Author: Sergei V. Jargin1*
Abstract
This is a narrative review on medical education, research integrity, related academic and healthcare issues with special reference to spots of bother. Apart from the literature, it is based on observations by the author, who entered the Sechenov Medical Institute (since 2010 University) in 1973, later practiced at different institutions in Moscow. Financial support of postgraduates is scarce. As a result, some of them combine their training with part-time occupations, which are often non-medical. Since the late 1980s functionaries and their protégés, planned for high positions in scientific or educational hierarchy, published largely fabricated reports. Admittedly, some of them have accumulated professional knowledge and experience. However, they contributed to the authoritative management style and paternalistic attitude to patients, disregard for the principles of informed consent, professional autonomy and scientific polemics. Under these circumstances, misinformation, persuasion of patients and compulsory treatments are regarded to be permissible. Suboptimal practices have been used as per instructions by healthcare authorities and leading professors’ publications. Invasive procedures applied without evidence-based indications have been reviewed previously. The training of medical personnel with an eye toward readiness for war has been one of the motives thereof. Shortages of medical education, limited availability of foreign professional literature, partial isolation and persisting Soviet mentality have contributed to preservation of outdated and suboptimal methods in everyday practice. Examples of misconduct (hidden conflicts of interest, manipulation of statistics, misquoting, plagiarism from foreign sources) are discussed here. The quality of research and conflicts of interest should be taken into account deciding which papers are to be included into reviews and meta-analyses.
Keywords: medical education, research integrity, medical ethics, Russia
Introduction
Previously we reported on the medical education and research integrity in the Russia (Jargin 2013, 2020). There have been other comprehensive reviews (Burger et al. 2004; Kabanova and Lozhkevich 2010; Mandel 2011). Here is an update. The attitude towards academic education has been complex since the early Soviet time. Many young people from different social strata strived for academic diplomas. The Soviet period brought about an expansion of admission numbers to universities and medical educational institutions; however, with insufficient regard for the quality of the preparation of the students. The task was to educate “proletarian” specialists (Large Medical Encyclopedia 1980). Instead of professional autonomy, medical students have been taught to be loyal and to follow instructions (Perevalov 2025). Admittedly, professional autonomy in conditions of insufficient education is precarious. Numerous new medical schools (called institutes) were founded. Medical faculties were extracted from universities (Burger et al. 2004). The quality of teaching, especially of theoretic disciplines, deteriorated due to this separation. The accelerated training of “red doctors” resulted in augmentation of errors in diagnostics and treatment (Zatravkin and Vishlenkova 2020). The social status and incomes of educated people and doctors’ salaries had been decreasing in comparison with the rest of the population from the 1950s till the economical reforms of the 1990s, when the incomes diversified. Obviously, it was the aim and a consequence of the policy, while the tool was expansion of the educational offerings. This resulted in an overproduction of specialists, many of whom passed examinations without much knowledge. Besides, there were privileged students such as the Party and Komsomol activists, who missed lectures whenever they wanted. Corruption in the university milieu with bribe-taking from students has been widespread (Mandel 2021). Since the late 1980s, unofficially paid private lessons by medical faculty lecturers have become widespread. Students sometimes had no other choice but to take paid lessons because answers to some questions could not be found in textbooks or lectures. Besides, there has been business around entrance examinations.
Medical education and postgraduate training
This review delineates some aspects of medical education in the Russian Federation (RF) during last decades. Apart from review of literature, it is based on observations by the author, who entered the 1st I.M. Sechenov Medical Institute (1990 renamed ‘Academy’ and 2010 ‘University’) in 1973, later practiced at the same and other institutions in Moscow. Neglectful attitude towards academic knowledge was noticeable. For example, students were compulsorily sent during semesters to collective farms to harvest potatoes and other vegetables. At the Sechenov Institute it usually happened during the 3rd academic year, so that many topics from pathology, surgery and internal medicine were lost. The agricultural works lasted up to 2 months, in 1984 even longer. In 1978, a student construction brigade (stroyotriad) came back in October (the semester started on the 1st of September). Participation in construction brigades was accepted as a substitute for the nursing and medical practice in summer after the 3rd and 4th academic years. Some courses were omitted e.g. clinical pharmacology and gynecological pathology (the latter for future pathologists) during the 6th academic year despite figuring in the record book. It should be commented that the 6th year of the basic medical education, named subordinatura, is in fact an undergraduate training in one of three main directions (internal medicine, surgery, obstetrics/gynecology) but possible also in pathology. Specialists in pathology, having completed a postgraduate training at the Sechenov Medical University (the leading institution, where many textbooks have been prepared) saw almost no gynecological specimens because the Department of Obstetrics and Gynecology had its own histopathological laboratory. It should be mentioned that during the whole basic medical education and postgraduate training in pathology, the topic of child abuse and neglect was not mentioned; neither by pediatricians nor by forensic pathologists. Even today, doctors have no clear instructions how to act in case of suspected child abuse. According to some estimates, the prevalence of family violence in RF during last decades has been 45-70 times higher than, for example, in the United Kingdom and France (Besschetnova 2015).
