ВСТУПЛЕНИЕ 19 страница

Упражнение 13. Вы участвуете в конференции «Медицинское образование в США».

а) Четыре студента вашей группы подготовили доклады по следующим темам:

1. The selection of students to a medical school. 2. Pre-medical and medical subjects studied at medical schools. 3. The work of a resident. 4. The work of young doctors after residency.

б) Прослушайте доклады и задайте вопрос каждому выступающему.

HEALTH CARE IN THE USA

Упражнение 1.Прослушайте и повторите за диктором (преподавателем)

следующие слова. Обратите внимание на ударения.

»

society [ss'saiati], physician [fi'zijn], relationship [ri 'leijnfip], staff [sta:f], trauma [Чгэ:тэ], insurance [in'Juarsns], atherosclerosis [, aeOsrssklia 'rousis]

Упражнение 2. Прочтите и переведите следующие словосочетания.

in case, government-financed hospitals, intensive сатеunit, health insurance, place of employment, maternal and child health care, retire­ment benefits

Упражнение 3. Прочтите следующий ряд слов. Выпишите слова, относящиеся к теме «Медицинское обслуживание».

medical, health, need, patient, gradually, hospital, program, illness, disease, week, nausea, importance, death, chief, forget, disability, preg­nancy, arthritis, cancer, opinion, emphysema, chronic bronchitis

Упражнение 4. Прочтите и переведите текст. ^{1 1 1} ^

j

Health Care System in the USA

The second meeting of Dr. Nelson and his colleagues with the Pro­fessors and students of the Medical Faculty of the Moscow Medical Academy was devoted to problems of medical service in the USA.

Dr. Nelson: Dear colleagues, it is a great pleasure for all of us to meet you again,. Today we'll speak about medical service in our country.

As for the health care system in my country, it exists on three levels: the level of the family doctor, the medical institution or hospital and the United States Public Health Service.

Dr. Kruglov: Do many Americans seek medical help from private doctors?

Dr. Haddow: Not many, I should say. A private doctor, we call him a family doctor, gives his patients regular examinations and inoculations. In case professional care is needed, the family doctor arranges for the patient to see a specialist or to go to a hospital. The family doctor receives pay directly from the patient. Most physicians have private practices. They make use of the hospital's facilities whenever necessary. >A family doctor either has his own private office or works with several other doctors in a so-called group practice.

Sasha Nikiforov: Dr. Haddow, what is characteristic of American hospitals? Do all patients pay for their treatment at hospitals?

Dr. Haddow: I should like to point out first that many Americans have no family doctor and they come directly to the hospital for all their medical needs. The hospital provides health care to the sick and injured. We have government-financed and private hospitals. The patients are admitted to hospitals or clinics staffed by consulting physicians, residents, interns and highly skilled nurses. The nursing staff is very important. Nurses and patients are in close contact throughout the patients' stay in the hospital. Social services are available to the patients and families regarding personal, emotional, and financial problems that may arise from continued illness or disabilities.

Most hospitals have at least the following major departments or units: suqjery, obstetrics and gynaecology, pediatrics and general medicine. They may also have trauma and intensive care units, neurosurgical and renal care units, and a psychiatric unit. The Emergency Room (unit) is a very special area in the hospital. The emergency patients receive immediate attention.

Dr. Nelson: Let's not forget about the high cost of medical care in our country. Two thirds of the population have private health insurance. Some people have health insurance, life insurance (financial assistance for the relatives in case of death), disability insurance and retirement benefits at their place of employment. fcMost employees and their fam­ilies now pay more than 50 per cent of the costs of health insurance. The great cost of medical care in the country and the great number of people who could not pay for it forced the federal government to devel­
op two health insurance programs — Medicaid and Medicare. Medic­aid, started in 1966, is a federal program providing free medical care for low-income people, the aged, the blind and for dependent children.

t)ean of the Faculty:Dr. Kendall, I've read that Medicare is a health insurance program for the elderly and disabled. What age group does the Medicare program provide for?⁴

Dr. Kendall:Medicare, started in 1967, is a federal program providing free medical care for aged Americans over 65, for those who in the past Ijad the greatest medical expenses.

Dr. Kruglov:Dr. Nelson, what are the scientific problems facing American medicine?

