial adaptation of patients, a set of standardized questionnaires was used: the abridged variant of the Minnesota Multiphasic Personality Inventory (SMOL), a clinical questionnaire for identifying and assessing neurotic condition, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), the 36-Item Short Form Health Survey Questionnaire (SF-36), the Mini Mental State Examination (MMSE), 14-question test Type D Scale-14 (DS14), MoriskyGreen test, the short version of the AUDIT questionnaire (AUDIT-C). We collected data on the patient's social status: gender, education, income level. The results obtained were analyzed. Results. Based on the SMOL personality profiles, patients of the second group were classified as neurotic an increase was noted in three neurotic scales: hypochondria (U=541; p=0.030), hysteria (U=579; p=0.048), and autism/schizoid (U=577.5; p=0.047) compared with patients of the first group. According to the results of the clinical questionnaire for the identification and assessment of neurotic condition, the greatest differences were found between patients of first and second groups on the scale of autonomic disorders (U=571; p=0.039) and neurotic depression (U=576; p=0.046). Comparing the groups according to the MLHFQ score, quality of life in patients of the second group was markedly reduced (U=447.5; p 0.001). According to the SF-36 questionnaire, a decrease in the quality of life was also found in patients of the second group on the scale Physical functioning (U=554; p=0.032) and Physical component of health (U=573.5; p=0.044). The cognitive status in patients of the second group was significantly decreased compared with the first group (U=427; p 0.001). No significant differences were found in adherence to treatment between the two groups (U=757; p=0.666). Also, there were no patients with type D personality on both subscales (U=717.5; p=0.483, U=784; p=0.933) and according to the AUDIT-C scores, there are no significant differences between men (U=681.5; p=0.257) and women (U=728.5; p=0.425) in both groups of patients. Conclusion. Signs of social maladjustment in patients with more severe NYHA functional class of the disease are expressed by significantly more pronounced social isolation (autism), a tendency to avoid communicating with others, isolation on their own problems and hypochondriacal attention to the somatic manifestations of chronic heart failure; probably, the main reason that reduces the level of social adaptation is a high score in neuroticism, which leads to a functional decrease in cognitive abilities and a significant deterioration in quality of life.

The article provides information on particular issues of treatment of mental disorders. An analysis was made of the issues of therapeutic resistance and compliance among mental patients, which play an important role in possible discrepancies between the results of randomized placebo-controlled trials and the use of psychotropic drugs in routine clinical practice. The main aspects of clinical pharmacology are presented in an accessible form, which determine the complexity and at the same time professionalism in the practice of a psychiatrist. Grouped and deciphered are the factors that have a direct impact on the therapeutic response of the drug, including the primary pharmacological properties of the drug, nosological, general biological, social, subjective-psychological factors.