Fitness and healthy lifestyle 

Medical professional consultation of teenagers. The noise level in production is normalized. Fundamental principles in the conduct of the military-industrial complex

IV. Creation of favorable conditions external environment during lessons.

Efficiency physical activities largely depends on compliance hygiene conditions. It is forbidden to conduct physical education classes in the basement and walk-through rooms, corridors. Each school must have a gym that meets the following requirements:

1. The area of ​​the gym is determined at the rate of 4 m 2 per student at a height of 5-6 m.

2. t° air should be maintained at 14-15° C.

3. A three-time air exchange per hour is required, which should be provided by supply and exhaust ventilation (with a supply of 80 muh per student) or cross-ventilation (transoms, vents).

4. Sufficient illumination level (SK 1:4-1:5), artificial illumination level - 150-200 lux.

5. Windows, lamps, heaters must be closed with removable nets.

6. The floors are wooden, the walls are even, without protrusions, covered with oil paint to a height of up to 2 meters.

7. Necessary auxiliary premises:

2 locker rooms (for boys and girls) with showers and toilets, equipment room, teacher's room.

8. Sports equipment must meet the specifications, not have nicks and other damage that could cause injury.

9. Only the equipment that is needed for this lesson should be in the gym. :

10. Wet cleaning of the hall should be carried out 2-3 times a day - before the start of classes, between shifts, at the end of classes.

11. spring-cleaning hall - once a week with hot water.

12. special care mats are required. Store them in a hanging position. Covers should be washed once a week. In addition, knocking out, cleaning with a vacuum cleaner is used.

Choosing a profession is an important life problem for every person. This choice begins at school in adolescence and is based for some - on own experience classes in circles, and for most others - on information received from relatives and friends, gleaned from fiction, television and radio programs.

However, many adolescents by the end of schooling do not develop a stable interest in any area of ​​​​knowledge or occupation, which is why they cannot independently choose a direction. professional activity. So, sociological studies conducted among schoolchildren in Moscow and the Moscow region in the 80s showed that only 20% of graduates had clear ideas about their future profession, about 50% of students did not make a choice at all, the remaining 30% did not know if they had certain desires. where they can be implemented, judged the proposed type of activity on random advice and recommendations.



This is a very common occurrence. It is not surprising that in the future, in the process of mastering a profession, training in vocational schools, secondary specialized and higher educational institutions or in production, adolescents, encountering difficulties, are disappointed in their choice, which causes moral damage, causing dissatisfaction, a desire to change jobs, and brings considerable loss to society.

The most common mistakes when choosing a profession are as follows:

1. Reassessment of one's strengths and capabilities. On the one hand, this is a consequence of ignorance of the content of the profession and the requirements that it imposes on the body. On the other hand, adolescents do not take into account the state of their health at all: in the presence of serious deviations and even chronic diseases, most of them considered themselves full-fledged and efficient in any field of activity.

2. Passion for "fashionable" and prestigious professions without taking into account physical abilities and production needs for these specialists.

3. Blind imitation of friends: "a friend went and I went with her" - a frequent motivation for choosing a profession among schoolchildren.

In order to harmonize the aspirations of adolescents and their individual qualities, special preparation of students for a conscious choice of profession is necessary. This system of events is called vocational guidance.

Career guidance - a scientifically substantiated system of measures aimed at helping students choose a profession taking into account their interests, inclinations, as well as the state of health and the needs of the national economy in personnel.

School, family, polyclinic, enterprises, organizations and educational institutions take part in this work. Professionals must be involved different profile: teachers, psychologists, physiologists, doctors, economists. There are 3 main aspects of career guidance:

1. Psychological - involves the study of the student's personality, his abilities, inclinations, psychophysiological characteristics of the body.

2. Medical - includes the study of the student's health, the establishment of irreversible defects and developmental anomalies, and in the presence of chronic diseases - degree of compensation.

3. Socio-economic - taking into account the needs of society and a given ecological region in personnel and specialists of various profiles and qualifications.

