The major accents are found in the southern, northern, and central areas. The most standardized language is found around Moscow, where the language contains characteristics of all regions. Those recently immigrated are usually highly educated and often enjoyed professional occupations. The most common occupations of this group are physicians and biomedical and general engineers. This group is usually fluent in English.
English language tends to be more problematic among older Russian immigrants.
Direct eye contact is acceptable, and Russians frequently utilize touch in conversations, especially with friends and family. Approval is communicated by nodding. Greetings Individuals are fairly demonstrative with greetings, utilizing hugs and kisses frequently. While Russian patients share a present-based concept of time with Americans, there are some differences regarding punctuality. Used to the socialized healthcare system in the Soviet Union, these patients may utilize time saving tactics in their clinic appointment planning.