EBCOG guidelines in Ob/Gyn-training or

How does EBCOG promote post-graduate training in Ob/Gyn?

Rolf KirschnerDept of Gynaecology,Women and Childrens´ DivisionOslo University Hospital

Secretary General, EBCOG

The aims and objectives of EBCOG are to improve the health of women and their babies by seeking to achieve the highest possible standards of training and care in the field of obstetrics and gynaecology in all European countries.

EBCOG is the Board of the Section of Gynaecology and Obstetrics of the Union Européenne des Médecins Specialistes (UEMS).

As such, the functions of EBCOG are bound by the statutes of UEMS, by national regulations, and by the relevant European Economic Area directives

Founded by the amalgamation of the European College of Obstetrics and Gynaecology (ECOG) and the European Board of the UEMS Section of Ob/Gyn (EBGO)

The objectives shall be achieved as follows:

The aims and objectives of EBCOG are to improve the health of women and their babies by seeking to achieve the highest possible standards of training and care in the field of obstetrics and gynaecology (referred to hereinafter as O & G) in all European countries

• Recommend the standards required for the training of specialists and the means of maintaining those standards

• Examine the content and quality of training in all countries of Europe• Recommend the criteria to which the specialist training centers should conform.• Make proposals for unifying the training programs to achieve specialist status• Ensure that knowledge and skills of specialist obstetricians and gynaecologists are maintained and

updated at regular intervals.• Develop, with the sub-specialties in O & G, a system to assess and recognize the quality of training

and practice.• Promote research relevant to the health of women and their babies.• Facilitate the exchange of specialist trainees between training centers throughout Europe to

harmonise and improve the quality of training.

EBCOG shall have the following bodies:·

The Council which is the governing body of EBCOG.

The Executive Committee which is the administrative bodyof EBCOG.

The General Assembly which is the advisory body of EBCOG.

Any European country is entitled to membership of EBCOG providing the requirements laid down in the Constitution and By Laws are fulfilled.

The Council of EBCOG shall comprise two delegates from each member-country. One delegate will be nominated by the National Scientific Society or Universities; the other will be one of the two national delegates to the Section, from the Professional Society. The mandates of all delegates must be endorsed by the National Medical Association which is recognized by UEMS

SCTA: Standing Committee on Training and Assessment (SCTA) Log book/ curriculum

SCTR: Standing Committee on Trainng Recognition (SCTR) Hospital visitation/ dept accreditation

SCTTT/V: Standing Committee on Training the Trainers/VisitorsTraining educational trainers/supervisors/hosptal visitors

SC e-L: Standing Committee on e-learningRegistration and structuring e-learning methods

SCMS: Standing Committee on Medical StandardsElaborating European treatment standards

CCME-CPD: Committee on Continuing Medical Education/Professional developmentElaborating European Standards for post-specialization learning

EBCOG Simulation Consortium

Four recognized subespecialtiesEAPM (Perinatal); ESHRE (Reproduction); EUGA (Uro-gynaecology); ESGO (Oncology).

Societies of Areas of Special InterestColposcopy, Endocrinology, Infection, Contraception, Sexology, Psychosocial. Pain…..

Collaboration with European Network of Trainees in Obstetrics and Gynaecology (ENTOG)Visitation and exchange

European Congress of Obstetrics and GynaecologyManagement-/scientific- and local committees.

FIGOObserver status/ official representative of European ObGyn

NAAs

ECAMSQ

Section

Section

Section

Section

Board

Board

Board

Board

European Individual Certification : How does it Work ?

