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The Executive Committee of the Section of Paediatric Surgery met twice in this year (Paris 9/1/99; Brussels 6/5/99) and two as well were the Meetings of the Council of Presidents and Secretaries of all UEMS Sections (Brussels 22-24/10/98 and 8/5/99). Here you can find a summary of the discussions and the decisions made in these Meetings.

Mme C.Fékété sent a letter of resignation from the Executive after 12 years of service in the UEMS and proposed Prof. Y.Aigrain as his successor. She was warmly thanked for her most valuable work in the Committee before as Executive and then as Vice President. An election at the next General Meeting of the Section in Liverpool will be therefore needed to designate a new member of the Executive and a new Vice President of the Committee.  

The Section has open a new bank account in Euro where to pay the annual fee. In order to simplify the budget the "unit" for the calculation of the fees has been fixed to 25 Euro (instead of 50 Dutch Guilders; the exact change being 22,68 Euro, this represents a modest increase of 9,2 %, that the Executive considered necessary to cope with the increasing costs). In the last General Council of the UEMS was noted that also Associated Countries contribute to the general budget in the measure of 1 unit each, regardless of the population of the Country. The possibility to leave a fee also from Associated Countries, although merely nominal (for our Section is 25 Euro), shall be discussed in the Liverpool meeting, as well as the problem of the Countries defaulting in fees payment.

The accreditation process of Training Centres through site visits is going on smoothly. In order to add authoritativeness to the Board's evaluations on Training Centres the Executive decided to send a copy of the site visit report -when positive- to the UEMS General Secretariat with request to forward it to the relevant National Authority and through it to the Hospital Authority where the training is based.

The possibility for the Sections to open the accreditation process not only to citizens of full members EU countries but also to those of Associated Countries (Croatia, Hungary, Malta, Poland, Slovenia and Turkey) has been thoroughly discussed at the Brussels meeting of the 24^th October 1998, and the conclusion was in favour of opening the accreditation process also to these Countries. This according to the fact that the European Certification of Accreditation released by UEMS Sections has to be considered to have the "moral" value to it bestowed by the community of the European Specialists in a particular field, but devoid of any legal value recognised by the EU government. Accordingly, the Executive decided to open the opportunity to apply for certification by the EBPS also to Paediatric Surgeons of Associated Countries, who are recognised in their country, are fully engaged in practice and/or have got a Specialisation degree before the 31^st December 1993 (three years before the 31^st December 1996, deadline of the accreditation process for EU Countries). Candidates will submit the application form, a detailed CV and an operative Log Book to an "ad hoc" national Committee appointed by the National Scientific Association represented to the UEMS who is requested to be very strict in processing the forms; forms approved by the national Committee will be further scrutinised and ratified by the Executive Committee, who takes upon itself the right to reject candidates not fully complying with the EU standards.

Young Paediatric Surgeons seeking for European Registration will undergo an European Examination. The Board edited an Examination Handbook, presented by the President at the III European Congress of Paediatric Surgery in Brussels. First examination will be held in Paris the 22^nd and 23^rd October 1999; closing date to apply, 22^nd August 1999.

Responding to another recommendation of the Brussels meeting it was emphasised the opportunity to have the European Journal of Paediatric Surgery as official journal of the Section. Since the first 1999 issue of the Journal the heading "Official Journal of the UEMS" appear on the title page. Documents of particular interest and newsletter regarding the activities of the Section and the Board will therefore appear on the EJPS as well as here on the Section website.

The Presidents’ and Secretaries’ Meeting of the 8^th of May was almost entirely devoted to the problem of the CME in Europe. The UEMS as a whole is deeply engaged in this issue, and some Sections have already drawn their own guidelines on CME. The Section will shortly prepare a draft of guidelines for the CME in Paediatric Surgery, to be discussed and adopted as soon as possible.

The UEMS Harmonisation Committee is now outlining a program on the exchange of trainees among European Countries. The EBPS picked up the suggestion: the opportunity to launch an European Exchange Program in Paediatric Surgery and how to realise it should therefore be discussed in Liverpool. An interesting model could be the one adopted by the Section of Gastroenterology: all data [Country, Institution, duration of training offered (3-6 months), type of training (ie special interests in PS), funding or accommodation from host (if available), year of training (1^st to 6^th), contact person)] are published on the Eur. J. Gastroenterology as well as in the Section website (http://www.uems.be/gastroen.htm ).

The need to examine current policies on manpower on the different countries, with particular interest on whom bestows the title of Paediatric Surgeon, prompted the Executive to appoint a Subcommittee on Manpower. In the first Meeting of the subcommittee (Brussels 6/5/99) general rules suggested by the BAPS were recalled, i.e. the need of 1 Paediatric Surgeon every 500.000 inhabitants, of 1 Paediatric Surgical Centre every 2.500.000 inhabitants and the optimal ratio of 1:1 trainee to consultant; substantial differences among countries were emphasised, with huge overcrowding of medical doctors and trainees in Italy and Germany and a lack of trainees in UK and Netherlands. It was also discussed the need to have or not in Paediatric surgical centres subspecialisations such as Urology, Traumatology or Orthopaedics; the various situations in different Countries were detailed, with the general agreement to keep at least Paediatric Urology within the frame of Paediatric Surgery.

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The Executive Committee of our Section met in Koln the 8^th of January, 2000. Here are outlined the discussions and the resolutions passed during the Meeting.

Two members of the Executive Council (Prof. Nielsen and Tovar) will end their term of office in 2000. In the next General Meeting in Sorrento two new members will therefore be nominated; Delegates are kindly requested to fill the attached candidature form and to send it back to the Secretary by the end of April.

The Section account in Blaricum was eventually closed and all residual money transferred to the account open (in euro) in Pavia. The Board account (in pounds) is in Glasgow for the Certification and Examination purposes.

The situation of the arrears in contribution has markedly improved, and just only few Countries are still missing.

Up to now have been visited the hospitals in Graz, Madrid, Copenhagen, Porto, Paris-Debré and Cologne; scheduled visits are for Bologna, Uppsala, Bruxelles and Barcelona. It has to be emphasised that the meaning of the site visits is not only to formally recognise units of standard considered adequate, but also to formulate recommendations pointing out hospital weaknesses, to help the responsible to overcome them, and suggesting the number of people that can be trained in each centre. A very useful tool in evaluating the Centres has been found to be the Log-Book to record trainees' activities; unfortunately not all Centres have introduced the use. We all are kindly requested to emphasise in our national Associations the need to further the use of the Log-Book: a new model is being studied and will be shortly printed. It was also concluded on the opportunity to public the results of the successful visits and to issue a Certification to the visited Centre. In order to further the expansion of the visiting process the President will write to the National Scientific Associations emphasising the need of keeping high standards in paediatric surgical training throughout Europe, and how site visits can enforce this goal.

