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Among the new professions, the introduction of which is in demand in the modern health system, is the profession of a bariatric and metabolic surgeon. Bariatric and metabolic surgery is a cost-effective field of medicine, with a relatively short payback period, and its development is of high social importance. Considering the positive impact on the life expectancy and quality of life of patients, the use of laparoscopic mini-gastric bypass surgery, as a more effective and reliable, as well as relatively safe method of bariatric and metabolic surgery, is an attractive investment area. The development of bariatric and metabolic surgery is of particular relevance in preventing the negative consequences of obesity for human health, in particular, in the combination of type 2 diabetes mellitus with morbid obesity. All this determines the high relevance of the development of such a new field of surgery as bariatric and metabolic surgery in the health system of the Republic of Kazakhstan and the training of bariatric and metabolic surgeons within the framework of specialization programs for medical specialists of the surgical profile.

Background Cardiovascular diseases (CVD) occupy leading positions in the mortality of the Republic of Kazakhstan (RK). In RK CVD screening is performed with 40-years of age. Objectives: to evaluate the effectiveness of screening over time. Methods We conducted a survey of 121 patients with CVD, identified on screening. Results The average age patients in survey-54.3 [95% CI: 52.64;55.96], of which 38% are men and 62%-women. Fact smoking mark 64 persons (52±8), alcohol-(37.2±11.6), family history-66 (54.5±8.1) daily physical activity-34 person (28.1±14.3). Middle systolic blood pressure (BP) is 144.3 [95% CI: 141.61;146.99] and diastolic BP 90.2 [95% CI: 89.02;91.38] mm.Hg. Most of the respondents have different degrees of obesity. The average BMI is 31.8 [95% CI: 30.93;32.67]. The average waist size is 89.1 [95% CI: 86.88;91.52], with the waist size of women over 80 cm (91.9 [89.03;94.77] and the waist size of men 86.1 [82.31; 89.89]. Mean values for total cholesterol of 5.9 [95% CI: 5.85;5.95]. To evaluate the effect of various factors on the increase in BP, we calculated the analysis of variance. According to our calculations, gender does not affect BP, however, age, BMI and waist size affect. We interviewed patients for complaints, analyzed outpatient cards, a check-up journal: chest pains or interruptions in the heart during exercise are noted by 25 people (20.7±17.5), improvement of the subjective state-29 (24±15.9), regularly receive basic therapy-59 (48.8±9.1), call the ambulance team-43 (35.5±12), are urgently hospitalized for a year-31 (25.6±15.2) and 7 person participate in the school of CVD. There is a statistically significant relationship between gender and smoking, gender and alcohol, gender and regular intake of basic therapy at a significance level of p < 0.05. Conclusions Identifying the low effectiveness of CVD screening over time requires the revision of a comprehensive training program for doctors-nurses and the public. Key messages Patients in Kazakhstan generally do not change their lifestyle after screening for a disease. The effectiveness of the screening depends on the teamwork of the doctor, nurse and patient.

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Background Employment of graduates of medical universities is one of the traditional problems of health care in the Republic of Kazakhstan (RK). The annual graduation of medical universities of RK exceeds 4500 young specialists. Despite this, as well as the positive dynamics of employment, the health care industry continues to experience a shortage of medical personnel. Methods To take effective measures to improve the employment performance of graduates of medical education organizations, to cover the shortage of medical personnel, an analysis was made of the employment of graduates of internship programs at 8 medical universities for the period from 2014-15 to 2016-17 school years Results For three years, medical schools of RK prepared 12019 people, of whom 8921 people studied under the state and 1343 under the rural grant. The total number of employed was slightly more than half of the graduates-6533, which amounted to 54.4%. At the same time, the number of those employed in urban hospitals is 1.5 times higher than the number of those employed in rural medical organizations. High percentages are persons who have continued their studies in residency/magistracy, and this figure tends to increase every year. The trend towards an increase is maintained by the free distribution index for pregnant women and people caring for children under the age of 3 years, for a total of three years it was 1,452 (12.1%) of a person. At the same time, those employed in rural health facilities are only 19.1% of those who studied under the grant and 31.5% of those who studied according to the rural quota. Conclusions Thus, the percentage of employed graduates, as well as graduates who studied under the state and rural grant, barely exceeds 50%. Even the employment of persons trained in rural quotas in rural health care facilities is only 31.5%. Universities do not fully monitor the employment of graduates, especially those who studied under a state or a rural grant. Key messages To create and implement an electronic platform with a complete database of students and graduates. To monitor employment and track the graduate’s work route; to organize employment services at universities.