OMI Made Me the Doctor I Am Today: Bulgaria’s Medical Leaders

“My participation in the activities of the Open Medical Institute had a significant and lasting impact on my professional development. It gave me access to international expertise, innovative surgical techniques, and clinical approaches that I was later able to introduce, adapt, and promote in Bulgaria.

One of the first major outcomes of this experience was my doctoral dissertation, entitled “Extracorporeal Shock Wave Therapy in the Treatment of Injuries and Diseases of the Musculoskeletal System.” The topic was developed after a valuable exchange of experience with orthopedic specialists from Vienna during my first OMI seminar, particularly with Dr. Wolfgang Schaden. This work was successfully defended as a doctoral thesis and later became an important basis for my academic promotion to Associate Professor. More importantly, it contributed to the wider introduction and dissemination of extracorporeal shock wave therapy in Bulgaria. Today, this method is used by an increasing number of orthopedic surgeons, physiotherapists, and rehabilitation specialists across the country.

Another important turning point came during one of the discussion seminars in Salzburg, where I was introduced to the rapidly developing field of foot and ankle surgery. The lectures, delivered by specialists from the Hospital for Special Surgery in the United States, opened my perspective to an area that, at that time, was not yet clearly established as a separate subspecialty in Bulgarian orthopedics and traumatology. Inspired by this experience, two years later I became one of the co-founders and Deputy Chair of the Bulgarian Society for Foot and Ankle Surgery. This helped position Bulgarian orthopedics within a modern and internationally relevant field.

The knowledge gained through OMI activities also had a direct impact on my surgical practice. Following the Salzburg seminar and further training with Prof. Wanivenhaus at the General Hospital of Vienna, one of my main mentors, I adopted the Chevron osteotomy technique for the treatment of foot deformities. Over time, this method became part of the routine practice in my clinic and has since been introduced and used by colleagues throughout Bulgaria. The confidence to apply and teach this technique came directly from the high-quality mentoring and practical examples provided by my Viennese colleagues.

A particularly important contribution was the introduction of a minimally invasive technique for the treatment of Achilles tendon ruptures, which I first encountered through the case-report discussions within the OMI seminars on foot and ankle surgery. At that time, this approach was new for Bulgaria. Unlike traditional open surgery, the technique allowed restoration of the tendon with smaller incisions and fewer postoperative problems for the patient. After returning to Bulgaria, I began applying the method, presenting my results, and publishing my experience. Initially, the approach was met with scepticism and even open resistance by some senior colleagues. However, after years of presentations, live surgical demonstrations, and accumulated clinical results, the method became widely accepted. Today, it is used by trauma surgeons throughout Bulgaria. I also shared my experience with a younger colleague, who developed his doctoral dissertation on this topic, successfully defended it, and later became an Associate Professor.

During one of my three internships at the General Hospital of Vienna, I was also exposed to innovative approaches in pediatric orthopedics, including the treatment of recurrent pediatric equinovarus foot using the Taylor Spatial Frame, a device for correcting limb axes and length. This technique later became part of my dissertation for the scientific degree Doctor of Science and is now routinely used in my clinical practice. During the same period, I also gained experience with reverse shoulder arthroplasty, which was innovative at that time and has since become an important and widely applied method in upper-limb surgery.

Looking back, the OMI programs contributed not only to my acquisition of specific surgical techniques, but also to my development as an academic surgeon, teacher, and leader. They gave me the confidence to operate, teach, and organize clinical work according to European standards. This is the same standard that I now actively pass on to and require from the young colleagues in my team.

I consider my participation in the OMI activities one of the key milestones in my career. The knowledge, mentorship, and international professional environment I encountered through these programs helped me transform new ideas into everyday clinical practice and contributed to the modernization of orthopedics and traumatology in Bulgaria.”

“My first participation in an OMI seminar was in 1998, in a seminar dedicated to tuberculosis in Eastern Europe. At that time, tuberculosis was again becoming a major public health and clinical issue in Europe, particularly because of the emerging problem of multidrug-resistant tuberculosis.

This seminar was a turning point in my professional development. Until then, access to up-to-date international scientific information in Bulgaria was very limited. There were few opportunities for direct communication with leading international experts, and formats of this kind were almost unavailable in medical education and postgraduate training. For me, the seminar offered a first real insight into the modern understanding of tuberculosis, its diagnosis, treatment, epidemiology, and the growing challenge of drug resistance.

I was particularly impressed by the presentations of World Health Organization officers, who shared their direct observations and experience from Africa and other regions with a high burden of tuberculosis. Their reports helped me understand tuberculosis not only as a local clinical problem, but as a global health challenge requiring coordinated medical, public health, and organizational responses.

One of the most valuable aspects of the seminar was the access to high-quality scientific literature. The lecturers and organizers provided extensive materials, including two large folders with articles, thematic bibliographies, and international documents. At that time, such journals and resources were not easily accessible in Bulgaria. These materials became an important source of knowledge for many colleagues and me after my return.

The knowledge gained at the seminar had a direct impact on my academic and professional work. I shared the materials and the newly acquired information with Prof. Zlatanov, then Chair of the Society of Internal Medicine, and together we helped disseminate this knowledge among the medical community in Varna and the region. The information was presented and discussed with physicians from different specialties, which made the impact of the seminar much broader than my individual participation. It became useful for the wider professional community in Varna, the region, and Bulgaria.

The seminar also influenced my scientific interests and academic development. It strengthened my engagement with the topic of tuberculosis and contributed to my work in this field, including the development of my dissertation related to this important medical and public health problem. The seminar helped me formulate the topic in a more modern and internationally informed way, with attention to diagnosis, treatment, resistance, and the broader public health context.

