Vulvovaginal candidiasis (VVC) is an inflammation of the mucous membrane of the vulva, vagina, urethra, and perineum by fungi of the genus Candida.

SYNONYMS OF CANDIDIASIS

Urogenital candidiasis, vulvovaginal mycosis, urogenital mycosis, thrush, genital fungus.

ICD-10 CODE B37 Candidiasis. B37.3 Candidiasis of the external genitalia and vagina. B37.4 Candidiasis of other urogenital localizations.

EPIDEMIOLOGY OF VULVOVAGINAL CANDIDOSIS

Vulvovaginal candidiasis- one of the common urogenital infections. Prevalence of thrush among women reproductive age is 25–40%. Vulvovaginal candidiasis ranks second after BV. More than 2/3 of the female population of the planet have experienced vulvovaginal candidiasis once in their lives. The most common occurrence is recurrent vaginal candidiasis. Already 3–6 weeks after the cure of candidiasis, in 10–33% of patients, when examining a vaginal smear, the presence of a Candida albicans culture is noted.

PREVENTION OF CANDIDIASIS

Rational antibiotic therapy, timely correction immune system, regulation carbohydrate metabolism, right choice hormonal contraception, personal hygiene are important and effective preventive measures.

SCREENING

Patients with complaints of curdled vaginal discharge, itching, burning, dyspareunia, all pregnant women upon registration and during the follow-up period, are subject to examination.

CLASSIFICATION OF VULVOVAGINAL CANDIDIASIS

Highlight:

• acute vulvovaginal candidiasis;
• recurrent (chronic) vulvovaginal candidiasis;

Candidiasis is not a generally recognized pathology due to the presence of fungi in healthy women.

ETIOLOGY OF VULVOVAGINAL CANDIDOSIS

The most common causative agent of vulvovaginal candidiasis is fungi of the genus Candida, including C. albicans, C. pseudotropicalis, C. glabrata, C. krusei, C. parapsilosis, etc. In addition, the frequency of mycoses caused by fungi of other species is increasing: Torulopsis glabrata , Saccharomyces cerevisae, etc. Fungi most often affect the vagina, vulva, skin of the perianal area, and urethra. The disease is urogenital candidiasis, which occurs as vulvovaginitis or vulvar dermatitis.

PATHOGENESIS OF VULVOVAGINAL CANDIDOSIS

Risk factors:

• wearing synthetic, tight-fitting underwear;
• sanitary pads;
• oral sex;
• diabetes mellitus;
• pregnancy;
• taking broad-spectrum antibiotics;
• high-dose oral contraceptives;
• treatment with steroid drugs;
• diaphragms, IUDs, spermicides.

Along with known risk factors such as pregnancy, taking hormonal contraceptive drugs V high doses, taking antibiotics, the main cause of vulvovaginal candidiasis is weakening immune defense. Women suffering from acute or chronic vaginal candidiasis have, on average, fewer T-lymphocytes, T-helper and V-lymphocytes, as well as a lower number of T-killers, compared to healthy women.

CLINICAL PICTURE OF VULVOVAGINAL CANDIDOSIS

For clinical picture characteristic:

• heavy or moderate curdled vaginal discharge;
• itching and burning in the external genital area;
• increased itching in the afternoon, during sleep, after water procedures, sexual intercourse, long walking, during menstruation;
• dyspareunia;
• dysuric symptoms.

U non-pregnant women complaints prevail clinical symptoms diseases. Patients complain of itching and burning in the area of ​​the external genitalia, gray-white “curdled” discharge from the genital tract and urethra, and urinary disorders. At gynecological examination swelling of the vulva, hyperemia and bleeding of the mucous membranes are noted, and areas of hyperemia and maceration on the skin. Characteristic sign diseases - gray-white plaques on the mucous membranes, difficult to remove with a spatula, areas of pronounced hyperemia under the plaque.

Complications of vulvovaginal candidiasis:

• vaginal stenosis;
• increased risk of pelvic infections;
• recurrent urinary system infections;
• miscarriage;
• birth of low birth weight babies;
• chorioamnionitis;
• premature rupture of membranes;
• premature birth.

DIAGNOSIS OF VULVOVAGINAL CANDIDOSIS

The diagnosis is made by assessing the history, complaints, clinical manifestations and results laboratory research. In addition to express methods (light microscopy of native preparations, microscopy of Grammasks stained with Accredinorange, fluorescent microscopy), cultural methods with selective media (Sabouraud) and immunofluorescent methods are used. To suspect a candida infection, a combination of three of these symptoms is necessary:

• curdled discharge;
• local signs of inflammation;
• the presence of spores or mycelium in smears.