A relatively low quality of the healthcare in RF was acknowledged by the Health Ministry (Svistunov et al. 2016). The deterioration tendency was noticed in 2016 (Sitnikov and Bizunkov 2016). According to surveys, the population’s satisfaction with the healthcare increased from 30% in 2006 to 40.4% in 2015 (Svistunov et al. 2016). We have found no assessments for the present day; but optimism would be premature. Deficiencies of the medical education and postgraduate training negatively influence the healthcare quality (Balkizov et al. 2016), giving rise to the phenomenon known as feldsherism. Some students characterized it by the phrases like: “You will learn all you need at your future workplace”. Attendance of lectures was stimulated by administrative measures, so that students came to the lectures to avoid trouble with the dean’s office; but many of them neither listened nor wrote down anything, if even present at a lecture. For example, biochemistry was regarded by many students to be useless, while pharmacology was studied by some of them using textbooks for nursing schools. Admittedly, there were exceptions: in the Sechenov Medical Academy, professors’ children were gathered in a few groups; the level of knowledge among them was comparatively high. Closer to the graduation, some students became diligent in learning of their chosen fields.
After the 6-year undergraduate medical education, to become a specialist in any field of medicine, a 2-year postgraduate program (ordinatura) without a preceding internship has been the usual way (Burger et al. 2004). The internship has been abolished in 2016; so that the postgraduate training has on average become shorter and the quality decreased (Balkizov et al. 2016). Less common is a 3-year program (aspirantura) that includes research for a candidate’s thesis (dissertation). There are two academic degrees in RF: Candidate of Sciences (often regarded to be analogous to Ph.D.) and Doctor of Sciences, more or less equivalent to the Higher Doctorate or the Habilitation in Austria and Germany. The minister of education (1999-2004) and head of the Higher Attestation Commission (2013-2024) Vladimir Filippov stipulated that the degrees should be not translated but transliterated to foreign languages. In particular, “the designation of the academic degree Candidate of Sciences as Doctor of Philosophy or Ph.D. is unacceptable” (Tkach et al. 2008).
Previously, the status of medical specialist could be obtained after a 1-year internship. The insufficient duration of the training was pointed out by some experts, who stressed that young medical specialists should practice 2-3 years additionally at large centers under supervision of seniors before starting independent practice (Domanskaia et al. 2009). According to a survey published in 2010, 73.1% of the residents (ordinators) entered the 2-year postgraduate program immediately after the basic medical education and 15 % - after an internship; the rest - after a period of practice (Kabanova and Lozhkevich 2010). The postgraduate students are on average not overworked; some of them come not every day and leave before noon, one of the reasons being part-time occupations discussed below. The postgraduate students on the 3-year program (aspirantura) are concentrated on their scientific work, which is often performed in a formal way. The rotation system is elaborated insufficiently; and many fields of theory and practice are left out. Admittedly, a good level of knowledge can be achieved by self-education, but gaps are hardly avoidable under the existing conditions.
The specialist certificates were introduced in the late 1990s. Before that, it was usual to become a medical specialist after a target internship (1 year) or a specialization course of several months’ duration (Morozova et al. 1994). Doctors with that kind of postgraduate training have later obtained specialist certificates. Many of them are efficient and experienced physicians albeit lacking a comprehensive postgraduate training. Since the 1980s there have been no educational standards that meet international requirements for the training of medical personnel (Suslonova 2014). Comparisons with foreign countries were seldom, probably in accordance with the policy that “we have our own ways”. Some comparisons were published in Ukraine (Kazakov et al. 2003).
