I.M. Sechenov First Moscow State Medical University, universally known as Sechenov University, is the oldest, largest, and most internationally prestigious medical university in Russia. Founded in 1758, it has an unbroken 267-year history of medical education that predates the formation of the United States and most modern university systems worldwide. Named after Ivan Mikhailovich Sechenov, the founder of Russian physiology, the university has been the intellectual home of Nobel laureates, Fields Medal winners, and generations of Russia's most distinguished physicians and medical scientists. Sechenov is not merely the oldest medical university in Russia. It is one of the largest in the world by any measure. Its academic structure includes more than 4,000 distinguished faculty members, 3,000 hospital beds directly accessible to students for bedside learning, cutting-edge technologies, including robotic surgery, 20 research and training buildings, and 25 university clinics and hospitals. No other medical university in Russia, and very few in the world, provide this level of direct clinical access to their students. International students from over 100 countries are enrolled, and the university's English-medium programme has operated for decades, with a well-developed international student infrastructure. The six-year MD (MBBS equivalent) programme at Sechenov is taught in English for international students. The programme is accredited not only by the standard NMC, WHO, and WDOMS bodies, but also by WFME, ECFMG (USA), and ASIIN, the German Association for the Accreditation of Science and Engineering Studies, a rigorous European quality standard. Clinical rotations at Sechenov's own university clinics and teaching hospitals in Moscow expose students to a breadth and complexity of cases that regional university hospitals simply cannot match. The simulation centre uses robotic surgery systems and advanced diagnostic technology that are the current standard of care in international medicine. Annual tuition at Sechenov University is approximately USD 17,000 to 18,335 USD per year, the highest on this Russia list reflecting its position as Russia's top-ranked medical institution, its Moscow location, its research-intensive academic environment, and the depth of its clinical training infrastructure. This, however, is still dramatically lower than comparable medical education in the United States, the United Kingdom, or Australia. For students who want the most academically and clinically prestigious Russian medical degree available, one that carries genuine global name recognition, Sechenov University represents the apex of what Russian medical education has to offer. An entrance examination in Chemistry and English is conducted, and applicants are expected to meet a higher baseline academic standard than is required at most regional Russian universities. Moscow itself is one of the world's great capital cities: home to the Bolshoi Theatre, the Kremlin, world-class museums, and a student culture of extraordinary energy and diversity. The cost of living in Moscow is the highest of any Russian city, but still dramatically lower than in London, New York, or Sydney. For students who can access Sechenov, the combination of academic prestige, clinical depth, and the Moscow experience is unparalleled in Russian medical education.