Nüüdisaegse laboratoorse meditsiini arendusloost Tartu Ülikoolis (1990-2016). History of the Development of Contemporary Laboratory Medicine at the University of Tartu (1990-2016)

Abstract

During the revision of the curriculum in the early 1990s, it was decided by the University of Tartu Faculty of Medicine to create an independent subject called clinical chemistry. Agu Tamm, MD PhD, DMedSc, Senior Research Fellow at the Institute of General and Molecular Pathology, was originally nominated to prepare and provide instruction in this subject. In1993 Tiit Salum, MD, biochemist; and Milvi Topmann, MD (0.5 work load), head of the laboratory of the Children’s Hospital, were employed as the first lecturers/assistants. In order to modernize the subject, instruction was provided both to domestic doctors (at the hospital and on the primary care level) and at foreign practices (in Holland and Finland).
In the years 1994–1997, financial support was received under
the PHARE / TEMPUS (Trans-European Mobility Project of University Studies) program JEP 7784 “Development of Academic Laboratory Medicine in Estonia” for staff training and the development of teaching infrastructure. Updating the undergraduate and postgraduate curricula was supported by experienced specialists from the University of Glasgow (project leader M. Dominiczak), Odense University (Prof. M. Hǿrder) and University of Turku (Prof. V. Näntö). In addition to the lecturers, during the project term, 24 people from future basic hospital laboratories, computer specialists from the Tartu University Hospital, as well as key personnel from the faculty and the University Hospital administration were trained in partner universities. The aim was to transform the general attitude towards the specialty and its needs. As an output of the project, Tartu University Hospital established United Laboratories (1996) and the University of Tartu established the Chair of Laboratory Medicine (1997).
The project also facilitated the reform of the entire curriculum of
the Faculty of Medicine, as a programme of seven guest lecturers was established and four symposiums on curriculum design was organised in several universities.
During the project, specialists from Estonian medical laboratories got acquainted with the Finnish Center for Quality Control (first at Labquality Days). Thenceforward, an external quality control system for hospitals’ laboratories began to operate, and it is still the predominant system to date. Two summer school programs for Estonian laboratory staff were also organized in the framework of the project. Summer schools have also remained in our calendar even now.
Initially, scientific research in our field proceeded from the needs
of practical work, e.g., verification of laboratory reference values (former test “norms”) and quality assurance. This was followed by the introduction of a few new bone and heart biomarkers (2003–2006). These implementation projects launched research and development in the field of tissue biomarkers, which still continues today.
Our specialty reached a new level of maturity in the 2010s, when our lecturers (T. Salum, 2011 and M. Tõnisson, 2014) and former residents (J. Kumm, 2012 and I. Kerna, 2014) completed and defended their dissertations. Our international cooperation was largely based on participation in the Baltic Bone and  Cartilage Conference (BBCC 2003–2013) and on the successful application of two EU 7th Framework Programme projects. The facts presented above confirm that laboratory medicine as an academic specialty has found its feet in Estonia.