After completion of the postgraduate training, medical specialists must complete every 5 years a continuing education course up to one month long (Burger et al. 2004). Some of such courses were rather formal and the attitude of trainees was skeptical (Sovtsov et al. 2014). Last time, many online courses have been developed; while their quality seems to be improving thanks to the free Internet resources. According to the Law No. 323-FZ and the Labor Code, the employer (medical institution) must pay for the continuing education required for further practice of a doctor. In the recent past, all phases of medical education were complicated by the limited access to the foreign literature and insufficient quality of domestic editions (Murphy and Jargin 2017). The quality of translation of foreign books has often been poor. Many internationally used textbooks and manuals are unavailable now as before. This is one of the causes, why practices in RF have not kept up with the evolution of evidence-based medicine in more developed countries (Tillinghast 1998). Insufficient theoretic knowledge caused, on one hand, excessive conservatism and, on the other hand, acceptance of non-evidence-based treatments. Today, the free availability of the international literature on the Internet facilitates the caching up with international standards.
The non-core and non-academic work during studies is a mass phenomenon since financial support of postgraduates is practically non-existent (Kuzminov and Yudkevich 2022). Au contraire, many ordinators and aspirants pay for the postgraduate education. As a result, some of them combine their training with part-time occupations. According to a survey, 78.5% of ordinators (on the 2-year postgraduate program) and 78.8% of aspirants (on the 3-year program) combined their training with a part-time occupation, which in 1/3 of cases was non-medical. Moreover, 9.6% of ordinators and 6.4% of aspirants combined their education with jobs at pharmaceutical or intermediary firms (Kabanova and Lozhkevich 2010), which creates conflicts of interest interfering with optimal practice and drug prescription.
Many former party, military and law enforcement functionaries (so-called nomenklatura), their relatives and protégées, occupy leading positions in academies and universities now as before. Being not accustomed to hard and meticulous work, some of them have been involved in scientific misconduct. As a result, under conditions of pressure to publish, numerous unreliable publications have appeared. By the end of the 1980s, this well-known phenomenon became prominent: the party activists and functionaries’ children defended evidently fabricated dissertations, containing provable falsifications, manipulations with statistics and plagiarism (Jargin 2020). Reportedly, plagiarism has been detected in Vladimir Putin’s dissertation (Mukhin 2015). Contrary to the rules, this work is not available in libraries, so that we cannot check. Discussions of such reports at conferences transformed into public demonstrations of loyalty, because professionals understand the real value. A few colleagues dared to criticize; some of them were later dismissed. Like generally with the nomenklatura, insufficient professional qualification did not hamper climbing the hierarchical ladder (Borshchevsky 2012). Most qualified doctors and lecturers remained on ordinary positions while functionaries became professors and university administrators, using e.g. the honorary authorship: figuring as co-authors without actual participation. Michael Voslensky (1984) rightly noticed that wherever the nomenklatura is found, much giving of orders can be found; but the real work is done by other people. His words have become prophetical: the nomenklatura’s “stubborn desire for world domination involves the grave danger of world war”.
The long time since the establishment of the Soviet state has not completely erased some stigmata of the worker-and-peasant origin of a large part of the ruling class (Djilas 1958; Vinnichenko and Vaganov 2016). In particular, certain first-generation military surgeons were responsible for the maintenance of invasive methods with questionable indications (Jargin 2022). The training of medical personnel with an eye toward readiness for war has been one of the motives. Of note, the military and medical ethics are not the same thing. The comparatively short life expectancy in RF is a strategic advantage as it necessitates less healthcare investments and pensions. Militarists and their relatives will become more dominant thanks to the Ukraine war. Those participating in it, factually or on paper, are obtaining the veteran status and privileges over fellow citizens. Some of them will occupy leading positions at universities and academies without adequate training and selection. War veterans enjoy advantages in the healthcare and everyday life; there are, however, misgivings that the veteran status has been awarded gratuitously to some individuals from the privileged milieu. At the same time, many relatives of superior officers evaded conscription under various pretexts. In particular, some institutions of higher education grant exemption from the conscription. Admittedly, certain functionaries and their children accumulated professional knowledge and experience. However, they contributed to the authoritative or autocratic management style and paternalistic attitude to patients, disregard for the principles of informed consent, professional autonomy and scientific polemics. Under these circumstances, misinformation, persuasion of patients and compulsory treatments are regarded to be permissible. Suboptimal practices have been used as per instructions by healthcare authorities and leading professors’ publications.
