Regulatory requirements and assessment of scientific research by a psychiatrist when considering the issue of assigning a qualifying doctor`s category

Introduction: In accordance with the requirements for the preparation of a report, a physician must provide information on scientifi c research in the following sections to obtain a qualifi cation category of a specialist: 6. Scientifi c and practical work (participation in scientifi c and practical conferences, medical scientifi c societies, presentations, publications); 11.2. List of publications of the attested in scientifi c journals and collections, abstracts and 11.3. List of speeches at international, all-Russian and republican conferences.


Introduction
The Regulation on the provision of public services for the assignment of a quali ication category for the preparation of a report for specialists with higher medical and pharmaceutical education formulates provisions on the scienti ic research of a doctor in two sections as follows: Section 6. Scienti ic and practical work (participation in scienti ic and practical conferences, medical scienti ic societies, speeches with reports, publications); Section 11. 2. List of publications of the attested in scienti ic journals and collections, abstracts and 11.3. List of speeches at international, all-Russian and republican conferences [Appendix No. 3 to the Administrative Regulations for the provision of public services for the assignment of a quali ication category to specialists carrying out medical and pharmaceutical activities in the Republic of Komi, in the manner prescribed by the authorized federal executive body]. It follows from this that a doctor who draws up documents for a quali ication category must be engaged in scienti ic work, have publications in scienti ic journals and speak at scienti ic conferences [1][2][3][4][5].

Material and methods
The analysis of 5 quali ication works of a psychiatrist was carried out in 1997 (for 1994-1996) When working on the material, the following methodological approaches were used: systemic, complex, dynamic, normative, quantitative and situational. Analysis methods included: historical, analytical and comparison. The following techniques were used for the analysis: groupings, absolute values, continuous and selective observations.

Results
Formation of the scienti ic interests of the future doctor begins in the classrooms of the medical institute in student scienti ic circles, and in each case it happens in different ways. As a rule, one of several directions is chosen, which becomes the scienti ic dominant and determines the face of the researcher. However, depending on situations, other effective parallel studies in various ields of medicine are often possible, if they touch on general medical issues and (or) a doctor's specialization is constantly in demand when he works in a stable scienti ic group on interdisciplinary problems.
In the analyzed case, the future psychiatrist was engaged in student scienti ic circles of the departments of topographic anatomy and operative surgery, dermato-venereology and psychiatry of the Arkhangelsk State Medical Institute (ASMI), was involved in scienti ic research at the department of psychiatry of the ASMI while studying in clinical residency, taught psychiatry and neuroscience medicine college. Therefore, in the ield of scienti ic interests were: Psychiatry. Mental health and morbidity of the population. Public health and health care of the subarctic region. Social medicine. Implementation of ITU recommendations for the rehabilitation of patients in various professional and age groups. Preventive medicine. Methods of teaching the basics of life safety, emergency medical care in case of injuries and accidents, healthy lifestyle and health-preserving technologies, social and hygienic consequences of HIV infection (AIDS), sexually transmitted diseases and bad habits (tobacco, alcohol, toxic and drug use) substances) in higher and secondary vocational educational institutions. Didactics of subjects "Safety of life" and "Fundamentals of a healthy lifestyle" for non-medical faculties of humanitarian and technical universities. Distance and additional education, active forms of education [11][12][13][14][15].
The psychiatrist, independently or in co-authorship, published 284 scienti ic and educational-methodical publications with a personal total volume of 197.85 conventional author's sheets (40,000 printed characters), of which scienti ic -141 (55.01) and educational-methodical -143 (142.84) works, including 1 monograph and 8 textbooks (two of them Recommended by the Presidium of the Council of Educational Methodological Association of Russian universities in the ield of teacher education as a textbook for students of higher educational institutions, students majoring Publications of physicians in scientifi c journals and collections, theses of reports should motivate their interest, and within the limits of the possibilities of the medical institution to have reasonable fi nancial support, fi xed in the employment contract.
An example of a practical doctor who speaks at international, all-Russian or republican congresses, congresses and conferences is an important indicator of his professional growth, an incentive for the disclosure and development of the potential of the medical institution team and the result of proper administrative and organizational-methodological guidance.
The scientifi c work and publications of a psychiatrist's practical doctor should be a weighty additional argument in favor of a positive decision on awarding the qualifi cation category he has declared. https://www.heighpubs.org/hjcap 027 https://doi.org/10.29328/journal.apmh.1001032 on discipline 033300 "Safety"). In the e-library (www.elibrary.ru) of the Russian Science Citation Index (RSCI): publications -47; citations -273; Hirsch index -4, publications in VAK list journals -16, weighted average impact factor of journals in which articles were published -0.902, weighted average impact factor of journals in which articles were cited -0.231. Elsevier Mendeley scienti ic metric system has 284 publications [16][17][18].
