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The urgent need to discuss with military surgeons the problem of improvement of educational process in the faculty of managerial medical staff of the Military-and-Medical Academy under the new social-and-economic conditions against the background of the RF Armed Forces reformation has prompted the authors to write this article. The first report deals with the problems of general organization of educational process taking into account the needs for surgeons with higher military education and creation of certified specialized surgical care in the Troops. The authors suggest that all people with interests at stake should express their opinion concerning this problem.

The article presents some conclusions on ambulatory surgery in the Military Medical Academy and Surgery Centers in St. Petersburg resulting in higher efficiency of surgical aid and its availability for military beneficiaries. Organization frames and staffing principles for day-time ambulatory surgery stations.

Article by the Chief of the Academy has been based on its history of 200 years. One of the oldest establishments of medical education has played a great role in the development of the national and world medicine. Among the Academy graduates of highest merit was N. I. Pirogov, a famous surgeon, who marked a new age in the medical science and education and introduced important innovations in the casualty treatment on the battlefield. He was the first to apply ether anaesthesia and plaster bandage and to have women taking care of the wounded on the theater of operations. Academy graduates S. P. Botkin, G. F. Lang and F. I. Komarov had founded their own schools of therapy. E. N. Pavlovskiĭ developed a study on the focus nativeness of infection and parasite disease process. Every year the Academy scientists implement more than 150 research projects for the government, ministries and different agencies, defend up to 75 theses on 30 specialties, conduct more than 20 national and international conferences, symposiums and meetings. For the last 35 years the Academy has been training medical doctors, scientists and healthcare specialists for 35 countries in Europe, Asia, Africa and Latin America.

The practical importance of the main genetic infringements in diagnostics of a wide circle of illnesses, including cardiology, nephrology, and oncology. Methods used. The exclusive effectiveness of application of the polymerasic chain reaction in the purposes of diagnostic. Expediency of application of the molecular-genetic methods for radiating, chemical and extreme effects evaluation.

The author states four main principles of maintenance of quality of the medical care to wounded and patients: a principle of conformity of preparation of the staff to soluble problems is provided by observance of the State educational standards of vocational training--carrying out the professiographic analysis of activity of the surgeons for creation of the models of the experts, perfection of the educational plans and programs; a principle of development of material base with sharp definition of priority spheres of its development for forthcoming year and use of material means for development of economic base of military-medical institutions; a principle of strict observance of modern medical technologies, based on the standards of equipment, outcomes (results of work of the medical institutions), medico-technological and medico-pharmaceutical; a principle of scientific quality management on the basis of estimation of staff-organizational structure of medical units and institutions, treatment-diagnostic technologies (processes) and the results of rendering of the medical care.

The results of medical examinations of the persons taking part in elimination of consequences of Chernobyl's disaster obtained by the specialists of Military-medical academy allowed to verify the conception of damage action of radiation and nonradiation complex of injury factors, to estimate well-information of stale and new biological indicators of radiation dose, to plan the ways of rescuers rehabilitation during stationary, polyclinic and sanatorium stages of treatment.

The actuality of a problem of cytomegaloviral infection in military transfusiology is substantiated by the increasing number of immunocompromised recipients, mass use of hemocomponent therapy in prophylaxis and correction of anemia, thrombohemorrhagic and immunodeficient syndromes. Cytomegaloviral infection in the recipients of hemocomponents may have unfavourable consequences, such as the development of mononucleosis, enhanced sensitivity to opportunistic infectious agents as a result of virus-induced immunodepression, graft rejection, risk of the development of oncologic diseases, atherosclerosis, disorders in the processes of reparation and regeneration. In the northwestern part of Russia the cytomegaloviral antigens are disclosed in 65-75% of men, age 18-23. Actual tasks are the following: put into practice cytomegaloviral antigens test for donors, make a wide use of effective leukocytic filters for leukocyte removal from hemotransfusional medium, minimize posttransfusion immunosuppression, determine recipients who need transfusions of hemocomponents prepared from seronegative donors.

One of the basic approaches which provides for the increase of immunological safety of hemocomponental therapy is the use of donor-recipient histocompatible blood. The decisive factor in the organism's individuality is HLA-antigen system. Antigen incompatibility of donor's and recipient's tissues in HLA-antigen causes the development of delayed hypersensitivity and sensibilization of the recipient, which provoke a number of complications and posttransfusion reactions. Histocompatibility is the key problem for modern transfusiology and transplantology.

The Military Medical Academy is a military educational institution which carries out the primary profile training of physicians for the Armed Services and all types of post-graduation training and advanced training of the scientific-pedagogical and medical specialists. Internship as a first stage of the post-graduation training is intended to improve practical medical training of the graduates of the Russian Military Medical Academy and other medico-military educational institutions by means of their primary specialization in one of the clinical or profile branches of medicine. The reforming of the post-graduation training rest system in the Military Medical Academy aims at its further development and putting specialists' training system into accordance with the Armed Forces reorganizations. This will make it possible to ensure high professional qualification of military doctors at the level of national and international standards.