A set of activities for career guidance should be carried out in schools starting from the 5th grade. This work is carried out mainly by teachers with the involvement of parents. Its purpose is to identify and develop the abilities of children, to get acquainted with professions by conducting excursions to production facilities, showing educational films. Already on it early stage the doctor of the school also takes part in vocational guidance, because he has been monitoring the development and health of the child for several years. He has the opportunity to find out the interests and abilities of schoolchildren - their professional intentions, establish contacts with teachers and parents, giving advice to the latter on the employment of children with deviations in health (in particular, in the presence of irreversible surgical defects or diseases, such as residual effects of polio , contractures and ankylosis of the joints, refractive errors, congenital and acquired heart defects, epilepsy, neuritis of the auditory nerve, chronic nephritis, severe scoliosis, residual effects of birth trauma, etc.). It is these children who need to be oriented as early as possible to the professions and specialties shown to them for health reasons and tactfully divert their attention from professions that can aggravate the course of the underlying disease or aggravate it.

Here is the time to define the concept of "medical-professional consultation" (VPK).

The main task military-industrial complex - selection for adolescents from many professions of this type of labor activity, which would not only not exacerbate his deviations, but would also contribute to their correction. correction, health promotion, physical development, i.e. recommendation of a profession and specialty specifically for each teenager in accordance with his state of health and functional capabilities.

VKK is carried out starting from the 7th grade in relation to all students. For this purpose, an in-depth examination is carried out by a pediatrician (as 15 to 18 years old - a doctor of a teenage office) and other specialists (ENT, neuropathologist, surgeon, ophthalmologist). Survey data and dynamic monitoring of students throughout the years of study make it possible to identify students with deviations in physical development and health conditions that require qualified medical council regarding the choice of profession. Based on the results of this examination and taking into account the data of the dynamic observation of the pediatrician contained in the medical documentation, a medical opinion is given on the professional suitability of the teenager. This conclusion is entered in a medical certificate (form No. 086 / y), which is issued to a teenager entering a job or study at a vocational school, technical school, secondary specialized educational institution or university, from a polyclinic at the place of residence or a comprehensive school where he studied.

Numerous works carried out in recent years in Moscow and the Moscow region, as well as in Leningrad, on the evaluation of medical and professional consultations at school, have shown that approximately every second teenager has restrictions on certain types of work. Therefore, it is very important to conduct the 2nd stage of career guidance - professional selection, those. determining the suitability of a teenager for health reasons for this profession, as well as assessing functionality and adaptive abilities of his body. This work is carried out by medical workers of vocational schools, technical schools, universities, etc., choosing from among candidates for certain types of work those who, in terms of their health and individual qualities, are more suitable for this work. The specificity of the medical examination is to identify the functional capabilities and compensatory reactions of those systems and organs that are expected to be predominantly affected by production factors.

A few words should be said about the features of morphology and physiology adolescence, since they are in to a large extent determine the features of the course of pathological processes, as well as the specifics of the reaction of adolescents in the process labor activity and adaptation to work and must be taken into account in the practice of the military-industrial complex.

Adolescence and youth (from 13 to 18 years) is characterized by a number of anatomical and physiological and psychological features distinguishing it from other periods of life. In morphological and functional terms, this period is characterized by the rapid growth of all organs and systems and, mainly, by the energetic restructuring of neurohumoral and neuro-regulatory relationships. As a result of these changes, adolescents may experience:

1) a pronounced increase in all vegetative reactions, inadequacy of reactions to the nature and strength of the impact - the maximum response even to small stimuli;

2) a significant increase in metabolism and energy spending, which, along with intense plastic processes, creates conditions for reducing resistance to adverse factors.

With vocational training, adolescents can come into contact with almost all physical factors of the external environment (except for penetrating radiation) and with many chemical agents. It has been proved that the degree of unfavorable influence of professional factors on the organism of adolescents is determined not only by the duration of contact, but also by a complex of conditions (intensity of exposure and reactivity of the organism).

