Report on 6th ESPE Caucasus & Central Asia School

Report on 6th ESPE Caucasus & Central Asia School held in Nur-Sultan, Kazakhstan, from Friday 11th to Wednesday 16th October 2019

This year’s ESPE Caucasus and Central Asia (C&CA) School represented a departure from previous schools in two ways. Firstly, rather than accepting new applicants from the Caucasian and Central Asian countries, those C&CA school participants from 2014-2018 who were considered to have been the best in their year were invited to reapply in 2019. The level of teaching was raised accordingly, represented in a new program of lectures and teachers’ cases, which were presented as dual English and Russian slides. Secondly, the last day of C&CA School took the form of an open meeting, sponsored by the AcinoKaz association, at which 90 doctors - endocrinologists and pediatricians - from all over Kazakhstan participated.

The 3-day ESPE School was held in Kazakhstan, Central Asia’s largest country and indeed the 9th largest country in the world albeit with a relatively modest population of 18 million. The venue was Wyndham Garden Hotel, situated outer part of Kazakhstan’s capital Nur-Sultan and near to the EXPO 2017 conference and exhibition centre.

The student faculty comprised 21 candidates, representing Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Russia, Tajikistan, Ukraine and Uzbekistan.

The teaching faculty, unchanged from 2018, consisted of Gunduz Ahmadov (Azerbaijan), Malika Alimussina (Kazakhstan) (local organiser), Francesco Chiarelli (Italy), Malcolm Donaldson (United Kingdom), Alina German (Israel, coordinator), Jan Lebl (Czech Republic) and Rasa Verkauskiene (Lithuania). Under Malika’s stewardship the meeting ran very smoothly, and it was very good to have a local organiser who was both close to the students in terms of age, medical background and language (Russian) while also is a steering committee member.

It was originally proposed that the meeting should be conducted in English with dual slide projection in Russian and English. However, since some students had limited English, and given the complexity of some of the lectures, it was decided to deliver the lectures in Russian with Malcolm and Franco being translated simultaneously by the Russian-speaking teachers.
Topics covered during the three-day meeting were: bone health and fragility, growth hormone replacement, smallness-for-gestational age, obesity, type 2 and monogenic diabetes, Turner syndrome, DSDs and pubertal problems. There was also a very informative talk on how to give a presentation by Franco Chiarelli, which emphasized the importance of showing slides with a readable font size, and of keeping to the allocated time (something that teachers find difficult!). As usual, teachers’ cases in small groups, which were held on each day, were very popular with the students. Each student rehearsed a case in small groups with two teachers, then presented their case to the whole faculty.

The one-day open meeting was held in National Research Centre for Maternal and Child Health. Topics covered included normal growth and puberty, congenital hypothyroidism and thyrotoxicosis, growth disorders and GH treatment, adrenal insufficiency and CAH, hypoglycemia, and recent advances in the diagnosis and treatment of diabetes.

This year, Nino Kheladze from Georgia and Gulzhan Amanbay from Nur-Sultan won joint prize for their case presentations. Of the eight research projects selected for plenary presentation, the prize went to Nataliya Pogadaeva from Ukraine for audit of congenital adrenal hyperplasia.
The Sunday afternoon excursion took the form of a coach ride through Nur-Sultan, a city of only 20 years in its current form, set on flat terrain, with the Ishim river running through it, and with an impressive array of skyscrapers, unusually-shaped buildings including a sports arena resembling a bicycle helmet, a golden-topped mosque, a mini-pyramid and the huge Hazrat Sultan mosque – the second biggest in Asia. This was followed by a visit to the National Museum which features an extensive display of Central Asian textiles, traditional costumes through the ages, sculpture, pottery and art.
The last evening of the meeting was held in Kerege restaurant, a building shaped like a giant yurt, and featured traditional Kazak cuisine, a Korean children’s dance troupe, Kazakh dancers with fans, and a young musician singing and playing the country’s two-stringed traditional oud. On a more informal note, the 8-year-old son of one of the students accompanied three songs (including Blur’s Song 2) on the drums, Franco gave a rendition of Elton John’s Your Song, and the students composed a hilarious parody of Serik Musalimov’s song “My Kazakstan”, with Malcolm accompanying on guitar!
The C&CA faculty are very grateful to ESPE council for once again generously funding this ESPE School for the third year. We also thank Malika, and our students Lusine Kalantaryan and Sona Samvelyan for their help in translating the lectures into Russian.

ESPE C&CA School has now enjoyed its sixth year, with 125 doctors participating between 2014 and 2018. Of the 21 students returning this year, 8 have already been awarded ESPE clinical fellowships. The gratitude of the doctors in the host countries is heartfelt and there is no doubt that C&CA school is fulfilling an important need, although much remains to be done in raising the profile of paediatric endocrinology in the region.

The next School will take place in Tblisi, Georgia, from 6-10 October 2020 and will feature another open final day. Visits to Mongolia in 2021, a return to Uzbekistan in 2022.

Alina German and Malcolm Donaldson, on behalf of the C&CA school faculty, December 2019