Medical Hodegetics - Almost Forgotten Art and Science of Upbringing Medical Doctors.

INTRODUCTION: Education in medicine faces a number of challenges and dilemmas and the onus is on Medical hodegetics, an important but almost forgotten discipline, to address them effectively. The task and final goal of education in medicine is to coach students into professionals, effective and ethical practitioners of medicine, giving them the best available knowledge, skills and attitudes and providing them with a professional identity so that they are able to think, speak, act and feel like medical doctors. During the life course human beings organize their experiences into a meaningful narrative that involves their personal, private, public and professional selves. The self can be defined as a distinct principle of identity, as a narrative construction and as an experiential dimension. AIM: The aim of this paper is to address the actuality and vitality of the hodegetic approach in medical education and professionalism. METHODS: By cross-sectional study authors of the paper searched on-line scientific data-bases and analyzed references about Medical hodegetics subject. RESULTS: Drawing on the literature on psychology of self, identity formation and personality styles as well as on own experience in medical education, the authors stress the increasing importance of medical hodegetics, very useful, but almost completely forgotten discipline. Medical hodegetics which involves all evidence-based medicine, values-based medicine, narrative medicine and person-centered medicine can significantly improve the quality of medical education. The identity of any person in any moment reflects its three domains: individual identity, relational identity, and collective identity, all relevant to medical education. The concept of professional identity formation has recently emerged and attracted great attention in literature on medical education and professionalism. Hodegetics, as a discipline that trains it, seems to us that the essential part of life and what every person should follow. CONCLUSION: Medical hodegetics is an important pillar of the triad of medical deontology as well as it could be an important discipline in medical education and professional identity formation.

Evaluation of the Medical Academic Community of Bosnia and Herzegovina Based on Scopus Parameters.

INTRODUCTION: The academic community of Bosnia and Herzegovina (B&H) is represented by four Academies, which include eminent personalities in the field of medical sciences (Academy of Sciences and Arts of Bosnia and Herzegovina, Department for Medical Sciences (ANUBiH), Academy of Sciences and Arts of the Republika Srpska (ANURS), Croatian Academy of Sciences and Arts in BiH (HAZU B&H), and the Academy of Medical Sciences of Bosnia and Herzegovina (AMNuBiH)). AIM: To present scientometric analysis of members of the medical sphere of the ANUBiH, ANURS, HAZU B&H and AMNuBiH, to evaluate members and their scientific rating. MATERIAL AND METHODS: The work has an analytical character and presents analysis of the data obtained from the Scopus database. Results are shown through number of cases, percentage, arithmetic mean, standard deviation, median and interquartile range, with Spearman's rank correlation coefficient. RESULTS: The analysis showed a significant correlation between the Academy and the country of origin of the academician. In AMNuBiH and ANUBiH are mainly represented academics originating from Bosnia and Herzegovina, while ANURS, 71.4% of the members, are academics with background from Serbia. There is no significant correlation between the observed parameters (Scopus parameters-number of papers, H index, number of citations) according to memberschip in Academies. By analyzing the correlation between the country of residence, the number of papers, H index and the number of citations, it has been shown that the correlation is significant between the state and the number of papers, but not the other two observed parameters. CONCLUSION: Criteria for admission to main academic communities are highly questionable, as this analysis showed. Progress in the academic hierarchy must be more stringent, and the criteria must be set to the highest possible level, as this is the only path which leads to progress.

Contribution of Arabic Medicine and Pharmacy to the Development of Health Care Protection in Bosnia and Herzegovina - the Second Part.

