Differences and similarities in rheumatology specialty training programmes across European countries

2015 ◽  
Vol 74 (6) ◽  
pp. 1183-1187 ◽  
Author(s):  
Francisca Sivera ◽  
Sofia Ramiro ◽  
Nada Cikes ◽  
Maxime Dougados ◽  
Laure Gossec ◽  
...  
Keyword(s):  
National Curriculum ◽  
Training Programme ◽  
Steering Committee ◽  
European Countries ◽  
Standards Of Care ◽  
Specialty Training ◽  
Internal Medicine Training ◽  
General Internal ◽  
European League Against Rheumatism ◽  
Training Programmes

ObjectivesTo analyse the similarities and discrepancies between the official rheumatology specialty training programmes across Europe.MethodsA steering committee defined the main aspects of training to be assessed. In 2013, the rheumatology official training programmes were reviewed for each of the European League Against Rheumatism (EULAR) countries and two local physicians independently extracted data on the structure of training, included competencies and assessments performed. Analyses were descriptive.Results41 of the 45 EULAR countries currently provide specialist training in rheumatology; in the remaining four rheumatologists are trained abroad. 36 (88%) had a single national curriculum, one country had two national curricula and four had only local or university-specific curricula. The mean length of training programmes in rheumatology was 45 (SD 19) months, ranging between 3 and 72 months. General internal medicine training was mandatory in 40 (98%) countries, and was performed prior to and/or during the rheumatology training programme (mean length: 33 (19) months). 33 (80%) countries had a formal final examination.ConclusionsMost European countries provide training in rheumatology, but the length, structure, contents and assessments of these training programmes are quite heterogeneous. In order to promote excellence in standards of care and to support physicians’ mobility, a certain degree of harmonisation should be encouraged.

scholarly journals 2019 EULAR points to consider for the assessment of competences in rheumatology specialty training

2020 ◽  
Vol 80 (1) ◽  
pp. 65-70 ◽  
Author(s):  
Francisca Sivera ◽  
Alessia Alunno ◽  
Aurélie Najm ◽  
Tadej Avcin ◽  
Xenofon Baraliakos ◽  
...  
Keyword(s):  
Musculoskeletal Diseases ◽  
Task Force ◽  
Training Programme ◽  
Assessment Practices ◽  
Specialty Training ◽  
Sufficient Time ◽  
Effective Implementation ◽  
European League Against Rheumatism ◽  
Training Programmes ◽  
Level Of Agreement

Background and aimStriving for harmonisation of specialty training and excellence of care in rheumatology, the European League Against Rheumatism (EULAR) established a task force to develop points to consider (PtCs) for the assessment of competences during rheumatology specialty training.MethodsA systematic literature review on the performance of methods for the assessment of competences in rheumatology specialty training was conducted. This was followed by focus groups in five selected countries to gather information on assessment practices and priorities. Combining the collected evidence with expert opinion, the PtCs were formulated by the multidisciplinary task force, including rheumatologists, medical educationalists, and people with rheumatic and musculoskeletal diseases. The level of agreement (LoA) for each PtC was anonymously voted online.ResultsFour overarching principles and 10 PtCs were formulated. The overarching principles highlighted the importance of assessments being closely linked to the rheumatology training programme and protecting sufficient time and resources to ensure effective implementation. In the PtCs, two were related to overall assessment strategy (PtCs 1 and 5); three focused on formative assessment and portfolio (PtCs 2–4); three focused on the assessment of knowledge, skills or professionalism (PtCs 6–8); one focused on trainees at risk of failure (PtC 9); and one focused on training the trainers (PtC 10). The LoA (0–10) ranged from 8.75 to 9.9.ConclusionThese EULAR PtCs provide European guidance on assessment methods throughout rheumatology training programmes. These can be used to benchmark current practices and to develop future strategies, thereby fostering continuous improvement in rheumatology learning and, ultimately, in patient care.

scholarly journals The balancing act: the variation among deaneries across Great Britain regarding provision of focus on diabetes and endocrinology training

