Physician Training in the Netherlands
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1 Physician Training in the Netherlands The Challenges of Physician Training An International Perspective July 26 th 2014 Andreas E. Kremer Department of Medicine 1
2 The Netherlands
3 Medical Studies in the Netherlands Year C o n t e n t BA 1 Human Body in Health and Sickness BA 2 Integration of Knowlegde and Practice BA 3 Chronic Diseases MA 1 Clinical Rotations MA 2 Clinical Rotations MA 3 Scientific Research Participation / Health Care Participation Practice Theory
4 Medical Studies in the Netherlands - Bachelor - Bachelor year 1: The Human Body in Health and Sickness Growth and Development 1 8 weeks Circulation and Breathing 1 8 weeks Regulation and Integration 4 weeks Thinking and Doing 1 8 weeks Digestion and Defence 1 8 weeks Diabetes, Obesity and Lifestyle 4 weeks Bachelor year 2: Integration of Knowledge and Practice Circulation and Breathing 2 6 weeks Growth and Development 2 10 weeks Elective 6 weeks Digestion and Defence 6 weeks Thinking and Doing 6 weeks Elective 6 weeks Bachelor year 3: Chronic Diseases Abdomen 10 weeks Locomotor Apparatus 10 weeks Circulation and Lungs 10 weeks Psychomedical Problems 10 weeks
5 Medical Studies in the Netherlands - Master - Master year 1: Clinical Rotations Dermatology 5 weeks ENT Medicine 5 weeks Ophthalmology Elective 5 weeks 10 weeks Internal Surgery Medicine 10 weeks 10 weeks Master year 2: Clinical Rotations Social Pediatrics Gynecology Psychiatry Neurology Medicine 5 weeks 6 weeks 6 weeks 6 weeks 6 weeks General Practice 10 weeks Master year 3: Participations Scientific Research Participation Health Care Participation 18 weeks 18 weeks
6 PhD Programme in the Netherlands Doctoral thesis can only be obtained as PhD Requirements for PhD: 4 years of scientific working in a laboratory 4 peer-reviewed first author publications Writing of a doctoral thesis Defense of doctoral thesis PhD thesis is required to obtain a position for physician training (except for general practitioner)
7 Hora est
8 Physician Training in the Netherlands - Application- Physician training for specialization (e.g. cardiology, gastroenterology, nephrology) limited to university hospitals Number of physician training positions are very limited (n = 5-25/year) Application already during PhD period 2-3 years prior of training Application round once per year If three times application failed à no further application possible
9 Physician Training in the Netherlands - Specialization - Year Specialization 1 Internal Medicine 2 Internal Medicine 3 Physician Training in University Hospital 4 Physician Training in University Hospital 5 Physician Training in University Hospital 6 Consolidation period Academic teaching hospital University hospital
10 Physician Training in the Netherlands - Academic Medical Center Amsterdam - Theme Supervisor 1 Gastro-intestinale oncologie *** Dekker/Tytgat 2 Inflammatoir darmlijden ** D Haens 3 Infecties van het maag-darmkanaal, bacterieel, viraal en parasitair * Tytgat 4 Ischaemische aandoeningen * Mathus 5 Maagzuur-gerelateerde aandoeningen * Krishnadath 6 Aandoeningen van de lever *** (incl. voor- en nabehandeling levertransplantatie) Beuers 7/8 Aandoeningen van de galwegen en het pancreas ** van Hooft/Rauws 9 Bekkenbodemproblematiek en proctologie * Vlug # 10 (Mal)absorptie en (mal)digestie * Kager # 11 Neurogastro-enterologie en motiliteit *** Smout 12 Voeding * Mathus 13 Spoedeisende maag-darm-leverziekten ** Ponsioen 14 Genetische en aangeboren aandoeningen * van den Brink 15 Diagnostische endoscopie ** v.hooft 16 Algemene therapeutische endoscopie (o.a. bloedingen, poliepectomie) ** Bergman 17 Geavanceerde endoscopie: ERCP, stents, EMR, EUS *** Fockens 18 Abdominale echografie Sprengers
11 Physician Training in the Netherlands - Academic Medical Center Amsterdam - Jaar 1 e trimester 2 e trimester 3 e trimester 1 Zaal F7zuid Maag Darm Thema s: 1-5, 7-12 Zaal F7zuid Lever Thema s: 6, 7, 12, 18 Dienstsein + ½ dag Endoscopie Thema s: 1-8, Endoscopie I - 1 Q-poli Thema s: 15 (o) Consultensein (m) Endoscopie II Thema s: 1-9, 15, 16 IBD Q-poli Endoscopie IBD Thema s: 2, 9, 15, 16 3 Hepatologie 1 à 2 dd Endoscopie Thema s: 6, 7, 15, 16, 18 Neurogastr./Motiliteit 1 à 3 dd Endoscopie Thema s : 11, 15, 16 Oncologie 3 à 5 dd Endoscopie Thema s: 1, 15, 16 4 Keuzestages ter verdieping * (maximaal twee gebieden; mogelijk parallel) Thema s: 1, 2, 6, 11, 17
12 Physician Training in the Netherlands - Academic Medical Center Amsterdam - Weekly roster Hepatologie stage Maandag Ochtend 08:00-08:30 MDL overdracht 08:30-09:00 Interne overdracht 09:00-13:00 POLI Middag 17:30-18:00 HCC bespreking (GIOCA C1) Dinsdag 08:00-09:00 HPB bespreking (Ziedses des Planteszaal) 09:00-09:30 Leverbiopt 10:00-12:00 Grote Visite 13:30-16:30 POLI 17:00-18:00 Hepatologie bespreking Woensdag 08:00-08:30 MDL overdracht 08:30-09:00 Interne overdracht 09:00-12:00 Echotraining, afd. Radiologie 17:15-18:00 Seminars in Gastroenterology & Hepatology Donderdag Vrijdag 08:00-08:30 MDL overdracht 08:30-10:00 Research seminar 10:00-10:30 Leverbiopt 08:00-08:30 MDL onderwijs 08:30-09:00 Interne overdracht 09:00-13:00 POLI 16: Klinische bespreking 13:00-14:00 Leverbiopt bespreking
13 Physician Training in the Netherlands - Teaching Aspects - During six years of specialization a trainee always has her/his own tutor Evaluation after each trimester Twice per year appraisal interview with consultant Once per year written examination (120 MC questions) Mandatory presentations on clinical subjects Once per year self-organized congress for trainees
14 Specialists in the Netherlands - Facts - Very low number of specialists compared to other European countries such as Germany or France Specialists only work in hospitals Patients always first have to go to general practitioner for referral to specialist Health system in the Netherlands much less expensive compared to many other European health systems Specialists are very well paid (comparable to US, Australia)
15 Physician Training in the Netherlands - Summary - Excellent and well structured physician training Focus on clinical teaching and scientific research Regular feedback, evaluation and appraisal interviews Regular clinical and scientific meetings, own presentations Low number of physician training positions
16 Thank you
17 The Netherlands a hot place
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