Criteria for diagnosing vulvovaginal candidiasis:

• Vaginal pH 4.0–4.5;
• absence of odor (in the mirror smell test and amino test);
• detection of yeast-like fungi or pseudohyphae in a wet preparation ( positive result 40–60%);
• detection of yeast-like fungi or pseudohyphae in a Gram smear (positive result up to 65%);
• detection of yeast-like fungi during cultural examination of the material (if symptoms from the vulva predominate, then the material must be taken with a swab in this area).

The procedure for diagnosing urogenital candidiasis

1. Smear microscopy.
2. Culture method.
3. Serological reactions RA, RSK, RP.
4. Enzyme immunoassay(ELISA).
5. Polymerase chain reaction(PCR).

PHYSICAL EXAMINATION

During a gynecological examination they find large number white cheesy discharge, hyperemia and swelling of the mucous membranes.

LABORATORY RESEARCH

• Microbiological diagnostics: ♦microscopy of smears of vaginal discharge (native and Gram-stained preparations); ♦cultural method (determines the quantity, genus and species, sensitivity to antifungal drugs, as well as the nature and degree of colonization by other microorganisms).
• Serological methods (RSC).
• Immunofluorescence diagnostics (CandidaSure).
• Express methods (do not allow identification of accompanying flora).
• Immunological studies.

It has been established that mycoses are not sexually transmitted, but it has been confirmed that this disease is associated with the nature of sexual contact (anal-vaginal, orogenital, etc.). Vulvovaginal candidiasis is not sexually transmitted, even despite the isolation of identical strains of fungi from partners. Treatment of sexual partners is necessary only in case of development of candidiasis balanoposthitis.

TREATMENT OF VULVOVAGINAL CANDIDOSIS

Terms effective therapy vulvovaginal candidiasis:

• withdrawal of estrogen progestogen drugs;
• withdrawal of glucocorticoids;
• discontinuation of antibiotics;
• giving up bad habits;
• carbohydrate restrictions, diet;
• local therapy in uncomplicated cases;
• combined local and systemic therapy with recurrent VVC.

Primary cases of treatment of acute vulvovaginal candidiasis, as a rule, do not cause difficulties. The use of antifungicides, mainly azoles, is effective. It is much more difficult to treat recurrent vulvovaginal candidiasis. Treatment requires not only antifungal drugs, but also carrying out a complex of auxiliary therapy. Very often treatment is unsuccessful, despite the use of many antifungal drugs. The HIV epidemic is doing this problem even more relevant. One more current problem- combination of infection with damage to the gastrointestinal tract.

Treatment of acute vulvovaginal candidiasis.

• Butoconazole: 2% vaginal cream 5 g once.
• Ketoconazole: vaginal suppositories 400 mg (1 suppository) 3–5 days.
• Fluconazole: orally 150 mg once.
• Itraconazole: 200 mg orally 2 times a day for 3 days.
• Sertaconazole 300 mg (1 vaginal suppository) once.
• Clotrimazole: 100 mg (1 vaginal tablet) for 7 days or 200 mg (2 vaginal tablets) for 3 days or 500 mg (1 vaginal tablet) once or 1% cream 5 g intravaginally for 7–14 days.
• Miconazole: vaginal suppositories 100 mg (1 suppository) at night for 7 days or 200 mg (1 suppository) for 3 days.
• Nystatin: vaginal tablets 100,000 units (1 suppository) daily for 14 days.
• Tioconazole 6.5% ointment 5 g intravaginally once

Despite high efficiency traditional local therapy, many patients experience relapses after 1–3 months. Many factors contribute to this. For example, broad-spectrum antibiotics, especially with long-term use, change the normal vaginal microflora, as a result of which BV develops. Oral contraceptives increase the risk of candidiasis as well as pregnancy: high level estrogen causes a high level of glycogen, which is favorable for the growth of Candida fungi. In addition, estrogens increase adhesion to the vaginal epithelium and its colonization by fungi. In patients with diabetes mellitus the risk of vaginal candidiasis is higher due to higher level glycogen in the vaginal epithelium and reduced immunity. An increase in the number of Candida species, such as C. pseudotropicalis, C. glabrata, C. Parapsilosis, is another reason for the increase in the number of relapses.