2018 ◽  
Vol 18 (1) ◽  
pp. 22-24
Author(s):  
Adnan Agha ◽  
Baldev Singh ◽  
Wasim Hanif
Keyword(s):  
Internal Medicine ◽  
Great Britain ◽  
General Internal Medicine ◽  
Medical Specialty ◽  
Training Programme ◽  
Internal Medicine Training ◽  
Accreditation Training Programme ◽  
General Internal ◽  
Accreditation Programme ◽  
Training Programmes

Diabetes and endocrinology is a medical specialty, and a five-year dual accreditation training programme in diabetes and endocrinology and general internal medicine is offered, with active participation in medical on-call rota. Some deaneries offer some respite from the ever-increasing general medical workload by offering a few months of training focusing only on specialty work in diabetes and endocrinology. The authors wanted to see if this experience is available uniformly to all the trainees in diabetes and endocrinology/ general internal medicine across Great Britain. To assess this, a survey of specialist training registrars on a dual accreditation programme for diabetes and general internal medicine from all deaneries in England, Scotland and Wales was performed by directly interviewing and asking them about any relaxation in either their on-call or ward commitments to focus on diabetes and endocrine specialty during their five years of training. The results showed that the acute take/general medical commitment-free training periodfocusing only on diabetes and endocrinology ranges from zero in some deaneries to nearly three years in others. This simple survey highlights the extent of variability that exists in dual diabetes/endocrinology and general internal medicine training programmes across deaneries in England, Scotland and Wales, which may increase further once the training programme is reduced to four years after new changes from Shape of Training.

scholarly journals The balancing act: the variation among deaneries across Great Britain regarding provision of focus on diabetes and endocrinology training

2018 ◽  
Author(s):  
Adnan Agha ◽  
Baldev Singh ◽  
Wasim Hanif
Keyword(s):  
Internal Medicine ◽  
Great Britain ◽  
General Internal Medicine ◽  
Medical Specialty ◽  
Training Programme ◽  
Internal Medicine Training ◽  
Accreditation Training Programme ◽  
General Internal ◽  
Accreditation Programme ◽  
Training Programmes

Diabetes and endocrinology is a medical specialty, and a five-year dual accreditation training programme in diabetes and endocrinology and general internal medicine is offered, with active participation in medical on-call rota. Some deaneries offer some respite from the ever-increasing general medical workload by offering a few months of training focusing only on specialty work in diabetes and endocrinology. The authors wanted to see if this experience is available uniformly to all the trainees in diabetes and endocrinology/ general internal medicine across Great Britain. To assess this, a survey of specialist training registrars on a dual accreditation programme for diabetes and general internal medicine from all deaneries in England, Scotland and Wales was performed by directly interviewing and asking them about any relaxation in either their on-call or ward commitments to focus on diabetes and endocrine specialty during their five years of training. The results showed that the acute take/general medical commitment-free training periodfocusing only on diabetes and endocrinology ranges from zero in some deaneries to nearly three years in others. This simple survey highlights the extent of variability that exists in dual diabetes/endocrinology and general internal medicine training programmes across deaneries in England, Scotland and Wales, which may increase further once the training programme is reduced to four years after new changes from Shape of Training.

scholarly journals Effect of sex on specialty training application outcomes: a longitudinal administrative data study of UK medical graduates

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e025004
Author(s):  
Katherine Woolf ◽  
Hirosha Jayaweera ◽  
Emily Unwin ◽  
Karim Keshwani ◽  
Christopher Valerio ◽  
...  
Keyword(s):  
Sex Differences ◽  
Medical School ◽  
Administrative Data ◽  
Training Programme ◽  
Primary Outcome Measure ◽  
Academic Attainment ◽  
Specialty Training ◽  
Medical Specialties ◽  
Medical Graduates ◽  
Training Programmes