Dr. Nelson: Well, in my opinion, the chief scientific problems facing American medicine are the same as those facing Russian medicine, they are heart disease and cancer. The chief causes of suffering and death today are cancer and cardiovascular diseases, including hypertension, jstroke and atherosclerosis. |Also much medical research is done on /illnesses of aging, disabilities caused by arthritis, mental illness, drug addiction, and genetic problems.

The Dean of the Faculty: Dear colleagues, you've given us a clear picture of the American health care system. We all want to thank you and wish you the best of luck in your woi^c.

Active Words and Word Combinations

private doctorчастныйврачto inoculateделатьпрививкуinoculationпрививкаconsulting physicianврач-

консультантdisabilityнетрудоспособность,

инвалидностиthe disabledинвалидыretirement benefitsпенсионные

выплаты emergencyunitотделение

неотложной помощи theinjuredпострадавшие,

раненые theblindнезрячие, слепые Medicareправительственная

предусматривающая частичную оплату

медицинского обслуживанияJпрестарелым за счет

программа, обеспечивающая | бесплатное медицинское | обслуживание беднякам и jинвалидам f

dependent children

несовершеннолетниедети

the aged (syn. the elderly)

пожилые, старые люди

strokeинсульт

mentaldiseasesпсихические 'drugaddictionпристрастие к

заболевания наркотикам, наркомания

Упражнение 5. Задайте вопросы, ответами на которые будут следующие предложения.

Model: A family physician provides health care for the entire family. Who provides health care for the entire family?

1. Cigarette smoking is the leading preventable cause of death and dis­ability in the USA. 2. Nine million people suffer from emphysema and chronic bronchitis because of smoking. 3. Smoking and hypertension are two major risk factors for cardiovascular disease. 4. Nausea, shortness of breath, shoulder or arm pain, or chest pain can be symptoms of a heart attack.

Упражнение 6. Ответьте на вопросы вашего товарища. Используйте в ответах слова и словосочетания, данные в скобках.

1. What kinds of hospitals are there in America? (government-fi- nanced, private hospitals) 2. Who comprises the staff of hospitals or clinics in America? (consulting physicians, residents, interns, highly skilled nurses) 3. What departments do American hospitals have? (surgery, obstetrics and gynaecology, pediatrics, general medicine, neurosurgical, a renal care unit, a psychiatric unit, an Emergency Room) 4. What is Medicaid? (a federal program, to provide free medical care, low income people, the aged, the blind, dependent children) 5. What is Medicare? (a federal program, a health insurance program, the elderly and dis­abled, to provide free medical care, aged Americans)

Упражнение 7. Расскажите вашим товарищам о работе частного врача в США. Используйтевсвоемрассказеследующиесловосочетания.

private doctor, family doctor, to give regular examinations, to ar­range for the patient to see a specialist, to make use of hospital facilities, private office, group practice

Упражнение 8. Прочтите следующие утверждения и выразите свое согласие или несогласие. Начните свои ответы со следующих фраз:Quiteso./ Ex­actly. /Yes,Ithinkthat... Или: I don't think that is correct.... I can't agree with the fact that.. . No, I don't think you are right...

1. Medicaid is a federal program, which provides free medical care for low income people, the aged, the blind and for dependent children.

2. Medicare is a federal program, which provides free medical care for aged Americans over 65. 3. Most employees and their families do not have their health insurance. 4. Many people in America have health insurance, life insurance, disability insurance and retirement benefits at their place of employment. 5. The chief scientific problems facing American medicine are heart disease and cancer.

Упражнение 9. Ведущий радиопередачи «В мире медицины» («IntheWorldofMedicine») беседует с американским врачом-гомеопатом д-ром Карлом Робинсоном. Используя приведенные ниже текст и диалог, составьте и разыграйте радиоинтервью.

Ведущий: представляет доктора Робинсона, сообщая краткие сведения о нем (см. Текст), и предлагает д-ру Робинсону ответить на вопросы радиослушателей (см. Диалог)

Доктор Робинсон: отвечает на вопросы ведущего и радиослуша­телей (см. Текст)

Text

1. Dr. К. Robinson received his B.A. from Yale University, his M.D. from Hahnemann Medical College in Philadelphia and he did his resi­dency in internal medicine in Ney York City. Then he studied home­opathy at the Royal Homeopathic] Hospital in London. Now Dr. Rob­inson practices in Albuquerque, New Mexico.