The first European Examination, duly organised by prof. Aigrain in Paris-Hôpital Debré, has been held the 22^nd October 1999, with 3 successful candidates over 4 applicants.

The reduced number of applicants prompted to draw some consideration from this experience. In particular the Executive pointed out two problems: a) the meaning of the Examination; b) the costs involved. About the first problem it must be emphasised that the European Examination is now the only way for trainees to get the European Certification in Paediatric Surgery; it is expected that in future, with the evolution of European integration, the need of a supranational certification will become evident. A foreseeable problem in this process will be that of language: fluency in the native language of each candidate will be needed by at least one of the examiners. About the problem of costs it was observed that the actual fee, although in the range of 300 UK pounds, was insufficient to cover the expenses, but on the other hand enough high to discourage potential candidates; a reduction to 250 UK pounds was decided.

A possible solution could be an additional funding of the European examination through a charge to the National Associations for at least a part of the expenses. The Council will be therefore asked to discuss this suggestion: the money needed to cover half of the expenses for 10 / 15 candidates / year (about 200 Euro per candidate) should roughly double the actual annual fee.

Next examination will be on November, 17 and 18, 2000. See under European Examination for further details.

The accreditation process has been opened also to Paediatric Surgeons of Associate Countries (Croatia, Hungary, Malta, Poland, Slovenia and Turkey) complying with the requisites. This process is going on smoothly and up to now have been received and evaluated the application forms from Turkey and Croatia; forms from Hungary and Poland are now under process. The accreditation process has to be considered closed on 31^st December 1999; thereafter no further certification will be thus issued but only getting through the European Examination.

This issue is becoming more and more important in the UEMS policy as well as in the National Health Systems of many European countries. A draft on CME in Paediatric Surgery has been prepared and discussed in the Executive and with the central UEMS Offices. Still unsettled is the remark dealing with the points to be credited to publications, lectures, etc. These will not centrally be considered according to the UEMS recommendations, but the Council disagrees (Other interesting data on European CME (EACCME) can be gathered at the UEMS website: www.uems.net )

In order to foster the exchange of trainees among European centres of Paediatric Surgery, particularly among those recognised by the EBPS, it was suggested to prepare a list of available Centres to be published on this website, with details about the name and address of the Centre, special paediatric surgical interests, length of the exchange period, availability of scholarships or other funding, contact person. Delegates are therefore kindly requested to circulate among their national Association the attached form, to be filled with relevant data [Country, Institution, duration of training offered (3-6 months), type of training (ie special interests in PS), funding or accommodation from host (if available), year of training (1^st to 6^th), contact person)] .

The updated edition of the Section's handbook is almost ready. Data gathered for the handbook will be the basis of the work of the Manpower Committee; for this work it has been suggested to prepare a sort of "European translation table" with the qualifications of medical doctors in the different positions (from trainee to chief surgeon) in the different Countries, both in university and hospital service lines, in order to be able to compare, at least in general terms, same positions differently defined in different countries.

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The Executive Committee of our Section met in Heidelberg  the 2^nd  of December, 2000 I would like to keep you informed on the developments in the Section and Board, in order to help you in actively participating to the next Meeting in Budapest.

Robert Carachi will end his term as a President of the Section with the Budapest Meeting. According to the Rules of Procedure he will not be immediately re-eligible; an election for the new President will therefore be held in the Budapest General Meeting. Candidatures for the post are warmly welcomed and will be addressed to the Secretary; it is usual but not mandatory to choose the President among the members of the Executive Committee or the General Council.

A detailed financial account is always available in the "Files" section of the Council E-mailing system; for every problem in consultation please feel free to contact the Secretary.

Section finances (account in euro in Pavia), after the arrears problem has been satisfactorily settled, do not rise worries for the moment. Nevertheless the ever increasing amount of activities involves the need to cover increasing expenses, and therefore a prudent expenditure policy will be paramount.

Board account (in pounds in Glasgow) is used for the Certification, Examination and CME purposes; the very expensive European Examination process also claims for attention not to waste our financial resources.

The only established Committees up to now are the Executive Committee and the Manpower Committee. 

For the Site Visits, instead of establishing a former Committee was suggested to gather a pool of examiners, with some of them already experienced (former Executive members, e.g.). Up to now have volunteered to join this pool Boston, Lindahl, Menardi. About this problem it was also suggested to write a letter to the National Societies to foster the spread of site visitations. 

About the proposal of establishing an Educational Committee it was noted that this particular area is  more  of EUPSA rather than of UEMS interest.: a possible solution could be to let EUPSA deal with educational matters, reserving to the UEMS to deal with the preparation for the European Examination.

About European Examination, it was decided to create a  Committee gathering  a pool of examiners. Up to now have been proposed Aigrain, Boston, Dagli,  Eizaguirre, Holschneider, Tovàr. A new call for  examiners will therefore be proposed for Budapest: if anybody wants to volunteer is kindly requested to contact the President.

Mrs Rosemary MacKenzie was confirmed as Secretary of the European Examination process.

In the letter of August 2000 to the Presidents and Secretaries of the UEMS European Boards the Secretary General of UEMS Dr. C.C. Leibbrandt stated that the status of  "Full members" (with right of vote), "Associate" or  "Observer" countries derives from the actual international status of these Countries in their relationship with the EU. Is therefore mandatory for the Central UEMS to keep them as such (i.e., full membership for which the Directive 93/16 is valid, associated or observer membership) until the political framework of that particular Country vs EU hasn't changed. On he other hand : "…there are no statutory restrictions for the policy of the Sections in this matter and the Sections are free to accept any European national specialist association in their specialty a associated member … [sitting] in an advisory capacity without voting rights (statutes art. 4 § II)."

We therefore can invite in the Council as Associated Countries those up to now admitted only as Observers: is this the case of Czech Republic, Baltic States and Romania, just to mention Countries whose observers have already participated in the past to General Meetings. Associated Countries have the right to participate to the General Meetings in an advisory capacity, while observers do not have this right; central UEMS rules do request for Associated Countries a contribution equal to 1 unit (now in our Section equal to 25 Euro). 

The Executive has agreed to invite these Countries to join the Council as Associated Members. The Secretary  will contact the involved Associations on this matter.

The draft on CME in Paediatric Surgery discussed in Sorrento was formally approved by Austria, Finland, France, Italy, Spain (with some adjustment if needed), Sweden. Ireland noted that they must stuck with U.K. regulations.

All delegates emphasised that  CME must remain on voluntary basis and therefore that  recertification is neither mandatory not desirable. Moreover, recertification process  would be a bureaucratic nightmare; much more appealing and feasible to register and publish in the Section website the list of paediatric surgeons properly fulfilling their CME commitments. Among PWG comments was that one of the task of UEMS is to help national bodies to implement CME.

The Executive therefore approved the draft with the amendments suggested in Sorrento. The final version will be published on the Section website.