These species are less sensitive to traditional topical treatments than C. albicans. Their clinical significance increases when patients complete local treatment before healing occurs. Failure traditional therapy to eradicate such pathogens, wide application short courses of imidazoles local action increases the risk of developing resistance. If for acute forms only local therapy is possible, then for chronic forms a combination of local, systemic and anti-relapse therapy is necessary.

Therapy for chronic vulvovaginal candidiasis:

• systemic antimycotic (itraconazole 200 mg orally 2 times a day for 3 days or fluconazole 150 mg for 3 days) and
• local therapy with azole drugs (on average, for 14 days).

Prevention of recurrence of vulvovaginal candidiasis:

• systemic antimycotic (itraconazole 200 mg orally or fluconazole 150 mg on the first day of menstruation for 6 months);
• therapy local drugs Once a week for 6 months.

Medicines used to treat genital candidiasis*

Imidazole preparations:
♦ ketoconazole (nizoral) - suppresses ergosterol biosynthesis in the fungal cell. Use 400 mg/day for 5 days;
♦ clotrimazole (canesten) - inhibits the synthesis of nucleic acids, lipids, and polysaccharides in the fungal cell. Used in the form vaginal tablets, 200-500 mg or 1-2% cream for 6 days;
♦ miconazole - 250 mg, 4 times a day, 10-14 days. Vaginal cream or vaginal suppositories (400 mg) daily for 3-6 days;
♦ bifonazole - 1% cream, 1 time/day. at night, 2-4 weeks;
♦ ginesol 100 or 400 mg: 1 suppository per vaginal;
♦ ginalgin - 1 vaginal suppository at night, 10 days;
♦ isoconazole (travogen) - vaginal balls, 3-5 days;
♦ econazole - vaginal cream 0.15 g, 3 days;
♦ batrafen - vaginal cream 5 g at night, 10 days. Triazole preparations:
♦ fluconazole - 0.05 -0.15 g 1 time/day, 7-14 days;
♦ itraconazole (orungal) - 200 mg 1 time/day, 7 days. N-methylnaphthalene derivatives:
♦ Lamisil - 0.25 g 1 time/day. (regardless of food intake), 2-4 weeks.

Antifungal antibiotics:
♦ nystatin - 500 thousand units 4-5 times a day, 10-14 days. To enhance the effect oral administration nystatin is combined with intravaginal suppositories of 100 thousand units for 7-14 days;
♦ levorin - 500 thousand units 2-4 times a day, 10-12 days;
♦ amphoglucamine - 200 thousand units 2 times a day, 10-14 days.

Medicines for local application:
♦ imidazoa derivatives (clotrimazole, miconazole, bifonazole, ginesol, ginalgin, isoconazole) - 1 each vaginal suppository or 1 portion of vaginal cream at night for 10 days;
♦ dekamin - 1% ointment vaginally 1-2 times a day, 2-3 weeks;
♦ polygynax complex (neomycin, polymyxin, nystatin) at night, 1 suppository for 12 days;
♦ Macmiror complex (nifuratel, nystatin) - vaginal suppositories at night;
♦ terzhinan (neomycin, nystatin, ternidazole) - 1 vaginal suppository at night, 10 days;
♦ pimafucort (amycin, neomycin, hydrocortisone). Used in the form of a cream or ointment 2-4 times a day, 14 days;
♦ meratin-combi (ornidazole, neomycin, nystatin) 1 vaginal suppository at night, 10 days;
♦ Betadine - 1 vaginal suppository (0.2g), 14 days.

CONTROL OF TREATMENT FOR VULVOVAGINAL CANDIDOSIS

• At acute form Treatment control is carried out 7 days after the end of treatment.
• In chronic VVC, the effectiveness of treatment is assessed within 3 menstrual cycles on the 1st day after the end of menstruation.

Microscopy of smears of vaginal discharge is performed (native and Gram-stained preparations). Culture of the discharge is necessary when the pathogen is not detected by microscopy, as well as in case of chronic recurrent VVC (in the latter case, species identification of the pathogen and determination of sensitivity to antifungal drugs are required).

Internal regulations for consumers of services

History of the institution

May 11, 2014 marked 50 years since the formation of the Military Medical Commission, which deals with the medical examination of internal affairs officers of the Moscow garrison. This commission was created in 1964 as the district Military Medical Commission of the Internal Affairs Directorate of the Moscow City Executive Committee and consisted of 8 people: a chairman, 5 expert doctors, 2 medical registrars. Between 1969 and 1996 it included a psychophysiological laboratory with up to 14 people.

