Shared Knowledge, Stronger Care: GMKA Supports Advanced Endoscopy Training Through Observership Program
The Global Medical Knowledge Alliance (GMKA) is strengthening Ukraine’s medical capacity by developing strategic partnerships with leading international healthcare institutions and committed Ukrainian hospitals and clinicians. Through a range of programs — including specialized training initiatives, system-strengthening projects, and clinical observerships — GMKA provides Ukrainian physicians with access to world-class expertise. This knowledge is directly applied to deliver better, safer care for patients in Ukraine — especially critical as the country navigates the pressures of a full-scale war.
More than 60 Ukrainian physicians have already completed observerships through GMKA. In November 2025, Kyiv-based endoscopist Ivan Hornik, MD spent several weeks training at the endoscopy departments of two leading Boston medical centers: Brigham and Women’s Hospital and Newton-Wellesley Hospital. He has now returned to Ukraine, where he is already applying these skills in his hospital and sharing knowledge with colleagues, amplifying the impact of the program.
“I had the opportunity to see the system as a whole — from routine screening to the most complex interventions performed by experts who define global standards in endoscopy,” he reflected. “An observership is not just a trip abroad — it’s a chance to understand why another system works and bring those principles home. Endoscopy in Ukraine is developing rapidly, and we’re moving in the right direction.”
Wartime conditions have intensified the strain on Ukraine’s medical infrastructure, making effective cancer screening and early detection a health-security priority. During his observership, Dr. Hornik focused on colorectal cancer screening, the country’s most common cancer. In 2025, GMKA conducted the first nationwide assessment of colonoscopy quality in Ukraine. Results published in JCO Global Oncology highlighted critical gaps in quality metrics and lesion management, underscoring the urgent need for structured quality-improvement programs as Ukraine moves toward national screening implementation.
“In the US, colorectal cancer screening is a system-supported program backed by strong quality standards,” Dr. Hornik noted. “It’s not just about having access to colonoscopy — quality determines whether the procedure is recognized, reimbursed, and effective. These insights are essential as Ukraine builds its own system.”
Ukraine continues to face significant system-wide challenges in quality and safety: lack of standardized care pathways, high rates of medical errors, limited training opportunities, and strained clinical resources due to the ongoing war. Without reliable and unified processes, patient outcomes vary widely, and system inefficiencies deepen.
During his training, Dr. Hornik learned how US electronic medical systems automatically calculate key quality indicators for endoscopy — tools that not only track performance but actively guide improvements.
“The data isn’t collected for compliance — it’s used to improve technique, workflow, and education,” he said. “That’s how thousands of high-quality procedures are performed consistently. Ukraine can adopt similar systems, but doing so requires both technical modernization and a shift in culture, where quality becomes a development tool, not just paperwork.”
At Brigham and Women’s Hospital, Dr. Hornik also observed advanced procedures including endoscopic submucosal dissection (ESD), EUS-guided interventions, and complex ERCP — skills critically scarce in Ukraine and urgently needed as hospitals face rising demand for minimally invasive care amidst wartime patient surges.
Although Ukraine cannot replicate the US training model directly, an adapted approach is achievable. Dr. Hornik emphasized the need to establish specialized training centers within Ukrainian hospitals with sufficient volumes of advanced procedures. These centers would standardize training, define competency requirements, ensure quality oversight, and expand patient access to high-level care.
Such a model would directly address systemic challenges, including:
- inconsistent performance of complex interventions,
- limited opportunities to acquire advanced endoscopic skills,
- increased risk of complications due to insufficient training,
- restricted access to specialized care for patients, especially in regions affected by the war.
Ultimately, this would enhance patient safety, improve outcomes, and help cultivate a national school of interventional endoscopy.
Reflecting on the experience, Dr. Hornik added: “What stood out most was the culture of mentorship. Teams work as a single unit — nurses, anesthesiologists, endoscopists — everyone knows their role. This structure minimizes errors and allows the team to focus on patient care rather than logistical challenges.”
GMKA remains committed to expanding access to high-level medical training for Ukrainian clinicians. Continued support for observerships and system-strengthening programs is essential to ensuring that Ukrainian physicians can deliver world-class care to patients at home, both during wartime and in the years ahead.