The management council UEMS 25/3/00 stated that the most fitting title for registered members of the Sections would be : "Fellow of the European Board of … " and that the certificate awarded by the Board would be "Certificate of Fellowship of the European Board of … " . The heading of the Certificate awarded by the Board should therefore comply with this rule.

Some doubts were risen about the official standing of UEMS certificates and the lawfulness of joining the F.E.B.P.S. acronym to our professional titles. UEMS Secretary General dr. Leibbrandt thus answered to the question we posed on this issue: "We had difficulties in the past (in Germany) with "Diploma" or "Certificate" of the Eur.Board. Their point was that there is only one legal diploma in European law, and that is the national diploma. So anything else is fraud. With "Fellowship" there were no problems up till now. Germany is still tricky, for there is also a law that doctors are not allowed to advertise themselves and additions like FEBPS might be interpreted as advertisement, but sofar there are no signs into this direction yet."   We'll discuss it n Budapest.

The last session of European Examination was held the 16^th  and 17^th  November  in Madrid with 11 candidates (6 from Spain, 1 each from Belgium, Hungary, Turkey, Syria and Tunisia - the latter with French graduation).

The presence of a Syrian candidate, although with part of his training done in Europe, raised the problem of the possibility to award to non-EU nor Associated Countries citizens the European certificate: this problem will be dealt with the central Offices in Brussels. Madrid experience suggested also to prepare guidelines for conducting the Examination. 

Next examination will be in Cologne, Germany, Friday 16^th and Saturday 17^th November 2001. 

Prof. Hjalmas, president of ESPU, has sent a proposal about to create an Intercollegiate Board in Paediatric Urology between the Sections of Paediatric Surgery and Urology. The attitude of the Council was to keep Paediatric Urology within our Specialty; the problem will be further discussed in Budapest where prof. Hjalmas will be invited. UEMS position on the matter is (Dr. Leibbrandt's letter): "I am all in favour of intercollegiate European Boards. In our Rules of Procedure we have the Multidisciplinary Joint Committees, and these MJC can establish a European Board. Personally I think that this is the future. As we are going into team work more and more, the value of the strict boundaries between the traditional specialties will decrease substantially"

Dr. Martinez Ibanez proposed to initiate a group of work on paediatric trauma among the European Paediatric Surgical centers dealing with trauma in the widest sense, not limited to fractures. The Executive agreed to foster this initiative, asking Dr. Martinez Ibanez to further study how to implement it. Colleagues willing to join the project are kindly requested to contact Dr. Martinez Ibanez.

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The Executive Committee of the Section met in Dublin the 12^th of January, 2002, and discussed about these developments in the Section and Board.

Financial year 2001 was closed with € 2188,73 in and € 1926,05 out, € 262,68 residual. Bank expenses are really high (€ 113,51); while paying most of the contributors do not specify "without expenses for the payee" in their drafts, thus adding to the expenses. Countries which paid 2001 contributions are Austria, France, Germany (already paid also the 2002, as well as the Netherlands), Italy, Sweden, Croatia, UK). All the remainders are still in arrears, with Denmark, Eire, Luxembourg  and Portugal going back to the 2000 or else 1999 (Belgium). 

To deal better with the problem of arrears it was suggested to individualise one of the two national representatives to take care of this problem; to set as a deadline for the payment the annual general meeting; to send a letter twice to the Countries in arrears before applying the rules of procedure that suspend from the right of vote these Countries. Delegates are kindly requested to take into due consideration these suggestions.

Actual account is € 4540,57; the average historical income in the last 8 years turned out to be € 1976,06 / year and the expenses € 1649,50 / year, with high yearly fluctuations but a rather good overall stability and a steady surplus of some € 300 / year. 

It was stated that final decision on approving or not  a site should stay with the Executive as a whole, on the basis of the Commissioners' report, and not only with the Commission that actually visited that Centre. Final report on the last Centres visited (Budapest / Pecs / Szeged  and Bologna) raised some problems still unsettled.

In order to avoid for the future such a problems it was agreed to charge prof. Aigrain, Chairman of the Site Visit Committee, to prepare a set of minimal requirements to be sent to the applying Centres, and to send a Commission for a site visit only to the Centres meeting these  standards.

The Chairman of the Examination Committee, Robert Carachi, presented the results of the last session held in Cologne with 4 out of 5 applicants approved. The offer of Hugo Heji to organise 2002 Examination in Amsterdam was accepted (8-9 November 2002). 2003 candidature for Paris, as a centrally placed location in Europe, was advanced, as well as the proposal of having two examinations in Turkey due to the high number of possible applicants from that country.

It was then discussed the issue of Colleagues volunteering to act as Examiners: to accept their offer or to reserve the choice to the Executive?  For the moment it was decided not to dictate any particular rule, but rather to prepare a Course for would-be Examiners, that possibly should come from a Centre already accredited and attend for  the first time as observers.  Final decision on composition of the Examination Commission will stay with the Chairman of the Executive Committee.

As further suggestions for next Examinations it was approved to create a sort of a "bank" of MCQ, to be solicited by the Executive and prepared by examiners, and to invite all examinees to present for discussion a published paper.

A series of documents from Brussels on EACCME is now available on the UEMS website at www.uems.be. Eizaguirre wrote a letter on that issue to the Secretary: "… Following the rules of procedure, the verification of CME activity corresponds to the Board, but I don´t know if the National Associations have or not to  play a role here monitoring the forms filled by each surgeon, before sending  it to the Board. I think that we should start to record our CME activities in January 2002 and is important to know what to do with the completed forms."

CME registration of all FEBPS would involve a significant workload to a Secretary, to be purposefully appointed (and paid for). Possible solutions: a) to set a fee for  Fellows re-registering for CME; b) to leave the task of CME registration to National Association, to be then transmitted to the EBPS; c) to increase the annual fee for National Associations, to cover also the costs of CME registration. 

Delegates are kindly requested to consider these alternatives and to give their advice on the one considered best fitting the needs of our Colleagues. It will be also very interesting to have a short survey on how CME is going on in the different European countries, in order to sort out the most effective way UEMS can help this process. 

New requests to apply for European Examination and Registration by not-European Colleagues have been received. The Secretary recalled the answer on that issue - already presented in Budapest General Council - given to us by C.C.Leibbrandt, Secretary-General UEMS: "…European Board examinations and qualifications are marks of excellence, but have no legal value … European Board qualifications do not give the right to practice in the EU. So there is no link with the European Directives. The result is that it is in the power of the Boards themselves to recognise the specialist qualifications that are presented to them".

The Executive then decided to reserve European Registration for non-EU citizens only to those trained in Europe, better if in recognised Centres: any different attitude would otherwise damage all other European Boards. It was also decided to involve relevant national Medical Associations while awarding an European Certification to a non-EU citizen working in Europe. Delegates are invited to comment on this position, to be ratified or disapproved.

