1. Update of the activities of UEMS-EACCME Dr. Bernard Maillet Secretary General UEMS - EACCME

2. Consulation with other European Medical Organisations : AEMH – CEOM – CPME – EANA – PWG – UEMO Consulation with other European Medical Organisations : AEMH – CEOM – CPME – EANA – PWG – UEMO European Commission EUCouncilEUCouncil EULegislation Decide jointly Prepares & proposes European Parliament The EU institutional triangle (simplified) UEMS political involvement in EU Affairs

3. UEMS Council Meeting Copenhagen, October 2008 Election of a new Executive Election of a new Executive Serbia : application for membership will have to be reviewed Serbia : application for membership will have to be reviewed Start of the implementation of the UEMS Strategy Start of the implementation of the UEMS Strategy Discussion Forum Discussion Forum – Proposed Directive on Cross Border Healthcare – UEMS Resolution

4. Executive 1st January 2009 President : Dr. Zlatko Fras (Slovenia) Treasurer : Dr. Giorgio Berchicci (Italy) Liaison Officer : Dr. Gerd Hofmann (Germany) Secretary General : Dr. Bernard Maillet (Belgium) Vice-President :Dr. Ricard Gutiérrez (Spain) Dr. Romuald Krajewski (Poland) Dr. Zoltán Magyari (Hungary) Dr. Kari Pylkkänen (Finland)

5. Council Meeting Brussels, April 2009 Launching of the ECAMSQ Launching of the ECAMSQ Green Paper on Health care Workforce Green Paper on Health care Workforce Issues concerning some Sections Issues concerning some Sections Curriculum for Emergency Medicine Curriculum for Emergency Medicine Curriculum for Pediatric Surgery Curriculum for Pediatric Surgery Requests for the creation of a Division of « Interventional Radiology » adopted and of « Head and Neck Oncology » rejected by the Council Requests for the creation of a Division of « Interventional Radiology » adopted and of « Head and Neck Oncology » rejected by the Council Report on the EACCME Report on the EACCME European Issues European Issues

6. Council Meeting Istanbul, October 2009 Creation of the ECAMSQ Creation of the ECAMSQ Agreement for a pilot project for an e- platform on Certification (Orzone) Agreement for a pilot project for an e- platform on Certification (Orzone) Issues concerning some Sections Issues concerning some Sections Policy Paper on Emergency Medicine Policy Paper on Emergency Medicine Curriculum for Pediatric Surgery Curriculum for Pediatric Surgery European Issues European Issues New constituency of the UEMS Council : delegates from all Sections as Observers New constituency of the UEMS Council : delegates from all Sections as Observers

7. Sections and Boards Brussels, March 2010 First steps of the ECAMSQ First steps of the ECAMSQ New constituency of the UEMS Council with delegates from the Sections New constituency of the UEMS Council with delegates from the Sections Issues concerning some Sections Issues concerning some Sections Proposal to create an MJC in Oncology Proposal to create an MJC in Oncology Report on the EACCME Report on the EACCME Report on the e-learning Report on the e-learning New application website New application website European Issues European Issues

8. Council Meeting Brussels, April 2010 Cancelled due to the Ash Clouds… Cancelled due to the Ash Clouds… Formal agenda will be moved to the next Council meeting scheduled in Prague on October 8th and 9th 2010 Formal agenda will be moved to the next Council meeting scheduled in Prague on October 8th and 9th 2010

9. Last Council Meeting Prague, October 2010 First edition of the new structure of the Council meeting First edition of the new structure of the Council meeting Length of all elected mandates Length of all elected mandates – 4 years renewable once Organization : Organization : – Standing Committees – Working Groups Update on EACCME and ECAMSQ Update on EACCME and ECAMSQ Issues from Sections and Boards Issues from Sections and Boards

10. UEMS Premises

11. Challenges in the next (close) future Evolution on the Working Time Directive Evolution on the Working Time Directive Revision of the Directive on Mutual Recognition of Qualification in 2012 Revision of the Directive on Mutual Recognition of Qualification in 2012 Implementation of the Directive on Patient Safety in Cross Border Health Care Implementation of the Directive on Patient Safety in Cross Border Health Care Evolution concerning the Green Paper on Healthcare Workforce Evolution concerning the Green Paper on Healthcare Workforce a lot of work for all of us...