For a doctor working with adolescents, it is absolutely not enough to know only the age characteristics, the clinic and therapy of certain deviations in the state of health, the functional and adaptive capabilities of the affected organ, the ability to predict the further course of the pathological process. For a full-fledged professional advisory opinion, a doctor must still have sufficient information about the characteristics of professions, about the nature of the impact of labor factors on the body of workers, the requirements for a particular type of work on the functional state of the body and individual organs and systems. Knowledge in the field of occupational health is necessary to select a specialty for a teenager that would not only fully correspond to his anatomical, physiological and age-sex characteristics, but also have a healing effect. To this end, together with sanitary-industrial doctors and a safety engineer for each profession, sanitary characteristics, reflecting all the essential leading factors inherent in the profession at the present level of production development.

The sanitary characteristic allows the doctor to predict the impact of production conditions and the nature labor process on the body of a teenager. The sanitary characteristic is drawn up according to a certain scheme with a mandatory description of the sequence of the work process and individual operations, the materials used, equipment and tools, the working posture (standing, sitting, forced). In addition, there is information about the presence of increased requirements for individual analyzers (hearing, vision, smell, etc.), central nervous system(attention, coordination of movements, memory, etc.), as well as the possibility of exposure to industrial hazards (dust, noise, vibration, chemicals, adverse weather conditions).

All professions according to sanitary characteristics can be conditionally divided into 4 groups:

The 1st group includes professions where there are no difficult working conditions and unfavorable production factors. These are the professions of the service sector, office work, watchmaking, instrument-making enterprises, etc. Schoolchildren with deviations in health status, as well as deviations in physical and mental development can choose one of the many professions included in this group.

Group 2 combines professions associated with the temporary impact of adverse production factors. For example, the work of a cook is associated with a temporary effect of high temperature (23-38 ° C) and high relative humidity. A teenager during work at the stove has profuse sweating, an increase in body temperature and an increase in heart rate up to 140 beats per minute. Consequently, the uncomfortable microclimate in the production room from time to time places increased demands on the respiratory and cardiovascular systems. Based on this, the profession of a cook cannot be recommended to adolescents suffering from respiratory and circulatory diseases.

Group 3 includes professions associated with the constant impact of a complex of various unfavorable factors. For example, in the work of a weaver there are: action elevated temperature, dustiness; intense noise (risk factors for people with diseases of cardio-vascular system and respiratory organs), as well as a forced posture (standing work), contraindicated to persons with posture disorders and flat feet. Thus, schoolchildren with diseases of the heart, lungs, hearing and musculoskeletal system given profession contraindicated.

Group 4 unites about 3,000 professions and jobs with heavy and harmful conditions labor. Work in these enterprises is allowed only from the age of 18. For the indicated professions, industrial practice (industrial training) is allowed for persons studying at vocational schools, high school students general education schools. Duration of stay - no more than 4 hours a day, subject to strict observance of sanitary and hygienic standards in these industries and at workplaces.

Adolescents represent the nearest labor reserve of society, this is especially true in relation to the age group of 16-20 years. It is at this age, as a rule, that a meaningful choice of profession and mastery of it takes place. The attention of physicians should be directed not only to health protection, but also to determining the student's ability to engage in the development of the chosen specialty and continue to work in it without harm to his health. When choosing a profession, adolescents often do not take into account the psychological, psychophysiological and somatic capabilities of their body. Most of them, even in the presence of chronic diseases, consider themselves fully functional in any field of activity. Neither do their parents think about it.

Professional interests are usually formed in school years. The sources of awareness about the profession are varied: the example of parents, relatives and acquaintances; peer interests, media, literature, visits to businesses and institutions. Nevertheless, by the end of school, less than half of the teenagers staunchly determine the interests. students high school, as a rule, are not properly informed about their health status and do not associate its level with the possibilities of choosing a profession.

Meanwhile, the state of health of a teenager is a decisive factor in solving the issues of his vocational training and rational employment. It is in the interests of society that the chosen profession should correspond to the health possibilities of the adolescent. Otherwise, having spent time and effort on mastering the chosen specialty, the young person will not be able to work effectively in it at all, and society will suffer both material and personnel damage. From this follows the importance and obligation of the timely conduct of qualified medical professional advice. Competent professional consultation helps to prevent the adverse effects of working conditions on the health of the student.