After a long gestation, on 9 February 2002 delegates of the UEMS Sections of Urology (Nijman and Kiely) and Paediatric Surgery (Nielsen and Aigrain) and of the ESPU (European Society of Paediatric Urology - Hjalmas and Bogaert) convened in Leuven and established the UEMS Multidisciplinary Joint Committee on Paediatric Urology. Chairman was named Prof. Yves Aigrain (Paris), Secretary Prof. Guy Bogaert (Leuven), e-mail guy.bogaert@uz.kuleuven.ac.be.

The MJC and the ESPU decided to establish a joint European Academy for Paediatric Urology, with the task to develop quality assurance programmes like European visitations of training centres and assessment of training. Among the recommendations of the Executive on this issue was to add in the syllabus of Paediatric Urology some training in neonatal surgery for people with an urologic background and some training in endoscopic procedures for people with a paediatric surgical background.

We agreed to establish this body in order not to create a new speciality but to have a joint venture with the Urologists, once stated as a prerequisite that every child has the right to be cared of in an appropriate environment : this is a Paediatric Surgical Unit were existing, otherwise  a Paediatric Unit. 

With the next General Council the Secretary / Treasurer will end his term. He can be re-elected for another term, and agreed to present his candidature that the Executive strongly supported. Candidatures have already been requested and have to be sent to the President to  be voted in Cambridge.

Next Europediatrics Congress will be held in Prague the 19-23 October, 2003. Organising Committee ask our Section to advertise  Paediatric Surgeons interested to join that Congress.

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The Hungarian Consortium for Training in Paediatric Surgery (Universities of Budapest, Szeged and Pecs), Berlin - Charité, Amsterdam, Nantes training centres have been visited, approved and Board certified. Certification has been officially awarded during the opening ceremony of the European Congress in Tours.

Problems experienced in approving some Centres raised the discussion about the opportunity to introduce a "staged" system of approbation, to be adopted with Centres not fully complying with the Board requisites but on the other hand not deserving a complete rejection. This option was eventually ruled out because unpractical.

It was suggested to have Board Certificates approved and signed by the National Authority responsible for the UEMS: such a suggestion will be put forward to the UEMS Headquarters for an opinion.

In the last session of examinations held in Amsterdam 4 out of 4 applicants were approved. Two observers from SAC - UK attended the examination. Next examination will be held in Paris, hosted by Yves Aigrain, Hopital Robert Debré, 21-22 November 2003.

In order to increase the number of examinees, it was proposed to split the Examination in two parts: the first one to be organised and held at a national level, possibly during a National Congress, with some 100 MCQ; the second part - to be reserved only to candidates successful in the first part - at European level, with the actual format (spot, clinical and vivas). Such an arrangement could involve ideally some 50 candidates per year; the increased costs could be afforded through the sponsorship of pharmacological industry or similar. 

The international ESPU Course held in Bologna (Italy) in November 2002  has been accredited through the CME Committee. The UEMS - EACCME has published various documents on this topic, available at www.uems.net . 

The problem of European accreditation of individuals was raised; the huge secretarial activity involved in such a program, although to be dealt with almost exclusively by e-mail, could be done by the actual Board Secretary with a further contract to be agreed upon. A fee of € 10 for paediatric surgeons asking to have their CME credits recorded in the European Register by 2005 (after the first 5 years from introduction of CME) could be paid for.

The letter of the Chairman of the Committee about his resignation from the chairmanship was then considered. The Executive unanimously agreed to express a vote of thanks to Juan Tovàr for his activity with the Committee and elected Inaki Eizaguirre as Chairman of the CME Committee.

Ten new countries will enter EU the 1^st may 2004  (Malta, Cyprus, Latvia, Estonia, Lithuania, Poland, Slovenia, Hungary, Czech republic, Slovakia). In italic countries that already are associated members to the UEMS - Section Paediatric Surgery.  Until entry of these Countries in the EU will not be formalised, there will be no particular steps to follow, if not inviting colleagues from these Countries to join the General Council in the next meeting in Tours. 

Multidisciplinary Joint Committee in Paediatric Urology, composed by Aigrain (chairman) and Nielsen for the UEMS-Paediatric Surgery, Nijman and Kiely for the UEMS-Urology and by Boegaert (Chairman Academy) and Hjalmas for the ESPU, met in  February in Leuwen. In agenda the preparation of Guidelines for training in Paediatric Urology and Site Visits of centres of Paediatric Urology. It was emphasised again that goal of the MJC is to raise the quality of training in Paediatric Urology and not to prepare a new specialty, although this position is not the one supported elsewhere by the ESPU.

Whit the next retirement of the President, the Section elected as a new representative in the MJC Dr. Jorgen Thorup from Copenhagen.

The President of the EUPSA,  Hoellwarth,  detailed to the Executive Committee the innovative project for the EUPSA, to be ideally transformed from an Association of Societies to a formal International Society with personal membership.  This step was suggested by changes in political situation with almost all European Countries entering the EU; the Executives welcomed the proposal. The Secretary advanced the issue if having or not a formal UEMS representation in the bodies of the future EUPSA, but the Committee agreed on going on with informal relationship and check in the future, step by step, how to deal with the new Society.

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Expenses are mainly represented by refunds to the President and Secretary for participation to the Executive Committee and to the Presidents’ and Secretaries’ meeting in Brussels, as well as by bank costs.

The problem of refunding  the Executives for their participation expenses to the annual Meeting was raised: working on behalf of the Section, should be the Section to take charge of these expenses. The Treasurer pointed out that this would increase dramatically Section’s expenditure, and would consequently need a substantial increase in annual fees. It was suggested that, possibly, enlargement of the EU to 10 new Countries could help to cope with this issue: the Treasurer was charged to inquiry in Brussels about the new repartition key in the EU after the enlargement, and to prepare a proposal to be discussed in the next Meeting.

European Examination finances are dangerously nearing the red zone; Examination secretariat suggested to shift some € 3000/ year from the Section to the Board account to keep on the European Examinations. Being the total annual budget of € 2600, to accept this suggestion would mean at least to double income; to cope also with the former proposal about Executive Meeting expenses, we should substantially increase the annual fees. The Treasurer  was charged to prepare a sort of a “business plan” to be discussed in the General Assembly.

The Chairman of the Committee, Aigrain, is preparing the recommendations dealing with the minimal prerequisites to be met before asking for a Site Visit. To foster the Site Visit initiative it was also decided to request every Delegate to act in this direction within every National Association

The European Examination held in November in Paris, hosted by Yves Aigrain, has been quite a success, so much so that another session had to be planned for the end of March 2004 in Glasgow. 

About the financial bearableness of the Examination, it was again emphasised the opportunity not to ask for sponsors, in order to have examination as free as possible from external influences; possibly a separate bank account in Euro could help to check expenses and revenues. 