After the collapse of the Arab rule, the Arab territorial expanses and cultural heritage were taken over by the Turks. Although scientific progress in the Turkish period slowed down due to numerous unfavorable political-economic and other circumstances. Thanks to the Turks, Arabic culture and useful Islamic principles expanded to the territory of our homeland of Bosnia and Herzegovina (B&H). Significant role in the transfer of Arabic pharmaceutical knowledge was also attributed to the Sephardic Jews who, with their arrival, continued to perform their attar activities, which were largely based on Arab achievements. However, insufficiently elaborated, rich funds of oriental medical and pharmaceutical handwriting testify that Oriental science has nurtured in these areas as well, and that the Arabic component in a specific way was intertwined with other cultures and traditions of B&H. The Franciscan monasteries in Bosnia and Herzegovina have museums which contain important exhibits and libraries rich in books, among which many from the field of medicine and pharmacy. Muslim mosques, also, had small libraries with Arabic books used for spreading medical knowledge. The second category was folk doctors and practitioners who were on disposition to the people of any religion. Some of them listened to lectures in medicine during the studies of theology and philosophy. However, most did not have any medical education, but by reading books and teaching experience they made their own recipe collection. Special books, called "Ljekaruse" (Books of recipes) were also born during the study when they came into contact with an even larger number of health books. However, it should not be neglected that a lot of them contained folk medicines that were used in some environments depending on the habits and available herbs. Although it has been proven that many recipes from Ljekaruse are pharmacologically and medically justified, one should not ignore the knowledge and skill behind them. The true flowering of medicine in B&H happening thanks to graduate doctors in Italy, Austria, Hungary, Turkey, etc. Through their action, in a short time, they greatly improved health in B&H, educated the population. The Franciscans were important because they opened the first open-air clinics, the first pharmacies, and wrote the first pharmacopoeia and regulations for the work of health care institutions. Numerous works preserved in monasteries have mostly brought about the study in only one or two copies. Their contribution to the development of health care and the prevention of illness and treatment of the population in B&H during that period is very significant.

Influence of Arabian Pharmacy on Diseases Tretament During Ottoman's Period in Bosnia and Herzegovina.

The Arab cultural heritage was an era of invaluable preservation and development of numerous teachings, including biomedical sciences. The golden period of Arab medicine deserves special attention in the history of medicine and pharmacy, as it was the period of rapid translation of works from Greek and Persian cultures into Arabic. They preserved their culture, and science from decay, and then adopted them to continue building their science on theirs as a basis. After the fall of Arabian Caliphate, Arabian pharmacy, continued to persevere, and spread through Turkish Caliphate until its fall in the First World War. That way, Arabian pharmacy will be spread to new areas that had benefited from it, including the area of occupied Bosnia and Herzegovina. Because of the vast territorial scope of the Ottoman Empire, the focus of this paper is description of developing pharmacy in Bosnia and Herzegovina during the time of Ottoman reign.

Contribution of Arabic Medicine and Pharmacy to the Development of Health Care Protection in Bosnia and Herzegovina - the First Part.

The time interval from the 9th to the 13th century remained known as the "Golden period of the Arab science", and a significant place among the taught sciences are occupied by Medicine and Pharmacy. In the history of medicine, Islamic medicine, also known as Arabic medicine, refers to the science of medicine developed in the Islamic Golden Age, and written in Arabic Arabs were able to use their cultural and natural resources and trade links to contribute to the strong development of pharmacy. After the collapse of the Arab rule, the Arab territorial expanses and cultural heritage were taken over by the Turks. Although scientific progress in the Turkish period slowed down due to numerous unfavorable political-economic and other circumstances, thanks to the Turks, Arab culture and useful Islamic principles expanded to the territory of our homeland of Bosnia and Herzegovina. Significant role in the transfer of Arabic medical and pharmaceutical knowledge was also attributed to the Sephardic Jews who, with their arrival, continued to perform their attar activities, which were largely based on Arab achievements. However, insufficiently elaborated, rich funds of oriental medical and pharmaceutical handwriting testify that Oriental science has nurtured in these areas as well, and that the Arab component in a specific way was intertwined with other cultures and traditions of Bosnia and Herzegovina.

Seventy Years of the Journal "Medical Archives".