Currently, VVK is located in a separate building with an area of ​​2100 sq. m. m., at the address: 117393, Moscow, st. Profsoyuznaya, building 64. Metro “New Cheryomushki”

The military medical commission is structural unit The Federal State Healthcare Institution “Medical and Sanitary Unit of the Ministry of Internal Affairs of Russia for Moscow” organizes and conducts military medical examination in Moscow.

Personnel potential

Today the employees of VVK are:

2 candidates of medical sciences,

9 doctors have the highest qualification category

6 doctors have the first qualification category.

List of medical documents forapplicants to study at the University of the Ministry of Internal Affairs of Russia

1. Information from dispensaries about being registered (observed) for mental disorders, drug addiction, alcoholism, substance abuse, abuse drugs and others toxic substances, HIV infection, about dispensary observation for tuberculosis, dermatovenerological and other chronic diseases indicating the diagnosis, date of registration and follow-up for the last 5 years

4. Information on vaccinations against: diphtheria and tetanus, against measles (or past illness in persons under 35 years of age), rubella (or past illness) in women under 25 years of age, viral hepatitis In (or past illness) in persons under 55 years of age (indicating the date of vaccination, dose, series) in two copies (or photocopies), certified by the seal of the medical institution.

5. Fluorographic (x-ray) examination of organs chest in two projections

6. ECG at rest and after exercise

7. Clinical analysis blood

8. General analysis urine

9. Blood test for HIV

10. Blood test for syphilis

11. Blood test for markers of viral hepatitis B and C

12. Study of function vestibular apparatus– those entering service (study) by types of activities classified as purpose groups 1 and 2

13. Examination by a dentist to determine the condition of the oral mucosa, dental formula, bite

14. For female candidates, examination by a gynecologist at the place of residence and from the clinic of the FKUZ “MSCh of the Ministry of Internal Affairs of Russia in Moscow”

15. X-ray of the paranasal sinuses (a radiograph of the paranasal sinuses and a conclusion on it are presented).

Survey results in mandatory must be certified by the seal of a medical institution (and not just the seal of a doctor or the stamp of a medical institution), valid for 3 months, fluorographic examination - for 6 months.

List of documents fornewly entering service in the police department

Reason: order of the Ministry of Internal Affairs of the Russian Federation dated July 14, 2010. No. 523 “On approval of the Instructions on the procedure for conducting military medical examinations in the internal affairs bodies of the Russian Federation and the Internal Troops of the Ministry of Internal Affairs of the Russian Federation.”

1. Information from dispensaries about being registered with psychoneurological, narcological, phthisiatric, dermatovenerological dispensaries (dates of registration and follow-up for the last 5 years). If the candidate has changed his place of residence over the past 5 years, then from each place of residence in accordance with the mark in the passport.

2. Medical records outpatient (inpatient) patient (medical records) and extracts from them about previous diseases over the past five years

4. Information on vaccinations performed against: diphtheria and tetanus, against measles (indicating the date of vaccination, dose, series) in two copies (or photocopies), certified by the seal of the medical institution.

5. Fluorographic (x-ray) examination of the chest organs in two projections (valid for 6 months)

6. ECG at rest and after exercise (valid for 3 months)

7. Clinical blood test (valid for 3 months)

8. General urine test (valid for 3 months)

9. Blood test for HIV (valid for 3 months)

10. Blood test for syphilis (valid for 3 months)

11. Blood test for markers of viral hepatitis B and C (valid for 3 months)

12. Study of the function of the vestibular apparatus - for those entering the service for types of activities classified as purpose groups 1 and 2 (valid for 3 months)

Russia regarded Israel's actions as hostile and stated that it reserves the right to take adequate retaliatory actions.

CONVERSATION AS EQUAL

IN Moscow after tragedy with a Russian spy plane IL-20 over Mediterranean Sea Israeli Air Force Commander arrived General Amikam Norkin. For negotiations in Ministry of Defense RF he was accompanied by a whole retinue of military and civilian specialists. Even before Norkin arrived in the capital Russia the Israeli press “let slip” that he allegedly intends to meet with Russian Defense Minister Sergei Shoigu, and then with President Vladimir Putin. However, presidential press secretary Dmitry Peskov said that “the Russian leader is not on the schedule for a meeting with Norkin.” There was no such meeting on Shoigu’s schedule either. And from the point of view of “diplomatic politesse,” this is a fairly clear sign that the Israeli general was destined for the appropriate “level of reception.” A conversation on equal terms was clearly envisaged here. Therefore, from the Russian side, the Commander-in-Chief of the Aerospace Forces (VKS) of Russia, Colonel General Sergei, was sent to negotiations Surovikin.

