GUIDELINES FOR THE RECOGNITION OF TRAINING CENTRES

Introduction

One of the tasks of the EBPS is to establish a standard for the training of paediatric surgeons in Europe. In order to assure the quality of training, certain criteria shall be laid down concerning the institutions which train paediatric surgeons.

Procedure

A training centre for paediatric surgery may apply for recognition by the EBPS. The chief of the training centre shall take the initiative for the recognition procedure. He or she declares the willingness to cooperate with the EBPS, to submit the information requested and to agree to site visits.

Criteria

1. For each training centre there shall be at least two trained paediatric surgeons.

2. The training centre shall be based in a university hospital or be associated to a university.

3. Since it is not expected that every centre will cover all aspects of paediatric surgery, rotation between training centres will be necessary in order to offer exposure to the whole field of surgery in children.

4. There must be up to date facilities for :

paediatrics and  sub specialities

paediatric anaesthesia

child psychiatry

paediatric imaging

laboratory services

5. There must be:

a regular discussion of indications for operation

a weekly programme of teaching

regular discussions of morbidity and mortality and attendance at autopsies

ready access to an adequate library with international journals and recent books

facilities for clinical and experimental research

6. The programme of training must give graded and progressive responsibility to the trainee under the supervision of the responsible paediatric surgeons and must be recorded in a detailed log book as approved by the EBPS.

1. Paediatric surgery

The field of paediatric surgery encompasses the surgical care of the growing individual. lt includes management and peri-operative care from before birth up till the final stages of development.

2. Paediatric surgical centres

Paediatric surgery should be provided in paediatric surgical units based in centres where a full range of medical and surgical facilities for the care of the sick child are available. Most of these centres should provide postgraduate training in paediatric surgery and research facilities.

The paediatric surgical unit should be headed by a trained paediatric surgeon.

3. Paediatric surgeon

A paediatric surgeon is a surgeon specifically trained in the care of children.

4. Specialist paediatric surgery

Specialist paediatric surgery should be performed in a paediatric surgical centre or in a specialised centre with possibilities to provide adequate care to children.

5. Training of surgeons, other than paediatric surgeons

Surgeons taking care of children should have had adequate training in a paediatric surgical unit. They should also continue to have regular exposure to this type of patients. Moreover, they should stay informed about new developments in the field of paediatric surgery.

6. Hospital

All children should be treated in a hospital environment appropriate for their age group. Children should not be admitted to hospital if this can be avoided.

7. Referral advice

Children should be treated by practitioners experienced in this field. lf the expertise is not available, the child should be referred to a centre as defined at article 2.

BOARD STATUTE

• Article 1 - Name, Duration and Office

The name of the board is 'European Board of Paediatric Surgery (EBPS)

• Article 2 - Objective

The main objective of the EBPS is to attain the highest standards of care in the field of paediatric surgery, as defined in the Dublin statements of 1987, in the countries of the European Union.

This aim shall be achieved by the following means:

1. The EBPS shall recommend the standards required for the training of specialists in paediatric surgery and supervise the maintenance of these standards.
2. The EBPS shall make proposals for the quality of training and for the syllabus for paediatric surgery.
3. The EBPS shall recommend criteria to which the training centres in paediatric surgery" should conform to be registered as EBPS-approved training centres for trainees in the speciality.
4. The EBPS shall recommend the requirements for quality control or certification as trained in paediatric surgery; 'European Board Qualification'.
5. The EBPS shall recommend procedures to facilitate tree movement of specialists in paediatric surgery in the EU.
6. Within the EU the free movement of paediatric surgeons or trainees shall be encouraged between member countries.
7. The EBPS may conduct site visits of institutions that have formally agreed to live up to EBPS standards. Site visits will be carried out only whit an agreement of principle of the visited institutions. The visits may result in certification as EBPS recognised training institution. In countries where residencies are already reviewed, the EBPS will cooperage with such activities.