This year journal "Medical Archives" celebrates 70th anniversary of its continuing publication. Medical Archives is oldest biomedical journal in Bosnia and Herzegovina and one of the oldest medical journals in Europe, established in the year 1947, as official scientific and professional journal of Association of Physicians of Bosnia and Herzegovina. Until present Medical Archives has published over 5000 articles. Today Medical Archives is internationally recognized medical peer-reviewed indexed journal, visible in more than 30 international on-line databases.

The Actual (Un)usefulness of the Bologna System in Medical Education.

INTRODUCTION: Faculty of Medicine, University of Sarajevo has officially started working on 22.11.1944, and is the oldest faculty in the medical field in Bosnia and Herzegovina. At the same time there are two systems of organization of the teaching process, the old system and the Bologna system. AIM: To analyze the implementation of the Bologna system, and making an overview of its justification. MATERIAL AND METHODS: Answers from questionnaires from total of 459 students were analyzed (197 who had studied under the old system and 262 who studied under the Bologna system), so total of four generations of the Bologna system. They filled out a questionnaire in which they evaluated the teaching process. Student's opinion about quality of medical education was measured by modified Lickert scale. RESULTS: Students of old system are older than students of the Bologna process, whose average age is increasing from generation to generation, given the growing number of students who repeat a year. All students of old system repeated an academic year once or several times (p <0.05). Analysis of average grades showed statistically significant difference (p <0.05), where students in the Bologna system had higher averages than students who were studying under the old system. The presence of large number of female students, in both systems is significant (p <0.05). Out of 33 questions about satisfaction of class, 15 were answered with better average grade from students of the Bologna system. A slight improvement in the Bologna system is in terms of the evaluation of the quality of the educational process (teachers, methods, effects). The only significant progress has been proven in terms of rating the degree of computerization of the educational process-general records on enrolled students (old system vs Bologna system-3,44 vs 3,63), record of attendance (3,47 vs 3,73), obtaining certificates (3,08 vs 3,84), method of registration of exam (2,98 vs 3,71), method of practical exam (3,06 vs 3,36) and theoretical methods of taking exam (3,01 vs 3,14). Average grades where no average grade, on any issue, does not reach grade 4 of Likert Scale, talks about real problems of education in medical field. CONCLUSION: In a relatively large sample (four generations of students) true benefit and progress of the Bologna system has not been proven, in comparison to the old system. Bologna system has eased the students in the administrative sense by introduction of computerization of faculties, but the old problems and old questions about the organization's process and delivery have not been eliminated.

Scientometric Analysis of Scientific Validity of Medical Archives Regarding Other Medical Journals in Bosnia and Herzegovina.

INTRODUCTION: Medical Archives is the oldest medical journal in Bosnia and Herzegovina (B&H) (founded in 1947.). A total of 104 articles were published in Medical Archives during 2015. Analyzing the type of articles, original articles are present in majority during 2015-80.7% (in last seven years, 561 (76%) were original out of 738). In last seven years, 651 (88.2%) articles were from the field of clinical medicine (preclinical disciplines, in the last three years are more represented than in previous years). Collaboration rate in 2015 was 0,92. Articles written in collaboration of five authors (21.1 %) are found to be predominant. From year to year, most often required time for a decision on acceptance or on the revision prior acceptance is between 50 and 60 days (30% of cases in 2015). During 2015, 47.1% of articles were originally from B&H (eleven countries were represented). H index of Medical Archive for 2014 was 12, and does not vary during the last decade. FINDINGS: In 2015 in B&H about twenty-five journals are issued in the field of biomedical and life sciences in general (six are indexed on Medline/PubMed, one is indexed in the Science Citation Index Expanded (SCIE)/Web of Science base). According to GoogleScholar the biggest h5 index has Bosnian Journal of Basic Medical Sciences (BJBMS) and Medical Archives, while the biggest h5 median has BJBMS i Acta Informatica Medica. The highest H-index (13) in B&H has Izet Masic MD, PhD, Enver Zerem MD, PhD and Semir Vranic MD, PhD, while highest g-index (22) has Enver Zerem MD, PhD (analyzed by software package "Publish or Perish"). CONCLUSION: By comparing the state of medical publishing in B&H with neighboring countries (Croatia, Serbia, Montenegro), we have concluded that B&H is behind Croatia and Serbia by following parameters: Total Documents, Total Cites and H index but in front of Montenegro.