The issue of vocational guidance includes:

Studying the needs of society in specialists of various profiles and qualifications;

The study of the characteristics of the profession in terms of the requirements it imposes on certain qualities person;

Determination of physiological, psychological and other personality traits for the optimal choice of profession;

An assessment of the health status of an individual in terms of compliance with his chosen or recommended profession.

The exceptional importance of work in the first two directions for the well-being of a civilized state is beyond doubt. However, in this chapter, only the physiological and medical areas are considered. The first of them - physiological, or biomedical, develops criteria for professional selection, mainly of healthy adolescents. The second, medical, studies the state of health of adolescents, develops criteria for the rational employment of adolescents with health problems.

It was these directions that G. N. Serdyukovskaya and L. M. Sukhareva had in mind when they proposed the following definition:

career guidance is a multi-aspect scientifically based system of influence on a student in order to assist him in choosing a profession, taking into account his desire, state of health and individual typological features individual, as well as taking into account the needs of society. It includes a wide range of problems, among which the most important are:

1) the study of the characteristics of professions in terms of the requirements for certain human qualities that ensure success in mastering these professions;

2) the study of psychophysiological and other personality traits and the identification of the optimal correspondence of individual typological characteristics of people certain types labor;

3) studying the state of health of a teenager to ensure its compliance with the chosen profession in order to preserve and strengthen health in the course of work.

The solution of these problems is the goal of medical or medical-physiological professional consultation in scientific and practical terms.

Successful development of a particular profession requires the presence of certain psycho-physiological qualities of the student's personality. Physiologists (Kartsev I. D. et al.) have developed criteria for the professional suitability and, especially, unsuitability of adolescents for training a large number professions.

The development and justification of medical and physiological criteria for the professional suitability of adolescents for various professions is one of the actual problems hygiene vocational technical training.

The systematic approach in this work consists in the skillful combination of different aspects of professional selection: educational, medical, psychophysiological, socio-psychological. At the same time, it is important to take into account indicators that characterize the individual characteristics of a teenager:

Functional state of body systems;

Physical development of psychological functions and qualities;

Psychological, personal characteristics.

Consideration should also be given to the factors and conditions affecting professional education and professional resilience of the adolescent. These include:

The structure of professional activity;

Sanitary and hygienic characteristics of the profession;

Health requirements for this profession.

The tasks of medical professional consultation are:

Choosing a profession that best suits the health status of a teenager;

Research for scientific justification professional advice;

The optimal choice of profession for sick adolescents.

It is advisable to conduct such a consultation in the eighth grade of a school or in another secondary educational institution. For those who leave school at the end of the eight-year period, such recommendations are especially relevant, and for those who continue their studies, a professional conclusion will give more time for an informed choice of a profession that is not contraindicated for health reasons. Medical recommendations gets a teenager, but they should be known to his parents and class teacher.

In the last decade of the 20th century, new, previously non-existent problems arose before career guidance work:

Early leaving school, which stops dispensary observation for a teenager and reduces awareness of the real state of his health;

Deterioration of the economic situation of the family, which may force the teenager to engage in any work, regardless of the possibility of its adverse effects on the body;

Curtailment in the country of a number of practical and scientific institutions dealing with career guidance and medical professional advice.

Adolescents, who not only suffer from chronic diseases, but also have certain functional disorders, need restrictions when choosing a profession. The fact is that some types of professions impose increased requirements on the functional state of organs and systems, and work can contribute to the transition functional disorders in organic diseases. The main principle of medical professional consultation is the selection of "a type of activity that would not only not exacerbate deviations in the state of health, but also contribute to their correction."

Almost 88% of all teenagers have significant deviations in health status and diseases that require qualified medical professional advice. Because of this, they are not free to choose a profession.

Even in the Declaration of the Rights of the Child, adopted by the UN General Assembly in 1989, it was noted that the child and adolescent should be “provided with opportunities and favorable conditions that would allow him to develop in social relations in a healthy and normal way, to enjoy the benefits social security including proper nutrition, housing, entertainment and medical service receive an education and be protected from all forms of neglect, cruelty and exploitation.” The Declaration provides that “a child may not be employed until the appropriate minimum age has been reached; he shall in no case be entrusted or permitted to work or engage in any work or occupation which would be injurious to his health or education or hinder his physical, mental or moral development.”