2. The word «homeopathy» is derived from the Greek language. «Ho- meo» means «like», «pathy» means «suffering». Homeopathy means «like suffering» or «like disease». Homeopathy is a scientific medical practice, which treats the whole person, that is the body, the mind and the emo­tions, which are affected when a person is sick

Homeopathy is a natural medicine. A homeopathic medicine is used to stimulate the person to heal himself. It is a system of therapy based on the law «Similia similibus curentur». In other words, homeopathy is a scientific system of medicine based on the discovery that a sub­stance can cure the same problems that it causes — usually by varying the dosage of the substance.

Homeopathic remedies are made from natural animal, vegetable or mineral sources.

Homeopathic medicines are not used to treat any particular oi^gan of the body. Side effects such as tissue destruction do not occur in home­opathy treatments.

dialogue

Interviewer. We have some questions dealing with homeopathy. The questions were sent to the National Center for Homeopathy in Washing­ton. We invited Dr. Karl Robinson to answer our listeners' questions. Now I'll introduce Dr. K. Robinson to you...

And now, Dr. Robinson, would you answer the first question of our listeners: What is homeopathy?

Dr. R.:

Interviewer. Is homeopathy a scientific system of medicine or is it based more on the intuition of the practitioner?

Dr. R.:

Interviewer. What are homeopathic remedies made from?

Dr. R.:

Interviewer. Do homeopathic medicines cause side effects?

Dr. R. :

Interviewer:Dr Robinson, thanks very much for your answers. With this we will end our program. Good-bye.

Упражнение 10. а) Прослушайте (прочитайте) фрагмент беседы профес­сора Андерсона со студентами Медицинского колледжа университета штата Огайо. Скажите, какие вопросы были затронуты во время этой беседы, б) Прочитайте текст выступления профессора Андерсона и найдите анг­лийские эквиваленты следующих слов и словосочетаний:

здоровье нации; общественное здоровье; личные/индивидуальные привычки; оказывать огромное воздействие; профилактическая медицина; здоровый образ жизни; главная цель; умеренная физическая нагрузка; поддерживать вес; иметь избыточный вес; курильщики; выбор образа/стиля жизни.

This is what professor Anderson said about the effect of life style and personal habits on the standards of health of a nation: «There is per­haps no more important principle in the field of public health than the realization that life style and personal habits have a great effect on the standards of health of a nation. The promotion of preventive medicine through a healthy life style is a major goal of the Federal Bureau of Health Education. Billions of dollars could be saved if the following lifelong habits were established in the US population.

1. Eat three meals a day at regular time; avoid snacks.

2. Eat breakfast every day.

3. Engage in moderate exercise at least three times a week.

4. Sleep seven or eight hours a night.

5. Don't smoke.

6. Maintain weight at or slightly below the «ideal» level. Statistics show that 40% of all Americans are 20 or more pounds

overweight and that smokers have a 70% greater chance of developing coronary heart disease than non-smokers. American physicians claim that the best way to improve the health statistics in the USA is to make people aware of the necessity of choosing a healthy life-style.

Упражнение II.Составьте 8-10 вопросов к тексту Упражнения 10 и разыграйте беседу американского профессора с российскими студентами-медиками.

Упражнение 12 Вы участвуете в викторине «Что я знаю о медицинском обслуживании в США». Несколько студентов вашей группы подготовились к викторине в качестве экспертов по следующим темам.

1. The three levels of health care in the USA. 2. The work of the family doctor. 3. The system of Medicaid. 4. The system of Medicare₁ 5. The medical units at American hospitals. 6. ThechiefscientificproblemsofAmericanmedicine.

Составьте по три вопроса к каждой теме и задайте их экспертам. Опреде­лите, кто лучше знает свою тему и, следовательно, является победителем викторины. \

\

MEDICALEDUCATIONINGREATBRITAIN

i

Упражнение 1. Прослушайте (прочитайте) и запомните следующие слова и словосочетания. Переведите предложения.