Modified Algorithm for the Risk of Coronary Heart Disease Estimation.

INTRODUCTION: Determination of the overall risk of coronary disease, enables the health professionals for planning the intensity of preventive action. AIM: The aim of this study is that by the results obtained using a modified algorithm with tables adopted by the European Society of Cardiology demonstrate the possibilities for assessment of the risk of coronary heart disease degree, for application to the targeted individual or risk factors groups. MATERIAL AND METHODS: The study was conducted as a retrospective, prospective and controlled (included two groups of 200 respondents). RESULTS: By comparing the presence of risk factors according to the representation of groups of diseases, or myocardial infarction, results showed that the European and SCORE table have significantly lower levels of risk factors, or those with sustained myocardial infarction are ranked in groups of low and present risk in relation to our algorithm which patients with myocardial infarction ranked as high and pronounced degree of risk. Results showed that the European and SCORE table significantly reduce the levels of risk or the persons with heart failure have been ranked in the group of low and present risks in relation to our algorithm which patients with coronary insufficiency ranked as pronounced degree of risk. CONCLUSION: Determination of the overall risk of coronary disease, enables the health professionals for planning the intensity of preventive action. The activities of primary prevention of risk factors, or already resulting disease, may be helpful in assessing the reduction in economic costs in healthcare, both due to lower morbidity, and reducing the total cost of treatment of patients with coronary disease.

The role of medical staff in providing patients rights.

Among the priority basic human rights, without a doubt, are the right to life and health-social protection. The process of implementation of human rights in the everyday life of an ordinary citizen in the post-war recovery of Bosnia and Herzegovina faces huge objective and subjective difficulties. Citizens need to be affordable adequate healthcare facilities that will be open to all on equal terms. The term hospital activity implies a set of measures, activities and procedures that are undertaken for the purpose of treatment, diagnosis and medical rehabilitation of patients in the respective health institutions. Principles of hospital care should include: Comprehensiveness (Hospital care is available to all citizens equally); Continuity (Provided is continuous medical care to all users); Availability (Provided approximately equal protection of rights for all citizens). Education of health professionals: The usual threats to patient safety include medical errors, infections occurred in the hospital, unnecessary exposure to high doses of radiation and the use of the wrong drug. Everyday continuing education in the profession of a doctor is lifelong.

The toxic effect on leukocyte lineage of antimicrobial therapy in urinary and respiratory infections.

INTRODUCTION: Antimicrobials are widely used in infectious diseases. Only the timely intervention will contribute to the positive outcome of the disease. Unjustified use of antimicrobial prophylaxis may have adverse effects, i.e., result in bacterial resistance to existing antimicrobials, as well as toxic effects on leukocyte lineage and other parameters of the blood. GOAL: The goal of this study was to confirm that the antimicrobial therapy of urinary, gynecological and respiratory infections has a toxic effect on leukocyte lineage. Followed by lowered immunity and the emergence of risk for health complications especially in oncology and other immunodeficient patients for whom to apply pharmacotherapy it is necessary to have adequate immunity, or white blood cell count that is greater than 4.0x10(9)/L. MATERIAL AND METHODS: A prospective-retrospective study was conducted on a sample of 30 patients in a Primary Health Care Center in Gracanica during the period from March 01, 2013 until April 01, 2014. Testing of this sample was conducted by survey on health status and treatment, or on taking of antimicrobial therapy and other treatment regimens, with the referral diagnosis and determination of leukocytes count in by hematology counter SYSMEX. Results of leukocytes below and close to the lower reference values were statistically analyzed by Students t-test. RESULTS: Mean WBC count in the group treated with antimicrobial therapy was 3.687±0.83 x10(9)/L, in the group which during repeated infection did not use the antimicrobial therapy 5.09±1.04 x10(9)/L, and in the control group of healthy subjects 7.178±1.038 x10(9)/L. Statistical analysis with Student's t test indicate highly significant differences between group of patients that used antimicrobial therapy with the group of patient that did not used antimicrobial during repeated infection (t=6.091; p=0.0001), as well as significant differences in mean WBC count of both of these groups and the controls (t=4.984; p=0.0001, and t=8.402, p=0.0001). CONCLUSION: Use of antimicrobial drugs leads to serious toxic reactions, or leukopenia. Indications for the use of antimicrobial therapy must be strictly followed, because banal, frequent infections are not indication for antimicrobial therapy. It is necessary to know the types of infection causes. Important is the proper and timely selection of antimicrobial therapy. When selecting the drug we should bear in mind its antimicrobial activity, pharmacokinetic and toxic properties, as well as patient health status. Possible is also the application of preventive medicine as well as other manner of solving infection.