In the Russian State Library (Moscow) in the Uni ied Electronic Catalog 4 textbooks are presented (www.rsl.ru).
In the Russian National Library (St. Petersburg) in the electronic catalog there are 4 textbooks (www.nlr.ru).
Two textbooks were presented at the collective stand of the "Universities of Russia" exposition at the 55 th International Book Fair in Frankfurt am Main (Germany), which after graduation entered the library of the University of Frankfurt (2003). The Presidium of the Council of the Educational and Methodological Association for the specialties of pedagogical education awarded both books the "Label of textbooks for students of higher educational institutions" (2004).

Discussion
The scienti ic work of an outpatient psychiatrist practitioner is dif icult to assess, since, on the one hand, its implementation is of a recommendatory and not mandatory nature, on the other hand, it is very clearly characterized by an interest in analyzing the results of one's own work, creativity and scienti ic activity [52,53].
The irst indicator of any analysis is, of course, quantitative results. And in this case, they are convincing enough for a scientist of any quali ication, especially a practical doctor. The total personal volume of works amounted to 197.85 conventional author's pages (each 40,000 characters). A qualitative analysis of works, irst of all, determines the ratio of works published in scienti ic publications (141): monographs, scienti ic and practical and scienti ic methodological journals, collections of works of scienti ic and practical congresses, congresses, conferences, including international ones, and educational and methodological publications (143). The next question to be answered is what the author writes: numerous abstracts of 3 paragraphs for 12-18, or even 25 authors (the so-called "mass graves") or scienti ic monographs and journal articles. The integral indicator of the psychiatrist's personal participation in each publication of 0.70 conditional printed sheet characterizes a solid volume of personal contribution to scienti ic research.
Serious work on two textbooks over 10 years, their relevance, expressed in a 4-fold reprint, was appreciated not only by users (students, cadets), but also by the scienti ic Modern science began to measure the value of publications by scienti ic metric indicators, including the number of citations. The indicator is important, but not very objective and, to some extent, quite "crafty". In the modern world of scienti ic journals, a huge number of scienti ic journals are published (including in electronic form), but their availability is sharply limited due to very small circulations, as well as payment for electronic copies, if they are provided by editors, publishers or Internet libraries. At present, it is dif icult to imagine yourself a provincial doctor who independently subscribes two or three professional journals at the same time (as a rule, published by leading scienti ic research centers or institutes of psychiatry in Moscow and St. Petersburg, plus something else from Europe or the USA on the generally accepted English language). But such a situation was quite common in every department of any Soviet hospital 25-30 years ago (there were international magazines from friendly countries of Eastern Europe in Russian). Since then, writing and publishing have become many times more, and the results of research have become much less read and applied in practice, mainly due to the inancial inaccessibility of scienti ic periodicals and the lack of awareness of their results. And, nevertheless, there is an e-library (www.e-library.ru) and the Russian Science Citation Index (RSCI), which conduct a comprehensive analysis of the author's publications online, calculate all kinds of indices and indicators. It turned out that the RSCI represented only 13.90% of the discussed scienti ic and educational-methodical publications of a practical doctor. This signi icantly reduces the scienti ic rating, which is not always justi ied by most modern scientists. The reason lies in the limited availability of the RSCI for practical independent users, since this is an ordinary commercial project. For the placement of publications of scientists published in journals, the Internet portal bears the costs, and for the introduction and correction of personal printed works outside of periodicalsa scienti ic institution. There is no reason to hope for some kind of payment from practical doctors of non-scienti ic and non-educational state medical institutions of the RSCI. Thus, scienti ic citation is carried out objectively only for registered scientists, scienti ic and educational institutions that pay for these services.
For the objectivity of the assessment of scienti ic work, it is important to understand how the researcher works: on a continuous basis or from time to time. To this end, it is important to know the scienti ic metric indicators of the researcher's scienti ic publications over the past 3-5 years. They can be low, including among professional scienti ic workers, or, conversely, command respect, as in this particular case.
At the head of the practical signi icance of any scienti ic publication at the present time, from the standpoint of curators of scienti ic metric projects and portals, the absolute number of its citations by other authors is put. And this important indicator may contain a certain amount of guile. How often do readers of scienti ic publications and publications that are freely available in libraries or the Internet cite the text they have read? Judge for yourself: three articles by authors published in 2013 in one of the international electronic journals OA Publishing London, at the time of this writing (after 6 years), according to the automated portal program, respectively, have 14303, 14146 and 11676 views and -not a single citation, for example , in the Web of Science. Researchers and users watch, perhaps read and even copy freely available pdf iles, but do not feel it necessary to cite literary sources (the unpredictable Internet!). On the other hand, 40,125 readers showed interest in works from Russia. This is also a very signi icant result. However, views are not citations, and the scienti ic community treats them as "emoticons"interested smiles from the Internet and nothing more.