Ethical and legal basis of medical practice and research has not been sufficiently known and observed. The term “deontology” is often used for medical ethics in RF. Textbooks and monographs on deontology explained the matter somewhat vaguely, with truisms and generalities but not much practical guidance. In conditions of the authoritative management style, professionals often accepted working in any condition without making an effort to set things in order, keeping the interests of patients in mind. The ruling class, largely persisting from the Soviet time, thwarted adoption of some foreign experiences including the Bologna Process (Borshchevsky 2012). The reason is evident: objective testing and evaluation of students within the framework of the Bologna Process is inconvenient for the Nomenklatura’s protégés receiving diplomas without much study, skipping lectures etc. (Kunitsa et al. 2015). Moreover, Bologna Process is hardly compatible with corruption at universities. In conditions of legitimacy and high ethical standards, the market economy stimulates a sound competition of constructive ideas, innovations and treatment quality. In conditions of disrespect for laws, regulations and ethics, the competition turns towards discrediting the free healthcare, manipulation towards paid services, and harassment of non-paying patients.
The shortages of medical education, limited availability of foreign professional literature, partial isolation from more developed parts of the world and persisting Soviet mentality have contributed to persistence of outdated and suboptimal methods in everyday practice (Jargin). Some domestic editions are scarcely illustrated, contain outdated information, and borrowings from foreign sources sometimes with mistranslations. More cooperation with the international scientific and professional community is needed. Without profound restructuring, the system of postgraduate training in RF can be adapted to the international standards if its options (2- and 3-year programs) would be transformed into consecutive steps. The total postgraduate training time would thus amount to 5 years, include preparation of a thesis and examinations to be awarded a degree equivalent to M.D. and a specialist certificate. Physicians not interested in research could prepare a thesis in the form of a literature review. Curricula including rotation should be modernized and adjusted to the corresponding fields of medicine. With time, the above-mentioned components of the training can be amalgamated in one program. In conclusion, the medical postgraduate training in Russia must be prolonged, intensified and protected from incompetent meddling. More cooperation with the international scientific and professional community is needed.
Research Integrity
The main varieties of scientific misconduct include falsification, misquoting and plagiarism. Besides, there are many subtypes: biased selection of data or specimens, discarding of “inconvenient” data, selective citation, publications without approval of the text by all co-authors, gift or honorary authorship, nepotism and companionship with mutual cover-up; violations of the rules of polemics, evasion from constructive discussion and questions at conferences, tangling of scientific texts and presentations, making them incomprehensible.
Scientific misconduct includes measures taken against whistleblowers, i.e. persons informing authorities and scientific community or publishing critical comments without sanctions of superiors. The denunciation has been generally condemned in the former Soviet Union; identity of the informant has sometimes become known to other people including perpetrators, with undesirable consequences for whistleblowers up to a dismissal etc. Certain experts having criticized forged reports were exposed to harassment and then dismissed. Whistleblowers must be protected from retaliation; they need a safe, confidential venue to report misconduct.
It is not surprising that unreliable science flourishes under the conditions of kleptocracy (Logvinenko 2021). Hidden conflicts of interest are not infrequent. Forged publications and speculative theories have been used for promotion of certain drugs and dietary supplements without proven effectiveness. Patients can be misinformed not only by the advertising but also by publications supposed to be scientific. Marketing of placebos in the guise of evidence-based medications seems to be on the increase (Jargin 2019).
Plagiarism
Numerous examples of plagiarism are documented in the book (Jargin 2020). Among plagiarists are functionaries occupying high positions in academies and universities. Students and young researchers learn from them that scientific misconduct brings success and profit. Borrowing from the Internet has become widespread (Efimova 2013). It is common practice to re-write entire paragraphs from foreign textbooks without references, to copy and translate tables and diagrams. Some translations are shortened and contain deviations from the original. Certain additions to the original text are misleading. It should not be left without comment, when the celebrated editions such as the Histopathology of the Skin by Walter F. Lever and Gundula Schaumburg-Lever; plagiarized in by Tsvetkova and Mordovtsev (1986), the classical Robbins’ Pathologic Basis of Disease, published without reference by Paltsev (1999a,b, 2001) or Handbuch der Speziellen Pathologischen Anatomie und Histologie edited by Friedrich Henke and Otto Lubarsch; fragments borrowed in (Strukov 1957), are rewritten without proper references, mistranslated, and distorted by additions. We can hardly imagine what immense work and immaculate integrity stands behind these great and truthful books. Today’s and tomorrow’s plagiarists should be aware that they may be identified and exposed. Otherwise the misconduct will spread over the globe and persist endlessly.