The Mesentery's Pivotal Role in the Brain-Gut-Liver Axis.

Background: Prior to 2012, the mesentery was perceived as a fragmented structure, lacking distinct functional and anatomical characteristics, and was merely considered part of other digestive organs. Dr. J. Calvin Coffey's in 2012 in his study redefined the mesentery as a distinct organ with a clearly defined anatomical and histological structure, although its specific function remains under investigation. The continuous structure and unique tissue properties of the mesentery classify it as the 78th independent organ in the human body. Insights into mesenteric adipose tissue have enhanced our understanding of normal metabolic processes and disease etiology, impacting health significantly. Experimental and clinical research highlights the vital roles of visceral adipose tissue, influencing neighboring organ function. The interaction within the brain-gut-liver axis is illuminated by the newfound functions of mesenteric adipose tissue, emphasizing its independent organ status. Objective: This study aims to evaluate the latest findings on the structure and function of the mesentery, focusing on visceral-mesenteric adipose tissue, and assess its role as a new organ in the brain-gut-liver axis. Methods: A comprehensive analysis of clinical and experimental studies on the mesentery's structure and function was conducted, focusing on recent discoveries regarding mesenteric adipose tissue and its role in the brain-gut-liver axis. Results and Discussion: Recent research has revealed the mesentery's unique functions, particularly in mesenteric adipose tissue. Mesenteric adipose tissue plays a crucial role in metabolic functions and influences disease onset. It acts as a vital link in the brain-gut-liver axis, directly influencing hepatic metabolism and disorders such as metabolic syndrome. Conclusion: Scientific evidence confirms the mesentery's anatomical and functional specificities, solidifying its status as the 78th independent organ in the human body. It serves as a crucial link in the brain-mesentery-small intestine-liver axis, impacting health and disease. Ongoing research holds promise for advancing our understanding of pathophysiological mechanisms and treatment approaches for metabolic syndrome and other chronic diseases.

Bosnian and Herzegovinian medical scientists in PubMed database.

In this paper it is shortly presented PubMed as one of the most important on-line databases of the scientific biomedical literature. Also, the author has analyzed the most cited authors, professors of the medical faculties in Bosnia and Herzegovina, from the published papers in the biomedical journals abstracted and indexed in PubMed.

The frequence of renal cell carcinoma in population of patients with kidney tumors.

