Higher medical education during wartime: focus on the resilience, transformation, and post-war prospects

Abstract

Introduction. The full-scale invasion of Ukraine in February 2022 imposed unprecedented challenges on the national higher medical education (HME) system, threatening its operational integrity, infrastructure, and human capital. The paper examines the systemic shock experienced by Ukrainian medical universities and analyses the subsequent adaptive strategies employed to ensure the continuity of education and scientific activity amidst active hostilities. This study aims to provide a comprehensive analysis of the resilience, transformation, and forward-looking innovations driving the sector’s evolution. Literature Review. Existing scholarly work on medical education during conflict frequently focuses on post-conflict reconstruction or regional stability issues. A significant gap exists regarding integrated analyses that capture the concurrent effects of mass internal displacement, infrastructure damage, immediate curricular reform (e.g., tactical medicine), psychological burden on staff and students, and the forced acceleration of digital transformation within a single, actively contested national educational framework. This study addresses this gap by synthesising these interwoven challenges and adaptive responses. Methods. The present analysis employs a qualitative, mixed-methods approach, based on a review of institutional reports, policy documents from the Ministry of Health and Ministry of Education and Science of Ukraine, internal curricular adaptations, and documented accounts of international cooperation initiatives between 2022 and 2025. The methodology utilised in this study is anchored in the analysis of case studies of relocated institutions, complemented by content analysis of updated educational programmes, with a particular focus on military medicine, rehabilitation science, and digital health. Results. The war resulted in widespread infrastructure damage and the forced relocation of several major medical universities. In response to these challenges, HME institutions have rapidly transitioned to blended and distance learning models. Curricula underwent radical transformation, integrating new core competencies in tactical medicine, combat trauma care, and psychological first aid. Moreover, there was a marked shift in scientific research priorities towards addressing pressing national needs, focusing on developing advanced prosthetics, reconstructive surgery, and large-scale mental health and psychosocial support programs (MHPSS). International cooperation was a crucial factor in providing the necessary stability, facilitated by shared research grants, the donation of equipment, and the establishment of robust academic mobility programmes. Discussion. The findings indicate that the Ukrainian HME system exhibits extraordinary resilience and adaptive capacity. Initially driven by necessity, the transition to digital modalities has significantly accelerated the adoption of telemedicine and telepsychology, paving the way for a more accessible and futureproof health infrastructure. Nevertheless, challenges persist, particularly concerning maintaining high-quality clinical training despite limited access to traditional clinical bases, and addressing the long-term psychological distress among academic personnel and students, and integrating war-related specialisations positions Ukrainian medical graduates as world leaders in trauma and crisis medicine. Conclusions. Ukrainian higher medical education has demonstrated survival and profound transformation during wartime. The lessons learned – particularly the reliance on digital innovation, the prioritisation of MHPSS, and the value of international partnership – are poised to form the bedrock of a modernised, digitally integrated, highly specialised post-war health system. This experience offers critical insights for planning global medical education in conflict and crisis zones.