Here follow more examples. Essential diagrams from (Garcia et al. 2020) have been translated verbatim without references in Matyushkina et al. (2023); the images have been reproduced by Jargin (2024a). In the textbook of magnetic resonance imaging (MRI) by Trufanov and Fokin (2007), some paragraphs were copied from foreign sources without references. Three sources of the borrowing have been identified: an open access website EMRF (accessed 26 June 2015; no longer accessible) and two books partly available online as free previews (Bogaert et al. 2005; Schneider et al. 2006). Neither of these sources was mentioned in the reference list. Copies of the borrowed text from the sources are reproduced in the book by Jargin (2020). Apparently, parts of the text were translated not by medics but by translators not acquainted with the professional terminology. The list of plagiarized books and articles can be continued endlessly.
Along with plagiarism, the partial isolation from the rest of the world and ideological bias gave rise to sweeping criticism of conditions in foreign countries. The following summaries are cited verbatim, as they are printed in journals and available in the PubMed. “Negative consequences of treatment are observed at least in 16% patients at multidisciplinary hospitals and may result from the causes that are independent of medical staff, but more frequently from errors and inadequate treatment standards due to human factors. Systematic improvement of professionalism, which should be started from some educational reforms at medical institutes, is needed” (Vovk et al. 2007). Comment: This is a review of foreign literature with extensive criticism of complications of therapy and alleged misconduct in foreign countries. Similar phenomena in Russia are not mentioned.
Some well-known phenomena are described without referring to original publications, creating impression of global novelty. For example: “The authors present the incidence and specific features of specific bone marrow lesion and the state of normal hemopoiesis and stroma. The criteria for the differential diagnosis of reactive polyclonal lymphoid proliferation in the bone marrow that may accompany many hematological and non-hematological diseases with specific bone marrow lesion in lymphoproliferative diseases are outlined” and further: “According to our results, several histological types of bone marrow involvement in lymphoproliferative diseases can be distinguished: diffuse, interstitial and focal” (Frank et al. 2007). Then follows a commonly known description of the bone marrow involvement patterns by lymphoma in accordance with many textbooks. The text can be misunderstood as an original description of bone marrow involvement patterns by lymphoproliferative disorders.
Environmental science
Misinterpretation of statistical data, plagiarism and misquoting were found in the literature on environmental and radiation-related science. Several examples with copies from the monographs (Demidchik et al. 1996; Yablokov 2002) are presented in the book by Jargin (2020). The misquoting seems to be tendentious, aimed at the overestimation of medical and environmental consequences of the Chernobyl accident in order to strangle the nuclear power production in many countries, thus boosting fossil fuels prices; more details are in (Jargin 2023).
An overestimation of medical consequences of elevated background radiation near the nuclear test site in Semipalatinsk area can be exemplified by Kogan et al. (2002) from the Sechenov University. The following is stated in the abstract about radiation doses: “17 patients (group 1) lived close to the testing area from the childhood to 1993 and were exposed to the radiation at the year dose 0.1 Ber.” A radiation dose unit “Ber” (Biological Equivalent of Rad), used in Russia, is designated internationally as rem. The annual individual dose of 0.1 rem (1 mSv) is below the global average for annual doses from the natural radiation background, which is 2.4 mSv. The term “radiation carcinoma” was used in the article for lung cancer (LC) cases of unknown etiology, while suppositions were made about its rapid growth and “bad prognosis”, thus creating an exaggerated impression about medical consequences of the slightly elevated background radiation. The following data are remarkable (verbatim from Russian): “The specific cytogenetical feature of LC in patients from the area of Semipalatinsk was the neuroendocrine differentiation of cancer cells in all tumors independently of their histological structure. We have established it by means of immunohistochemical and ultrastructural investigations.” At the same time, “No neuroendocrine differentiation was shown in the control group”. It means that the marker determined by two independent methods appeared in the first group in 100 % of cases (17/17) and in the control group - in 0 % (0/40). The extremely high statistical significance of the difference between the two groups (P<0.0001) confirms the supposition that the “LC in persons exposed for a long time to radionuclide radiation pollution” (Kogan et al. 2002) is a special entity, different from spontaneous LC. It was concluded that “LC in patients, who resided in the area of Semipalatinsk and underwent elevated radioactivity, can be classified as neuroendocrine carcinoma”. It remains incomprehensible, how could all 17 randomly selected LCs belong to the supposedly radiogenic neuroendocrine carcinoma. In the general population, tumors from neuroendocrine cells (small cell carcinoma, carcinoid) represent 20-30 % of lung malignancies. At the same time, the distribution according to age and sex in the first group was typical for spontaneous LC caused by smoking, industrial air pollution and other factors: 15 from 17 patients belonged to the age group of 51-70 years. Under the influence of radiation, affection of younger persons could be expected. Especially typical for spontaneous LC is the male predominance because of cigarette smoking and professional carcinogens. Radioactive contamination of the environment, on the contrary, would exert an equal effect on both genders. In the group from Semipalatinsk area were 16 men and one woman (Sagindikova 2001). The term “radiation carcinoma” and speculations about its rapid growth and “bad prognosis” can contribute to an exaggerated impression about medical consequences of elevated radiation background and overtreatment of supposedly radiation-related lesions (Robertson and Jargin 2025). Some other research on Semipalatinsk and Chernobyl by the same scientists contain analogous drawbacks. For example, in the study by Kogan et al. (1999), discussions on molecular-genetic features of the Chernobyl-related “radiation cancer” is led on the basis of 15 random autopsy and surgical LC cases from areas quite distant from Chernobyl: eight cases were from the Tula province in Russia.