12. Revision of the Directive on Mutual Recognition of Qualification Update of the list of specialties Update of the list of specialties Update of the content and length of training Update of the content and length of training Introduction of the concept of “Particular Qualification” Introduction of the concept of “Particular Qualification” – Oncology – Intensive Care – Emergency Medicine – Hand Surgery

13. Recognition of Qualifications New Concept Particular Qualification : Following a basic specialty Can be started from different basic specialties For particular fields of activities Have to be introduced Actual Directive only recognizes Basic Specialties Examples : Oncology, Intensive Care, Emergency Medicine, Sports Medicine, Hand Surgery...

14. European Accreditation Council for Continuous Medical Education Task Force on CME-CPD Task Force on CME-CPD Improvements Improvements – Webbased application form – Agreements with Sections and Boards – Agreements with National Authorities – Contacts with other parts of the world – Contacts with UEMO – Contacts with other Health Care Professionals

15. Webbased application form www.eaccme.eu

16. Different steps : January 15th 2008 : Introduction of a Webbased application form for live events Some start-up problems No solutions to problems Decision to stop with provider February 1st 2010 New website… no problems… continuous improvements…

17. Organiser Request> 3 months UEMS - EACCME N.A.A.Sections Evaluation< 3 weeks Evaluation UEMS - EACCME Certificate of Recognition Organiser

18. EACCME Purpose UEMS policy Contribute to quality and harmonization of CME in Europe To make life easier for our colleagues by easing access to international CME Developing quality guidelines Maintaining national authority

19. Formal Agreements with Sections or European Speciality Accreditation Boards Current : Anaesthesiology Anaesthesiology Child and Adolescent Psychiatry Child and Adolescent Psychiatry Dermatology Dermatology Ear, Nose and Throat (ORL) Ear, Nose and Throat (ORL) Endocrinology Endocrinology Gastro-Enterology Gastro-Enterology Geriatric Medicine Geriatric Medicine Internal Medicine Internal Medicine Medical Biopathology Medical Biopathology

20. Formal Agreements with Sections or European Speciality Accreditation Boards Current : Nephrology Nephrology Neurology Neurology Neurosurgery Neurosurgery Nuclear Medicine Nuclear Medicine Occupational Medicine Occupational Medicine Ophtalmology Ophtalmology Oral and Maxillofacial Surgery - Stomatology Oral and Maxillofacial Surgery - Stomatology Orthopaedics Orthopaedics Paediatric Surgery Paediatric Surgery

21. Formal Agreements with Sections or European Speciality Accreditation Boards Current : Pathology Pathology Physical and Rehabiitation Medicine Physical and Rehabiitation Medicine Plastic Surgery Plastic Surgery Psychiatry Psychiatry Radiology Radiology Rheumatology Rheumatology Emergency Medicine Emergency Medicine Intensive Care Medicine Intensive Care Medicine Sport Medicine Sport Medicine Oncology (ACOE) Oncology (ACOE)

22. Formal Agreements with Sections or European Speciality Accreditation Boards Signed recently : Cardiology (EBAC)25-11-2007 Cardiology (EBAC)25-11-2007 Infectious Diseases (EBAID)13-1-2009 Infectious Diseases (EBAID)13-1-2009 Pneumology (EBAP)17-2-2009 Pneumology (EBAP)17-2-2009 Genetics (MJC) 22-11-2008 Genetics (MJC) 22-11-2008 Vascular Surgery10-4-2010 Vascular Surgery10-4-2010 Surgery Surgery Urology Urology Gastro Enterology Gastro Enterology Pending in the future : Allergology Allergology

23. Formal Agreements with National Accreditation Authorities Current : Spain, Cyprus, Greece, RCSI, Malta, RCPI, Turkey, Slovakia, Norway, Luxemburg, Belgium, Romania, Slovenia, Sweden, Regione Lombardia, Finland, Austria Soon : Czech Republic Near Future : France, Regione Veneto, Regione Frluli… Future : Germany, UK (RCoP), Poland, Portugal, Italy…

24. Agreement with the American Medical Association on Mutual Recognition of Credits Till June 30th 2006 : Pilot project for 2 years each time Pilot project for 2 years each time From July 1st 2006 : Real agreement for 4 years Real agreement for 4 years From July 1st 2010 : Agreement including also e-learning Agreement including also e-learning

25. Agreement with the American Medical Association on Mutual Recognition of Credits Credits granted to events taking place in the United States and approved by an ACCME accredited provider are recognized in Europe Credits granted to events taking place in the United States and approved by an ACCME accredited provider are recognized in Europe Credits granted to events taking place in Europe approved by EACCME can be recognized in the US as AMA PRA Category I ® credits Credits granted to events taking place in Europe approved by EACCME can be recognized in the US as AMA PRA Category I ® credits