The meeting of the delegations (about 15 people sat at the table on our side) took place in one of the halls of the Ministry of Defense. The KP military observer was told about how the negotiations took place by a source who (for obvious reasons) asked that his name and position not be used. Here is a recording of our conversation.

OUR FACES WERE SEVERE

- How did the negotiations begin?

From the fact that Surovikin and Norkin greeted each other, shook hands and, together with the accompanying persons, sat down opposite each other at long tables. I noticed that all of our people had very stern faces, and the Israelis did not smile diplomatically. Everyone understood that the situation was not the same - the conversation would be very difficult.

Norkin first of all expressed his condolences to the relatives and friends of the deceased Il-20 crew, and then said that the Israeli side is ready to provide the Russians with all the necessary information about the situation with our aircraft. In front of him lay a plump folder with documents. These were the findings of an investigation carried out by the Defense Army Israel after the incident. Including pre-flight information about the four IsraeliF-16, which appears in this tragedy. I estimated that there would be about fifty pages there.

- And how did Surovikin react to this?

He expressed himself in the sense that, well, thank you for the documents, but we need to understand them very thoroughly. Because we are also conducting our own investigation, and we have our own objective control documents. There are also Syrian...

“WHAT DOES ASAD HAVE TO DO WITH THIS?”

And then Norkin outlined the Israeli side’s vision of the tragic situation with our IL-20. He spoke for a long time, I can only tell you some of the main points. And I’ll immediately note that we haven’t heard anything fundamentally new.

There was a set of arguments already heard from Tel Aviv, from the Israeli Ministry of Defense...

- And which ones?

Well, for example, Israel places full responsibility against the Assad regime for the death of the Il-20. When our people heard this, many wanted to exclaim: “What does Assad have to do with it?” This is typical demagoguery! Yes, yes! The Israelis seriously blamed the Bashar al-Assad regime for the tragedy, emphasizing that it was the Syrian Air defense shot down a plane.

Someone from our side immediately cut off the Israeli with a strong counterargument: “If only yourF-16 did not break into airspace Syria, if they had not provoked the Syrian air defense to open fire, then no tragedy would have happened.”

- And how did the Israeli delegation react to this?

Again I suffered the same demagogic blizzard. They say Israeli The Air Force attacked Syrian army facilities, which (with a caveat - allegedly!) were producing weapons for Hezbollah, which (and here again - allegedly!) were intended for use against Israel, escalating the threat...

"WE HAVE OTHER DATA"

- What did Surovikin say to this?

He said all this needed serious factual evidence, not speculation. Because you can go far this way. Military people operate with facts, not versions. In response to this, the Israelis showed our satellite images of those areas in whichF-16 struck. And they started singing again: they say, from these photographs we can conclude that these are military factories for the production of high-precision missiles, and not aluminum factories, as the Assad regime claims. One of our people cut them off again: they say, different conclusions can be drawn... Including far-fetched ones... Let's get closer to the point. But again they heard: “Israel believes that Iran and Hezbollah bear responsibility for this tragic incident."

Here Surovikin, with his questions to Norkin, returned the negotiations to the right direction. And again he made it clear to the other side that it was the actions of Israeli aviation that day that provoked the tragedy. And again he reminded the guests of Shoigu’s words: “The blame for the downing of the Russian plane and the death of the crew lies entirely on the Israeli side.” This is our principled position.

- And what did Norkin answer to this?

The Israelis turned around here too: “When the Syrian army fired missiles that hit the Russian plane, Israeli Air Force planes were already on Israeli territory.” And that, they say, during the attack by the Israeli Air Force, the Russian plane that was hit was not in their zone of action.

- And what was our response to this?

And from our side it was immediately announced that we had other data. Other documents. The Syrian air defense command also has them. Here you need to thoroughly check the data. Literally in minutes and seconds.

NEARLY FELL FROM THE CHAIRS

- And the question was asked about why the Israelis informed us only a minute before the moment when their fighters burst into the Syrian sky?

Certainly! It was clear from the expressions on the faces of the Israeli delegation that this was a very, very unpleasant issue for them. Moreover, both Surovikin and our other officers reminded them of our long-standing, back in 2015, agreements on the “rules of the game.”

- And how did the Israelis react to this question?