It should be noted that only authors of dissertations for the degree of candidates and doctors of sciences are extremely careful (scrupulous) and conscientiously citing, since they need to recruit 150-200-300 authors-predecessors for the solidity of the study. And in such works, they try to cite all the authors who published works on this topic. In Russia, there is a special site for the Scienti ic Electronic Library of Dissertations and Abstracts (Pubmed: https:// www.dissercat.com/), the fund of which is more than 740 thousand research papers -over 440 thousand theses (386 thousand candidate and 54 thousand doctoral works) and 300 thousand abstracts and re lects the entire modern science of the country and its development. A list of citations of each dissertation is freely available, that is, the scienti ic works of the author's predecessors and contemporaries in demand. It is reasonable to place these citation results in the RSCI, but the copyright holder of Dissercat.com and the possible assignee for some reason still do not do this. And only if the dissertation candidates independently post their work in the RSCI, it is possible to ind out the authors of the cited scienti ic works and objectively evaluate their Hirsch index.
In an ordinary journal (non-dissertation) article, the task of comprehensive citation is not worth it. The editors strongly limit the number of citations for articles to 10-15 sources, literary reviews -30-45 in the conditions for authors. And thus, many studies are not mentioned and remain outside the main scienti ic indicator. Sometimes the authors are not mentioned intentionally, since they work in the same scienti ic direction or they are mentioned necessarily and repeatedly, since they can be (or become) the most likely reviewers of the article, employers, scienti ic advisors of the author, reviewers of the dissertation work or its opponents.
In order for an article to start "living" in modern scienti ic https://www.heighpubs.org/hjcap 029 https://doi.org/10.29328/journal.apmh.1001032 life, it must not only be written and published, but also entered into the electronic databases of libraries and the world's authoritative search platforms Scopus, Web of Science and others. How to do this if your organization is not a subscriber of the RSCI, and it does not have an authorized person to do this. There is only one way -the citation itself in the next article, if it gets into the scienti ic system automatically. But this citation will not be taken into account as an equal citation in the scienti ic pro ile for calculating the Hirsch index and will be attributed to a rather humiliating and not respected category -"citation itself".
Authors often independently ind in Internet publications citing their works by colleagues working in parallel scienti ic areas, but if these publications have not concluded an agreement, do not pay for services, then there is no citation.
Copyright holders must enter all information about the publication and citation themselves, including in the RSCI. No payment -no citation.
Often, researchers make mistakes not only in the names of the authors, but even in the titles of the journals, so the mentioned scienti ic work will never be included in the list of their citations. For example, in one Russian scienti ic publication, when citing the Far Eastern Medical Journal, it is named as the Marine Medical Journal. The citation itself is not in the RSCI, but the work is hosted by Mendeley.com, a Scopus subsidiary platform. To correct inaccuracies, it is necessary to enter into a legal relationship with the citing platform, which for the practitioner presents long-term unpredictable dif iculties, which are usually ruled out as unnecessary.
Thus, over the past 20 years, systems of domestic and international citation of scienti ic publications have been created with good intentions, which requires complex legal and inancial regulation of relations between scientists, research centers and the citing organization.
Understanding even a small part of the above arguments, people who are able to effectively engage in scienti ic research do not embark on this thorny path or curtail their already begun activities. Motivation, as a rule, comes down to the wording: "The time and money are huge -the practical results are questionable." Why go on with this? Therefore, at present, practice shows that in most cases, practitioners are increasingly refraining from discussing the results of their work and publishing them not only in the scienti ic press, but also presenting them to the Attestation Commissions due to the large expenditure of personal time for registration of work and low inancial motivation. in case of successful completion of certi ication and assignment of a medical quali ication category. Having accepted by appointment after the main working appointment, two or three patients per month on a paid basis, they easily compensate for wages in the absence of a quali ication category.