ECAMSQ: European Council for Accreditation of Medical Specialist QualificationsNAAs: National Accreditation Authorities

• Universities • Scientific Societies• Teaching Hospitals• Others

EACCME(Sections &

Boards)+

NAAs

Education

Accreditation Individual Certification

ECAMSQ(Sections &

Boards)+

NAAs

EACCME: European Accreditation Council for Continuing Medical Education

European Education Quality Policy

Eurolingo:Harmonisation = Sharing of Competency

UEMS: Article III. Objectives UEMS aims for the following international non profit-making objectives: -The study, promotion and harmonisation of the highest level of training of the medical specialists, medical practice and health care within the European Union; Summary:

•Undergraduate• 5 years average, Exam/Assessment

•Specialist Training•5 years average, Exam/Assessment

•Professional Life•Lifelong, Formal Requirements

UEMS:

CHARTER on TRAINING of MEDICAL SPECIALISTS in the EUROPEAN COMMUNITYCharter adopted by the Management Council of the UEMS, October 1993

” with an aim to set the basis for high quality medical training. This charter outlines the guiding principles for high level Medical Training and provides the essential criteria for medical training programs”.

UEMS 2003 / 49 FINALPROMOTING GOOD MEDICAL CARE ECAMSQ: The aim of this body is to address this issue through establishing a comprehensive mechanism of appraisal of knowledge, skills and professionalism of post-graduate medical trainees according to the highest standards of medical training in Europe. With a view to assess the competence of European medical specialists according to these high standards of medical training

Background information:

UEMS 2006 / 18 FINALBUDAPEST DECLARATION on ENSURING THE QUALITY OF MEDICAL CARE

SCTA: Standing Committee on Training and Assessment (SCTA) Log book/ curriculumRECOMMENDATIONS FOR POSTGRADUATE TRAINING AND ASSESSMENTIN OBSTETRICS AND GYNAECOLOGY•MISSION•RECOMMENDATIONS•EDUCATIONAL OBJECTIVES OF TRAINING IN •OBSTETRICS AND GYNAECOLOGY•ORGANISATION OF TRAINING•SUMMARY Trainees must have an adequately remunerated hospital post and participate in all activities of the training department.The number of training posts should reflect the country's need for specialists as well as the country's capacity to train.The minimum duration of postgraduate training in Obstetrics and Gynaecology is five years, at least four of which must be spent in a department of Obstetrics and Gynaecology. It is recommended that part of the training should take place in another European country.A specialist qualification should be granted at the end of training after an assessment of the trainee's theoretical knowledge and practical skills.The training syllabus will be regularly updated by EBCOG (Standing Committee on training and Assessment).LOG BOOK

SCTR: Standing Committee on Training Recognition (SCTR) Hospital visitation/ dept accreditation

• Application for specialist training & visiting • What are the objectives?• What are the benefits? • What is the focus of the Visit?• Who conducts the Visit?• Who pays for the Visit?• How to apply for an EBCOG Visit? • Questionnaire regarding specialist training. (HEAD OF DEPARTMENT)• Questionnaire regarding specialist training. (TRAINEES)

SCTTT: Standing Committee on Training the TrainersTraining educational trainers/supervisors

Trainers are medical doctors who have usually not had any formal education in how to teach. In human affairs generally there is less progress than in technology.

Training the Trainers courses (TTT) give trainers tools to deliver better adult education, something which was demanded by the European Network of Trainees in Obstetrics and Gynaecology (ENTOG) from the European Board and College of Obstetrics and Gynaecology (EBCOG). An RCOG course was organized for EBCOG trainers who then started to spread TTT courses within EBCOG countries.

What are Training the Trainers (TTT) courses?TTT courses are interactive, with around 15 % of the time spent on lectures and 85 % of the time spent on discussion and feedback. The main topics are listed below.

Basic adult medical education theoryGiving proper feedback.Practical skills training in a four-step cognitive training method:Differences between assessment and appraisal are stressed..“When training becomes fun for trainers and trainees”, available free online

SC e-L: Standing Committee on e-learningRegistration and structuring e-learning methods UEMS 2011 / 20The Accreditation of e-Learning Materials by the EACCMEModern medical education should be based on the best available tools. Developing new modalities to achieve

appropriate educational goals is in the scope of medical faculties in Europe. One of these novel approaches is E-Learning. EBCOG founded a Working Group on E-Learning in 2008.

E-Learning offers an additional tool for creating a virtual electronic network between individuals but not replacing human contact and clinical work. It enables the effective use of electronic learning materials as well as human interaction between trainees and trainers in Europe. E-Learning is an opportunity to form a bridge between basic and post-graduate medical training and continuing professional development in the medical community.

