XVI National Congress of the Italian Society of Neonatology

Education and Research in the Mediterranean area: can we find a common track?

Hercília Guimarães ,on behalf of UENPS

Bari, 19-22th May 2010

XVI Congresso Nazionale-Societá Italiana de Neonatologia

Education and Research in the Mediterranean area

Education

Paediatric Section of the

Union of European Medical Specialists

&

ESNTHE EUROPEAN SOCIETY

FOR NEONATOLOGY

EUROPEAN CURRICULUM AND SYLLABUS FOR TRAINING IN NEONATOLOGY

(Second edition – Version 3; 2 January 2007)

Education and Research in the Mediterranean area

Education

• Neonatology is a highly technical and rapidly evolving area of paediatric medicine, which is established as an independent specialty in most European countries.

• In different countries the form and duration of the training, as well as process for accrediting training centres and monitoring the quality of training, vary markedly.

Education and Research in the Mediterranean area

European CV may be utilised to:• Harmonise training in Neonatology between different

European countries. • Establish clearly-defined standards of knowledge and skills

required to practice Neonatology at a tertiary care level. • Foster the development of a European network of proficient

tertiary care centres for Neonatology. • Through these measures, the curriculum and assessment

framework will – improve the quality of care for severely ill newborn babies

and – enhance European contribution to international scientific

progress in the field of Neonatology.

Education and Research in the Mediterranean area

The perinatal unit providing trainingObstetrics

• A hospital offering training for neonatologists must be part of a perinatal centre: The institution, or one closely linked to it, must be equipped for prenatal diagnosis of fetal disorders, management, admission and delivery of pregnant women with maternal or fetal high risk disorders, facilities for receiving maternal and infant transfers, delivery and caesarean section room with facilities for resuscitation of the newborn infant.

Other Specialities• Each unit providing training in Neonatology should have defined lines of

communication and access within the institution to specialist advice from the following: Neonatal surgery and anaesthesia, paediatric cardiology, paediatric respiratory medicine, radiology (including ultrasound), ophthalmology, laboratory services for clinical chemistry, microbiology, and haematology & transfusion, child development centre (clinical genetics, paediatric neurology and neurophysiology), paediatric nephrology, audiology and other surgical specialists (ENT, orthopaedics, neurosurgery). There should be access to necropsy by a trained perinatal/ paediatric pathologist.

Education and Research in the Mediterranean area

Size of the NICU providing training

• At a Neonatology training institution the number of patients and their care must be of such a standard as to be able to meet the training requirements within the time set. The institution should provide care for a majority of the range of neonatal diseases and must admit at least 50 VLBW/year.

• Specifically the trainee will be expected to demonstrate experience of primary care and/or resuscitation for at least 25 VLBW infants (less than 1500 g) including at least 10 ELBW infants (<1000 g).

Education and Research in the Mediterranean area

DURATION OF THE TRAINING

• The recommended minimum training period as a neonatal specialist is 2 years (following a common trunk of paediatric training of 3 years) and it is strongly recommended that at least one year of training should be in a tertiary academic centre.

Education and Research in the Mediterranean area

EXAMINATIONS

• At present there are no plans for a centrally administered examination to licence practice as a Neonatologist.

• Several European member countries currently have such certification and we anticipate that these processes will be recognised.

• Certification of medical practitioners occurs on a national basis

• Individuals holding their national Certificate of Completion of Specialist Training (or equivalent) are eligible to work in other EU states.

.

Education and Research in the Mediterranean area

Questionnaire Education

1. How is defined the Training in Neonatology in your country? 2. Did your country adopt the document of UEMS and ESN (where the recommended

minimum training period as a neonatal specialist is 2 years (following common trunk paediatric training of 3 years) and it is strongly recommended that at least one year of training should be in a tertiary academic centre)?

3. What do you think about on-line postgraduate educational programme in neonatology?

3.1. Advantages, Disadvantages, Difficulties

Research 1. How many research centers exist in your country? 1.1. basic research and 1.2. paediatric / neonatal 2. Publications per year of each center 2.1. Publications per year of each center in international revues 2.2. Publications per year of each center in international revues IF>2.5 3. Budget per year to Research 4. Time given by the institution to do research per person per week Comments

Education and Research in the Mediterranean area

DURATION OF THE TRAINING IN EUROPE• Belgium: 1 year following 5 years of paediatric training (1 in

Neonatology)• Bosnia: 1 year following 4 years of paediatric training.• Denmark: 3 years following 5 years of paediatric training. • Germany: 3 years following 5 years of paediatric training. • Latvia: 2 years following 3 years of paediatric training. • Norway: No formal education in neonatology. • Poland: 5 years (neonatal training following a common trunk)• Portugal: 18 months following 5 years of paediatric training• Spain: No official training; 1 year after 3 years in paediatrics.

Education and Research in the Mediterranean area

Research centers (Neonatology)• Belgium: 2 of 7• Bosnia: 2 of 5 universities • Denmark: 7 of 17 pediatric departments • Germany: 33 • Latvia: 2 universities• Norway: 5• Poland: 11 academic centres• Portugal: at least 5. • Spain: at least 7, in basic research

Education and Research in the Mediterranean area

Publications• Belgium: no figures• Bosnia: no figures; 5 of 8 journals registered in

Medline (each of them, 4 issues per year)• Denmark:12 per year in Rigshospitalet Copenhagen• Latvia: no figures• Germany: no figures • Norway: 30-40 per year (Oslo)• Poland : no figures• Portugal: 10 per year (the best centre). • Spain: no figures

Education and Research in the Mediterranean area

Budget to research• Belgium: no figures• Bosnia: no figures• Denmark: 220.000 per year in Rigshospitalet Copenhagen• Germany: no figures • Latvia: State Grants (?)• Norway: 500.000 € per year + grants to pay full time

fellows• Poland: grants (?) (State Committee for Scientific

Research)• Portugal: 500.000 € per year ( the best centre)• Spain: no figures

Education and Research in the Mediterranean area

Time to research• Belgium: 1 day / week• Bosnia: ? • Denmark: 10% (specialist doctors); 25% (professors) of

working hours per person per week • Germany: ? • Latvia: no time• Norway: ?; best centre - grants to full time fellows • Poland: no time• Portugal: no time; best centre - grants to full time fellows • Spain: ?

Education and Research in the Mediterranean area

Regionalization in EuropeScientific and Academic Societies/Parents Associations

European and Local Health Authorities

working together will define the methodology to achieve our aims that could be to act in these 3 key points:

1 - Organization of Healthcare in Perinatal Medicine in each country

2 - Neonatal/Perinatal European Networks

3 - Post graduation of Paediatricians in Neonatology

XVI National Congress of the Italian Society of Neonatology

Education and Research in the Mediterranean area: can we find a common track?

It will be not easy…

but

UENPS must contribute to find it in collaboration with ESN/ESPR !