Misunderstanding can arise from the paper by Balonov (2007), containing the following phrase in the abstract: “Apart from the dramatic increase in thyroid cancer (TC) incidence among those exposed at a young age and some increase of leukemia and solid cancer in most exposed workers, there is no clearly demonstrated increase in the somatic diseases due to radiation”. This is misquoting. In the Chernobyl Forum publication (IAEA 2006a) cited by Balonov (2007), leukemia and solid cancers (other than TC) are not discussed. In another Chernobyl Forum publication, it is stated that “apart from the dramatic increase in TC incidence among those exposed at a young age, there is no clearly demonstrated increase in the incidence of solid cancers or leukemia due to radiation in the most affected populations” and further “there have been many post-Chernobyl studies of leukemia and cancer morbidity in the populations of contaminated areas in the three countries. Most studies, however, had methodological limitations and lacked statistical power. There is no convincing evidence at present that the incidence of leukemia or cancer (other than thyroid) has increased in children, those exposed in utero, or adult residents of the contaminated areas” (IAEA 2006b). In the Report of the UN Chernobyl Forum Expert Group “Health”, it was commented that “there is currently no evidence to evaluate whether a measurable risk of leukemia exists among the exposed as adults in the general population. With regard to liquidators, there is clearly a need to clarify the existing observations” and further “there is no evidence of increased risk of non-thyroid solid cancers resulting from Chernobyl” (WHO 2006). The same, in principle, is said in the text of article by Balonov (2007). The above-cited statement in the open access abstract is substantiated neither in the article text nor in the Chernobyl Forum publications referred to in this article titled “The Chernobyl Forum: major findings and recommendations” (Balonov 2007).
High aggressiveness of TC in patients from contaminated areas after the Chernobyl accident was reported by many studies, commented by Robertson and Jargin (2025). The misclassification of advanced neglected cases as aggressive radiogenic cancers gave rise to the concept that malignancies in radiation-exposed individuals are more aggressive than in the general population (Fridman et al. 2015; Iakovleva et al. 2008). This had consequences for the practice: surgical treatment of supposedly radiogenic cases was recommended to be “more radical” (Rumiantsev 2009). Indeed, after 1998, thyroid surgery in some institutions became more radical (Iakovleva et al. 2008; Demidchik et al. 2006). Guidelines recommended “total thyroidectomy combined with neck dissection followed by radioiodine ablation” (Demidchik et al. 2007) and irradiation with 40 Gy (Mamchich and Pogorelov 1992). Even the last edition of the National Manual, the most authoritative handbook of pediatric surgery, recommends organ-saving surgery only for T1aN0M0, and for all other kinds of TC “thyroidectomy with subsequent radioablation” with “central (perilaryngeal, pre- and paratracheal) neck dissection” is recommended (Razumovsky 2021). Certain experts recommended total thyroidectomy with neck dissection for all forms of TC (Demidchik and Kontratovich 2003). This is at variance with a more conservative treatment also in the settings of nuclear accidents. The sources (Arici et al. 2002; Giuffrida et al. 2002; Danese et al. 1997) were misquoted to support the recommendation: “The most prevailing opinion calls for total thyroidectomy regardless of tumor size and histopathology” (Demidchik et al. 2006). In the quoted publications, not total but subtotal resection is discussed. Along the same lines, the sources (Danese et al. 1997; La Quaglia et al. 1988; Segal et al. 1997) were misquoted by Demidchik and Kontratovich (2003).
