In January 2026, the President of Kyrgyzstan, Sadyr Japarov, signed a new law that introduces stricter requirements for medical education and scientific activities in the healthcare sector. This document revises the principles of accreditation, licensing, and quality control of specialist training.
The key aspects of the new law include:
Mandatory state accreditation for all educational programs in medicine and pharmacy, including secondary, higher, postgraduate, and continuing education. Educational institutions that do not pass accreditation will not be able to enroll students or issue state diplomas.
The establishment of a state franchise system, under which private medical educational organizations must operate under the auspices of a state university. This implies the use of state curricula and standards, as well as oversight by the foundational structure.
Tightening control over the quality of medical training, which will be carried out by the relevant health authority.
Revision of the internship and residency procedures, where programs will only be implemented by accredited institutions and clinics.
In this regard, the following questions arise:
What are the actual standards for training specialists, especially in the field of cardiovascular medicine?
Who will be able to provide training in accordance with modern international standards (in real conditions of lectures, seminars, practical classes, and clinical discussions)?
To assess the scale of the problem of training highly qualified medical personnel, one can refer to the current document "2025 ACC/AHA/ASE/ASNC/SCCT/SCMR Advanced Training Statement on Advanced Cardiovascular Imaging," prepared by six professional organizations, including the American College of Cardiology and other associations involved in training physicians in cardiovascular medicine. This document clearly outlines the requirements for physicians engaged in heart and vessel imaging:
Physicians must:
Know the normal ranges of sizes and functional characteristics of heart chambers based on demographic factors (age, sex, race).
Possess knowledge of normal heart physiology and the pathophysiology of cardiovascular diseases.
Know the anatomy and functions of the cardiovascular system, including relevant structures related to various imaging methods.
Understand the clinical significance of normal and pathological anatomy in extracardiac imaging.
Be familiar with the physics and basic principles of data collection, image formation, and reconstruction for each imaging method.
Know the methods for optimizing image resolution and eliminating distortions.
Know the risks and procedures for reducing them for patients and staff when using imaging methods.
Know the contraindications and preferred imaging methods based on patient needs.
Understand the basics of radiation safety and methods for minimizing radiation exposure.
Know the pharmacokinetics and pharmacodynamics of contrast agents for each method, as well as how to identify and manage side effects.
Know the specifics of imaging during pregnancy and the postpartum period.
Possess knowledge of the risks and complications associated with physical and pharmacological stress tests.
Understand the principles of cardiovascular hemodynamics both in health and disease.
Know the indications and limitations of each imaging method for assessing hemodynamics.
Know the differential diagnosis of ventricular dysfunction and cardiomyopathies.
Possess knowledge of imaging valvular defects and their functional assessment.
Know the data on normal and abnormal valve anatomy for various imaging methods.
Know the indications and contraindications for imaging in critical conditions.
Understand how to use imaging results to optimize treatment and assess patient conditions.
Know how to manage complications associated with stress tests.
Understand how to combine testing results with imaging to assess the risk of cardiovascular diseases.
Know how to interpret results to assess the condition of the cardiovascular system in women and in various clinical scenarios.
These requirements are specified for different specialists using various imaging methods. Training in modern methods implies a high level of knowledge and proficiency in all four imaging modalities. A competency-based approach requires the use of various tools to assess progress in learning.
In a field such as cardiovascular imaging, achieving a high level of competence depends on the quality and volume of training. An effective learning process includes both theoretical classes and practice with various pathologies. The volume of procedures that must be mastered is also important but insufficient for complete competence. Competence in imaging is based on successfully meeting all educational requirements and receiving a positive evaluation from the program leadership.
The minimum necessary volume of procedures to demonstrate competence in cardiovascular imaging is presented in the table below:
| Cardiovascular Imaging Specialists | Narrow Field Cardiovascular Imaging Specialists | ||
| Interpretation of Multislice CT Results | 250 | 450 | Includes various types of MSCT, including coronary, as well as other types of studies (e.g., heart valve defects, formations in the heart, etc.). Archived cases may be used to ensure diversity but should not be the primary source. |
| CT Studies Involving Patient Preparation, Data Collection, and Interpretation | 65 | 150 | These studies are included in the total number of interpreted MSCTs. Trainees must actively participate at all stages—from preparation to interpretation. |
| Total Number of Interpreted MRI Studies | 200 | 350 | Includes a wide range of pathological conditions, including ischemic cardiomyopathy and heart defects. Archived cases may be used to ensure diversity. |
| MRI Studies Involving Patient Preparation and Data Interpretation | 100 | 150 | Includes participation in various imaging methods, such as coronary imaging and mapping. |
| Total Number of Interpreted Echocardiographic Examinations | 475 | 1100 | Includes a set of studies and implies interpretation of the performed echocardiograms. |
| Total Number of Interpretations of Cardiac Nuclear Tomography | 300 | 575 | Includes a range of studies, such as SPECT or PET. |
In conclusion, to develop medicine and improve the quality of physician training, it is necessary to understand who and how will be able to implement these requirements. Without this, our patients will be forced to seek alternative sources of information about their health.
