It takes a great deal of communication, coordination, flexibility and teamwork to manage the many patients who come in, and out, of the hospital each day. Within MGH Interventional Radiology alone, staff handle up to 70 cases per day – and this number is expected to steadily grow.
Since the onset of the Russia-Ukraine war in February 2022, the Heal Ukraine Group (HUG) has hosted numerous activities and provided resources to help address the health care crisis in Ukraine. Through one of HUG’s most recent impactful initiatives – along with the Harvard Scholars at Risk Program – six Ukrainian clinical scholars came to Boston for six months of specialized training as part of this at Harvard-affiliated hospitals, including Mass General.
Through this program, these medical practitioners gain new knowledge and skills – with guidance from mentors at Mass General and Brigham and Women’s Hospital – to bring home to Ukraine. These clinical observerships not only address the medical education disrupted by the war, but further contribute to the improvement of long-term medical care and delivery and advancements in health care provision for Ukraine.
“In addition to the education and training Ukrainian clinicians receive through this initiative, many new relationships have been forged,” says Mark Poznansky, MD, PhD, director of the MGH Vaccine and Immunotherapy Center and co-founder of HUG, along with Nelya Melnitchouk, MD, a colorectal surgeon at Brigham and Women’s Hospital, and Jacqueline Hart, MD, director of a Boston-based non-profit serving vulnerable populations. “These lasting connections help create a network for international collaboration to continue to fortify and repair medical care and delivery in Ukraine.”
One such relationship is between Vadym Vus, MD, a Ukrainian family medicine visiting scholar, and Andrew Liteplo, MD, chief of the MGH Division of Emergency Ultrasound and director of the Center for Ultrasound Research and Education (CURE) at Mass General. The two met on Vus’s first day of his observership when Liteplo – who is Ukrainian-American – approached Vus, speaking Ukrainian. They discussed their shared focus of work in ultrasound imaging and diagnosis, and in education and training of ultrasound methodology.
“Prior to the war, it could take days to get an ultrasound in Ukraine, even more so in areas like the countryside where resources are limited,” says Vus. “To make matters more difficult, ultrasound performance was limited to physicians, specifically doctors trained as sonographers, unlike in the U.S. where other types of trained specialists can complete ultrasounds.”
Throughout his observership in Boston, Vus – who has since returned to Ukraine – consulted with
Liteplo to expand his knowledge and skills in ultrasound, learning about advanced ultrasonographic techniques and different applications of ultrasound, including for cardiac, musculoskeletal, procedural and sinuses, which is not currently used in Ukraine. Prior to his return home, Vus began sharing his observations with Ukrainian colleagues at weekly virtual rounds, providing the preliminary steps to implementing improved methods of education and teaching for ultrasonography.
“Many said it was impossible for a family doctor to give an ultrasound,” says Vus. But now, after his time at Mass General with Liteplo and two years of medical reform in Ukraine, Vus leads the FOCUS POCUS ultrasound team. The group provides training in sonography and point-of-care ultrasound (POCUS) to medical clinicians including nurses, physician assistants, military personnel and paramedics. This method of imaging is used for rapid diagnosis as opposed to traditional radiology-based ultrasound. It is performed by the clinician at the bedside, and the results are immediately integrated into patient care.
“This has tremendous benefits for patient care because it can provide rapid, life-saving information in seconds; the procedure is also safe and inexpensive,” says Liteplo. “During this time of chronic warfare, life-threatening injuries such as pneumothorax, abdominal bleeding or even shrapnel that we can’t see by X-ray imaging can now be identified quickly via POCUS for immediate and life-saving intervention in the operating room.”
Liteplo also supports other global health efforts through international courses designed to educate and train residents, medical students and fellows in a variety of POCUS applications and techniques. Most recently, he traveled with his team to Ghana to provide a bedside ultrasound course, disseminating the knowledge and skills necessary for proper ultrasound clinical use.
“We are democratizing this technology and putting a powerful tool in the hands of everybody, which is facilitated as the price of the devices continues to fall,” says Liteplo.
Together, Vus and Liteplo plan to further broaden the scope of ultrasound education in Ukraine, maximizing its potential in saving lives. Liteplo hopes to travel to Ukraine soon to teach POCUS to physicians who provide frontline care to injured soldiers and civilians, and to provide additional training to Vus and the FOCUS POCUS team in advanced applications like nerve blocks.
“The goal is to improve patient care in Ukraine by further disseminating POCUS education to fellow Ukrainians in an effort to broaden life-saving ultrasound use and application in the country,” Liteplo says.
The valuable collaboration between Liteplo and Vus is just one of many successes born of the Ukrainian visiting scholars and Mass General and Brigham and Women’s Hospital mentors. Also among the first group of six visiting Ukrainian scholars were a psychiatrist, anesthesiologist, infectious disease specialist, medical oncologist, and surgical oncologist. With these observerships complete, HUG and Scholars at Risk are in process of identifying the next round of physicians to visit.
“There are so many different areas of medicine that weren’t fully appreciated before the war – psychiatry, trauma care – and people find the time to make the most of this program for the Ukrainian physicians to support training in these areas here at MGH and BWH,” says Poznansky. “The commitment of the doctors here is truly amazing as they do anything they can to help their Ukrainian counterparts in any way they can.”