26. International Agreements on Mutual Recognition of Credits Other systems : Canada Canada Japan Japan Australasia Australasia South Africa South Africa South America South America Middle East Middle East

27. European CME Credits (ECMEC‘s) CreditsUEMS suggestion Full credits ECMEC’s No weighted factors 1 ECMEC per hour of activity 3 ECMEC for a half day / 6 ECMEC for a full day activity Translation of these E CME C’s to National credits can follow the rules of the National Accreditation Authority For instance : can have a maximum weighting factors can be introduced nationally Translation table

28. Updating of Agreements Spain Financial aspects (fee) Credits translation table 1 ECMEC = 0,12 Spanish Credits

29. Conversion Table SpainSpain 1 ECMEC = 0,12 Spanish Credits BelgiumBelgium 1 ECMEC = 1 CP RomaniaRomania 1 ECMEC = 1 Romanian Credit SwedenSweden 1 ECMEC = 1 Swedish Credit GermanyGermany 6 ECMEC = 8 German Credits

30. Fees Based on a sliding scale Number of participants (expected) Three invoices can be expected : – UEMS – Section – National Accreditation Authority

31. Fees ParticipantsUEMSSectionNAA up till 50 50 €50 €50 € 51 – 250100 €100 €100 € 251 – 500200 €200 €200 € 501 – 1.000 300 €300 €300 € 1.001 – 2.000 400 €400 €400 € 2.001 – 5.000 500 €500 €500 € > 5.000 1.000 €1.000 €1.000 €

32. Future Systematic evaluation of meetings by the participants Systematic evaluation of meetings by the participants Long Distance Learning Long Distance Learning More agreements with the Sections More agreements with the Sections More agreements with the National Accreditation Authorities More agreements with the National Accreditation Authorities Contacts with other parts of the world Contacts with other parts of the world Contacts with UEMO Contacts with UEMO Contacts with other Health Care Professionals Contacts with other Health Care Professionals

33. e-Learning The big project started on April 6th 2009 with the inclusion of e-learning programmes The big project started on April 6th 2009 with the inclusion of e-learning programmes The quality criteria for e-learning material have been revised The quality criteria for e-learning material have been revised Costs of evaluation of e-learning events are different because the workload in assessment is more demanding Costs of evaluation of e-learning events are different because the workload in assessment is more demanding 600 € for the first module and 600 € per next hour 600 € for the first module and 600 € per next hour We do not envisage authorising provider accreditation for e-learning We do not envisage authorising provider accreditation for e-learning

34. Feed-back form for participants Did I learn something Did I learn something Did the meeting change my practice Did the meeting change my practice Was the meeting well organised Was the meeting well organised Quality of content Quality of content Quality of speakers Quality of speakers Was the venue appropriate Was the venue appropriate Did I feel the meeting was biased Did I feel the meeting was biased YesNeutralNo 12345

35. “If you think education is expensive, you should consider ignorance.” Socrates (469 – 399 BC)

36. Specialist Sections* 2 delegates nominated by the national monospecialist association European Boards* 2 delegates per country (Balance profession-academia) Council* Plenary decisions 2 delegates per country Board* Financial matters 1 Head of delegation per country ECAMSQ European Council for Accreditation of Medical Specialist Qualification of Medical Specialist Qualification CESMA WG PGT National Licensing Authorities and UEMS Sections EACCME* European Accreditation Council for CME Governance Council National Accreditation Authorities, ESAB’s, UEMS Sections and UEMS Executive Committee and UEMS Executive Committee EACQM (?) European Advisory Council for Quality Management of Specialist Medical Practice Committees (?) National authorities and UEMS Sections (???) SecretariatBrussels Executive* Daily management President, Secretary General, Treasurer, Liaison Officer + Vice-Presidents (4)

37. Sections and Boards Are a fundamental and specific structure Are the backbone of the UEMS Propose minimal training schemes for specialisation Facilitate the harmonisation of training About 2000 specialists active in the work in Europe

38. Sections and Boards 38 Sections Divisions 7 Multidisciplinary Joint Committees

39. What are Sections and Boards Sections Two delegates of the Specialty from each EU member state Mandated by their National Medical Association Boards Working Group of the Section Delegates from the Section together with representatives of the Scientific Society

40. UEMS Rules of Procedures VI.3. Sections, Membership A. Conditions and procedure of admission The quality of a medical specialist, independently practising is required in order to represent a full or associate Member within the Sections.