ObjectivesTo examine sex differences in the specialty training recruitment outcomes of UK medical graduates; and whether sex differences were explained by prior academic attainment and previous fitness to practise (FtP) declarations.DesignRetrospective longitudinal cohort study.SettingAdministrative data on entrants to all UK medical schools from the UK Medical Education Database.Participants10 559 doctors (6 155; 58% female) who entered a UK medical school in 2007 or 2008 and were eligible to apply for specialty training by 2015.Primary outcome measureOdds of application, offer and acceptance to any specialty training programme, and on to each of the nine largest training programmes, adjusting for sex, other demographics, prior academic attainment, FtP declaration and medical school.ResultsAcross all specialties, there were no sex differences in applications for specialty training, but women had increased odds of getting an offer (OR=1.40; 95% CI=1.25 to 1.57; p<0.001) and accepting one (OR=1.43; 95% CI=1.19 to 1.71; p<0.001). Seven of the nine largest specialties showed significant sex differences in applications, which remained after adjusting for other factors. In the adjusted models, Paediatrics (OR=1.57; 95% CI=1.01 to 2.46; p=0.046) and general practice (GP) (OR=1.23; 95% CI=1.03 to 1.46; p=0.017) were the only specialties to show sex differences in offers, both favouring women. GP alone showed sex differences in acceptances, with women being more likely to accept (OR=1.34; 95% CI=1.03 to 1.76; p=0.03). Doctors with an FtP declaration were slightly less likely to apply to specialty training overall (OR=0.84; 95% CI=0.71 to 1.00; p=0.048) and less likely to accept an offer to any programme (OR=0.71; 95% CI=0.52 to 0.98; p=0.036), after adjusting for confounders.ConclusionsSex segregation between medical specialties is due to differential application, although research is needed to understand why men are less likely to be offered a place on to GP and Paediatrics training, and if offered GP are less likely to accept.

scholarly journals UK-wide study of the opinions of gastroenterology trainees: COVID-19, Shape of Training and the future workforce

2021 ◽  
pp. flgastro-2021-101965
Author(s):  
Suneil A Raju ◽  
Rebecca Harris ◽  
Charlotte Cook ◽  
Philip Harvey ◽  
Elizabeth Ratcliffe
Keyword(s):  
Internal Medicine ◽  
General Internal Medicine ◽  
Training Programme ◽  
British Society ◽  
Specialty Training ◽  
Endoscopy Training ◽  
Electronic Survey ◽  
General Internal ◽  
The Impact ◽  
Training Opportunities

IntroductionThe COVID-19 pandemic has disrupted training. Gastroenterology higher specialty training is soon to be reduced from 5 years to 4. The British Society of Gastroenterology Trainees Section biennial survey aims to delineate the impact of COVID-19 on training and the opinions on changes to training.MethodsAn electronic survey allowing for anonymised responses at the point of completion was distributed to all gastroenterology trainees from September to November 2020.ResultsDuring the first wave of the COVID-19 pandemic, 71.0% of the respondents stated that more than 50% of their clinical time was mostly within general internal medicine. Trainees reported a significant impact on all aspects of their gastroenterology training due to lost training opportunities and increasing service commitments. During the first wave, 88.5% of the respondents reported no access to endoscopy training lists. Since this time, 66.2% of the respondents stated that their endoscopy training lists had restarted. This has resulted in fewer respondents achieving endoscopy accreditation. The COVID-19 pandemic has caused 42.2% of the respondents to consider extending their training to obtain the skills required to complete training. Furthermore, 10.0% of the respondents reported concerns of a delay to completion of training. The majority of respondents (84.2%) reported that they would not feel ready to be a consultant after 4 years of training.ConclusionsReductions in all aspects of gastroenterology training were reported. This is mirrored in anticipated concerns about completion of training in a shorter training programme as proposed in the new curriculum. Work is now required to ensure training is restored following the pandemic.

