From August 31 to September 4, 2026, Dr. Smigel participated as a senior faculty member and clinical instructor at the European School of Prolotherapy (ESP) Medical Mission in Sofia, Bulgaria. This annual international initiative combined hands-on medical education with community service, bringing physicians together to advance their clinical skills in prolotherapy and regenerative medicine while providing care to local patients experiencing musculoskeletal conditions and chronic pain.
The 2026 mission was a tremendous success. Over four and a half days, 15 international physicians worked together to treat 166 patients from the local community under the guidance of experienced clinical instructors.
Advancing Prolotherapy Through Hands-On Clinical Education
The European School of Prolotherapy designed this five-day, immersive educational program to provide participating physicians with practical experience in regenerative medicine. Rather than relying solely on traditional lectures, the mission emphasized individualized mentorship, direct clinical practice, and collaborative learning.
Each learning group consisted of one clinical instructor guiding just two to three participating physicians, allowing for personalized instruction and close supervision. Under the guidance of experienced faculty, participants had the opportunity to perform prolotherapy treatments on patients while developing their clinical skills and confidence.
The program also incorporated both palpation-guided and ultrasound-guided techniques. Physicians rotated between clinical classrooms daily, exposing them to different approaches and teaching styles while broadening their understanding of prolotherapy practice.
Each morning began with an interactive educational session focused on detailed anatomy and essential clinical insights. These discussions helped prepare physicians for their work with patients and reinforced the importance of anatomical knowledge, thoughtful assessment, and sound clinical technique.
Participation was reserved for medical doctors who had already completed a basic prolotherapy course, ensuring that the mission built upon existing foundational knowledge and focused on advancing clinical proficiency.
Dr. Smigel's Role in Teaching and Mentorship
As a senior faculty member and clinical instructor, Dr. Smigel contributed her knowledge and experience to the educational program, helping guide participating physicians as they treated patients and refined their techniques.
Teaching in an international clinical setting provides a unique opportunity to share knowledge, exchange ideas, and learn from colleagues with diverse experiences. For Dr. Smigel, these educational missions reflect the importance of mentorship and the responsibility experienced physicians have to support the continued development of their colleagues.
Hands-on education also reinforces a fundamental principle of medicine: clinical knowledge must be paired with careful patient assessment, sound technique, and compassion. Working directly with patients allows physicians to connect their training with real clinical needs while remaining focused on the individuals they serve.
Making a Difference in the Sofia Community
A central purpose of the mission was to provide care to local residents experiencing musculoskeletal conditions and chronic pain disorders. The successful treatment of 166 patients over four and a half days demonstrated the impact that a dedicated international medical team can make when education and patient care come together.
Beyond the number of patients treated, the mission fostered an environment of collaboration in which physicians could learn from experienced instructors while contributing to the well-being of the local community.
Initiatives like this help strengthen the international prolotherapy community by encouraging physicians to share their expertise, develop their clinical abilities, and remain committed to lifelong learning.
Gratitude for an International Collaboration
Dr. Smigel extends her heartfelt thanks to the faculty members who traveled from around the world to teach, mentor, and support the mission, as well as to all the participating physicians who dedicated their time and energy to this educational experience.
Their collective commitment made the Sofia mission a meaningful success for both the medical professionals involved and the patients they served.
Dr. Smigel looks forward to continuing her work in prolotherapy education, mentoring fellow physicians, and participating in initiatives that advance regenerative medicine and compassionate patient care around the world.
Learn more and view photos: 2026 European School of Prolotherapy Medical Mission — Sofia, Bulgaria.