41. UEMS Rules of Procedures VI.3. Sections, Membership Each Section includes as members two specialist doctors: - as representatives of each of the member countries of UEMS; - in active practice in the relevant specialty or involved in negotiating on behalf of medical specialists; - competent either in French or in English; - approved by their national professional Organisation, their nominations having been agreed by the national Organisation representing specialist doctors of that country within the UEMS Council. The latter national organisation gives its formal approval and advises the Secretary General of the UEMS by official letter.

42. Emergency Medicine Genetics Hand Surgery Immune Mediated Diseases Intensive Care Medicine Pain Medicine Paediatric Urology Sport Medicine Oncology Multidisciplinary Joint Committee

43. Tasks of Sections and Boards and MJC’s Determine Core Curriculum for training Determine Core Curriculum for training Propose a log-book Propose a log-book Helps in the harmonization of training and qualification Helps in the harmonization of training and qualification Helps in the harmonization of health care services with visitation Helps in the harmonization of health care services with visitation

44. Requirements to enjoy automatic recognition To be recognized in the home country To be recognized in the home country The specialty must be recognized in the host country The specialty must be recognized in the host country The specialty must be listed in the addendum of the Directive 2006/100/EC The specialty must be listed in the addendum of the Directive 2006/100/EC Both countries (host as well as home) must be mentioned in this list Both countries (host as well as home) must be mentioned in this list Alternate solution : individual decision based on portfolio Alternate solution : individual decision based on portfolio

45. Situation for Radiology Radiology is mentioned in the Annex to the Directive 2006/100 and mentioned as Diagnostic RadiologyRadiology is mentioned in the Annex to the Directive 2006/100 and mentioned as Diagnostic Radiology It is recognized as a basic specialty in the 27 Member StatesIt is recognized as a basic specialty in the 27 Member States The minimal length for training mentioned is 4 yearsThe minimal length for training mentioned is 4 years

46. DIAGONSTIC RADIOLOGY Minimum length of training course : 4 years Belgique/België/Belgien Radiodiagnostic/Röntgendiagnose България Образна диагностика Česká republika Radiologie a zobrazovací metody Danmark Diagnostik radiologi eller røntgenundersøgelse Deutschland (Diagnostische) Radiologie EestiRadioloogia Ελλάς Ακτινoδιαγνωστική España Radiodiagnóstico Dir 2006/100 EC

47. Revision of the Directive on Mutual Recognition of Qualification For Radiology Denomination of the Specialty Denomination of the Specialty Update of the content and length of training Update of the content and length of training Introduction of “Particular Qualification” Introduction of “Particular Qualification” – Neuro Radiology – Interventional Radiology – Other ?

48. What is needed for a good (specialist) training Harmonization Clear Definition of Specialties throughout Europe Clear Definition of Specialties throughout Europe Harmonized training program Harmonized training program Log book Log book Decent working conditions for the trainees (income and working times) Decent working conditions for the trainees (income and working times)

49. How to assess Medical Specialists qualifications? Develop harmonised curricula in each specialty Develop harmonised curricula in each specialty Ensure that all Medical Specialists have the same main core competencies in their specialty across Europe Ensure that all Medical Specialists have the same main core competencies in their specialty across Europe Ensure that all member states adopt the curricula and translate them into their national system Ensure that all member states adopt the curricula and translate them into their national system

50. How can we assess PGT Examinations Examinations In training evaluation In training evaluation Visitations Visitations 360° appraisal 360° appraisal

51. Relevant UEMS Policies Charter on Training of Medical Specialists (1993)Charter on Training of Medical Specialists (1993) Charter on Continuing Medical Education (1994)Charter on Continuing Medical Education (1994) The European Training Charter (1995)The European Training Charter (1995) Charter on Quality Assurance in Specialist Practice in the EU (1996)Charter on Quality Assurance in Specialist Practice in the EU (1996) Charter on Visitation of Training Centres (1997)Charter on Visitation of Training Centres (1997) Charter on Continuing Professional Development - Basel Declaration (2001)Charter on Continuing Professional Development - Basel Declaration (2001) Policy Statement on Assessments during Postgraduate Medical Training (2006)Policy Statement on Assessments during Postgraduate Medical Training (2006)

52. History and backgrounds UEMS – established 1958 UEMS Specialist Sections – first created in 1962 Doctors Directives – 75/362/EEC and 75/363/EEC (mutual recognition of diplomas) ACMT and CSOPH – created in 1975 Consolidation of Doctors Directives – Directive 93/16/EC Launch of EACCME Recognition of Professional Qualifications Directive – Directive 2005/36/EC + 2006/100/EC Launch of ECAMSQ

53. UEMS ECAMSQ - Scope To surveysurvey monitor, andmonitor, and assessassess specialist medical education and training for the purpose of accreditation of medical practitioners across Europe. Ensure sufficient experiencesufficient experience education, trainingeducation, training supervisionsupervision assessmentassessment EvaluationEvaluation supportsupport safe working environmentsafe working environment to enable doctors in training to meet the objectives of their training programmes.

