Zarys genezy i przekształcenia szkół medycznych w Kielcach i regionie w latach 1945–2014

The Second World War caused an enormous loss of medical and nursing staff across the country. The deficit of staff was particularly notable in the Kielce region. A lack of nurses, teaching staff, study aids, and educational premises prompted management authorities to quickly reactivate medical education and hospital treatment. These were the priority tasks created just after the liberation of the Health Department. Two months after the liberation of Kielce in 1945 the first School of Nurses and Midwives in Sandomierz was established, which provided one-year courses. Due to a lack of suitable school premises and teaching staff, its activity was suspended and, in 1948, transferred to Kielce [1]. After suspending the school’s activity, the training of younger nurses was undertaken in 1949 by the Provincial Board of the Polish Red Cross on six-month courses (11 courses were organized in Kielce, eight courses in Radom, and several in Starachowice, Jędrzejów, and Częstochowa). By 1956, approximately 1230 junior nursing diplomas were issued following six-month courses [2]. Based on the Sandomierz School model, the first School of Hygienists and Midwives was established in Kielce in 1948. Later, the hospital hygienist course was turned into a two-year general nursing course (September 1st, 1973), and the Department of Medical Nursing, Vocational College became the Midwifery Department, Medical Vocational College, in Kielce at 30, Prosta Street (a medical secondary vocational school modelled after a high school) [3]. On June 1st, 1950 the first high school for nurses was opened in Kielce: a two-year State School of Nursing (as the only one among 31 types of school in Poland), directly responsible to the Ministry of Health [4]. From January 1st, 1952, pursuant to the instructions of the Minister of Health, medical schools were transferred to fall under the supervision of the Presidencies of the Provincial National Councils [5]. The first document establishing the legal principles of the functioning of medical schools was the statute of medical secondary schools, constituting annexes to the instructions of the Minister of Health, valid until 1957 [6]. In 1957, a new instruction was issued by the Minister of Health and it concerned the organisation of medical secondary schools [7]. In 1956, the financing of medical secondary schools was transferred from central to local government [8]. In 1956, on the basis of the transformation of training courses for unqualified nurses, a two-year Basic School of Psychiatric Nursing Assistants in Morawica was created [9]. In 1958 and 1960, a two-and-half-year State School of Nursing in Radom and a four-year Nursing High School in Kielce were established, respectively [10].
Until 1960, two-year and two-and-a-half-year medical secondary school programs were the basis of didactic and educational activity in schools and teaching organisations, based on nine grades of comprehensive education issued in 1949–1950 [11, 12]. During the years 1950–1959, teaching plans changed in terms of the quantity and quality of objects as well as their hours [12]. Although the practical training of the profession was governed by separate provisions of the Minister of Health [13], in 1950 the Ordinance of the Minister of Health and Social Welfare introduced changes in medical education that permitted the supplementation of theoretical general education to full secondary school level, and allowed graduates to enter universities and obtain vocational diplomas [14].
Pursuant to the Resolution of the Provincial National Council in Kielce (No. 149, dated May 26th, 1959), the State School of Nursing in Kielce extended its courses from two years’ duration to four years, and in 1963 changed its name to the Medical High School in Kielce [15]. In the 1959–1960 academic year, after the reorganisation of the two-and-a-half-year State School of Nursing in Radom, a four-year course was established, the duration of which was later extended to five years, and, in the same year (1961), the name of the educational establishment was changed to the Medical High School of Nursing. On that basis the Basic School of Nursing Assistants also functioned, which was liquidated in 1968, and similarly, in 1969, the State Medical School of Occupational Therapy Techniques was established [16]. Following the decision of the provincial Faculty of Health, in 1961 a two-year State School of Nursing was established in Skarżysko-Kamienna, whose task was to supplement staff shortages in the newly built hospital in Skarżysko (Ordinance of the Minister of Health and Social Care October 27th, 1961) [17, 18]. Due to a further lack of nursing staff in health care facilities in the area of Skarżysko, in 1962 a Basic School of Nursing Assistants was established for primary school graduates, which functioned until 1968 [19].
In Radom in 1962, a Basic School of Nursing Assistants was also established, and in 1965 the name of the school was changed to the Basic Medical School of Nursing Assistants, which functioned until 1969 [20].
In connection with the construction of a large hospital in Starachowice, as well as the creation of a health centre, in 1962 the State High School of Nursing was established, which in 1963 changed its name to the Medical High School of Nursing [21–24]. In 1963, due to a lack of pharmaceutical staff, a Faculty of Pharmacy was established in Kielce pursuant to the Resolution of the Faculty of Health in 1961 [18].
After building a psychiatric hospital in Morawica and due to the continuing deficit in staff in 1964, using the model of the Basic School of Psychiatric Nursing Assistants (1961 Ordinance of the Minister of Health and Social Care, October 27th, 1961), a two-and-a-half-year Medical School of Psychiatric Nursing for Workers was created, which transformed, in 1972, into the Medical Vocational College with departments of psychiatric and general nursing [19, 20].