• Article 3 - Recognition of Qualification (European Board Qualification)

The EBPS shall issue a certificate of recognition of qualification in paediatric surgery to individuals who have attained the required training and successfully completed the educational requirements specified by the Board.

An European Board quality control in paediatric surgery will be established.

Only fully trained specialists having undertaken recognised training in a Member State of the EU, in a EFTA country or in another state at a comparable level may apply for this quality control to the EBPS.

This quality control shall give the candidate the right to 'European Board Qualification'.

Application for quality control:

1. The candidate shall have been working in paediatric surgery for at least three years when he or she applies for quality control
2. It shall be demonstrated that he or she has effectively practised in paediatric surgery during that period.
3. The candidate shall prove that he or she has continued in his or her post- graduate education.

Concerning free movement of paediatric surgeons in the EU;

1. The recognition of qualification is optional and shall not be a condition for immigration into the countries having mutual] recognition of the training in paediatric surgery with the candidate's home country.
2. It is desirable to each agreement that obtaining this qualification shall be considered by the authorities as proof of the quality and relative equivalence of the contents of training. It is therefore a factor which shall be added to compliance with the normal conditions authorising free movement.
3. Within the EU this recognition of European Board Qualification should foster the free movement of recognised paediatric surgeons.
4. The European Commission is invited to approve this initiative and consider it as a factor in achieving free movement.

• Article 4 - Membership

Full membership of the EBPS shall be confined to representatives elected by the professional organisations and/or the scientific societies for paediatric surgery in the countries which are full or associate members of the UEMS. Representatives from other European countries may be invited to take part in the EBPS as observers and their membership will be notified to the Council of management of UEMS.

The EBPS shall comprise two representatives for each country. They shall be confirmed by the national professional organisation, recognised by the UEMS.

At least one of the representatives shall be a member of the national delegation to the monospecialist section of paediatric surgery.

A member of EBPS shall be in office for a peri-od of 4 years, which may be renewed once, provided the delegate continues in active practice.

The EBPS may form working committees.

The EBPS may call upon one or more experts.

A special relationship between the EBPS and the European Union of Paediatric Surgical Association (EUPSA) will be created with respect to the standards and the contents of training.

The Permanent Working Group of Junior Hospital Doctors (PWG) has the right to delegate a specialist under training in paediatric surgery. He will sit with deliberative vote.

• Article 5 - Executive Committee

The EBPS shall elect an executive committee from among its full members. The executive committee shall comprise president, vice-president, secretary and treasurer. As far as possible the secretary should be the secretary of the monospecialist section of UEMS. Up to four additional members may be elected to constitute the executive committee.

The executive committee shall establish rules of procedure to be communicated to the General Secretary of the UEMS. It shall undertake the organisation of meetings and the execution of decisions.

The executive committee shall communicate with the General Secretary of the UEMS who shall be informed of the activities of the EBPS as prescribed in the statutes of the UEMS.

The president and vice-president shall remain in office for four years. They cannot be re-elected immediately. The secretary and treasurer shall remain in office for four years and can be re-elected for another four years.

• Article 6 - Meetings

The EBPS will hold its annual meeting (plenary session) once a year. Additional meetings may be convened by the executive committee with the agreement or at the instigation of the executive of the monospecialist section, the UEMS General Secretary or on the request of one third of the members of the EBPS.

Items for the agenda may be proposed by the members, associate members, the EBPS executive committee, the monospecialist section, the UEMS Management Council or its General Secretary. They should be forwarded to the secretary three months before the meeting.

The agenda of the EBPS plenary meetings shall be communicated to the members and the UEMS General Secretary at least two months before every meeting.

Minutes of the meetings, resolutions, recommendations, opinions, studies and all other relevant documents will be forwarded to EBPS members, to the General Secretary of the UEMS and to the secretary of the monospecialist section within one month after the meeting. They will be read, amended, proposed and signed as an accurate record at the next meeting.

The EBPS executive committee meets at least every six months.

Meetings of the executive committee are convened by the president, the vice- president and/or the secretary.