Beyond the scientific content, I was deeply impressed by the excellent organization of the OMI seminar and the outstanding preparation of the lecturers. The structure of the program, the quality of the presentations, the open discussions, and the collegial atmosphere became a model for me in organizing and participating in scientific and educational events later in my career.

Looking back, I consider my participation in the OMI seminar an important milestone in my professional growth. It gave me access to international knowledge at a time when such access was limited, helped me develop my academic work, and enabled me to transfer valuable information to the medical community in Bulgaria. The seminar contributed not only to my personal development, but also to the wider understanding of tuberculosis as a modern clinical and public health challenge in our region.”

“I attended the OMI seminars for the first time over ten years ago, and the first seminar was in General Pediatrics. I was fascinated by the presentations, the faculty, and the overall spirit and atmosphere of the place.

The following year, I started my specialization in neonatology, and having a strong interest in this specific area of pediatrics, I attended seminars on Maternal and Infant Health. I gained a profound new perspective in a field that I thought I knew a lot about. This was the moment I learned things that we do not teach at universities in Bulgaria: to look at data, work with research, and doubt every fact that has not been verified. The opportunity to listen firsthand to world-renowned professors, discuss interesting topics, and look at treatments or procedures from a different angle elevated my own experience and expertise.

As a next step, I was able to participate in a neonatology observership at the Medical University of Graz. This experience gave me the opportunity to see an area of neonatology that I had only read about in real-life practice. The newborns were kept in quiet rooms, almost all were on non-invasive ventilation, feeding started as early as possible, and all were fed exclusively with breast milk. We do not have a breast milk bank in our hospital, and most of our babies do not have the opportunity to receive their own mothers’ milk.

The management of a newborn in the delivery room, especially some groups, such as those born with asphyxia or premature, requires specific skills and a well-trained team. I observed many births and delivery room care, as well as many situations that showed me how to apply each step of the consensus for resuscitation. Additionally, I was able to observe the insertion of the PICC line, along with the opportunity to discuss every step of the process.

An aspect that was very important for me was the organization of the daily work in the neonatal unit. There was an early morning visit with a discussion of every detail of each patient’s condition, followed by a review of all treatments and procedures planned for the day.

Soon after my return to Bulgaria, I became the Head of the Department of Neonatology in my hospital. The experiences from Graz gave me the opportunity to demand changes in postpartum care in the delivery room, including a gentle approach to each baby, keeping them warm, without unnecessary procedures such as washing immediately after birth. I managed to convince my colleagues to rely primarily on non-invasive ventilation and to introduce LISA as the main way to distribute surfactant.

We managed to introduce a PICC line, but we still feel a little uncomfortable with these central line devices. I have planned some changes in the organization of the work of the midwives in the department, but there is still a lot to be done, considering that one of our really serious problems is the shortage of medical personnel.

Now that I have the opportunity to listen to recorded seminars in Salzburg, I review all of them related to neonatology and discuss new topics with my colleagues and residents. I hope one day I can speak as boldly and inspiringly as all the lecturers do.

I always emphasize that the medical seminars in Salzburg and the observership are some of the best experiences I have had and that they made me the doctor I am today.”

“I attended my first seminar in neonatology organized by the OMI in Salzburg in 2003. This experience had a lasting impact on my professional development. At the time, I was still in the process of building my expertise in neonatology in Bulgaria, and the seminar gave me access to knowledge, clinical approaches, and international standards that were not easily available in everyday practice.

I was deeply impressed by the high scientific level of the programme and had the privilege to meet and listen in person to world-renowned neonatologists, including Dr. Steven Donn and Dr. Richard Polin, whose names I had previously known only from textbooks. The lectures and discussions helped me better understand modern approaches to neonatal intensive care, especially respiratory support, mechanical ventilation, the management of critically ill newborns, and the importance of structured follow-up after discharge.

In the following years, I also attended OMI seminars in Maternal and Infant Health and Pediatric Neurology. These seminars broadened my understanding of neonatal care beyond the acute hospital period. They helped me appreciate the close connection between perinatal care, neurological development, early diagnosis, and long-term outcomes in high-risk newborns. This knowledge changed the way I followed critically ill and premature infants in my daily work.

The seminars were followed by three-month clinical observerships in the Neonatology Departments in Graz and Salzburg. During these stays, I gained valuable practical experience in mechanical ventilation, neonatal brain ultrasound, monitoring of premature and critically ill newborns, and organization of neonatal intensive care. After returning to Bulgaria, I was able to apply this knowledge directly in my clinical practice. In particular, I introduced and strengthened a more systematic approach to respiratory care, neurosonographic assessment, and follow-up of newborns at risk.

The OMI program also contributed greatly to my personal and professional confidence. It gave me the opportunity to compare my work with international practice, to learn from experienced mentors, and to build contacts with colleagues from different countries. These exchanges helped me grow not only as a clinician, but also as a teacher, mentor, and leader.

After completing my specialty and obtaining a Master’s degree in Neonatology, the knowledge and skills gained through the OMI seminars and clinical training helped me take responsibility for the newly established Neonatology Department at the Multidisciplinary Hospital for Active Treatment “St. Anna” in Varna, Bulgaria. More than 20 years later, I continue to serve as Head of this department.

Looking back, I consider my participation in the OMI seminars one of the important milestones in my career. The program helped me transform international knowledge into everyday clinical practice and contributed to the development of neonatal care in the hospital where I work.”