The hospital in Busko-Zdrój faced similar difficulties. In 1961, a two-year School of Nursing in Busko- Zdrój was established, and in 1972 was renamed as a two-year Medical Vocational School in Busko-Zdrój. The school met the partial demand for nursing staff, and in 1992 the education there was extended to two and a half years, continuing until 2003 when the school was closed down (Resolution No. IV/41/02 of the Council of the Świętokrzyskie Voivodeship, December 30th, 2002).
Despite many schools functioning in Kielce, Starachowice, Radom, Busko, and Morawica, there were still shortages of staff in newly established health care facilities. Correspondingly, in 1970 an annual State School of Nursing Assistants was set up in Skarżysko-Kamienna for those having obtained a secondary school certificate, and in 1972 a two-year Medical Vocational School was established with the General Nursing Faculty in Skarżysko-Kamienna [25, 26].
Due to the completion of a large hospital in Ostrowiec Świętokrzyski, there was great demand for nursing staff. In 1973, a two-year Medical Vocational School was established, and in 1992 it was converted into a two-and-a-half-year Medical Vocational School [27].
The 1970s was a period in which many health care facilities were built and a high demand for nursing staff in the Kielce region followed. In connection with the above, in 1974 a two-year vocational course was established in Miechów with one general nursing department, which in 1992 was turned into a two-and-a-half-year Medical Vocational School.
On September 1st, 1973, following the decision of the provincial health department, a two-year Medical Vocational School with a department of nursing was established in Radom [28].
In 1975, significant administrative changes took place in Poland, which resulted in the creation of new voivodeships. Radom became the capital of its own voivodeship. Medical schools functioning in Radom ceased to be subject to authorities in the Kielce Voivodeship. Accordingly, no further transformations that took place in Radom medical schools after 1975 are presented in this publication.
The further development of health care institutions was associated with a demand for specialist staff, and therefore in Starachowice on September 1st, 1975, a Medical Vocational School was established (ordinance No. IV.001 / 2/75 from February 28th, 1975), and in 1976 both the Faculty of School Hygiene (study was suspended in 1996) and the General Nursing Department were formed (decision No. 90/76 of the Kielce Voivodeship governor on August 10th, 1976) [29].
In 1978 following the decision of the Superintendent of Education and Upbringing in Kielce, two existing institutions, the Medical High School and the Medical Vocational School, were merged into the Medical Schools Complex in Kielce [30].
In 1978, the Faculty of Dental Technology was established in Starachowice on the instruction of the Superintendent of Education and Upbringing, dated June 20th, 1978, No. oIIa-141/7/78, which functions to the present day. In 1979, the name of the school was changed, as a result of the merger of the Medical School and Medical Vocational School, to the Medical School Complex in Starachowice [30, 31].
In 1980, a department of social workers was established at the Medical Schools Complex in Kielce, which functioned until 1998. In 1981, the Vocational College of Midwifery was joined with the Faculty of General Medical Nursing in the Department of Medical Schools in Kielce. The College functioned separately as a midwifery college in Kielce, on Prosta street. After building further health care units in Końskie and Włoszczowa, based on the Medical School Complex in Kielce, faculties were established in 1983 under instruction from the Superintendent of Education and Upbringing on September 28th, 1989, No. oIIa-5011/1/85. These were the Post-Secondary Medical School for Workers with headquarters in Końskie and, in 1985, the Post-Secondary Medical College for Workers in Włoszczowa (Internal Regulation No. 7/85 of the Main Provincial Physician of the Department of Health and Welfare of the Voivodeship Office in Kielce dated August 30th, 1985, in the matter of changing the organisation of the Medical School Complex in Kielce). After supplementing the nursing staff in health care facilities, as well as the lack of further recruitment, faculties situated at a distance from Kielce were terminated in 1986 and 1988 [32, 33].
In 1987, the Department of Dental Hygiene was established in Starachowice as the Faculty of Medical Vocations (but subsequently closed in 1990) [33]. As a consequence of the market demand for radiology technicians, Medical Vocational School No. 1 with a department of electroradiology was established on January 9th, 1988 and was included in the Medical Schools Complex in Kielce (functioning until 1991) [33].
In 1983 the Faculty of Physiotherapy in Busko- Zdrój was established due to the high demand for employees in the physical therapy department [33]. In 1989, pursuant to internal ordinance No. 4/85 of the Main Provincial Physician of the Department of Health and Social Welfare, dated February 10th, 1989, a Social Worker Department was created in the Team of Medical Schools in Starachowice, which functioned for two years until 1991 [33]. In 1991, on the instruction of the Ordinance of the Minister of Health and Social Welfare, the last recruitment of candidates to the Medical School in Starachowice took place, and the school ceased operations in 1996 (by decision of the Director of the Department of Health of the Voivodeship Office in Kielce, dated October 7th, 1996, No. 8034/65/96), and the Medical School Complex was renamed as the Medical Vocational School, which educated young adults in the fields of general nursing (abolished in 2000) and dental prosthetics. The Medical School (former Medical Vocational School) with a department in dental prosthesis still functions in School Complex No. 1 in Starachowice [33].