1. to charge a tuition fee взиматьплатузаобучениеcharge плата; free of charge бесплатный

In Great Britain higher medical education is not free of charge. Tu­ition fees are charged in all medical schools in Great Britain.

2. the degree of Bachelor of Medicine степеньбакалавравобластитерапии

In Great Britain the degree of Bachelor of Medicine is given to a medical student after passing his final examination.

3. a thesis диссертация.

In order to obtain the degree of Doctor of Medicine in Great Britain a post-graduate must write a thesis based on original work.

Упражнение 2. Прослушайте (прочитайте), следующие гнезда слов и определите, какой частью речи является каждое слово. Переведите.

to qualify, qualification; to supervise, supervision, supervisor; to in­struct, instructor, instruction, instructive; to require, requirement

Упражнение 3. Прочтите и переведите текст.

Medical Education in Great Britain

A delegation of English doctors visited the Pavlov St. Petersburg Medical University. They were shown the clinics and laboratories of the University. At the end of their visit the Rector of the University invited the guests to the Conference Hall where they had a meeting with the teaching staff and students!J5r. Glenn Stanton was asked to speak about medical education in Great Britain, This is what Dr. G. Stanton said: «Dear colleagues. In Great Britain physicians are trained in either medical schools or faculties of Universities. We have medical schools in the Universities of London, Oxford, Birmingham, Bristol and Edin­burgh. There are faculties of medicine in the Universities of Liverpool, Manchester, Glasgow and Aberdeen. And there is the School of Clini­cal Medicine in the University of Cambridge. Entry to a medical school is highly competitive and usually the number of candidates is much higher than the number of the places/^

To enter a medical school in Great Britain candidates must pass entrance examinations. Entrance examinations are both oral and writ­ten. Students take these examinations at the end of their 6-year second­ary-school course, generally at the age of 18—19 years. For entrance to a faculty of medicine or a medical school, it is required that the subjects of chemistry, physics and biology or mathematics should be taken at the advanced level. Tuition fees are charged. Most students receive finan­cial assistance in the form of grants, which cover their expenses wholly or in part.

]Now about the academic year. It is divided into 3 terms, each of 10—11 weeks' duration. The terms run from October to December, from January to March and from April to June. Clinical students, how­ever, attend for 48 weeks of the year. I must tell you that undergraduate education occupies five years, consisting essentially of two years of basic sciences and three years of clinical work. j

Two pre-clinical years are occupied by human anatomy and biology, physiology and biochemistry. They also study physiology, statistics and genetics. Students attend lectures, do dissections and practical work in labs. Unlike in your country Latin is not taught in all medical schools.

English and Latin spellings are similar and it is possible to write out prescriptions in English too.

Beginning with the third year the students study the methods of clinical examinations and history taking, general pathology, microbiology, phar­macology and community medicine. Senior students and especially under­graduates spend most of their time in teaching hospitals, which have both in-patient and out-patient departments, or units. Daily bedside instruction in hospital wards and out-patient departments is given by teachers and doctors. Students follow up their patients and attend ward rounds. Besides the work in the wards the students attend demonstrations and clinical conferences as well as lectures in clinical subjects which are being studied j f^nd now about the examinations. As in your country examinations in our medical schools are held at the erfd of each term. In our case it is three times a year. At the end of each term and after each special course students take final exams. They are called sessionals. Most of the exams are written. They include academic and practical problems. The final examinations or finals are in Medicine^ Surgery, Obstetrics and Gynae­cology and Pathology. Finals also iijemde history taking and diagnosing. Before finals in Surgery students assist in operations. Before finals in Obstetrics and Gynaecology they must assist during the delivery of at least 20 babies. These examinations are both written and oral. Written test includes short and long questions and questions of multiple choice. Oral tests include diagnosing a case. So three years are spent in clinical studies to obtain degrees of Bachelor of Medicine (B.M.) and Bachelor of Surgery (B.S.). The degrees of Bachelor of Medicine and Bachelor of Surgery give the right to register as a medical practitioner 3 ^After the finals graduates work in hospitals for a year. This period is called internship. The newly qualified doctor must serve for six months as a house physician and six months as a house suigeon under the supervision of his medical school. House physicians and surgeons are on call every second or third night. The work of interns is very difficult and their salary is very small. After internship a young doctor obtains a «Certificate of Experience» from the medical school and he or she may work as a medical practitioner. ^tr!Turther specialization requires training in residency. It takes one or two years of work in a hospital in some field. Residency trains highly qualified specialists in a definite field: gynaecologists, urologists, neu­rologists and others. The salary of residents is higher than the salary of interns. After residency a specialist gets rather a high salary.

