In the past 25 years, Kazakhstan has undergone a period of rapid education reform. As it began transitioning from a Soviet Republic to an independent nation-state, President Nursultan Nazarbayev and the Kazakhstani government made it clear that the lynchpin to becoming a globally competitive market economy was education (Aitzhanova et al. 2014). Ideologically, this focus signified a watershed moment, as the philosophical underpinnings of Soviet higher education (HE) were uprooted, with the transition toward a market economy. However, this process of reforming Kazakhstan's HE system is situated amidst significant demographic, sociocultural and political shifts which have taken place in the last two decades.

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Background: Primary hepatic carcinosarcoma is a rare subtype of liver malignancy, with only a small number of cases described in the English literature. Case Report: We report the case of a 72-year-old man with a history of hepatitis C, who presented with complaints of abdominal pain. The patient's alpha fetoprotein (AFP) level was highly elevated at 7,406 ng/ml. His albumin, total bilirubin, aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase levels were within normal ranges. Computer tomographic scans discovered a 12×9×8 cm mass in the left lobe of the liver, extending to the anterior gastric wall. A partial hepatectomy of segments 2 and 3 with en bloc distal gastrectomy and omentectomy, a Roux-en-Y gastrojejunostomy, and a cholecystectomy were performed. Pathology revealed the mass to be a hepatic carcinosarcoma composed of collision tumor of four malignant components: hepatocellular carcinoma, cholangiocarcinoma, osteosarcoma and rhabdomyosarcoma. One and half month post-surgery, the patient was found to have a mass confirmed by biopsy as hepatocellular carcinoma in the right lobe, nodules in his lung and bone, and his AFP level elevated to 51,027.6 ng/ml. He died after two months during hospice care. Conclusion: To the best