Next examinations will be split in two parts, the first with MCQ during EUPSA Congress; to cover expenses it was suggested to charge 50€ for the first part and 350€ for the second one.

A paper on the mutual possible relationships between European Examination and EUPSA, to be published on the EJPS, could be advisable.

Main issue is the re-accreditation of registered surgeons. We have to arrange for a system for checking CME activities of the registered surgeons, as stated in the Guidelines approved two years ago.

It was discussed the problem raised in some European Countries about the total amount of duty hours for paediatric surgeons, exceeding European rules and hence to be reduced; this could lead to an increased need of Paediatric Surgeons in these Countries, while in some other Countries Paediatric Surgeons are in excess. Moreover, the concept of independent consultancy is different among various national regulations; many training programs actually do not provide for independent activities 

Another point of debate is the amount of training time to be devoted by trainees in Paediatric Surgery to the common trunk in general surgery, provided for but not specified in the Charter on Training of Medical Specialists in the European Community. 

Ten new countries will enter EU the 1^st may 2004  (Malta, Cyprus, Latvia, Estonia, Lithuania, Poland, Slovenia, Hungary, Czech republic, Slovakia). In italic countries that already are associated members to the UEMS - Section Paediatric Surgery. 

The President of the Slovakian Society of Paediatric Surgery asked about the possibility to have accreditation of Slovakian Pediatric Surgeons according to the rules utilized until 1996 for established Paediatric Surgeons in the EU. The Committee stated that, according to what stated in the Annex 2, Chapter 6, CHARTER on TRAINING of MEDICAL SPECIALISTS in the EU - REQUIREMENTS for the SPECIALTY PAEDIATRIC SURGERY, is not possible to open again the accreditation procedures followed until 1996; hence the need for the Colleagues willing to enter the European Register of Paediatric Surgeons to be approved at a formal European Examination. No other procedure of certification is anymore possible.

Dr. Timo Raatikanen,  President of the Finnish Society for Surgery of the Hand and Finnish delegate to the UEMS Section of Surgery, proposed the institution of a MJC in Hand Surgery, asking the agreement of our Section as well as the name of a Section’s representative. 

The Executive agreed to join the MJC and entrusted the President to choose a representative. 

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Section’s financial situation is rather stabilised. We have at 31/12/2004 an account worth € 4382,26; input in 2004 was of € 2676, expenses (participation to Meetings and bank costs) € 1668,02. As usual, there is the nasty issue of arrears: out of 21 members, just 10 (Denmark, France, Germany, Italy, Norway, Portugal, Spain, Sweden, Hungary and Turkey) paid in full the fees, while the others are 2 to 6 years in arrear.

In 2005, fees will be increased by  10 euro per point / quota as decided in Zagreb to partly cover the expenses for the European Examination, for an annual amount of 1000 euro. Attached is the list of the fees and arrears.

About the new entries in the EU: the new repartition key will be presented in Gdansk and introduced since 2006; for the year 2005 the Executive decided to charge a single quota (i.e., 35 euro) for the new entries as well as for the observer Countries, with exemption  from the payment of Malta and Slovenia (one to three pediatric surgeons per Country) in analogy with what decided for Luxembourg.

Site visits activity goes on: in the last year have been visited and approved two Centers, Hacettepe University in Ankara and Rotterdam University. The Executive appraised the excellent standard of care, notable research facilities and very high level of training. The Certificate will be awarded during the next European Congress in Gdansk.

Cerrahpasa University in Istanbul has been also visited after the Meeting, and its report will be discussed before Gdansk meeting.

There are still many Centers that in formal or informal ways applied for a Site Visit (among them Lille, Vienna, Uppsala, Utrecht, Zurich, Bochum, etc.): Training Courses Directors are kindly requested to contact the Secretary for further agreements.

Ongoing are contacts regarding the cooperation between UEMS and BAPS-SAC Site Visit Programs,  in order to reach an agreement on ratification and approval in UEMS program of Site Visits.

Next European Examination will be held during the European Congress in Gdansk. The exam has been advertised on the EUPSA website; it was also decided to realise a dedicated website for the exam, upon responsibility of the Committee Chairman, to be linked with the Section’s website. It must be underlined again that the Examination in itself is a mark of excellence but is devoid of any legal value in front of the European Authorities.

First part of the exam will be based on a standardized set of MCQ, prepared by an ad-hoc subcommittee (Carachi, Aigrain, Fitzgerald, Hoellwarth and Nielsen).

The second part of the Examination, in November,  will be held in Barcelona, positively and gratefully accepting  the invitation of Prof. Morales.

Cost of the first part of the exam has been fixed in 70 euro; cost of the second part has to be discussed in Gdansk.

On the last EACCME meeting in Brussels, November 2004, it was approved the concept of ECMECs, ECM European Credits, in the forfait amount of 6 credits for a full day event and 3 credits for a half day event.

How this will apply to our requests is still under discussion with EACCME; to foster the registration in the EACCME of the events organised in our Countries a possible way could be to arrange this issue in partnership with the EUPSA.

According to some Executives all the issue of ECM is a bureaucratic nightmare, mostly meaningless; before embarking the Section in complex re-registration problems overtaking national Authorities it was reputed wiser to wait for the arrangement of local systems by National authorities, and only thereafter to look for an European coordination system.

The Chairman of the Committee prepared a document on Manpower, to be forwarded to the General Council for discussion and approval. It was also requested to involve formally the President of the  EUPSA in the discussion of the document.

The Multidisciplinary Joint Committee in Paediatric Urology (MJC-PU) was created upon initiative of Kelm Hjalmas, President of the European Society of Pediatric Urology (ESPU), during a meeting in February 2002 where attended a representative of UEMS Headquarters as well as delegates from the Sections of Urology, Paediatric Surgery (Aigrain and Nielsen) and the ESPU. Within the MJC was created an “Academy” of PU (EAPU), in analogy of what “Boards” are towards the “Sections”. From 1^st January onwards a new setting of the MJCPU was devised, with two new candidates for the EAPU. Aim of the MJC was to set a standard for training in PU, harmonising a complementary training between Urology and Paediatric Surgery, and not the recognition of a new specialty, also being outside the rules of UEMS to set up new specialties. In this setting will be paramount the rules of UNICEF and WHO about children’s hospitalisation in appropriate environnment: morover, it must be emphasised that Paediatric Urologists have to do 100% of their activity with children and 80% with PU. Mission of our representatives in the MJC is to defend the major role that Paediatric Surgeons have in this field.

In the Committee has been reached a general agreement on some basic documents, published in the ESPU website (www.espu.org); in particular about the minimum limit of 80% on the total activity devoted to PU requested to those willing to be formally recognised as Paediatric Urologists by the UEMS. It has to be emphasised that one thing is to seek a formal recognition as Paediatric Urologist, another is to perform PU as a part – not  exclusive - of the general activity as Paediatric Surgeons. Actually, in every Department of Paediatric Surgery there is usually somebody particularly devoted to the care of urological cases – an eligible candidate for recognition as “Paediatric Urologist” -, and if otherwise it should be arranged to have such a figure.

