UEMS Section of Medical Microbiology General Meeting Vienna, 21 st April 2017 Implementation of an Electronic Board Examination in Surgery Wolfgang Feil, MD, MAS, F.A.C.S., F.E.B.S. President of the European Board of Surgery Professor of General & Visceral Surgery, Vienna, Austria Medical Director, Surgical Departments, EKH, Vienna, Austria
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UEMS Section of Medical Microbiology General Meeting Vienna, 21st April 2017
Implementation of an Electronic Board Examination in Surgery
Wolfgang Feil, MD, MAS, F.A.C.S., F.E.B.S.
President of the European Board of Surgery Professor of General & Visceral Surgery, Vienna, Austria
Medical Director, Surgical Departments, EKH, Vienna, Austria
17th European Congress of Trauma & Emergency Surgery
Vienna, 24th - 26th April 2016
Implementation of an Electronic Board Examination in Surgery
Wolfgang Feil, MD, MAS, F.A.C.S., F.E.B.S.
President of the European Board of Surgery Professor of General & Visceral Surgery, Vienna, Austria
Medical Director, Surgical Departments, EKH, Vienna, Austria
NO DISCLOSURES
Europe
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What is Europe?
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Geography Countries Culture History Religion Language Politics Economics Migration
Where people live & work
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European Union
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1957: 6 countries 2016: 28 countries
1957 2016
European Union
28 countries > 500 million inhabitants largest peacekeeping project in Europe ever
principle of "freedom of movement, labour and
services principle of "subsidiarity" principle of "mutual recognition of diploma"
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European Union
European Union Legislation
(law = a unique legal system which operates alongside the laws of member states of the E.U.)
Directives (directive = is a legislative act of the E.U. which requires member states to achieve a particular result without dictating the means of achieving that result)
Advisory Bodies
U.E.M.S. (Union of the European Medical Specialists)
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U.E.M.S. Union of the European Medical Specialists
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1958 - 6 members NGO & NPO
2015: 37 member states 28 EU countries Non-EU: Norway, Switzerland, Iceland associate member: Armenia, Israel, Turkey observer status: Georgia, Lebanon, Morocco
covers all "Medical Professional Authorities" (1.6 mio M.D.s) Medical Chambers Scientific Societies Professional Boards
Promote "free movement" make labour markets more flexible & further liberalise the provision of services encourage automatic recognition of qualifications and simplify administrative
procedures
Harmonisation and standardisation of the highest level of specialist training and medical care Postgraduate specialist medical training (Syllabus, LogBook) Standards for specialist qualifications Quality Assurance in specialist medical practice CME-CPD – Continuing Medical Education and Professional Development Clinical Guidelines (not: CEN)
E.B.S.Q. (European Board of Surgery Qualifications) Examinations for "transferable competencies" Title for Qualification (Fellow of the European Board of Surgery - F.E.B.S.)
Cooperation with Scientific Societies Accreditation of training centers/institutions
Harmonisation … of what ? denominations ? contents ?
Standardisation … of what ? structures (training centers) processes quality
Validation & Accreditation … of what ? examination accreditation of training centers accreditation of trainers & examiners
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The House of Surgery
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Common Trunc/Basic Surgery
General Surgery
Vascular
General ?
Coloproct. Endocrine
Oncology Thoracic
HBP
Tx
Breast Hand Trauma
Pediatric Plastic
Orthop. Urology
OMF Neuro
Heart
ECS
Gyn ENT
The House of Surgery
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Common Trunc/Basic Surgery
General Surgery Vascular
General ?