INTRODUCTION: A kidney tumor is an abnormal growth within the kidney that usually occurs over a period of a time. Each tumor has its own characteristics and it is important to know what tumor the patient has so that the proper treatment can be administered. Kidney tumors can be benign or malignant. Symptoms of all types of kidney tumors are very similar and unspecific. The aims of study: a) To determine how many patients, who were clinically and radiologically diagnosed with kidney tumor, after surgical intervention, have histopathologicaly confirmed renal cell carcinoma; b) To compare number of female and male patients have histopathologicaly confirmed renal cell carcinoma; c) To compare numbers of patients with renal cell carcinoma who are older than 50 years with the ones who are younger than 50 years; d) To determine the most common risk factors for renal cell carcinoma; e) To determine the most common symptoms of renal cell carcinoma; f) To determine what was the most common stage of kidney cancer in the time when it was histopathologicaly confirmed. MATERIAL AND METHODS: This study was observational, descriptive, retrospective study of renal cell carcinoma. The study consisted of 28 patients who were clinically and radiologically diagnosed with kidney tumor, which was surgically removed and histopathologicaly tested. All patients were surgically treated at the Urological Clinic of Clinical Centre University of Sarajevo from 1/1/2012 to 06/30/.2012. RESULTS: from 28 patients with a kidney tumor 26 had RCC, the most of patients with RCC were older than 50 years (22 patients), there was 7 female and 19 male patients, the most common symptom was pain (10 patients), the most common risk factor, excluding age, was hypertension (11 patients), patients with RCC was usually diagnosed stage 4 Fuhrman (11 patients). CONCLUSION: Doctors should give their intention to discover early symptoms of renal cell carcinoma and to do preventive exams and tests in the population of patients who have one or more risk factors for developing this disease. Early diagnose and appropriate therapy could reduce mortality and morbidity of the patients with renal cell carcinoma, and could also reduce costs of treatment.

Development of basic prequisites of quality education system in PhD studies at the faculties of health sciences in Bosnia and Herzegovina.

PhD degree in nursing is a relatively recent phenomenon and there is not enough experience in making the initial studies for the start of such studies. While nursing in the countries of Western Europe, USA, Asia, Canada and New Zealand develop as in the professional as well as in academic direction, our region has failed to catch up with these changes. The past 20 years is characterized by turbulent changes in the development of medical science and in line with these changes developed the idea of PhD studies. The necessity of the existence of this type of study is expressed in the fact that the doctors in the field of nursing are essential for the development of nursing in our area. Doctors in the field of nursing contribute to the development of education, quality assurance, development of scientific research and the advancement of nursing as a profession. Shortage of highly trained nurses and long-term stagnation in scientific research in nursing forced, especially developed countries, to develop doctoral studies in this field and then introduce reforms in nursing, which as the outcome given the improvement in the development of health systems, ways of education and science research in nursing. This article discusses the initial perquisites of the quality system for the development of efficient and high-quality doctoral studies at the health oriented faculties in Bosnia and Herzegovina and the region.

Medical publication and scientometrics.

As the fact that today is conducted a number of scientific research works in the field of medicine, it is necessary to define the steps by which it is carried out to make it universal and to have scientific value. This paper describes the research methods, study design, the way in which one should be written, and why it is important to publicize the same. Special emphasis is placed on scientometrics as the science that evaluates scientific papers and their citation in the selected sample of journals. The paper also answers why scientific research works should be carried out and what kind of satisfaction they provide to the researcher.

The Birth of Medical Dramaturgy - On the Occasion of the Published Book of Academician Benjamin Djulbegovic: "An Impossible Decision - the Life Interrupted by Uncertainty".

Background: The book "An Impossible Decision - the Life Interrupted by Uncertainty"has been published by Avicena Publisher in Sarajevo, Bosnia and Herzegovina in 2023 - ISBN: 978-9958-720-76-5. Objective: The aim of this article is to analize what is the most rational and ethical way to treat people facing life-and-death decisions and how do we exactly communicate these inevitable uncertainties that all of us will sooner or later face? Methods: Author of the book shows real-life relevance to patients often left alone to make these difficult decisions. Using the techniques of medical dramaturgy, this text brilliantly bridges science. Results and Discussion: The author of the book explained and proposed how to educate the public on how medical advances are made and how inferences and evidence are generated and appraised - in the best tradition of evidence-based medicine while highlighting uncertainties and inevitable trade-offs that accompany science, policies, and personal choices in the attempt to arrive at most satisfactory decisions. In addition to the general public, this play's important audiences are students and faculty in humanities disciplines and medical schools. These students are required to read many dense scientific, philosophical, and technical writings (many of which are referenced/annotated in the footnotes in the play). The play provides an exceptional teaching tool, which includes over 35 theoretical concepts to show how they can be applied to decisions relevant to all of us and what shared decision- making entails. Conclusion: Author's answer on the question "How to make the life and death medical decisions?" coul'd and shoul'd be: The method of using a playwright and Socrates dialogue format to connect the science of uncertainty with personal humanity decision will be appropriate. It will be important and quiet usefull for phisicians and, also, patients in healthcare practice, as joined decision makers.