The agenda and relevant papers will be distributed to the members of the executive committee at least one month before the meeting - with a copy for information to the General Secretary of the UEMS.

In dealing with third parties EBPS and its executive committee respect Article 13.111 of the UEMS.

• Article 7 - Voting

The elected representatives of each UEMS full and associate member country have one deliberative vote. Between them this amounts to one vote per country.

The voting procedures described in the UEMS Rules of Procedure of 2.10.87 in Art. 14 and decision rights [Article 15) and speaking rights (Article 16) are to be followed.

For each country the right to vote is subject to the payment of the contribution.

Experts and observers have a consultative status and shall not have voting rights.

• Article 8 - Committees

The EBPS shall establish, apart from the executive committee, other committees, in particular with the remit of education, training, mobility and manpower.

Each committee is elected by the EBPS and describes his own objectives and procedures in a detailed document (by-laws) according to the UEMS statutes and Rules of Procedures. These by-laws must be submitted to the approval of the EBPS.

Each committee shall establish its own executive and shall be responsible for the management of its own finances, subject to the approval of the treasurer of the EBPS.

Each committee is empowered to raise such funds as may be necessary to achieve its objectives. Their annual budgets are, however, part of the EBPS global budget and must be submitted for approval to the Annual General Meeting of the EBPS. They are to be sent to the General Secretary of the UEMS for information.

• Article 9 - Finances

Funds shall be acquired by contributions by national professional associations; subsidies and donations; gifts and other benefits.

Over and above payment of the agreed annual subscription to the monospecialist section for paediatric surgery, a quota can be reserved for the EBPS.

The financial activities of the EBPS are subject to the approval and the control of the treasurer of the EBPS and the monospecialist section for paediatric surgery.

All works performed on account of or on behalf of the EBPS by the UEMS Secretary's office, are to be paid for to the General Secretary, the same as for any work executed for any monospecialist section.

The treasurer of the EBPS will present a budget to the Annual General Meeting for approval, sending a copy for information to the General Secretary of the UEMS.

The accounts of the EBPS shall be audited by an independent committee of two elected delegates appointed annually at the General Meeting.

• Article 10 - Relationship with National Associations

The EBPS will achieve its objectives by setting standards and by encouraging health authorities, national paediatric surgical societies, training institutions, paediatric surgeons in charge of training and trainees to live up to these standards.

The EBPS does not seek any legislative or executive power within countries of the European Union (Article 13 of UEMS Statutes).

The EBPS will be kept informed about national rules and regulations which concern the areas covered by its objectives. Conflicting rules and situations will be registered. The EBPS annual plenary meeting will be the appropriate assembly to discuss such situations and to work out recommendations and amendment procedures.

A synopsis of the training situation in the member states shall be made to the EBPS. It will be submitted to the monospecialist section, that will forward d to the UEMS General Secretary. Such report will serve as a basis for the committee's work in order to reach the comparable high level as required by the EBPS.

No EBPS rule shall be in contradiction with the UEMS Statues and Rules of Procedure and particularly with the working rules of the monospecialist section.

• Article 11 - Amendments, Dissolution and By-Iaws

The procedure for amendment of Statutes and Rules of Procedure and for the Dissolution of the EBPS are identical to those described in Article 14,15 and 16 of the UEMS Statutes.

The executive committee may determine by-laws, which cover subjects which have not been included in these statutes.

A by-law shall not be in violation with the statutes of the EBPS or those of the UEMS.

Accepted by the representatives at the meeting of the monospecialist section paediatric surgery of the UEMS held in Leeds (UK) on the 21^st July 1992. With some minor amendments approved by the executive council of the monospecialist section paediatric surgery in its meeting on 30th January, 1993, in Madrid, Spain.

Members of the examination committee 

Prof Salvatore Cascio (Chairman)

Prof Oliver Munsterer

Prof Udo Rolle

Prof Tolga E Dagli

Prof Lucas Krauel

Prof Alan Mortell

Mr Mohamed Shalaby

Dr Diane De Caluwe

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