Verbose and muddy. Even the translator had difficulty finding the words. And when they said that “the Syrian anti-aircraft batteries fired indiscriminately,” and then “we (the Israelis, - ed.), unfortunately, also did not bother to make sure that there were no Russian planes in the air,” here are our officers Almost fell out of my chair! With the vaunted ultra-modern Israeli radars, you can’t “see” such a colossus as the Il-20 under your nose?! Even an Israeli schoolchild would not believe this. We had to firmly repeat our position again: Israeli pilots exposed the Il-20 to fire from a Syrian S-200.

THERE WILL BE ADJUSTMENTS

In general, the impression was created that Norkin and those accompanying him, at the peak moments of the negotiations, tried to avoid specific military-technical issues related to our Il-20, and pressed on something completely different. The fact that Iran, for example, wants to strengthen its military presence in Syria and transfer weapons to Hezbollah.

But what does this have to do with it, if we are primarily interested in the main thing - will the Israelis admit that it was the actions of their fightersF-16 provoked the tragedy?

- And how did the negotiations end?

Surovikin once again reminded the Israeli delegation of the point of view of the Russian Ministry of Defense, which was expressed by Shoigu. Well, agree to continue contacts. They also said that after such a tragedy it is necessary to make serious adjustments to the Russian-Israeli agreements that were established three years ago.

- Russia assessed Israel’s actions as hostile and stated that it reserves the right to adequate retaliatory actions. Was this discussed during the negotiations?

No.

- But there will be such actions?

We are military people. We have a Supreme Commander-in-Chief and a Minister of Defense.Whatever order we receive from them, we will carry it out.

In order to get a job in the fire department (namely, a service, a certified position), you need to pass the Higher Military Examination and not everyone succeeds. Perhaps this is the main authority for screening out potential firefighters.

What is VVK

This is a military medical commission, the main task of which is to determine the suitability of a candidate (employee) for service (further service) in the specified position.

Let's try to make the process a little easier and familiarize you in advance with what is necessary to pass the IHC.

Documents for passing

• Firstly, it is necessary direction of the established pattern , which you need to obtain from the personnel department of the organization where you are going to get a job. The referral is valid for three months from the date of issue;
• Passport of a citizen of the Russian Federation;
• Military ID

Applicants, that is, candidates for study who have not completed military service in the Armed Forces, must have with them registration certificate , in which there is a mark A - fit for service.

Candidates whose registration certificate contains the mark B-3, B-4 are not allowed to pass the IVC; even minor restrictions on service are grounds for refusal to pass the IVC.

This requirement applies to boys; girls do not have a registration certificate.

Analyzes

1. clinical blood test (with detailed leukoformula);
2. general urinalysis;
3. blood test for syphilis, HIV, hepatitis B and C;
4. certificate of vaccination against diphtheria (or a corresponding note on the vaccination certificate);
5. fluorography of the chest organs (in two projections). Please note that not only the conclusion is necessary, but also the photographs themselves;
6. ECG with interpretation at rest and with load;
7. study of vestibular function (for positions of the first and second purpose groups);
8. chemical and toxicological testing for narcotic substances;

The examination results are valid for three months, fluorography – for 6 months.

Inquiries

1. Outpatient card or detailed extract from an outpatient card for the last 5 years. If you have changed your place of residence over the past five years, then extracts are needed from all clinics where you were observed;
2. Certificates indicating existing (if any) diseases and medical records;

Certificates of clinical observation from psychoneurological, drug addiction, dermatovenerological and tuberculosis dispensaries. As a rule, these certificates are paid, in a standard form, and are issued at the appropriate dispensaries.

Doctors who will need to be examined directly by the commission:

• dentist;
• surgeon;
• otolaryngologist;
• neurologist;
• psychiatrist;
• dermatologist;
• ophthalmologist;
• therapist;
• female candidates additionally visit a gynecologist.

Let us note that each doctor examines you very meticulously, and if the slightest doubt arises, as a rule, he refers you for additional examinations.

When extending service life

(The list is attached to the post using the download button)

1. Direction of the HR department to medical examination.
2. Service ID.
3. Service characteristics.
4. Outpatient card.

Certificates indicating existing diseases and deadlines dispensary observation according to them:

All certificates must be certified by the personal seal of the doctor and the seal of the relevant medical institution.

Preparing to pass the commission

Preliminary preparation is not necessary, but if a candidate is serious about serving in the Ministry of Emergency Situations of Russia and wants to have the maximum chance of passing the Higher Military Commission, a serious approach is required.