Besides the degrees of B.M. and B.S., we have the degree of Doctor of Medicine (M.D.). This degree is a postgraduate qualification ob­tained by writing a thesis based on original work. It is not required for practice. Such a degree in surgery is termed a mastership (M.S.)»

Glenn Stanton answered the questions of the teachers and stu­dents. Then the Rector thanked Dr. Stanton for his interesting talk and invited the British delegation to the performance of the students' ama­teur theatre.

Active Words and Word Combinations

financial assistenceфинансовая

помощьexpensesрасходы, затратыto cover expensesоплачивать (букв, покрывать) расходыacademic yearучебныйгод (в

высшем учебном заведении) clinicalstudentsстуденты старших курсов (занимающиеся на клинических кафедрах) basicsciencesзд. теоретические

дисциплиныto write out prescriptions выписыватьрецептыhistory takingсборанамнезаto take a (case) historyсобирать

анамнезcommunity medicine bedside instructionобучениеу

постели больного tofollowupнаблюдать больного (после проведенного лечения) afollowupпоследующее врачебное наблюдение; изучение отдаленных результатов wardround(врачебный) обход demonstrationдемонстрация больного tobeheldпроводиться,

проходить medicineтерапия deliveryродоразрешение, роды housephysicianтерапевт-интерн

или ординатор housesurgeonхирург-интерн

илиординатор«Certificate of Experience» эквив. русск. Сертификатспециалистаmastershipмагистратура, магистерскаястепеньM.S. (Master/ship in Surgery) магистерскаястепень, присваиваетсяхирургамВ.М. (Bachelor of Medicine) бакалаврмедицины, степень, присваиваемаяврачам-терапевтамB.S. (Bachelor of Surgery)

бакалаврхирургииM.D. (Doctor of Medicine) доктормедицины, магистерскаястепень, присваиваемаятерапевтамbedside instructionобучениестудентовупостелибольногоmedical practitioner практикующийврач

Упражнение 4. Прочтите вопросы, которые были заданы во время беседы доктору Стентону преподавателями и студентами Университета. Ответьтенаэтивопросы, используятекст.

1. When are entrance examinations to a medical school taken? 2.What kind of financial assistance do medical students receive in Great Britain? 3. What examinations do medical students take? 4. What degrees are given to medical students after their final examinations? 5. Is it obligatory to obtain the degree of Doctor of Medicine for all graduates of a medical school? 6. When can a young doctor start working as a medical practitioner?

Упражнение 5. Прочтите следующие утверждения и выразите свое согласие или несогласие. Начните свои ответы со следующих фраз:Yes, youareright. I agree with you that...; No, . I don't think you are right ...

1.Entry to a medical school in Great Britain is a simple matter. 2. The Certificate of Experience is obtained at the end of a one-year intern­ship. 3. The examinations in medical schools in Great Britain are only oral. 4. Different grants are available to aid those students who do not have sufficient funds to finance their medical education.

Упражнение 6. В дискуссионном клубе международного молодежного лагеря вы познакомились с Дональдом Эдвардсом, студентом 4 курса медицинского факультета университета Глазго. Попросите Дональда рассказать, сколько лет учатся студенты-медики в Англии, какие экзамены сдают студенты, сколько учебных недель в каждом семестре? Можно ли получить высшее медицинское образование в Англии бесплатно?

Задавая вопросы, начните со следующих фраз: Whatcanyousayabout...; Couldyoutellus...; Andwhatabout...?

Вответахнавопросыиспользуйтеследующиефразы: Well, I have to say that...; As for (exams)...; I can add that...; I want to stress that...

Используйтевсвоейбеседеследующиесловосочетания: the curriculum; to occupy five years; pre-clinical studies; clinical work; tuition fees; financial assistance; grants; to be available; methods of clinical examination; history taking; clinical subjects; teaching hospi­tals; to attend a ward round; final exams; sessionals; questions of multi­ple choice; oral and written tests; written exams.