EULAR/eumusc.net standards of care for rheumatoid arthritis: cross-sectional analyses of importance, level of implementation and care gaps experienced by patients and rheumatologists across 35 European countries

2020 ◽  
Vol 79 (11) ◽  
pp. 1423-1431
Author(s):  
Rachelle Meisters ◽  
Polina Putrik ◽  
Sofia Ramiro ◽  
Monika Hifinger ◽  
Andras P Keszei ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Regression Models ◽  
European Countries ◽  
Standards Of Care ◽  
Implementation Barriers ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
European League Against Rheumatism ◽  
Care Gaps ◽  
The Difference

ObjectiveAs part of European League against Rheumatism (EULAR)/European Musculoskeletal Conditions Surveillance and Information Network, 20 user-focused standards of care (SoCs) for rheumatoid arthritis (RA) addressing 16 domains of care were developed. This study aimed to explore gaps in implementation of these SoCs across Europe.MethodsTwo cross-sectional surveys on the importance, level of and barriers (patients only) to implementation of each SoC (0–10, 10 highest) were designed to be conducted among patients and rheumatologists in 50 European countries. Care gaps were calculated as the difference between the actual and maximum possible score for implementation (ie, 10) multiplied by the care importance score, resulting in care gaps (0–100, maximal gap). Factors associated with the problematic care gaps (ie, gap≥30 and importance≥6 and implementation<6) and strong barriers (≥6) were further analysed in multilevel logistic regression models.ResultsOverall, 26 and 31 countries provided data from 1873 patients and 1131 rheumatologists, respectively. 19 out of 20 SoCs were problematic from the perspectives of more than 20% of patients, while this was true for only 10 SoCs for rheumatologists. Rheumatologists in countries with lower gross domestic product and non-European Union countries were more likely to report problematic gaps in 15 of 20 SoCs, while virtually no differences were observed among patients. Lack of relevance of some SoCs (71%) and limited time of professionals (66%) were the most frequent implementation barriers identified by patients.ConclusionsMany problematic gaps were reported across several essential aspects of RA care. More efforts need to be devoted to implementation of EULAR SoCs.

Letter to the editor: Acute Medicine Journal

2020 ◽  
Vol 19 (1) ◽  
pp. 56-56
Author(s):  
Adam Williamson ◽  
Keyword(s):  
Internal Medicine ◽  
Point Of Care ◽  
Training Programme ◽  
Point Of Care Ultrasound ◽  
Internal Medicine Training ◽  
Acute Medicine ◽  
Front Door ◽  
Medicine Journal ◽  
Wide Range ◽  
Training Programmes

Editor- I note with interest that the Joint Royal College of Physicians Training Board curriculum for Acute Internal Medicine (AIM) has been reviewed and circulated for comment and consideration of implementation in August 2022. The proposed curriculum hopes to produce doctors with generic professional and specialty specific capabilities needed to manage patients presenting with a wide range of medical symptoms and conditions. It aims to produce a workforce that reflects the current trends of increasing patient attendances to bothprimary care and emergency departments- one that has a high level of diagnostic reasoning, the ability to manage uncertainty, deal with comorbidities and recognise when specialty input is require in a variety of settings, including ambulatory and critical care. The new curriculum moves away from each trainee being required to develop a specialist skill, such as medical education, echocardiography or endoscopy throughout their training1, to trainees acquiring competencies in a specialist theme for their final 24 to 30 months of their training programme after they have completed their Point of Care Ultrasound certification. The current curriculum allows trainees to have regular dedicated time to develop interests inside or outside acute medicine to supplement their professional experience and training. This often allows trainees time away from the ‘front door’, can be welcomed break from high intensity acute care and uniquely offers trainee physicians flexibility in their training programmes and curriculum requirements. This sets acute medicine training apart from other physician training programmes and can attract trainees to apply to the specialty. It also addresses Shape of Training recommendations, which suggest more flexibility and choice in career structure for postgraduate doctors.2 Point of Care Ultrasound will undoubtedly be a welcome addition to the curriculum and will benefit patients, trainees and front door services up and down the country.3 However, concerns regarding supervision and maintenance of competency exist.4 More importantly, time spent gaining competency in this before pursuing an interest in an additional area or procedure will offer trainees less time to attain accreditation in some of the existing specialist skills currently available. With ongoing concerns regarding recruitment and retention in Acute Internal Medicine5 we should be careful that we do not lose a unique selling point that acute internal medicine training offers.