Misquoting
Here follow several examples in addition to those presented above in the section “Environmental science”. Some publications recommending invasive procedures apply misquoting, for example: “The average life expectancy for malignant gliomas in patients receiving only conservative therapy was 9 weeks - 6.6 months” (Martynov et al. 2011) with references (Fazeny-Dörner et al. 2003; Kreth et al. 1993; Simpson et al. 1993), where the survivals are considerably longer. Apparently, the misquoting was aimed to advocate excessive surgery for glioblastoma (Jargin 2024b). Furthermore, it is written in the paper (Razvodovsky 2014) with reference to (Kim and Johnston 2011): “In 2002 the stroke mortality rate in Russia among men age 45-54 years was ten times higher than in France, Germany or Italy”. There are no such statements in the cited article; neither there are breakdowns by age range and sex. Misquoting was found in other articles by the same author e.g. in (Razvodovsky 2020), commented by Jargin (2020b). Numerous wrong citations have been found in publications by Aleksandr Shishonin (2024) applying manual therapy of the neck area potentially associated with adverse effects; details and references are in (Jargin 2025). Many incorrect citations have been found in the doctoral thesis of the chancellor (since 2010) of the Sechenov Medical University Petr Glybochko (2001), documented in (Jargin 2020). Finally, Alexey Koterov (2017) mistranslated several statements e.g. from (Jargin 2015) and papers titles, commented in (Jargin 2021). Andrei Iordanishvili (2025) misspelled the author’s name and hasn’t published correction despite his promise per e-mail. The screenshot with the misspelled name has been published by Jargin (2026). Iordanishvili’s works have been noticed because of potential overdiagnosis of dental caries, diagnosed in army conscripts (18-19 years old) in 85%, needing treatment in 76% of the cases (Iordanishvili et al. 2015).
Manipulation of Statistics
Trimming of statistics has not been unusual in the former Soviet Union. By the end of the 1980s, some functionaries and their protégées, predestined for high positions in scientific or educational hierarchy, published and defended as these largely fabricated reports, containing provable falsifications and manipulations of statistics. An example is the doctoral thesis of the former (1990-2009) Chancellor of the Sechenov University Mikhail Paltsev (1985) documented as illustrations in the book (Jargin 2020).
Gam-COVID-Vac (Sputnik V) vaccine
Among limitations of clinical studies on Sputnik V including its updated XBB variant are the following. The studies have been open-label, non-randomized and did not include appropriate controls. The size of the cohorts was limited. Observation period was limited to 90 days for safety assessment and 42 days for immunological studies. The studies have focused on humoral immunity without adequate consideration of cellular immune responses (Shuliakova et al. 2026). However, the most important limitation is ideological bias in researchers who would not impartially criticize the hyped-up domestic product. The underreporting of adverse effects of Covid-19 vaccinations is sometimes caused by policies discouraging such reporting (Joob and Wiwanitkit 2021).
The author worked in 2013 at a laboratory of the Gamaleya Institute where the Sputnik V has been developed and noticed drawbacks: commercial and scientific teams working at the same premises, lack of modern equipment, readiness to manipulate statistics, poor discipline. The drawbacks have been reported to the administration of the Institution and to the Health Ministry; more detail and documents are in (Jargin 2017). Besides, it has been reported to the Minister on intracoronary injections of cells obtained from abortion material, misquoting and failing to disclose a conflict of interest by Fatkhutdinov et al. (2010) and Orekhov et al. (2014).
There have been reports on cardiovascular, clotting-related derangements, arthritis and other adverse events after vaccinations with Sputnik V. According to a retrospective study of 6600 participants, Gam-COVID-Vac had the highest rate of adverse effects, the overall percentage being 82.7% (Babaee et al. 2022). Of particular importance has been myocarditis, which can lead to dilated cardiomyopathy. The number of unreported complications is unknown. Regarding the studies on Gam-COVID-Vac effectiveness, ambiguities have been noticed and objections raised. The domestic acceptance of Sputnik V has been low due to its perception as a propaganda tool rather than health-saving medicine. References are in (Bludau and Jargin 2025).
Among other complications, herpes zoster has been reported after the vaccination with Gam-COVID-Vac. As for mechanisms, changes in the host’s immune status can result in a failure to suppress the virus replication. A serious post-vaccination event is Varicella-Zoster meningitis. The most common manifestations of ocular herpes include conjunctivitis and keratitis; less frequent are uveitis, episcleritis, retinitis, retinal necrosis, and optic neuritis. Moreover, herpes can affect the initiation and progression of periodontitis. Association of symptoms with the vaccination has sometimes been left unrecorded by practitioners. Color images and references are in (Bludau and Jargin 2025).