54. UEMS ECAMSQ - Aims to invite the NMAs, UEMS S&Bs, and national authorities responsible for accreditation of medical education and training in each of the 27 member states to reach consensus on the core essentials that inform high quality medical specialist education & training programmes,to invite the NMAs, UEMS S&Bs, and national authorities responsible for accreditation of medical education and training in each of the 27 member states to reach consensus on the core essentials that inform high quality medical specialist education & training programmes, to convey the agreed outcome of these deliberations to the European authorities with a view to having these agreed principles formally incorporated into EU legislation,to convey the agreed outcome of these deliberations to the European authorities with a view to having these agreed principles formally incorporated into EU legislation, to offer and ensure the appropriate tools in order to implement the comprehensive process of individual/organisational/institutional PGMST accreditation at the European level.to offer and ensure the appropriate tools in order to implement the comprehensive process of individual/organisational/institutional PGMST accreditation at the European level.

55. European Council for Accreditation of Medical Specialist Qualification (ECAMSQ) “Fusion” of the Working Group PGT of the Council and CESMA Electronic Platform Electronic Platform Certification Certification CME activities CME activities Re-certification Re-certification

56. Council for European Specialist Assessment (CESMA) Initiated by the Section of Pediatric Surgery in February 2007 Initiated by the Section of Pediatric Surgery in February 2007 Started with 11 involved Sections and now 28 are participating Started with 11 involved Sections and now 28 are participating Proposed the “Glasgow declaration” Proposed the “Glasgow declaration” Delegates from the Sections of UEMS and one delegate from PWG Delegates from the Sections of UEMS and one delegate from PWG Harmonization of the Assessment process in Europe Harmonization of the Assessment process in Europe

57. Council for European Specialist Assessment (CESMA) Chairman : Zeev Goldik (Anesthesiology) Chairman : Zeev Goldik (Anesthesiology) Board : John Boorman, Robert Carachi, (Zlatko Fras, Bernard Maillet) Board : John Boorman, Robert Carachi, (Zlatko Fras, Bernard Maillet) Next meeting : November 20th 2010 in Brussels Next meeting : November 20th 2010 in Brussels Exams have no legal value but can help in portfolio Exams have no legal value but can help in portfolio

58. Council for European Specialist Assessment (CESMA) Negotiations have been started with American Board of Medical Specialties to have a kind of mutual recognition over the Atlantic Ocean

59. UEMS Working Group on Post Graduate Training Chairman : Dr. Hans Helmqvist Chairman : Dr. Hans Helmqvist Rapporteur : Dr. Umut Akyol Rapporteur : Dr. Umut Akyol Dr. Zlatko Fras is very much involved as past Chairman Dr. Zlatko Fras is very much involved as past Chairman Wide representation Wide representation

60. UEMS Working Group on Postgraduate (Medical Specialist) Training HARMONIZATION of various aspects of Medical Specialist Training in Europe Access to training Access to training Curricula - Chapter 6 (UEMS Charter PGT) Curricula - Chapter 6 (UEMS Charter PGT) Quality of training – provisions on trainees & trainers, quality indicators, monitoring and visitations Quality of training – provisions on trainees & trainers, quality indicators, monitoring and visitations Certification Certification Recognition of qualifications Recognition of qualifications

61. Glasgow Declaration 1.European Board Examinations have no Legal Value 2.European Board Examinations is complimentary to National Examinations 3.Promotion of the European Examinations 4.To be considered as a Label of Excellence 5.Clear Curriculum and Reference Book 6.Clear Eligibility criteria 7.Certificates for successful application

62. European Examinations AllergologyAnaesthesiologyCardiologyDermatology Ear, Nose and Throat Hand Surgery Internal Medicine NeurologyNeurosurgery Nuclear Medicine Ophthalmology Oral & Maxillofacial Surgery

63. European Examinations Orthopaedics and Traumatology Paediatric Surgery PathologyPaediatrics Pediatric Surgery Physical Medicine and Rehabilitation Plastic, Reconstructive and Aesthetic Surgery RadiologySurgeryUrology Vascular Surgery

64. knowledge skill attitude = COMPETENCE Doctor… Competence based education/training....