According to the international standards of the ILO, minimum age for employment - 15 years. There are special standards (requirements) for the age group of 15-18 years. In some countries, they extend to the age of up to 21 years.

somatic, psychological and social development A teenager is accompanied by a progressive acquisition of experience, which, combined with mental and physical development, contributes to an increase in trust in elders, a more sober self-esteem and leads to maturation. The key to growing up is being able to choose. A teenager is faced with many choices, the implementation of optimal opportunities contributes to his maturation, while an unfavorable choice can slow down the development of the organism.

Child and adolescent labor is a socio-economic problem. International Standards on labor allow adolescents aged 13-15 to perform only “ light work". This term refers to work that:

A) not harmful to the health and development of the child;

B) does not prevent attendance, school, participation in vocational guidance and training programs approved by specialists, and the opportunity to apply the acquired vocational education.

The same documents define three situations in which no minimum age is required by law:

1) participation of children in public events;

2) employment in family production, provided that this work is not harmful, dangerous or damaging;

3) attendance at a vocational and technical training school.

It is important to anticipate how the work will affect the mental, and somatic and moral development, at school, life and relationships in the family, and finally, on the health of a teenager, and later on a young person. It should be remembered that work limits a teenager in rest, walks, games, communication with peers and study in the most critical period his life. Problems are inevitable with medical care working teenagers - doctors treat them either as children or as adults, while they are neither.

For development modern requirements many scientific specialties are involved in the optimal choice of profession, including anthropometry, biomechanics, labor physiology, hygiene environment, psychology of mental activity, psychology of labor, ecology, toxicology, etc.

The final stage of the preliminary medical examination of adolescents is drawing up a medical professional-consulting opinion designed to help a teenager in choosing a profession in accordance with his state of health. The conclusion must be based on integrated assessment functional state an organism that is synthesized by an adolescent doctor based on the results of examinations of all specialists: a comprehensive assessment of the state of health is one of the conditions for determining professional suitability. We have already mentioned that in no case can the choice of a profession be made by a doctor only on the basis of the study of any one system, no matter how important its condition was for the work chosen by the adolescent. Professional selection and, moreover, medical professional consultation should be based on a comprehensive assessment of the state of all organs and systems. The conclusion must contain:

1. The ascertaining part, including the found objective data on physical development, the results of the examination of all specialists and applied additional methods research.

2. Recommendations for treatment and prevention (if necessary) that a teenager needs, including outpatient, inpatient, spa treatment, dispensary observation, health-improving medical and physical education activities, advisory assistance, etc.

The preliminary examination data should, of course, be used for the purpose of clinical examination if the teenager needs them and there is no reason to postpone these recommendations until the next, periodic examination.

3. The main conclusion on professional suitability, on the compliance of the type of work chosen by the teenager with the state of his health, on the possibility of studying at the educational institution chosen by the teenager. When resolving this issue, one should take into account the conditions and nature of work in the chosen profession (specialty), their possible impact on the body and the correspondence of this work to the state of health of the adolescent. This decision should be based both on the doctor's knowledge of the course of diseases and deviations under the influence of various production factors, on the possible worsening effect of these factors on health, and on the indications of the current lists of medical contraindications for work and vocational training of adolescents in various industries.



In cases of a negative decision on suitability for the chosen profession, reference should be made to the article number of the lists. However, there may (and quite often) there are cases when either the lists do not contain indications of this profession, or the doctor's convinced, motivated opinion about the suitability of a teenager does not agree with the indications of the lists. The latter is quite possible, since many years have passed since the publication of the lists, the nature and content of a number of professions have changed, many new professions have appeared, and, finally, a number of conditions, diseases and deviations are simply absent from the lists, and contraindications for many professions have not been developed at all. In such cases, especially if the doctor’s opinion does not coincide with the indication of the lists and it is based on sufficient knowledge of the profession, it is necessary to convincingly motivate the reasons why the occupational consultant doctor considers it possible to allow or, conversely, prohibit training in the chosen profession. In case of recognition of unsuitability for the chosen profession, it is necessary to indicate several (possibly more) professions that a teenager can study for health reasons, the most appropriate professions that are most appropriate for the state of health should be recommended. At the same time, whenever possible, it is necessary to take into account the desire and inclinations of the adolescent, socio-economic motives, as well as the need for professions of a certain profile when recruiting educational institutions. However, all these factors are not decisive, but subordinate, the main thing is the state of health, and other factors are taken into account if they do not contradict the basic principle of professional advice - maintaining the health of a teenager in any type of work activity.