Similarly to Starachowice in 1991, the last recruitment drive for the Medical High School in Kielce was carried out and the school’s operations were halted on August 31st, 1996. (Internal Ordinance No. 4/92 of the Provincial Physician). In 1992, a Medical Rescue Department was established in the Medical School Complex in Kielce (education was suspended in 1996 due to a lack of appropriate legal provisions regarding the status of a medical rescuer in the labour market) [34].
In 1993 under Ordinance No. 3/92, dated December 12th, 1992, the Faculty of Medical Analytics was transferred to the original school building in the Medical School Complex in Kielce. In 1994, a new department of hygiene instruction was established. In connection with existing transformations up until that time, the Medical School Complex in Kielce was renamed the Medical Vocational College with the following departments: general nursing, midwifery, pharmacy, hygiene instruction, crèche, and medical analysis (internal order of the Provincial Physician in Kielce No. 2/94 dated March 30th, 1974) [35, 36]. In 1994, the Department of Psychiatric Nursing was closed in the Medical Vocational College in Morawica due to the change of regulations regarding education in this field [37].
In 1996, two new faculties: the Faculty of Dietetics and Occupational Therapy, were established at the Medical Vocational College in Morawica [38, 39]. During 1998 a second wave of significant administrative changes took place across the country, wherein new voivodeships were formed. The Medical Vocational College in Miechów was handed over to the authorities of the Małopolska Voivodeship 1st, 2000, the Medical Vocational College in Kielce and the Medical Vocational Colleges in Skarżysko-Kamienna, Ostrowiec Świętokrzyski, Starachowice, and Morawica all transferred their subordination to the Health Department of the Voivodeship Office in Kielce and became self-governing institutions under the supervision of the Marshal of the Świętokrzyskie Voivodeship. In 2001, the Department of Nursing and Midwives in the Medical Vocational College in Kielce ended its activity. Despite the transfer of the building to the authorities of the Świętokrzyskie Academy, from September 15th, 2001 the education of medical rescuers was resumed at Kielce’s Medical Vocational College. In 2002, after the completion of the education cycle in this field, the school was discontinued [40].
The Medical College in Skarżysko-Kamienna ended its activities in 2001 and, in the school building, there was established a Post-Secondary School of Social Workers (resolution No. XXX/294/05 dated July 18th, 2005), which in 2006 was transformed into a Collegium of Social Service Employees (the patronage of which was overseen and exercised by UMCS in Lublin). In this form the school still functions under the management of local government in Skarżysko- Kamienna [41].
The activities of the Faculty of Nursing at the Medical Vocational College in Starachowice ceased in 2000. The Medical Vocational College changed its name to the School of Medicine with a faculty of dental technology, which in 2005 was given by the Marshal of the Świętokrzyskie Voivodeship to the district office in Starachowice and still functions at School Complex No. 1 (Resolution No. XXX/301/05 of the Świętokrzyskie Voivodeship Council dated July 18th, 2005) [41]. In 2000 the department of general nursing in the Medical Vocational School in Busko-Zdrój was also discontinued, but the faculty of physiotherapy remained. After the completion of the full cycle of education in 2003 the Medical Vocational School was closed down, and the school building handed over to the district office in Busko [42, 43].
The Medical Vocational College in Ostrowiec Świętokrzyski, together with the general nursing department, was brought to a close in 2000 (on the order of the Marshal of the Świętokrzyskie Voivodeship dated July 14th, 2000). The department of general nursing at the Medical Vocational College in Morawica was dissolved in 2003 [44]. In 2005, the Medical Vocational School in Morawica changed its name to Hanna Chrzanowska Medical School [44, 45]. In 2003, a new teaching discipline was established: massage technician, which functioned until 2014 [46]. In 2007, the course of medical rescuer was set up [47]. A course in medical supervision was established in 2010 [48], in 2011 that of pharmaceutical technician was set up [49], and a course to train electroradiology technicians in 2013 was commenced [49, 50]. In 2013, a technical school of cosmetic services was established [51]. In 2014, the following vocational training courses were established: assistant for a disabled person, environmental guardian, electronics technician, and medical informatics [52]. The training courses mentioned above still function depending on recruitment. The school continues to develop, expanding education with vocational courses for workers.
In 1945, the first were three-month and six-month courses for the sanitary emergency services [53]. The number of nurses and midwives currently working in hospitals is decreasing, which may pose a new threat to the labor market. Modern medical education both in Poland and in the Kielce region should meet the in health care in providing the best care to the ill, the disabled, children, and the elderly. Working conditions, salaries of mid-level medical staff leave much to be desired. The effects of our medical education are collected by those who can offer better working conditions and wages. It is evident that mid-level medical staff escape the public sector for the private one, focused on health care rather than on prevention and health education.

Conflict of interest

The authors declare no conflict of interest.

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Address for correspondence:

Elżbieta Zawierucha
Department of Prevention of Gastrointestinal Diseases
Jan Kochanowski University
al. IX Wieków Kielc 19 A, 25-317 Kielce, Poland
Phone: +48 537 416 805
E-mail: mzawer@interia.pl