Brief Explanation of the German System of Surgical Training and Exam 27.03.2015 UEMS Surgical Training and accreditation in Germany and in Europe Dr. med. Markus Wenning Geschäftsführender Arzt der Ärztekammer Westfalen-Lippe
GME Surgery in Germany 1. Surgery Curriculum 2. Accreditation of Teaching Hospitals and Teaching Surgeons 3. Board Exam 4. Quality Assurance 5. Outlook Seite 2
1. Surgery Curriculum Seite 3
board exam + 2-3 yrs + 4 yrs Vascular General surgery surgery Cardiac surgery Paediatric surgery ad. training trauma orthopaedics board exam Trauma and orthopaedic surgery Plastic surgery Thoracic surgery ad. training visc. surgery. Visceral surgery 2 yrs Basic training: 6 months A&E; 6 months ICU, 12 months surgery optional: 6 months in a private practice (outpatient setting) Seite 4
Basic training Principles and Techniques of Surgery ultrasound central venose catheters infusion therapy, transfusion therapy, enteral and parenteral nutrition local and regional anaesthesia minor surgery (not specified) and assisting at surgical operations Seite 5
Speciality Training in Visceral Surgery abdominal operations 400 - cholecystectomy 25 - inguinal hernia 25 - appendicectomy 20 - adhesiolysis 10 - small bowel resection 10 - emergency laparotomy 30 - colorectal resections 10 thyroid gland operations, tracheotomy 25 Seite 6
Additional Speciality Training in Visceral Surgery additional abdominal operations 300 - gastric surgery 25 - gastric resection 10 - colon surgery 50 - segmental colectomy 30 - rectal resection surgery 30 - anterior resection 10 - abdominoperineal resection 5 - transanal operations 5 - laparoscopic surgery 65 - liver surgery 10 - pancreatic surgery 10 Seite 7
GME Surgery in Germany 2. Accreditation of Teaching Hospitals and Teaching Surgeons Seite 8
Accreditation of Teaching Hospitals and Teachers several years of experience after board exam personal qualification ( persönliche Eignung ) curriculum (specific for clinic and trainees) length of training at a specific clinic depends on number of patients, number of trainees accreditation limited to 6 8 years (in Westfalia- Lippe), then re-evaluation and re-accreditation Seite 9
GME Surgery in Germany 3. Board Exam Seite 10
Board Exam most important: trainer confirms trainee is fit for practise and capable of working without supervision logbook oral exam (two experienced surgeons) Seite 11
GME Surgery in Germany 4. Quality Assurance Seite 12
Quality assurance evaluation of teaching hospitals (questionnaire) every 2-3 years routinely re-evaluation and re-accreditation of teaching hospitals visitations Seite 13
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excellent poor Seite 15
What do trainees think of their training? excellent good poor General (internal) medicine Paediatrics Trauma and orthopaedic surgery General Surgery Anaesthetics General Practitioner 003 003 003 003 003 002 0 1 2 3 4 5 Seite 16
GME Surgery in Germany 5. Outlook Seite 17
Outlook The Future of GME in Germany economic framework for teaching is getting worse demand for health care on the rise time spent on patients is shrinking (at least in Germany ) women will shape the future of medicine Seite 18
female doctors choose different fields than male percentage of female doctors (age < 35) Obs. & Gyn. 83 % Child and adolescent psychiatry 82 % Paediatrics 81 % Dermatology 76 % Neurology 68 % General (internal) medicine 59 % General medical practitioner 53 % Anaesthetics 50 % Urology 30 % Trauma and orthopaedic surgery 21 % Seite 19
male doctors choose different fields than female percentage of male doctors (age < 35 yrs) Trauma and orthopaedic surgery 79 % Cardiac surgery 77 % Urology 70 % General Surgery 63 % Cardiology 62 % ENT 56 % Radiology 54 % Anaesthetics 50 % General (internal) medicine 41 % Neurology 32 % Seite 20
Fields of interest of young doctors (age < 35 yrs) Internal Medicine (all specialities) 24 % Surgery (all specialities) 14 % Anaesthesiology 10 % Paediatrics 7 % Obs. and Gyn. 6 % Neurology 5 % Radiology 3 % Psychiatry / Psychosomatics 3 % Urology 2 % Dermatology 2 % Opthalmology 2 % Seite 21
Fields of interest of young doctors (age < 35 yrs) Surgery (all specialities) 14 % General Surgery 7 % Trauma and Orthopaedic surgery 5 % Visceral Surgery 1 % Vascular Surgery 1 % Seite 22
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