Thus, this section of the conclusion contains 2 main parts - the decision on the issue of professional suitability and medical professional advice! The latter is the most important and only correct form the participation of a doctor in the choice of a profession by a teenager, and the element of professional consultation in the conclusion should also be in the case when the teenager is recognized as fit for the profession he has chosen. Even in this case, it is advisable to indicate a number of suitable, and possibly more suitable than the chosen one, professions. At the same time, the recommendations of professions should be specific, one should not recommend those that are not taught in the area (this is possible only in extremely rare cases serious illnesses in which it is possible to learn one or two professions that are not trained at the place of residence), or which are not suitable for a teenager in terms of age, educational qualification. Such recommendations undermine the adolescent's faith in effective help doctor, cause a feeling of dissatisfaction, resentment; the task of the doctor is to provide effective assistance, to give actionable advice subject to mandatory health conditions.

Doctor's opinion on professional suitability should be given not only during preliminary, but also during periodic annual in-depth examinations of working adolescents and students in vocational schools.

There may be cases when unsuitability for further education is detected not at admission, but at subsequent periodic examinations, due to a disease suffered during training or the progression of a previously completely compensated disease (for example, psoriasis). In these cases, the conclusion about the transfer to another profession or expulsion from the school must be made by a doctor, regardless of the period that has elapsed since the start of training, even if there is little time left before graduation from the school. Of course, it is very important to take into account the time spent on the vocational training of a teenager, and to strive in every possible way to transfer to training in related or “related” professions in which the acquired knowledge can be used. However, this circumstance should not have a dominant influence on the decision of the doctor to expel in case of impossibility of such a transfer. Completion of training in a profession that is contraindicated, on which the administration of schools often insists, will not benefit either the teenager or society, because the teenager will not be able to work in this profession in production. In conclusions on such cases, it is necessary to indicate the negative dynamics of the disease and motivate the reason for the need for transfer or expulsion, as well as give recommendations on suitable professions. The stated position is especially important to take into account in chronic diseases prone to relapse under the influence of certain labor factors.

Helping a student make a rational choice of a profession, determining his professional suitability for the chosen profession is one of the ways to preserve and strengthen the health of a teenager, the harmonious development of his personality. Timely determination of professional suitability allows schoolchildren and their parents to choose a profile class and decide on the USE academic disciplines necessary for enrolling in a chosen institution of higher education.

Taking into account the formation of psychosocial maturity, including the choice of a profession by a teenager, the order of the Ministry of Health of the Russian Federation No. 154 of 05.05.1999 provides for close interaction between pediatricians and teachers and psychologists.

The additional medical preventive examination of children aged 11-12, regulated by this order, implies mandatory medical professional consultation (VPK) in this age period. In connection with the possible dynamics of the disease, the formation or change of a teenager's inclination to a particular profession, as well as the need to choose a specific specialty, a repeated vocational consultation is held in the 9th and 11th grades.

The main role in the implementation of vocational counseling of students is assigned to the school doctor with the involvement of a school psychologist. Of particular importance is the medical and professional consultation of adolescents with malformations, chronic diseases, functional abnormalities, as well as the risk of their occurrence.

Medical professional consultation is a consultation by a doctor of adolescents who are healthy, at risk and with health problems in order to choose an educational institution and a future profession that best suits their physical and mental health. This takes into account the performance of a teenager at school, his inclination to a particular profession, predicts the impact of production and professional factors on the occurrence and course pathological process, as well as the possibility of mastering the recommended profession in the presence of existing deviations in the state of health.