The regulatory framework of indicators and requirements for the presentation of the report is also far from perfect. Legal expertise (lawyer, actual state adviser of the 3rd class of the Komi Republic Shapovalova P.K.) notes that there is no synchronization in the daily work of a practical doctor, his job duties with the wording of the Regulations. When concluding an employment contract with an employer, it does not mention that a doctor must be engaged in scienti ic work, and it is an integral part of his functional duties and quali ication requirements. Scienti ic work is not mentioned In most medical institutions at the level of rural, district, and individual city hospitals, scienti ic work is not carried out at all, since there is no material base for this, no administrative, methodological and scienti ic leadership. And only during the departure for advanced training to central universities, interested doctors can join scienti ic research, and some of them ind a scienti ic advisor, determine the topic, carry out and successfully defend dissertations. If there are no requirements to engage in scienti ic work in the doctor's job description, and they are not included in his functional duties, then in most cases there can be no scienti ic results and their publications. Therefore, there is no reason to require a mandatory report on scienti ic research from a doctor, all the more to introduce an independent section in the Regulations for qualifying work. Doctors ind a way out of the situation in different ways. Most often, in most qualifying works, they avoid numbering sections in accordance with the requirements, and section 6 automatically disappears. Scienti ic work. But if from the irst day of work of a doctor, of icial duties obliged him to engage in scienti ic work, then after 3, 5, 7 years (minimum work experience in the specialty for the award of the second, irst and highest quali ication categories, respectively) she would no doubt have been presented.
The regulatory framework of indicators and requirements for the presentation of the report is also far from perfect. a specialist should orient himself in modern scienti ic and technical information and use it in his professional activities, but to orientate does not mean to engage in research work and publish its results. The second important aspect of this problem is that the employer, represented by the chief physician, does not motivate employees to engage in scienti ic research. What follows the performance of the work -its report at a scienti ic conference, as a rule, on the road to a regional, and more oftena central city. The path from Petropavlovsk-Kamchatsky to St. Petersburg is not close and very expensive. It is necessary to pay for organizational costs and travel, which in the conditions of self-inancing of medical institutions is not always possible, especially in large quantities. Publishing in a scienti ic journal becomes an exorbitant burden on physicians and researchers. Editors set a variety of tariffs from a sparing 8 thousand rubles per article to 5 thousand rubles per page. Electronic mailboxes are over lowing with offers of publications in foreign journals, but the cost in some of them exceeds 2000-2500 conventional units, and even the promise of subsequent citation in the Scopus system does not arouse the desire for such "expensive" scienti ic cooperation. Therefore Section 11.2. The list of publications certi ied in scienti ic journals and collections, abstracts of reports is a serious test for a practical doctor and requires guarantees of inancial support from the employer, which makes such serious demands on him. Although it is dif icult to imagine that a public health institution would pay signi icant sums for the publications of doctors, especially in mass numbers. Currently, a relatively good indicator is considered if more than half of the doctors of a medical institution have quali ication categories. That is, every second specialist of a medical institution potentially not only can, but should also be the author of a scienti ic research.
The third problem is formulated in clause 11.3. List of speeches at international, all-Russian and republican conferences. For a modern practitioner to prepare and present his report on the materials of the section of his own results of certi ication work does not seem to be a timeconsuming process. Submitting an application and receiving positive feedback from an anonymous reviewer is already a great success for the practitioner. What's next? What decision will the employer make? Will he send the employee on a paid business trip, which will become an example and incentive for the rest of the medical team. The question is the price. The All-Russian conference, the congress will cost 25-30,000 rubles, and the international one, where only the registration fee is 500-600 conventional units, is not less than 1800-2000 USD. And here the administration, perhaps, will only smile in response and offer to look for other payment options, including scienti ic grants, which can be extremely dif icult to obtain (and for a practitioner from the provinces, it is simply impossible) or to use personal funds (with the wording "at the expense next labor leave "). But, please note that the doctor's quali ication report will not be complete if the above item is not illed out. It is extremely rare, but it is also possible to manipulate the scienti ic section by the administration and (or) the quali ication commission, when the doctor is detained, postponed or downgraded due to the absence, "insuf icient" or "poor quality" of scienti ic publications in the quali ication 3-year period under consideration.
With the growth of quali ication requirements, the volume of work, as well as the inancial costs of its registration and technical support, grows signi icantly. If the irst qualifying papers were allowed to be submitted with a font of size 12 with 1 line spacing, nowadays -font 14 with 1.5 spacing, which signi icantly increases the volume of attestation work in pages. And this entails an increase in the cost of technical support for the qualifying work of a doctor: paper, printer, etc.

Conclusion
The attitude to the Administrative Regulations for the provision of public services for the assignment of a quali ication category to specialists engaged in medical and pharmaceutical activities should be revised in terms of its synchronization with the of icial duties of a doctor. The provision on the compulsory conduct of scienti ic research should be introduced, substantiated and provided by the employer, or be excluded from the administrative regulations as an independent section and be exclusively advisory in nature.
Publications of doctors in scienti ic journals and collections, abstracts of reports should motivate their interest and, within the capabilities of a medical institution, have reasonable inancial support, enshrined in an employment contract.