Further discussion and inputs on these documents are kindly requested from all Delegates.

A MJC in Hand Surgery has been established, with two representatives from our Section (Dr. Nicos Marathovouniotis, Koln; Prof. Michael Hoellwarth, Graz). They have been requested to regularly report to the Section ongoing issues and to specify, in all documents of the MJC, that children must be kept in paediatric environnment according to UNICEF and WHO rules.

According to the UEMS ROP, Part two, art. 24, comma IX (“…Each mandate lasts for four years and may be renewed twice, except that of the President, he may only be re-elected after an interruption of four years, the President and the Secretary being elected with an interval of two years”) Executives’ term can be renewed up to 12 years (three 4 years mandate).

According to the ROP, having Fitzgerald served for 12 years he cannot be reelected for another term; Eizaguirre has not been re-elected as Spanish representative and hence resigned his post as Executive; the enlargement of the EU to 10 new Countries suggested the opportunity to increase to 6 the number of Executives, plus President and Secretary. Hence the need in Gdansk General Council to elect three new members of the Executive. It was suggested to ask National Delegates to have a broad view towards new Countries in the choice of the new  Executives.

It was also decided to ask Baltic Countries to designate two representatives each, instead of a single joint representation as per today.

In order not to lose the expertise gained in many years of work in the UEMS from “fired” (!) Executives, it was also suggested to coopt them as members of the different Committees.

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The Hospital of Lille has been visited the 1^st December 2005; the Center was approved under proviso of a new visit in five years time, and to stress again the essential need of properly filed log-books as prerequisite for approvation of a Center.

The Certificate will be awarded during the next EUPSA European Congress in Maastricht, and specifically during the Award Honor Ceremony; this arrangement should become the standard for the Certification award.

 Under evaluation are further visits to the First Paediatric Surgery Department at General Hospital “G. Gennimatas”, Aristotle University of Thessaloniki, Greece, and to the University of Prague, the day before the Czech and Slovak Congress of Paediatric Surgery with international participation, to 26th of April 2006. It was made clear that the expenses for the visit have to be meet by the requesting Institution and not by the Congress Organisation.

 An informal request by the Children's Hospital, Department of Paediatric Surgery, Zagreb, Croatia, will be examined just after formal presentation of the relevant application form; requests formerly advanced from Wien, Uppsala and Brussels have not yet been reiterated.

 Informal request for a visit to the Royal Belfast Hospital for Sick Children raised a debate on mutual relationships between UEMS and UK, were visits are already performed by a governmental body, the Postgraduate Medical Board, but were the situation is reported as being actually somewhat confused. It was stressed the wisdom of “building bridges” among the UEMS and the BAPS, finding practical arrangements able to overcome the “political problems” of the scientifical recognition of training centers made by a non-governmental body such as UEMS. Being now the situation in UK under evolution it was concluded for a “wait and see” attitude, examining how this issue will be arranged and how to harmonise it with UEMS regulations.

 The issue of re-visiting all Centers already approved was judged very impractical; it was rather suggested to check the actual situation in these Centers through a questionnaire. The Committee unanimously approved this suggestion and appointed the Site Visit Committee to prepare the questionnaire.

The Presidents of the three Baltic Paediatric Surgical Societies sent to the Executive a formal letter asking to re-open the opportunity to apply for certification by the EBPS for the established Paediatric Surgeons working in the Countries newly admitted to the EU, namely Estonia, Latvia and Lithuania.

The request was positively considered, and was therefore agreed to offer also to these Colleagues the opportunity to apply for a registration as Fellows of the European Board of Paediatric Surgery. This opportunity will be consequently offered also to Colleagues of the other Countries newly entered in the EU, namely Slowakia, Slovenia, Czech Republic, Malta, Cyprus; Poland and Hungary already underwent this process in their capacity as Associated Countries.

Applicants must be “bona fide” Paediatric Surgeons recognised in their country, fully engaged in practice and having got a Specialisation degree  before the 31^st December 1993 (three years before the 31^st December 1996, deadline of the previous accreditation process). Candidates will submit the enclosed application form, a detailed CV and an operative Log Book to an “ad hoc” National Committee to this purpose appointed by the National Scientific Association represented to the UEMS; forms approved by the National Committee will be further scrutinised and  ratified by the Executive Committee, who takes upon itself  the right to reject candidates not fully complying with the EU standards.

Successful applicants will be awarded the Board Certification and registered in the EBPS website upon payment of a processing fee of 35 UK pounds, the actual equivalent of the 25 UK pounds charged for the original certification process.

It has to be pointed out that regulations in the EU are inspired by a vision that in the mid- and long-term future will consider a single examination ruled by EU authorities for all European Countries. Hence the strategical importance of the Examinations run by the UEMS Sections, being the only such experiences already in place at European level: changes foreseen for the year 2008 in the European regulations will possibly lead to a legal recognition of this kind of examination. Moreover, the UEMS has a semi-official state in front of the EU Commission, as well as an official standing in front of the National Medical Associations of the affiliated Countries. This position could be possibly increased in future due to the vanishing role of the Advisory Committee on Medical Training, this one being a moribund official advisory body to the Commission, already technically if not yet formally replaced by the UEMS. 

 Being the problem of European Examination common to many Sections and Boards, the President proposed a formal Meeting of these Sections and Boards to be held in Brussels in order to discuss this issue. In detail, it was emphasised that: 1) aim of these examinations organised by the Sections is not to bypass National Authorities nor UEMS Headquarters, but rather to support  them by increasing the quality of medical training in Europe according Basel declaration; 2) European examination is an instrument of quality approvement, the only instrument beside site visits which is able to certificate quality; 3) organising this Examination at European level could stimulate those Countries not running a national final examination after higher specialist training to send their candidates to the European Examination instead.  

 The experience with the “two steps” exam, scheduled in Glasgow, Thessaloniki, Maastricht and Istanbul is going on smoothly, with 15 applications already received. The first experiences with MCQs in Gdansk and Barcelona revealed some problems in understanding the formulation of questions, thus making for some candidates difficult to attain the cut-off point of 62% correct answers needed to pass the exam. Nevertheless, some 80% of the candidates were successful in both examinations.

 To overcome this problem the pool of matching questions will be extended to a total of at least 600, from where to pick up randomly 10 questions for each one of the 10 sections in which the Examination is divided.