One of the conditions for the full implementation of the military-industrial complex is good knowledge nature and working conditions, their influence on the growing organism. All of the above information is contained in the so-called professiograms - sanitary and hygienic characteristics of professions - and includes a description of the labor process, characteristics of materials, equipment, tools, working postures, special working conditions, an indication of the presence of requirements for the central nervous system, analyzers, organs and functional systems taking into account the degree of their tension, statokinetic stability, the possibility of industrial injuries, the possibility and levels of exposure to production factors (5).

For the implementation of the military-industrial complex, it is necessary to study and assess the state of health, the level of development of psychophysiological functions. The main psychophysiological functions on which the development of skills and abilities specific to a given profession and the formation of a working stereotype depend are called key professionally significant functions and are divided into the following groups:

    analyzer: accuracy of the eye, color, auditory, olfactory and tactile sensitivity; muscle precision;

    motor: muscle strength and endurance, speed of reaction, etc.;

    attention-mnemic: mechanical, semantic, operative memory, the ability to concentrate and switch attention;

    intellectual: the level of development of verbal and non-verbal intelligence, thinking;

    individual typological properties of higher nervous activity: strength, lability, mobility and balance of the nervous system;

    characterological personality traits, the severity of extraversion, neuroticism, rigidity, etc.

The study of psychophysiological functions should be carried out according to unified methods in the same conditions for all in order to maximize the exclusion of fitness and the functional state of the body.

During a medical examination in order to determine the professional suitability of a teenager, an active collection of complaints is necessary; application of screenings, functional and laboratory methods studies to assess the functional state of the main systems and organs. If a teenager has a chronic disease, it is necessary to involve narrow specialists, and professional consultation is recommended during the period of remission or compensation for a chronic disease, and preferably in the presence of parents.

When drawing up a conclusion for a child with a pathological condition, it should be borne in mind that professional suitability determines not only the diagnosis of the disease, but also an assessment of its severity, course trends and compensatory capabilities of the body. It is important to objectively evaluate not only the negative impact of harmful production factors on the patient, but also the positive rehabilitation role of labor.

In addition to drawing up a professional opinion, the doctor should also give recommendations on the implementation of therapeutic, preventive measures, training of key professionally significant functions - professionally applied physical training, exercises on special simulators, the development of attention-mnemic functions and intelligence using special techniques for memorizing and analyzing the material.

"The main directions of the reform of the general education and vocational school", approved by the Plenum of the Central Committee of the CPSU on 10/IV and the Supreme Soviet of the USSR on 12/1V 1934, provide for further improvement of work on the professional orientation of secondary school students. This task is dictated by the increased needs of all branches of the national economy for specialists capable of worthy work in the period of developed socialism. Under these conditions, work on the professional orientation of young people to medicine, one of the most humane human professions, is becoming more relevant.

As you know, medicine for a long time predominantly considered art and relied on the bare practical experience and intuition of the healer. Gradually, it turned into a complex science, using the achievements of biology, genetics, chemistry, physics and many other exact sciences. Mastery medical profession requires a good general and deep special training. Along with this, doctors are required to have special personal qualities, without which it will be very difficult to engage in medical practice.

The health worker must have a gentle nature and at the same time be self-possessed, balanced, be able to manage oneself in any, even extreme, conditions. His hallmark there must be love for people and all living things.

Medicine in our country has become one of the mass professions. More than 1 million doctors and almost 4 million paramedical workers are now working in the Soviet Union. Every year, various medical institutions are replenished with young specialists. Naturally, the problem of selection when entering medical institutes and schools becomes the task of those medical institutions who are most interested in well-trained specialists. Therefore, they should and can take the most direct part in the work of professional orientation of schoolchildren to medicine, i.e. in identifying persons capable of devoting themselves to this humane profession.

We have many years of experience in the participation of the medical staff of a large multidisciplinary hospital in the work of vocational guidance for schoolchildren in the schools of the Kuntsevsky district of Moscow. Soon after the decision of the Council of Ministers of the USSR "On the organization of interschool educational and production complexes labor training and Career Guidance of Students”, the specially trained medical staff of the hospital actively joined in the work on career guidance.