Professionals in Obstetrics and Gynaecology can benefit from using electronic materials such as telecommunication with video cameras from lecture rooms to other hospitals and decentralised teaching units and health care centres. This technology opens up additional opportunities for distributing expertise and promoting new ways of human interaction in basic and post-graduate training locally, nationally and internationally.

In many EBCOG member countries, E-Learning is already in active use. One of EBCOG’s E-Learning Working Group’s tasks is to collect the material available in Europe including teaching videos and teaching courses (e.g. colposcopy, ultrasound, prenatal counselling, pelvic floor diseases). The Working Group has proper technical assistance and appropriate solutions to support a well functioning E-learning section of the website which registered users can benefit from. This process has now started

SCMS: Standing Committee on Medical StandardsElaborating European treatment standards

Why do we need standards of care in Europe?Paper prepared in January 2011 for a meeting with EU Parliamentarians in Brussels.

Over the past decade, there has been an unprecedented emphasis on the quality of clinicalcare. This has involved three main stakeholders, namely consumers, healthcare providers,and commissioners. The consumers of healthcare expect a safe, effective and equitableservice. A survey carried out by the Department of Health (DH) in England suggested that thepublic seems to perceive the inclusion of a quality framework to be important for good quality.

Remit• To review current evidence based published Standards of care in the memberstates of the European Union• To develop agreed Standards for maternity care, from pre-pregnancy through tothe post natal period including care of the newborn• To develop agreed Standards of gynaecological care for benign and malignantconditions affecting the health of women

Collaboration with European Network of Trainees in Obstetrics and Gynaecology (ENTOG)Visitation and exchange

29 Countries

CouncilExecutive ENTOG Sessions at CongressEBCOG trainee fellowshipENTOG Yearly Exchange: The Exchange guidelinesENTOG annual meetingEuropean Training ProjectENTOG Delegate in Visitation and Accreditation

EBCOG Simulation Consortium

Head: Professor Rudi Campo, Leuven, Executive MemberPresident European Society of Gynaecological Endoscopy

EndoscopyColposcopy Ultrasound Imaging ObstetricsEtc…

Simulation Corner at Congess

CCME-CPD: Committee on Continuing Medical Education/Professional development

Elaborating European Standards for post-specialization learning

European CME/CPD is needed for the accreditation of any CME/CPD-Event/Product in Medicine at the European level

Need for Harmonisation European CME/CPD must be independent

Need for an Independent Accreditor: EACCME

Four recognized subespecialtiesEAPM (Perinatal); ESHRE (Reproduction); EUGA (Uro-gynaecology); ESGO (Oncology).

CouncilExecutive. Sub- specialization Documents and DemandsSub- specialization Visitations and AccreditationsSub- specialization Sessions at Congresses Representations and sessions at Sub- specialization Congresses

Societies of Areas of Special InterestColposcopy, Endocrinology, Infection, Contraception, Sexology, Psychosocial. Pain…..

SCTA- representationMDJC-UEMS Multidisciplinary Joint Committees.Sessions at CongressesSimulation ConsortiumExchange of Sessions/ EBCOG at Special-Interest Congresses

European Congress of Obstetrics and GynaecologyManagement-/scientific- and local committees.

7-10. May 2014, HOT/ENTOG/Young Scientists/Practical Sessions/Symposia/Head Sessions

FIGOObserver status/ official representative of European ObGyn

American CollegeCongressesTrainee Exchange

Certification systems are already in place in many European countries.Some countries approach the implementation of a certification systemSome specialties/subspecialties are already running European exams (without coordination and without a common framework).Europe is slowly striving towards obligatory certification and maybe even re-certification Free movement of MDs and patients within the EU, Pressure from national authorities, Health insurance companies etc.Economic squeeze in many countries

Current Situation of European Certification

SO: How does EBCOG promote post-graduate training in Europe?---by continously and structurally working with and towards national and international associations inside the EU/EEA to make possible

good quality and life-long learning!

Rolf KirschnerDept of Gynaecology,Women and Childrens´ DivisionOslo University Hospital

Secretary General, EBCOG