1. The Dutch Way since January 1st 2005
The change on that date was quite impressive, it made quality visitations compulsory
Re-registration

2. To become a medical specialist
Follow a training in certified training centers
Pass all your intermediate exams
Get your final positive judgement
Send your paperwork to the MSRC
The usual schedule, nothing special

3. When you are a medical specialist
Your name and credentials are listed public in the BIG register
The MSRC is counting your years as a medical specialist
The MSRC can only count to five
They are told to do so by the CCMS
And when they are almost at five they will send you a bill and a form
The BIG register is explained later on. BIG means Professions in Medicine
MSRC means Medical Specialist Registration Committee
CCMS means Central Council on Medical Specialisms, the CCMS has several registration commissions

4. What to do at 5 to 12? First pay the bill Then fill in the form
Find some evidence
Send in the form with the evidence
5 minutes to twelve is three months before your licence expires
The amount is some € 300

5. What….if you do nothing?
Some minutes after 12 you are not longer the medical specialist you were before 12
So pay the bill and find the evidence!!!!
So the rules are that you have to come into action

6. The evidence that is needed
Have done at least on average 16 hours a week of professional work in your specialty during those previous five years
Have had at least 200 hours of accredited medical education in the previous five years, GAIA.
Have had at least one quality visitation in the previous five years

7. The evidence that will be needed soon
Have participated in one of the two choosen ways of IFMS
About an exam is not spoken up till nowadays

8. Some explanations
CCMS is the council that thinks about the rules of specialist education and training
MSRC is the committee that has checks the work the council invents
GAIA is a highly automated and smart system that counts your CME hours
Quality visitation is a peer to peer judgement, not for university medical specialists
BIG is a law on medical profs
The council has three committees, on clinical medical specialist, on general practitioners, on social medical specialists
GAIA is impossible tot translate, it is a sophisticated webbased system that counts CME credits. All accredited activities are listed in it as soon as the accreditation committee of the DOA accepts an activity. When you visit an activity you register with your BIG number. After attending you not only get a proof of attendance but the hours are added to your account in GAIA. The account is personal but near the five year mark you allow the MSRC to have a close look.
Quality visitations are also on a regular base, every five years or earlier when something is not as it should be. In that way there is almost no chance that an individual specialist will not have his attendance to at least one visitation. The quality visitation is almost 25 years old

9. One more explanation
IFMS is a way of personal evaluation along the seven CanMEDS roles for medical professionals
IFMS is in its starting age

10. So…….
Every five years you will lose a few hundred euro’s and you have to do some administration
The reward is a nice sheet of paper that you have to show every time you change job position
The original certificate of your specialty becomes useless

11. And remember! By doing nothing you will lose your certification.
You only get it back with re-education
And remember!