Упражнение 7. Расспросите Дональда Эдвардса о том, как проходит специализация выпускников медицинских школ в Великобритании. Используйтеввашейбеседеследующиесловосочетания:

internship, house physician; house surgeon; under the supervision; Certificate of Experience; medical practitioner; to train qualified spe­cialists; training in residency; to be given the B.M. or B.S. degrees; post-graduate qualification; to write a thesis.

Упражнение 8. Прослушайте (прочитайте) диалог и скажите, о чем беседуют Марина и студент из Иордании, которые учатся в медицинской академии в России.

Dialogue

Marina: Hello, Mohammed, Where are you going?

Mohammed: I'm going to the library. I'd like to take some books for my report in histology next Wednesday. Come with me.

Marina: I wish I could join you now, but I'll go to the library after the lecture on microbiology.

Mohammed: Do you know that attendance at lectures in the Oxford University Medical School is free?

Marina: But we are not in Oxford. Who told you that?

Mohammed: I was in Great Britain this summer. I visited Oxford and met two guys who turned out to be students of the Medical school there. Now I know that they have no academic groups and students work according to their own plans. But they have tutorials with their tutors.

Marina:And what do the tutors do?

Mohammed: As far as I remember, tutors plan the work of students and suggest the books to be read. At the end of each term students have written examinations. The students' papers are corrected and marked by the tutors. And on the last day of the term the tutors give a report on the students' work for the term.

Marina: Do students meet their tutors every day?

Mohammed: Certainly not. You see, each week 2 or 3 students go to their tutor, bring essays for criticism and he discusses with them the work they have done. Such classes with the tutor are called tutorials.

Marina: Does the tutor deliver lectures?

Mohammed: Yes. Some lectures are delivered by tutors, others are delivered by professors. But usually professors don't do teaching.

Marina: You want to say that Professors carry on academic research, don't they?

Mohammed: Quite so. Professors in Oxford mainly carry on academic research in their practical subject.

Marina:You really know a lot about the British system of medical training. Could you explain to me what the words «undergraduate», «graduate» and «post-graduate» mean? I can never use them correctly.

Mohammed: Well, I'll try. First of all, an undergraduate is the student who hasn't yet taken a University degree.

Marina: Did you say «degree»?

Mohammed: Yes. A University degree is given to a student who has finished a course of studies and passed his final examinations. By the way, a person who has taken a Degree of Bachelor, that is the lowest degree, is called a graduate, while any graduate who continues his studies or does research to receive a Degree of Master or Doctor is called a post-graduate.

Marina: How very interesting! And, how very different from the Rus­sian system of medical training. Thanks a lot. Well, bye-bye. The lec­ture will begin in two minutes.

Mohammed: See you at the library. Bye.

Упражнение 9. а) прочитайте диалог (упр.8), найдите и выпишите английские эквиваленты следующих слов, словосочетаний и фраз:

жаль, что не могу пойти с тобой; свободное посещение лекций; учебная (академическая) группа; заниматься по собственному пла­ну; занятия с руководителем/тьютором; предлагать (рекомендовать) литературу, которую следует прочитать; письменная работа студен­та; исправлять и оценивать (работу); критический анализ; читать лекции; проводить научные исследования

б) расскажите о работе тьюторов со студентами-медиками в Великобрита­нии, используя выписанные при выполнении задания, «а)» слова и слово­сочетания

Упражнение 10. Джоан Петерсон — студентка медицинского факультета Лондонского университета. На встрече английских и русских студентов Джоан рассказывает о системе высшего медицинского образования в Англии. Попросите ее ответить на интересующие вас вопросы.

Упражнение 11. Студенты вашей группы дают интервью корреспонденту английского молодежного журнала. Основная тема интервью - сравнение систем подготовки медицинских специалистов в нашей стране и в Великобритании. Чтовырасскажетекорреспонденту?

Чтобыотметитьсходство,начнитесоследующихслов:What we have in common is...; The similar aspects are...; Both in Russia and in Great Britain... .

Чтобыотметитьразличия, начнитесоследующихслов:The ma­jor difference is...; Unlike (the British system of medical training...); In contrast to (the Russian students...).