An international inventory of antimicrobial stewardship (AMS) training programmes for AMS teams

2021 ◽  
Author(s):  
Naomi Weier ◽  
Dilip Nathwani ◽  
Karin Thursky ◽  
Thomas Tängdén ◽  
Vera Vlahović-Palčevski ◽  
...  
Keyword(s):  
Antimicrobial Stewardship ◽  
Online Survey ◽  
Training Programme ◽  
Medical Doctors ◽  
Online Search ◽  
Barriers To Participation ◽  
Potential Barriers ◽  
Training Costs ◽  
Training Programmes ◽  
Individual Training

Abstract Background Healthcare professionals are increasingly expected to lead antimicrobial stewardship (AMS) initiatives. This role in complex healthcare environments requires specialized training. Objectives Little is known about the types of AMS training programmes available to clinicians seeking to play a lead role in AMS. We aimed to identify clinicians’ awareness of AMS training programmes, characteristics of AMS training programmes available and potential barriers to participation. Methods AMS training programmes available were identified by members of the ESCMID Study Group for Antimicrobial Stewardship (ESGAP) via an online survey and through an online search in 2018. Individual training programme course coordinators were then contacted (September–October 2018) for data on the target audience(s), methods of delivery, intended outcomes and potential barriers to accessing the training programme. Results A total of 166/250 ESGAP members (66%) responded to the survey, nominating 48 unique AMS training programmes. An additional 32 training programmes were identified through an online search. AMS training programmes were from around the world. Less than half (44.4%) of respondents were aware of one or more AMS training programmes available, with pharmacists more aware compared with medical doctors and other professionals (73% versus 46% and 25%, respectively). AMS training programmes were most commonly delivered online (59%) and aimed at medical doctors (46%). Training costs and a lack of recognition by health professional societies were the most frequently cited barriers to participation in AMS training programmes. Conclusions The development of a systematic inventory of AMS training programmes around the globe identifies opportunities and limitations to current training available. Improving access and increasing awareness amongst target participants will support improved education in AMS.

Evaluation of quality and reliability of musculoskeletal ultrasound videos on YouTube

2021 ◽  
Author(s):  
Nihan Cüzdan ◽  
İpek Türk
Keyword(s):  
Video Quality ◽  
Musculoskeletal Ultrasound ◽  
Quality Analysis ◽  
Competency Assessment ◽  
Exclusion Criteria ◽  
Educational Value ◽  
European League Against Rheumatism ◽  
Ultrasound Findings ◽  
Training Programmes

ABSTRACT Objectives To evaluate musculoskeletal ultrasound (MSUS) video contents on YouTube, regarding their quality, reliability, and educational value. Method The first three pages for the keywords ‘Musculoskeletal Ultrasound’, ‘joint ultrasound’, and ‘articular ultrasound’ were searched through YouTube website. The quality of the videos was assessed according to the European League Against Rheumatism (EULAR) Guidelines and EULAR Competency Assessment in MSUS. The reliability was evaluated with modified DISCERN tool. Results After the exclusion criteria applied, 58 videos were evaluated. The video quality analysis showed that probe holding (68.9%; median: 5, range: 0–5), scanning technique (63.8%; median: 4, range: 0–5), identification of anatomic structures (72.4%; median: 4, range: 0–5), and description of ultrasound findings (65.5%; median: 4, range: 0–5) were found to be sufficient, whereas ultrasound machine settings adjustments (1.7%; median: 0, range: 0–4) and final ultrasound diagnosis (12.1%; median: 0, range: 0–5) were insufficient. The total median value of the modified DISCERN scale was 2 (percentile: 2–2, range: 0–3). Conclusion MSUS video contents on YouTube are insufficient for educational purposes on MSUS training. There is a need for affordable, easily accessed, standardized, and peer-reviewed online training programmes on MSUS and MSUS-guided injections.

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