Initially, on the basis of one of the schools in the district, which was turned into a training and production plant, classes were organized for schoolchildren of the 9th and then 10th grades of many schools in the district to train junior nurses to care for the sick. Class for medical classes was equipped with posters, tools, patient care items, dressings, immobilization means. Doctors and experienced paramedical workers were involved in classes with schoolchildren. The course program was approved in 1982 by the Main Departments of Health and Public Education of Moscow. It is designed for 2 years. Those who have completed the training and successfully passed the special exams are issued certificates of the established form indicating the qualification "junior nurse for the care of the sick."

We gradually improved the work on vocational guidance for schoolchildren. Now the interschool educational and industrial complex of the district, where more than 20 different professions are represented, maintains contacts with 38 schools of the district. According to a predetermined schedule, 3-5 schoolgirls from grades 9-10 come to classes in the class of junior nurses from each school every day, who have chosen future profession medicine. On the day of classes on courses from schoolwork they are released.

With each group on the day of classes, lessons are held: 2 hours of theoretical lessons and 4 hours of practical lessons. At theoretical lessons with students of the 9th grade, a program for the care of patients with a therapeutic profile is worked out, and with students of the 10th grade - a surgical one. Workshops we carry out mainly on the basis of the City Hospital No. 71, but we also use other medical and preventive institutions of the district. In practice, students (under the supervision of nurses) directly help in caring for the sick: they feed, take them for a walk, to places common use, serve and clean the vessel, disinfect them. In addition, schoolchildren prepare instruments and dressings for sterilization, plaster bandages, splints for immobilization, collect and carry material for research to the laboratory, and are present when nurses perform all manipulations. Thus, students in the hospital are not observers, but actively participate in the work of caring for the sick, maintaining cleanliness in the department. In addition to scheduled classes, excursions are periodically organized to the pavilion "Health of the USSR" VDNKh, to the Polytechnic Museum, where there is a permanent exhibition on career guidance "Our name is doctors." Excursions to medical schools are interesting. Propaganda teams from other medical schools in Moscow often come to us for the purpose of professional selection of schoolchildren.

During summer holidays our schoolchildren, but on a predetermined schedule, practice as orderlies in medical and preventive and children's institutions, which provide them with invaluable assistance. For this study-work, the administration of institutions encourages schoolchildren with souvenirs, vouchers for a tour of Moscow, the Moscow Region. etc.

V last years work on vocational guidance has become more differentiated. Now it covers students more than lower grades(starting from the 5th-6th). At the same time, the knowledge and practical experience of high school students are used. Thus, students in grades 9-10 tell students in grades 5-6 about the work of doctors and nurses in medical institutions where they practiced, about the difficulties they encountered, about the responsibility of medical personnel for patients and much more.

V orderly pupils of the 8th grade, sometimes with their parents, come to the training and production plant to get acquainted with various specialties, including medical ones. We have a mostly individual orientation conversation with them and give them time to think. Then the students who have chosen medicine are united in groups. Targeted conversations are already being held with them by a doctor or paramedical worker. At the same time, we do not focus on the romantic side of medicine, but on the real difficulties that doctors and nurses face in their practice. With each group during the academic year we conduct 2-3 career guidance classes. Naturally, in the first months there is a certain dropout. With the rest, we conduct planned career guidance classes during their studies in grades 9-10.

Every year there is an increase in the number of schoolgirls completing nursing courses. So, if our first graduation in 1974 was 91 people, then by 1982-1983. it increased to 146-150. From 1976 to 1983, 1,143 people graduated from our courses. Based on the annual surveys of graduates of our courses, conducted in September - October, the following emerged. Some of the graduates (91) went to medical schools, others (207) to medical schools, and 76 girls continue to work as nursing assistants with the intention to continue medical education. Thus, every third student, educated career guidance, all subsequent life connects with the medical profession. We are confident that these people will be reliable additions to healthcare institutions.

As a result of well-organized vocational guidance work, a double win is obtained: on the one hand, it provides a clearly focused on medicine replenishment, and on the other hand, additional labor force in medical and children's institutions of the district, personnel of trained junior medical personnel.

The decisions of the April (1984) Plenum of the Central Committee of the CPSU aim us at further improvement of work on the vocational guidance of schoolchildren, which is a task not only for schools, but also for health authorities and institutions.