Curriculum training pulmonology in The Netherlands

Training in a quick glance 2 years of internal medicine 1 year ward 4 months cardiology 2 x 4 months other subspecialties 4 years of pulmonology

4 years in pulmonology – various internships 1 year pulmonology ward 1 year out door patient clinic (preferably throughout the 4 year training period) Interventions 4 months (continuously throughout the 4 year training period, for example 1 morning in the week) Lung function, sleep disordered breathing 4 months Intensive care 4 months Consultations at internal, neurology wards 3-6 months Consultations at surgical wards 3-6 monts Facultative – 6 months (scientific subject, lung rehabilitation center, and so on)

The end terms ~ comparable with HERMES  Divided in themes/topics Dyspnea analysis Hemophtisis analysis Thoracic pain analysis Chronic cough analysis Asthma COPD Pneumonia Recurrent lower airway infections

The end terms ~ comparable with HERMES  Divided in themes Tuberculosis Thoracic oncology Interstitial lung diseases Occupational lung diseases Intensive care Pleural diseases Lungfunction

The end terms ~ comparable with HERMES  Divided in themes Repiratory allergology Sleep disordered breathing Mediastinal pathology Vascular pathology

Relationship Internship - Theme

Individual training programme

Interventions

Formal education (not in the ‘clinic’) At a national level (infections, oncology, immunology, and so on) – 10 days a year At a regional level – 3 days a year At a local level – 2 days per month Examination in radiation hygiene (level 4 A/M  to be able to safely use fluoroscopy (2-4 days) Emphasis in training is on training on the workfloor

How is the progress of a trainee followed? 10 times a year a mini CEX 10 times a year OSATS 10 times a year BSTAT 10 times a year judgment of patient correspondence to GP 3 times CAT 3-4 times 360 degree feedback Yearly HERMES exam 1 scientific paper / presentation (national scientific meeting or internationally) Mini clinical examination exercise

Judgment on the 7 CANMEDS skills Medical expert Professional Scholar Communications Collaborator Manager Health advocate

Longitudinal evaluation

An overall picture of the level of competences of one individual trainee

Results aggregated in (electronic) PF 2 times yearly feedback session with trainee Targets met? New targets set 1 time yearly a formal go or no go judgement