1. Development of a Curriculum of Orthopaedics and Traumatology
What is new in Austria?
Development of a Curriculum of Orthopaedics and Traumatology
Stefan Nehrer
Krems, Austria

2. Austria 2014 Austria: 8 Mio inhabitants
Austrian Society of Orthopedic Surgery
800 active members
Austrian Society of Traumatology (Unfallchirurgie)
1600 active members

3. A. Lorenz, founder of Orthopedic Surgery in Austria (Vienna)

4. Orthopaedics / Trauma/Unfallchirurgie A. Lorenz/ L. Böhler

5. Orthopaedic and Traumatology
Revision of educational system was proposed 2012 by ministry of health and medical board
ASOS prepared a new curriculum in Orthopaedics
By March 2013 we were informed to merge Orthopaedic and Traumatology (Unfallchirurgie)
Both societies agreed to form a new speciality: Orthopaedic and Traumatology
The new specialisation starts July 2015

6. European Educational Plattform
General Considerations
Syllabus
Assessment

7. Name of the specialtiy: Orthopaedics and Traumatology

8. Name of the specialtiy: Orthopaedics and Traumatology

9. Name of the specialtiy: Orthopaedics and Traumatology

10. Proposal for name of the speciality: Orthop(a)edics and Traumatology

11. Scope for the workforce for Health

12. Population projection 2008-2060

13. Scope and definition of the specialisation (EFORT EPF)
The specialty of orthopaedics and traumatology involves prevention, diagnostics (including imaging techniques), conservative, pharmacological and surgical, treatments, the treatment and rehabilitation of degenerative, inflammatory, infectious, metabolic and neoplastic pathologies as well as the management of acute and chronic musculoskeletal trauma and posttraumatic conditions. Furthermore it encompasses contributions to the multidisciplinary management of congenital and acquired deformities and functional disorders at any age. Fundamentals of basic science, including applied biotechnology, evidence based medicine and ethics should underpin the educational process

14. Focus and Scope of the Speciality (A) Orthopaedic and Traumatology
The speciality of orthopaedic and traumatology comprises prevention, diagnostics- including radiological techniques-, surgical and non surgical / pharmacological treatment, follow-up and rehabilitation and specific reports of degenerative, inflamatory, metabolic and neoplastic pathologies as well as injury and trauma of the locomotor system and posttraumatic conditions and congentital and aquired malformations and deficiencies and functional disorders at any age on basis of scientific knowledge and evidence levels.

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Residency NEW - duration
(D) Specialization: Level 4
Additional Training for specialists
(C) Further module 3: 9 months
1 year 6 months
(C) Further module 2: 9 months
Specialists in training
(C) Further module 1: 9 months
(A+B) general education : Level 3
5 years 3 months (=63 months)
3 years 9 months (=45 months)
(A+B) general education: Level 2
(A+B) general education: Level 1
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17. Ortho/Trauma Education Levels of competence 1-4 Level 1 knowledge, Level 2 experience, Level 3 skills Level 4 specialist
Internship: General medical competence
Basic education: Level 1-3
Basics and Concept of orthopaedics and traumatology
Modules: Level 3
Fractures and Osteosynthesis, Joint Surgery-Endoprosthesis and Arthroscopy, Orthopedics and Traumatology Spine, Hand and Foot Surgery, Pediatric Ortho/Trauma
Specialisation / Fellowship Level 4
Tumor, Sports, Rheuma, Pediatrics, Polytrauma, Spine, Foot, Hand, Joint reconstruction, Conservative Treatment, Pain treatment, Rehabilitation

18. Knowledge, Experience, Skills, Attitude
Surgical skills
Conservative skills
Skills
Diagnostics
Experience, Attitude
Knowledge
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19. Educational Modules- Austria

20. Educational Modules Austria

21. Syllabus

22. Residency (Level 1 – 3) – Specialisation (Level 4)

23. Orthopaedic/ Traumatology
New curriculum needs new structures !
Traumatology has twice as much resources as orthopaedics
Orthopaedic demands increase, traumatology decreases
Treatment of the locomotor system includes operative and conservative treatment
Emegency surgery should be interdisciplinary approach by surgical speciality and anethesiology
Transition of systems is difficult
European Curriculum as a template is helpful
Final Exams on European level. EBOT- MCQ
UEMS/ EFORT educational platform

24. ROT = UC
BLAU = OR

25. OR/UC OR/UC% Amount of interventions
Interventions on nervous and fascia –
21,557
49%
Athroscopy -
49,454
76%
Reconstructive sugery-
8,590
78%
Osteotomy-
535
84%
Osteosynthesis-
53,283
79%
Resections-
6,855
60%
Endoprosthetics-
36,282
85%
Amputation -
312 8%
Others- specialisation
Spine –
10,954
38%
Shoulder, elbow, upper limb -
11,756
82%
Hand, forearm -
8,487
Pelvic, hip, knee -
11,304
Foot, lower leg -
9,010
66%

26. Vienna

27. Expected end of training
Training will be completed in respective specialization
Change into new specialization is possible
Training only can be completed in new specialization

28.  Beginning of new training
New specialization
New specialization
New specialization
New specialization
New specialization
Change into new specialization
Change into new specialization
Change into new specialization
New specialization
Old specialization
New specialization
New specialization
Change into new specialization
Change into new specialization
Old specialization
Old specialization
Old specialization
Old specialization
Old specialization
Old specialization
 Beginning of new training
 Beginning of „new“ specialist examinations
 Beginning of further modules?
Old specialization:
Old training regulations
Old syllabus
Old specialist examination
Transitional rules:
22,5 months into „old“ specialization
3x9 months further module respective new training regulations
Accomplish the training content including Richtfallzahlen respective new training regulations
New specialist examination
New specialization:
New training regulations
New syllabus
New specialist examination

29. Replacement of departments
Transitional rules for finished specialists
22,5 months into “old” specialization
3x9 months further modules respected new training rules
Accomplish of case numbers respected new training rules
New specialist examination
Replacement head of departments :
OR-departments: orthopaedic specialists
UC-departments: specialists for trauma surgery
Replacement head of departments:
Direction through specialists for „Orthopaedic“ or „trauma surgery“
Establishment of a deputy direction out of the respectively other specialization
Replacement head of departments :
Direction through a specialist for Orthopaedics and traumatology

30. Overview: future scenario
Key:
Hospital
Polytrauma-center for seriously injured
university hospital for orthopaedics and traumatology
key-departments for orthopaedics and traumatology
department for orthopaedics and traumatology
displaced unit for orthopaedics and traumatology

31. ROT = UC
BLAU = OR

32. Assessment throughout European Orthopaedic Residency
Language ?

33. Problems/ Solutions
Can we agree on an european standard of a curriculum in Orthopaedic/ Trauma Specialisation?
Is the concept of an Orthopaedic (Bone and Joint) Surgeon with trauma competence appropiate?
How can we evaluate progress in education?
Logg-book, intraining exams, final exam-oral and clinical cases, surgical skills, conservative skills, attitude
Frame Curriculum as basis of an European specialist in Orthopedic/Traumatology

34. Postgraduate Programes in Cooperation with Austrian Orthopaedic Society and the Danube University

35. Exam: Orthopedic Surgeon
Residency Programe
Residency programe of Department
Orthopedic Surgeon MSC
Orthopedic Surgeons
Danube University
Modul 1-5
Modul 1-5
Modul 6-8
Masterthesesis +
Exam: Orthopedic Surgeon
MSC Orthopaedic