The article provides an analysis of significant changes in legislation aimed at improving continuous medical education and staffing of the healthcare system. The main novelties related to the prohibition of the use of distance learning technologies and e-learning in the implementation of medical and pharmaceutical education programs, the approval of standard additional professional programs, the introduction of a mentoring system in healthcare, and changes in the organization of targeted training for specialists are considered.

Keywords: additional professional education, staffing, standard programs, mentoring, accreditation of specialists

Multimodal foundation models and medical multimodal large language models are establishing a new class of diagnostic clinical decision support systems capable of operating on heterogeneous data sources, including medical imaging (X-ray, CT, MRI, ultrasound, histopathology), physiological signals (ECG, EEG), clinical text (electronic health records, reports, discharge summaries), laboratory measurements, molecular profiling data, and related modalities. This article systematizes model architectures and training strategies that enable transferability across tasks and modalities, and discusses requirements for reliability, clinical validation, and regulatory classification of such models. Universality is interpreted as the ability of a single model or a unified modular framework to address a broad spectrum of tasks (detection, segmentation, triage, summarization, information extraction, and vision-language question answering) while preserving auditability of outputs and strict operational constraints. In particular, the system must not issue a final diagnosis or replace the clinician; instead, it provides well-grounded hypotheses, observations, and decision cues suitable for clinical verification and documentation in compliance with existing regulatory requirements.

Keywords: multimodal models; medical diagnostics; foundation models; SaMD; MDSW; clinical validation

The article is devoted to the urgent problem of increasing the availability of specialized ophthalmological care in the regions of the Russian Federation and broadcasting modern medical technologies through a mentoring system. A model for organizing mobile medical teams to provide specialized ophthalmological care in second-level medical organizations that do not have the necessary equipment and trained personnel is presented.

The main goal of the system is not only the provision of medical care to patients, but also the implementation of innovative technologies for the surgical treatment of the most common and socially significant diseases of the eye – cataracts, diabetic retinopathy.

The model includes a mandatory component of training specialists within the framework of internship and mentoring, which allows you to gradually transfer part of specialized medical care from federal centers to regional medical organizations. We analyzed regulatory requirements, the composition of diagnostic and surgical teams, financing mechanisms within the framework of the basic compulsory health insurance program, regulatory barriers to entry and ways to overcome them. Recommendations were proposed for the implementation of the model in accordance with the requirements of the federal project «Medical Personnel» of the national project «Long and Active Life» and improving the regulatory framework for providing specialized assistance in the conditions of mobile medical teams. The system has been tested by the S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery».

Keywords: mobile medical teams, technology translation, specialized ophthalmic care, mentorship, mandatory health insurance, regional healthcare, cataract, high-technology care

In the article there is considered ed the relevance of the category of responsibility in the context of patient subjectivity in the system of interaction of various actors in the field of healthcare as a basic category for the potential development of a patient-oriented healthcare model in Russia. The necessity of distributing responsibility between the main subjects of interaction in the healthcare system – the doctor and the patient – is substantiated. The author's definition of “responsible patient” is proposed/ It is correlated with the concepts of compliance and responsible self-treatment. The limits of applicability of this concept are defined.

Keywords: patient-oriented healthcare, responsibility, responsible patient, responsibility for your own health