The document that was previously used by the Military Military Commissions when determining suitability for service is Order of the Ministry of Internal Affairs of the Russian Federation dated July 14, 2010 No. 523 ( currently no longer valid).

There are currently 2 documents in force:

• “On the requirements for the health status of citizens entering service in internal affairs bodies Russian Federation, and employees of internal affairs bodies of the Russian Federation, lists of additional mandatory diagnostic studies“conducted before the start of a medical examination, forms of documentation necessary for the activities of military medical commissions, the procedure for conducting a control examination and re-examination and the recognition of certain normative legal acts as invalid”;
• (lost its force, in exchange: Order of the Ministry of Emergency Situations of Russia dated August 30, 2018 N 356 ) “On the requirements for the health status of citizens entering service in the federal fire service of the State Fire Service, and employees of the federal fire service of the State Fire Service, lists of additional mandatory diagnostic tests carried out before the start of a medical examination of citizens entering service in the federal fire service of the State Fire Service fire service, and employees of the federal fire service of the State Fire Service, the procedure for conducting a control examination and re-examination based on the results of an independent military medical examination and forms of documentation necessary for the activities of military medical commissions in the system of the Ministry of Emergency Situations of Russia.”

Pay attention to the section: additional requirements for citizens who have not served and are entering the service and (or) educational organizations.

Now you can preliminary assess the state of your health and its compliance with the requirements. It is clear that this will only be a rough estimate, but in some ways it is possible to be proactive and take action. There are health problems that are an obstacle to service, but can be corrected. Therefore, it would be more advisable to come to the commission, having treated and corrected everything that can be corrected and treated.

What needs to be done before passing the commission? It is worth estimating the ratio of your height and weight and the compliance of your parameters with the norm (Table No. 2 to the appendix to the Requirements of Order No. 190), it is quite possible to lose extra or missing kilograms in advance or, conversely, to eat up. It is worth contacting your dentist in advance for sanitation. oral cavity, caries can play a cruel joke. In general, it is worth treating in advance everything that can be treated and corrected, so that doctors do not have unnecessary reasons to focus their attention. But pay attention - if correction requires surgical intervention, you need to go through the commission no earlier than 6 months after the operation; if you come before the expiration of six months, the verdict will be “temporarily unfit.”

Is it possible to hide any health problems and pass contrary to existing rules? Of course, nothing is possible. Now, with the active development of paid medical institutions, many prefer them to budget clinics at their place of residence, preferring comfort, the absence of queues, and appointments. At the same time outpatient card at the place of residence, accordingly, will be clean, without records of treatment.

You also don’t have to answer the whole truth to standard questions from specialists about the presence of complaints in your profile - not all diseases can be identified by a doctor without additional examinations, therefore, when determining the need for these surveys, we will still rely on your words and the card data.

Therefore, if you set a goal, it is, of course, possible to hide (or try to do so) the presence of problems, but you should think hard - who will you ultimately deceive? It wouldn't work out like that of yourself. The commission's health requirements are extremely high, but this is due to the serious stress on the body when performing duties in this position. And some insignificant feature, which does not interfere in any way in ordinary life and does not cause absolutely any trouble, in extreme conditions can play a fatal role and turn into disaster not only for the employee himself, but also for those for whose lives he is responsible.

How to pass the CPD

When hiring, it is important not only physiological health, but also psychological. That's why special attention is devoted to psychodiagnostics, which is carried out by specialists from the Center for Psychology and Education. The abbreviation CPD means nothing more than a psychodiagnostic center, where candidates for service undergo a psychological examination.

You can also prepare for passing the CPD. First, you need to carefully analyze your appearance. Yes, and in such serious organizations you are greeted by your clothes, so they should be clean, tidy, and remember that you are still going to a reputable institution for a very specific purpose, so you should not shock others. Resist the temptation to show up in shorts and flip-flops, no matter how hot it is.

If you have tattoos or piercings, be prepared to answer additional questions. If there are scars, be prepared to answer questions about their origin.

Try to look at yourself from the outside. Psychologists draw conclusions not only on the basis of testing, they evaluate the candidate comprehensively. Believe me, nothing will go unnoticed. Bitten nails, dirty shoes, the aroma of a just smoked cigarette - all these are “hooks” that a specialist can “catch onto”, so you shouldn’t give him an extra reason.

Immediately before the day on which the examination is scheduled, you must:

• Get some sleep. Lack of sleep will definitely affect your psychophysiological state;
• Don't be hungry. Provide in advance the opportunity to satisfy hunger and thirst;
• Be prepared that the examination will take a lot of time. Don't plan anything else for this day, so as not to be nervous and not to rush.