 The increasing authoritativeness of the European Examination was further underlined by the applications received by rather many Colleagues non-EU citizens, not trained nor graduated in Europe, asking to sit for the Exam. Allowing them to do so would entail the risk of interfering with National regulations about the free exchange of Medical Doctors among European Countries. Therefore it was decided to state clearly in the Exam website that: “Eligible for the European Examination are Medical Doctors fully trained in Paediatric Surgery and with a Diploma or equivalent recognised by a National Authority or by a National Scientific Association of an EU or EU-Associated Country. Individual cases outside these domains can be discussed with the Examination Board, whose decision will be final."

 Another problem was raised by a message received from prof. N.Bax (Netherlands), dealing with the inclusion of Paediatric Urology in the format of the Exam. In his Country, as in the USA, paediatric Urology is a separate entity from Paediatric surgery: therefore people trained in these Countries will not  be adequately prepared to pass the Exam. Hence his suggestion “…to divide the board examination in an examination with and one without Paediatric Urology”. In the discussion about this request it was emphasised on one hand that a general knowledge in basic data about Paediatric Urology cannot be considered an optional, but a must for every paediatric surgeon although not directly practising urological surgery; on the other hand, the need to keep as much as possible Paediatric Urology under the umbrella of the Paediatric surgery. Therefore Bax’s suggestion was rejected.

The Executive Committee received letters from Slovakia, Croatia and Bulgaria, all  dealing from different points of view with the same problem, i.e. what is the content of Paediatric Surgery and how should be organised the training. It was in this respect stressed the concept that is fully within our mission to  give an expert and authoritative advice, although not legally binding, on what has to be taught, and how, in a training course in Paediatric Surgery: hence the need of a Syllabus in Paediatric Surgery.

The Committee agreed in principle on this idea, suggesting to involve EUPSA Educational Committee in the redaction of the document: it should detail which are the contents of Paediatric Surgery, what is essential and what not essential, which fields are mandatory and which just optional. 

The issue of CME /CPD within UEMS is becoming hot, due also to the amount of money involved. A group of Sections has created its own “European Specialty Accreditation Board” (ESAB) that edited a “Position Paper”, heavily critical towards the UEMS Headquarters.

 Our Section already agreed in Gdansk not to follow the idea of building up a specific ESAB but rather to sign a Mutual Agreement with EACCME, signed the 26^th of November by our President and Hannu Halila, UEMS President, during the Advisory Council for CME. In this Council, according to our President’s report,  it was emphasised the raising importance and influence of CME/CPD on medical work in the future. In some Countries the income of the practitioners will be cut down if the necessary CME points will not be collected; moreover, some negative consequences for the insurance of the individual doctor will probably be introduced in the future.On the other side, CME/CPD, mandatory  in only some of the European countries,  is an interesting instrument for quality assessment but not for quality improvement: nobody knows whether the required CME points really increase the medical knowledge of the individual doctor.

 Details of the agreement were presented: it was noticed that the fees charged for an event are too high, therefore the President was entrusted to discuss this topic during next Genral Meeting in Brussels in May.

 In 2005 these events have been examined and approved 

 1.      EUPSA Congress, Gdansk, May 2005

2.      Congress Paediatric Urology, Heidelberg 15-17 September 2005

3.      Gastrointestinal failure in children: meet the expert, Foggia, Italy, 23 – 24 September 2005

4.      EUPSA Congress, Maastricht May 2006

It was suggested to ask National Delegates to go through the Handbook published on the Section’s website update it and to check the national members in the Register: modifications have to be forwarded to the Secretary /webmaster.

The problem about the 80% of surgical activity to be done in pediatric urology to be recognised as Pediatric Urologist was further discussed; a written examination in Pediatric Urology was organised during ESPU Congress, while no Site Visits were till now performed. Aims of these visits will be to define the contents of a specialistic training in Paediatric Urology as well as to approve Centers devoted exclusively to the practice of Paediatric Urology.

The President of the EUPSA and  UEMS Executive, Pintèr, emphasised the wisdom of further increasing the already excellent relationships between UEMS and EUPSA. As an example of the already ongoing joint projects were quoted the European Examinations, organised during EUPSA Congress, and the just approved project of joint redaction of a Syllabus  in Paediatric Surgery. This could be ideally presented at Torino 2007 Congress, containing propositions and not rules aimed to help Paediatric Surgical Associations. The request to the EUPSA Educational Committee is to lay down a draft of the Syllabus by January 2007, to be presented and discussed at 2007 Executive Committee by the Presdient of Educational Committee J.M.Guys.

 Further proposals could be the joint organisation of a network of centers available to host trainees and Colleagues willing to spend some time in Centers performing high level Paediatric Surgery. EUPSA members could offer their availability, UEMS could take care of the mutual recognition of medical certifications.

Another project could be the "twinning" of Centers UEMS certificated with Centers either willing to undergo the same certification process or just improve their clinical level with exchange of trainers and trainees, joint meetings, etc., in particular  linking full members EU  Countries with Associated Countries (Romania, Bulgaria, Croatia, etc.), in the perspective of their full integration in Europe.

The already ongoing cooperation in the European Examination could be improved inviting EUPSA to organise seminars or courses to help newcomers to prepare themselves to pass the Examination, to improve and harmonise the cultural and technical background of paediatric surgeons in Europe. 

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Our President prof. Holschneider has been highly active as Representative of the Surgical Sections within the UEMS Central Executive Committee, together with prof. Greenhalgh of the Section of Surgery. In this capacity he strongly supported the position of the Sections in the general framework of the UEMS organisation and their initiatives such as European Examination and Site Visits, intended as main available ways to raise and to keep the standards of medical training in Europe.

The need of a standardisation of training is becoming more and more evident due to the increased exchanges of medical specialists throughout European Countries. This phenomenon raised a lot of problems because of evident inequalities of training and quality assessing among the different Countries: this leads to consider more in depth the issue of international recognition of the validity  of the European Examinations, once thwarted and now just barely recognised by the UEMS headquarters.

Our Section will go on strongly supporting the request of voting right for the delegates representing the Sections and Boards in the UEMS Management Committee, to express at the highest level of our Organisation proposals and views coming out from the people directly involved in the patients’ care, European medical specialists.

The 9-10/2/2007 our Section organised a Meeting in Glasgow, attended by representatives of 9 Sections already  running European Examination as well as by the General Secretary of UEMS Bernard Maillet, to discuss different issues on the topic of European Medical Examination. A common Declaration was agreed upon, where it was also proposed to establish a Council for European Specialist Medical Examinations (CESME) as an advisory body to the UEMS and its Sections. The so-called “Glasgow Declaration” was then presented and discussed at the Presidents’ and Secretaries’ meeting in Brussels the 26^th May; amended version was again discussed in the UEMS Executive Meeting in Bratislava the 11-12/10/2007, while two other meetings of the CESME were held in Brussels (16/6/2007 and 17/11/2007). Up to now 22 out of 38 Sections took part to these meetings.

The Glasgow Declaration is still waiting its final approval, but the issues raised by problem of European Examination and dealt within the Declaration are on top of the Agenda of our Section.

