MED-NET Conference 1997. Rotterdam, the Netherlands.
Proceedings 6.1.

Report of the reference group on postgraduate education

V. Costigliola (Brussels, Belgium)

Introduction

At the MED-NET conference in Rotterdam the EMA held a workshop on the present situation on medical post-graduate education in Europe. There were 18 participants from 13 different countries representing 15 different universities. The main items discussed were the following:

• Definition of PG (Post-Graduate) Education
• Present situation in Europe
• Problems related to the present situation
• Source of information
• Suggestions

Definition of PG Education

All participants agreed that it was fundamental to define clearly the subject of the discussion. The result is that they identified that the PG Education concerns the period from the end of medical basic education till the recognition of competencies or specialisation, certified by a diploma or a certificate or an authorisation to practice, generally under the responsibility of official authorities (Ministry of Health or Education).

This period corresponds to the 3rd cycle as mentioned by the European commission. For all participants, it was clear that PG Education is not a continuing medical education.

Present situation in Europe

The present situation is quite hard to define properly as the responsibility of the organisation of PG Education in the European Union, and in some countries in Eastern Europe, is usually shared by different official bodies like:

• Universities
• Ministry of Health
• Ministry of Education
• Professional Associations
• Teaching Hospitals

This creates a complex situation which does not facilitate the possibility of PG exchange. Although the SOCRATES program now allows exchanges of PG students it was agreed that, in the present situation, it seems very difficult to find the right correspondent in each Member State. For the participants a fundamental issue is the quality of the PG Education whatever the structures involved in this process are.

Problems related to the present situation

Two main problems were identified and discussed:

1. The access to the PG Education
2. The mobility of MD in this 3rd cycle
   ad 1) Unfortunately, the access to PG Education is different in each member
   State but based, in the same way on two main selection criteria:
   - The curriculum of the applicant at the end of medical studies (marks, interview, examination, etc.).
   - The local financial disposability since the PG students are now paid.
   ad 2) The mobility of medical doctors is limited essentially for economical reasons (the payment of the PG)

The discussion led to the observation that probably the lack of harmonisation in the European Countries prevents also the mobility since the future specialists have some fears of leaving their medical structure.

Sources of information

All participants mentioned different sources of information, but everybody agreed that a fundamental step to reach as soon as possible is to optimalize all the already existing information, for example, Internet, Home Pages and Universities. 

Recommendations

Two main issues are to be considered in this complex and confused European situation:
1. The standards of quality of the PG Education
2. The mobility of PG Education students
Concerning the standards of quality, it has been widely recommended to have a European consensus, while concerning the mobility, an ad hoc committee should be constituted in order to identify the equivalent and the correspondent level of responsibility in each European Country.

Final considerations

The PG Education is mainly linked to the Health economic aspect and the local healthcare system. For all participants it is essential to collect and share information on PG Education in each Member State and, furthermore, it is fundamental for MED-NET to play an interface role between actors promoting meetings and forums on this very important aspect of healthcare. After the conference the EMA continued the inquiry contacting:

• DGXXII (including its Documentation Center and its Library)
• bureau EURIDICE
• bureau ORTELIUS
• Agence Nationale du Ministère de l'Éducation
• Inseignement Sécondaire
• Inseignement Supérieur
• Association of Medical Schools in Europe (AMSE)

Unfortunately these sources do not provide information on this topic as it is too specific.
So, to the best of our knowledge, no information is available, therefore the EMA would like to propose to continue the research suggesting a call for a conference in September 1997 inviting experts interested in this topic. The EMA proposes to do this under the auspices of MED-NET.

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