65. What competences to assess? Knowledge: Knowledge: test the knowledge of the trainee mainly through MCQs developed by UEMS members according to the highest standards of medical education test the knowledge of the trainee mainly through MCQs developed by UEMS members according to the highest standards of medical education Skills: Skills: assess the practice of medical specialists focusing on technical and non technical skills through real life training, and assessment, risk-free training… assess the practice of medical specialists focusing on technical and non technical skills through real life training, and assessment, risk-free training… Professionalism: Professionalism: Assess the “non technical” attitudes of trainees such as decision making, communication, leadership.... Assess the “non technical” attitudes of trainees such as decision making, communication, leadership....

66. European (Re-)Certification : How Should it Work ? Professionalism Skills Knowledge

67. European (Re-)Certification : How Should it Work ? Professionalism Skills Knowledge Structured curriculum including building blocks of theoretical knowledge, i.e anatomy, physiology and pathology. Trainee can gain and demonstrate knowledge through regular formative and summative assessments. Tools: curriculum, educational content, MCQ´s

68. European (Re-)Certification : How Should it Work ? Professionalism Skills Structured approach to become proficient. Focus on technical and non-technical skills. Instructions for real life training and assessment. Simulation may provide risk-free training and objective assessment. Tools: curriculum planner, e-logbook, assessment (DOPS), simulations

69. European (Re-)Certification : How Should it Work ? Professionalism Decision making, communication and leadership are core competencies for Medical Specialists. Continuing Medical Education (CME) and Continuing Professional Development (CPD) are generally accepted performance metrics for professionalism. Multidisciplinary team training in realistic environment allows Medical Specialists to train and be assessed by colleagues. Reflection upon outcome, the trainee is likely to improve behaviour and attitudes. Tools: log of CME/CPD, assessment using multi-source feedback (360° Appraisal), scenario based simulation training and assessment

70. Project of e- platform Pilot project for 2 years Involving 3 UEMS Sections AnesthesiologyCardiologyRadiology After the pilot project : Evaluation of the outcomes Extension to ALL UEMS Sections and Boards and MJC’s

71. Structure for the project Management Board Equal representation of UEMS and Orzone Project Teams One for each specialty With appointed representatives of the relevant UEMS Section and members of the Management Board sitting “ex officio” e-Platform Steering Committee All Project Teams together with UEMS and Orzone

72. Milestones for the project April 2010 Finalization of the Framework for the Curriculum July 2010 Finalization of the Question Bank for the MCQ’s October 2010 Pilot Assessment for the 3 UEMS Sections simultaneously Kind of PR event 8 locations About 200 candidates for the first assessment

73. Conclusion Conclusion Tackling medical specialists qualification by ensuring the highest standards of quality of care through harmonised medical competences Tackling medical specialists qualification by ensuring the highest standards of quality of care through harmonised medical competences European assessment and certification of medical specialists European assessment and certification of medical specialists Ensuring the free movement of healthcare professional Ensuring the free movement of healthcare professional The added value of ECAMSQ

74. “Vision without action is a daydream. Action without vision is a nightmare.” Anonymous “Point n’est besoin d’espérer pour entreprendre Ni de réussir pour perséverer” Guillaume d’Orange

75. Thank you Merci Muito obrigado Vielen Dank Grazie mille Muchas gracias Tack Dank U Kiitos ευχαριστώ сбасиво Dakujem Dekuji Köszönöm Go raibh maith agaibh Ginkuje Grazzi Multamesc Takk Благодаря Dėkoju Gracies Faleminderit Hvala Teşekkürler Paldies

76. U.E.M.S. Union Européenne des Médecins Spécialistes European Union of Medical Specialists www.uems.net

78. Objectives Individual certification of medical specialists’ competences Individual certification of medical specialists’ competences Harmonisation of Medical Specialists qualifications across Europe Harmonisation of Medical Specialists qualifications across Europe Harmonisation of existing European Assessment of Medical Specialists qualifications Harmonisation of existing European Assessment of Medical Specialists qualifications

79. Who is concerned? Medical specialists in training: From the beginning of their training period as specialist From the beginning of their training period as specialist Medical specialits in activity Evaluate trainees according to the highest standards of quality Evaluate trainees according to the highest standards of quality