Acquisition of New Philips Affiniti 30 Vascular Color Doppler Ultrasound Device - Cost Benefit Analysis to Reduce Cardiosurgical Patients' Treatment.

Background: Cerebrovascular accidents (CVI) are considered the second most serious complication in cardiac surgery patients with a frequency of 10%. By preventing complications of surgical treatment, using a Color Doppler ultrasound (CDU) device, in the population of cardiac surgery patients, the unplanned costs of prolonged postoperative treatment would be reduced. Objective: To prove that the acquisition and use of the newly developed CDU device "Affinit 30" is completely economical, profitable and medically justified. Methods: Numerical parameters of the treatment of cardiovascular patients were analyzed (number of procedures, number of days in the intensive care unit, cost of additional consultative services of the clinic for radiology and neurology), and the calculated economic value of the potential investment, as well as the cost of preventing surgical complications, by purchasing and installing a new modern CDU device. Results: The profitability of the investment was assessed using the economic parameters Net Present Value (NPV) of the investment, Internal rate of return (IRR) and Profitability Index (PI). A mathematical calculation with the given parameters yields NPV = 948,850 KM and IRR of 273% when applied to the given parameters. The PI value is 12.6, which matches the previously calculated NPV and IRR values. Conclusion: The acquisition and use of the newly developed CDU device "Affinit 30" is economically profitable and medically justified. This is shown by the calculated values of the economic parameters Net Present Value of the investment (NPV), Internal rate of return (IRR) and the Profitability Index (PI).

Quality assesment of medical education at faculty of medicine of Sarajevo University.

INTRODUCTION: Goal of measurement of the quality assessment of students' satisfaction is identification of weak and outdated sections of medical education. By finding out the unnecessary aspects, it is possible to start with improvement of the educational system. METHODOLOGY: The survey was conducted on the sample of 108 students of the final year of the study of Medical faculty in Sarajevo in December 2011. Questionnaire has 24 process and outcome variables for the purpose of quality assessment of the education at the Medical faculty. RESULTS: The measurement of quality of realized lectures of final year of Medical faculty in Sarajevo with formatted questionnaires determined that above 90% students rated it very low with grades under 3 of possible 5, compared with average 3 in survey from 2008. Unpreparedness of independent service after finished medical education has raised to 70% of questioned students, compared to 53% in 2008. Ratio of educators and assistents to students was graded mostly with grades under 3 of possible 5 by more then 80% questioned participants. Students grading satisfaction with concept of preclinical training has peaked in low levels of grade 1 by 44% survey participants, what are similar results compared to 2008. The measurement of satisfaction with concept of clinical education determined even lower and embarassing values of 94% negative attitudes and opinions by questioned students, compared with 83% in 2008. Availability of modern technical equipment at Faculty of Medicine is very low rated with grades under 2 by 87% of students. DISCUSSION AND CONCLUSION: The problems and weak points in medical education of Faculty of Medicine University of Sarajevo have persisted during period of more then a decade what comparsion of survey results clearly show. There is urgent need of improving and reforming the educational system which will bring more practical clinical and preclincal work, patient-student contact and interaction with bigger full attendance of educators and tutors, all supported by new modern technical and informational technologies. On this way the achievement of independent and patient oriented work after received medical education is granted for future generations of doctors.