Coloproct. Endocrine
Oncology
Thoracic
HBP
Tx
Breast Hand
Trauma
Pediatric Plastic
Orthop. Urology
OMF Neuro
Heart
ECS
Gyn ENT
General Surgery
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General Surgery: "automatic mutual recognition" in the Directive no motivation for E.U. surgeons
all other (sub)specialisations: "general system" motivation to show qualification development of multiple Divisions within the Section Surgery
harmonisation process would lead to a very low common denominator: useless definitively no motivation
Implementation of EBS Documents
European Training Requirements (General Surgery) Assessment Quality Requirements (Version 3.0)
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European Board of Surgery Fellowships in "Transferable Competencies"
General Surgery Coloproctology Endocrine Surgery Surgical Oncology Thoracic Surgery Transplantation Trauma Surgery Breast Surgery HPB Surgery
Hand Surgery Esophagus, Cardia & Stomach Surgery
(2015) Minimal Invasive Surgery (2017) Metabolic & Bariatric Surgery (2017) Emergency Surgery (2016) Endoscopy & GI-Functional
Diagnostics (2017) Basic Sciences (projected)
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Transferable Competencies
draw back from denominations omit jungle of different names for the same contents (e.g. GI-surgery and visceral surgery) omit same name for different contents
(e.g. emergency) omit harmonisation and low common denominator (=never
ending story)
switch to competencies honest logbooks from different institutions enhance rotation individualised combinations of fellowships
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European Training Requirements for all "Transferable Competencies"
Definition & Rationale of the "Transferable Competency (=TC)" Criteria for Training Institutions, Centers and Trainers Syllabus (catalogue of competencies within TC)
Eligibility Criteria for the "TC Board Fellowship" incl. CME, Mini-CEX, DOPS, courses, hospitations, publications
Board Examination
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Transferable Competencies
consider national peculiarities of contents e.g. thyroid surgery, breast cancer, endoscopy
allow variable duration of training consider national structural requirements
e.g. Finland versus Greece (geography)
allow individual programs and combinations enhance migration based on contents, competencies and
qualifications full legal acceptance and automatic mutual recognition
following the EU-principle of subsidiarity as final goal
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Transferable Competencies
robust and clearcut standardisation and validation of certain specialist qualifications
free combination of multiple TCs possible TCs also between Sections (e.g. Vasc, Thoracic) Board Fellowship is no entrance ticket into the EU enhancing migration within EU system supporting the
Maastricht criteria facilitate selection of applicants on the labour market (also
from abroad) increase employability on the labour market
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Board Examination Quality
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Eligibility Committee (Divisions) Examination Committee (Divisions) Credentials Committee (EBS/EBSQ) Preparatory Course Committee (EBS & Divisions) all report to the European Board of Surgery within the Section of Surgery
E.B.S.Q. Board Examination
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Qualification: Title "F.E.B.S." (Fellow of the European Board of Surgery)
legal aspects & safety concerns options for Examination development & service MCQ & OSCE (case studies) merge
(eliminate "jump back" in case studies)
OSCE circuit free for other requirements (e.g. scientific paper, "hands-on", simulator, interview, difficult conversation)
Why? The Board Fellowship is no "remote diploma"!
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Presentation of Systems
3 presentations (IQUL, ORZONE, SQUIZ)
mock examination at lunchtime (prepared sample questions)
decision in afternoon session (based on features and costs)
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Electronic Board Exam
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The proposal includes a basic offering at €20/candidate as well as an optional advanced offering for preparatory work, for delivery and for post processing of examination events (see attachment 1).
Additional negotiations for costs using certain "advanced options" necessary to guarantee the certified Board Examination quality
Electronic Board Exam
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Board Examination Quality
Online MCQ test regular MCQ questions (Type Apos, Aneg, Kprim, E type) include "clinical pathways" (before in OSCE) include "case studies" (before in OSCE)
OSCE circuit (oral) interview (CV) e.g. scientific paper check "soft skills" e.g. decision making processes
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European Board of Surgery Fellowships in "Transferable Competencies"
General Surgery Coloproctology Endocrine Surgery Surgical Oncology Thoracic Surgery Transplantation Trauma Surgery Breast Surgery HPB Surgery
Hand Surgery (Esophagus, Cardia & Stomach
Surgery) Oesophagogastric (2015) Emergency Surgery (2016) Minimal Invasive Surgery (2016) Metabolic & Bariatric Surgery (2017) Endoscopy & GI-Functional