Last Centers visited and approved are the Training Centers in Paediatric Surgery of Warsaw, Poland and Bern, Switzerland, raising the total number of approved Centres to 20 (1 Austria, 1 Czech Republic, 1 Denmark,  4  France, 3 Germany,  1 Hungary,  2 Netherlands, 1  Poland, 1 Portugal,  2 Spain, 1 Switzerland, 2 Turkey).

National Delegates have been invited to appreciate in full the importance for a Training Center to be recognised at European level, as a mark of excellence, and to foster the application from Centers in their Country not yet approved by the European Board. Actually, site visiting is the only way to assess the quality of Centres and to increase quality standards, also because National Authorities in many countries do not deal with this issue.

About the problem of setting the standards required by a Training Centre in Paediatric Surgery, discussion within the Section underlined how needed are them particularly now with our discipline so rapidly evolving with  new technologies. This issue prompted some Countries such as UK to consider dividing Centres in two different branches, the first – with few centres of excellence - devoted to advanced Paediatric Surgery and the second – the “average” Centre – dealing with ordinary Paediatric Surgery. While considering the basic requisites for a training centre it comes out the problem of the number of index cases to be dealt with by the trainees, not always available in different periods of the year: this also implies the need of fixing the maximum number of trainees each Centre can train at a time. 

This problem presents different aspects in the different Countries. If the training is meant to prepare the trainee to enter private practice he will need to master only standard procedures for routine surgery; moreover, approbation of a Centre needs to take into account multiple factors, such as regional boundaries, catchments area, number of treated patients, facilities available, number of surgeons and their subspecialties, which are the results of the Centre (is there an audit system or not ?). Definition of the minimum standard for a Centre to be recognised is yet to be defined, as well as the number of trainees it can train at a time.

After the extension to Romania and Bulgaria of the EU boundaries, it was decided to offer also to our Bulgarian and Romanian Colleagues the opportunity to apply for European Registration for established Paediatric Surgeons, with the same procedure and limitation applied for the last Countries admitted to EU,  i.e. allowing them one year to register according to the rules set up for the first Registration. This was reserved for bona fide Paediatric Surgeons already established from at least three years in 1996, in other words for pediatric surgeons specialised before 31^st December 1993. About the issue of amount of fee to be paid for registration, it was decided to reduce it to 25 euro instead of 35 pounds as formerly established, clearly specifying that this sum has to be intended as a fee and not as a coverage of the expenses for registration.

In 2007 European Examinations part one (100 MCQ, preliminary screening) were held in Glasgow, Turin and Budapest; European Examination part two (clinical examination and vivas)  were held in Istanbul, were 25 candidates were examined, 22 approved and 3 failed, and in Budapest  with 24 candidates examined, all approved but one.

Two major problems were encountered: 1) difficulties in english fluency by some candidates, declaring a workable knowledge  of english but on the contrary needing on the spot translation; 2) high number of candidates, involving a complex organisation.

Turkish Association of Paediatric Surgeons agreed to adopt the European Examination as National Examination, automatically approving at national level the Turkish successful candidates; locally organised national examination were performed with the same set of MCQ and general setting of European Examination.

The issue of admitting to the European Examination also candidates not EU citizens or not trained in EU was discussed: considering that it seems advisable to separate political issues from cultural ones, that keeping the European Examination as a high level standard improves the position of the UEMS towards foreign Countries, that in the Glasgow Declaration it was expressed a common position on this issue, it has been agreed that the Examination will be open also to non-EU citizens, recording the successful candidates in two different Registers for EU and non-EU citizens.

The long way to final approbation of the European Syllabus in Paediatric Surgery saw in 2007 the presentation of  the third draft, the discussion of the fourth one and the collection of suggestions and amendments from the National Scientific Societies, summarised in the final draft that will be hopefully approved and published in 2008.

Topics emphasised in the last versions are the need to keep Urology within the umbrella of Paediatric Surgery; the opportunity not to compare and to copy the UK system for the whole Europe; not to impose guidelines so strict to make them impossible to follow; not to be too much specific in detailing procedures; to be very careful with minimum numbers of procedures to be performed.

In 2007 two events (Sevilla Hypospadias Course on Current Surgical Treatment and Live Surgery and European Congress in Torino) were approved and accredited by the EACCME.

The agreement signed with the UEMS headquarters is working smoothly and the accreditation of events approved by the Section’s Committee is registered promptly, assuring a recognition also by the American AMA  accreditation system.

This issue raised a lot of discussions and practical proposals aimed to harmonise the formal requests of the Directive with the needs of a proper training of postgraduate students. The 48 + 12 working hours model was judged essential to allow enough time for good patient care as well as for research. Unfortunately, the huge amount of variables involved in this issue as well as the total impermeability of European Commission to the modifications suggested by the UEMS made any further discussion on this topic practically useless.

 Our Section is involved in four  Multidisciplinary Joint Committees, i.e. Paediatric Urology (MJCPU), Sport, Emergency Medicine and Hand surgery.

About MJCPU and particularly about the resolution of the Committee to register as Paediatric Urologist only Colleagues dealing with this subspecialty for more than 80% of their activity, it was raised the problem that many Paediatric Surgical Centres perform a lot of Paediatric Urology, but cannot by approved by the MJCPU because of the “80% rule”.  According to our representatives in the Committee also with this rule the work of MJCPU is running smoothly: the committee organised the European Exam in Paediatric Urology with now some 120 Fellows of the European Academy of Paediatric Urology. Seventeen candidates were rejected because devoting to Paediatric Urology less than 80% of their activity. Site visits were performed in three Centres while 3 are still in the waiting list; a system of recertification as a Fellow of the Academy through CME achievements was set in place.

No specific activities have to be reported for the other three MJCs.

Relationship between the Section and the EUPSA (European Paediatric Surgeons’ Association) continues to be very strict, both having the same goal to increase the quality of Paediatric Surgery in Europe. The main instrument of EUPSA is since many years the European Pediatric Surgical Scientific Congress. In addition, in the last year many further activities concerning the exchange of clinical experience and research activities were realised.

The Executive agreed to keep EUPSA and UEMS meetings in parallel in order to go on working together, but with a clear definition of “who’s who”, the EUPSA a private scientific association and the UEMS a “political” one dealing with the European Commission.

The Syllabus is the example of a very important issue to be dealt with jointly; about the istitutionalisation of relationship between the two bodies, it was agreed that both Presidents will be reciprocally invited in the Executive Boards without voting rights.

2007 has been the last year of term for the President Holschneider,  for the Secretary Parigi and for two Executives, Aigrain and Lindahl. The General Council of the Section held in Turin elected Gian Battista Parigi (Italy) as new President for the term 2008-2011, Tomas Wester (Sweden) as Secretary for the same term, and re-elected Yves Aigrain (France) and Harry Lindahl (Finland) for another term as Executives.

 

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