Premature approval of vaccines due to political ambitions and rivalries without long-term safety data should be avoided. Reports on side effects of renowned vaccines do not imply higher risks but indicate that they are better studied than those coming from less open societies. Further research, especially that on long-term risks from different vaccines, is needed. The process of ageing is associated with a reduction in cellular immunity, which may predispose to herpes zoster and other infections. Aged people sometimes pay for victories in the vaccine race and other rivalries, which is roughly reflected by the life expectancy statistics of different countries. The winner of the vaccine race may end up with a mass vaccination by suboptimal vaccines, bringing more harm than benefits. Covid-19 pandemic has highlighted the need for less hubristic leadership.
Discussion and conclusion
Scientists, editors, and authorities should cooperate in combating misconduct. Whistleblowers must be protected from revenge. Forged publications and speculative theories have been used for promotion of drugs, dietary supplements, treatments without proven effectiveness and/or with adverse effects. Patients can be misinformed not only by advertising but also by publications supposed to be professional. It has become usual practice to disregard published criticism in spite of personal communications and debates at conferences. Some scientists seem to make use of published critical comments without citing them or just continue publications ignoring the criticism. The same individuals continue working in cooperation with renowned researchers; and it is possible that some later papers are more reliable than earlier ones. However, it is not sufficient to hope that reliable publications would be confirmed while forgeries would fall into oblivion. Fake papers are misleading for research and practice, costing time and money. Isolation from the international scientific community contributes to persistence of pseudo-science (Kuzminov and Yudkevich 2022). Wrong concepts are persisting and re-emerging, which can result in useless experimentation and application of invasive procedures without indications (Jargin 2022). Some scientific writers have perfected themselves in tangling their texts, making evaluation increasingly difficult. Scientific misconduct also includes measures against whistleblowers. The fact of denunciation and the informer’s identity became known to the perpetrators with unfavorable consequences for whistleblowers up to a dismissal.
The response to misconduct in medical research and practice needs national and international bodies to provide leadership and guidance (Smith 2006). In Russia, there is a Higher Attestation Commission, generally known as VAK, the main purpose of which is the maintenance of a high level of scientific research. The VAK awards or approves all academic degrees. Nevertheless, there are dissertations (these) with detectable trimming of data, manipulations with statistics, misquoting etc. As mentioned above, the doctoral thesis of the chancellor (since 2010) of the Sechenov Medical University Petr Glybochko (2001) contains numerous inaccurate citations, documented in the book (Jargin 2020). His predecessor’s dissertation (Paltsev 1985) contains provable manipulations with statistics. Reportedly, plagiarism has been detected in Vladimir Putin’s dissertation (Mukhin 2015). Contrary to the rules, this work is not available in libraries, so that we cannot check.
Many dissertations approved by the VAK are low quality (Kuzminov and Yudkevich 2022). In a study of Russian theses of the 21st century, an independent association Dissernet discovered 7251 “false dissertations” with “unscrupulous borrowings and substitution of experimental and statistical data”. Selected authors of such theses are listed by Mandel (2021). The dissertations of above-mentioned chancellors of the Sechenov University, Paltsev (1985) and Glybochko (2001), are not on that list, although their flaws have been reported to the VAK.
One of the requirements to the doctoral dissertation is that main results must be published in peer-reviewed journals or editions officially acknowledged as equivalent to them. As a result, Russian journals are overloaded with articles of questionable value, while other manuscripts have to wait longer or may be rejected. Some functionaries have not enough time to make their theses and order them, or at least the literary reviews, from businesspeople offering such services (Mandel 2021). This is one of the causes of misquoting.
In the early post-Soviet time, scientific misconduct seemed to be a heritage from the past, but it is persisting until today. The economic situation has changed; some experts from other countries would probably find reasons to move to Russia. They should be warned: what awaiting them is compliance training, threats and harassment, if they do not collaborate in dubious research and publications. It happened to researchers and lecturers in Moscow, which ended with dismissals. Whistleblowers need a safe, confidential place to report misconduct. The quality of research and conflicts of interest should be taken into account deciding which studies are to be included into reviews and meta-analyses.
Conflict of interest
The author declares no conflict of interest.
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Citation: Jargin, S. V. (2026). Medical Education and Research Integrity in Russia. J. Psychol. Neurosci. Res. Learn.