Well, it would be useful to remind you that it is completely unacceptable to appear for examination in a state of residual alcohol intoxication(with smell). Even if you have good reason in the form own wedding or the anniversary of your beloved mother-in-law - refrain.

How is the examination carried out? First you will be tested. Standard tests used for CPP are not difficult to find, they are all available, and you can even take them in advance.

What should you pay attention to?

• Read the questions carefully, highlighting the words always, sometimes, never, often, occasionally.
• Don't try to seem perfect. All tests contain questions that determine the so-called sincerity scale, based on which the degree of your truthfulness is assessed. You will not pay for luggage transportation in empty bus in the absence of a conductor? So don’t be afraid to admit that you won’t.
• Remember your answers. There are a lot of questions, often they are repeated, with slight changes in wording. Don't get confused.

IQ testing. These tests can also be found and familiarized with them in advance, with the correct answers, respectively. But still, do not rewrite the answers, but solve the problem first so that you can demonstrate your train of thought, if necessary.

There will be a lot of tests, with a large number questions, please be patient. After testing, you will have a mandatory conversation with a psychologist. And here, try to remember that you are talking with a psychologist and he is assessing your suitability for service. Don’t relax, be on your guard, although the task of a psychologist is exactly the opposite.

During a conversation, you should not take a “closed” pose - cross your arms and legs, hide your eyes, and often touch your face with your hands. Based on the results of the conversation, the specialist may send you for additional examination.

The results are not given to the candidate; they are taken by an employee of the HR department.

In what other cases is it necessary to undergo VVC and CPD?

In case transfer to position, the purpose group of which is higher than the one for which you passed the commission.

It is worth noting that the health requirements for current employees in this case are somewhat different from those imposed on candidates.

It is somewhat easier to pass the transfer commission than initially for the position. So in some cases, if a candidate did not pass the first group of assignment, but passed, for example, the third, it still makes sense to apply for a position in the group in which he passed. And later, already as an employee, try again to apply for the position for which you were originally planning.

If an employee is transferred to a position with an increase in the assignment group, he also needs to undergo the CPT.

In the event of an insured event. Employees of the Ministry of Emergency Situations of Russia are insured without fail, that is, when an insured event occurs, the employee is paid a certain amount. The amount of the insured amount depends on the severity of the injury. And it is precisely the severity of the injury that is determined by the military medical commission. You can read more about it in our article.

It is necessary to collect all certificates, all doctors’ reports, all photographs - all this will be useful at the commission.

Full list of required documents:

1. Referral for medical examination. The HR department issues the referral; it must be indicated that the employee is being sent to determine the severity of the injury. The referral is valid for three months from the date of issue;
2. The conclusion of the official investigation (certificate of injury) is signed by the head of the unit. It indicates the circumstances of the injury and must necessarily contain a conclusion in the following wording - “the injury was received during the performance of official duties” or “the injury is not related to the performance of official duties.”
3. Medical characteristics (written by the attending physician).
4. Outpatient card.
5. A copy of the sick leave certificate.
6. A copy of the certificate of passing the Military Military Test for fitness for service from your personal file.

If, when you received an injury, you went to another clinic other than the Ministry of Internal Affairs medical institution, then you must additionally provide:

1. certificate of initial application to the state or municipal institution healthcare (original);
2. an extract from the medical history of an outpatient (inpatient) patient;
3. discharge summaries and other medical documentation(certified copies).

All medical documents must be certified with a corner stamp and the seal of the health care institution to which you applied.

IMPORTANT! Do not delay the registration; the period from the moment of injury to the moment of insurance payment should not exceed three years.

When extending service life

(reaching the age limit)

When reaching the age limit (currently it is 45 years for employees whose rank is not higher than lieutenant colonel) and extending their service life, the employee needs a commission opinion on the possibility of continuing to serve.

Upon dismissal

Upon dismissal, the employee is asked to undergo an IVC, which he has the right to refuse. If the VVK recognizes an employee as unfit for further service or fit with restrictions, then the basis for dismissal may change. You can read about it in our article.

Also, an employee must be sent to the IHC if the total duration of days of incapacity for work is 4 months a year or more.

This is a relative innovation, please note that previously people were referred to the IVC if they had continuous sick leave for 4 months, now all sick leave during the year is counted.

The employee is directed to undergo the CPD by the department psychologist based on the recommendations of the previous report and examination results.

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