UEMS and Clinical (Medical) Microbiology in Europe
When the European Union was founded and as a result the Union Européenne des Médecins Spécialistes (UEMS) was established in 1958, within this organisation a Specialist Section of Laboratory Medicine was created in 1962. In 1992 this Section was renamed Medical Biopathology and under this umbrella of diagnostic specialties a sub-discipline of Medical Microbiology was formed. This was well accepted at the time when microbiology was a small specialty and practiced together with clinical pathology in the majority of the six member states (Belgium, France, Germany, Italy, Netherlands, Luxemburg). This picture has changed dramatically in the following decades when many other countries joined the EU, in which medical microbiology had been recognized as a full specialty since many years.
In the mean time microbiologists in the UEMS had concentrated themselves on formulating the profile of the specialty and terms for training. In 1996 the eight main tasks of the specialist were defined during a Section meeting in Helsinki. These tasks (see table 1) are the backbone of the ensuing training programme and the detailed logbook.
Because of the fact that the status of medical microbiology was inconvenient for the traditional delegates and incomprehensible for the new members in the EU family a plea was made in the direction of the UEMS Council to become an independent Section and a fully recognized specialty. Because the requirement was fulfilled that 18 of the 27 member states, which is more than one third of the countries, were recognizing medical microbiology as a full specialty, and after a voting procedure of the Council, a new Section was born on April 19th 2008 in Brussels. According to EU directives the Section is named the Section of Medical Microbiology (1, 2, 3).
During the first official meeting of the Section it was realized that tasks and practices in the specialty of medical microbiology may partly overlap with activities as performed by specialists in infectious diseases and the group of specialists trained in general laboratory medicine with sub-specialisation in microbiology. These professions are represented in the Section of Infectious Diseases and in the Section of Medical Biopathology. Ways have to be found to communicate with these specialists, e.g. by delegating observers by each Section to the other Section.
According to UEMS Chapter on Training of medical Specialists in the European Community (4) the training programme and the logbook have to be implemented and standards and assessment of the quality of training centers and trainers have to be developed. Very recently agreement on the requirements for the specialty of Medical Microbiology has been reached by the delegates in the Section. The draft of a UEMS Chapter 6 containing these requirements for a five year training program has been submitted for scrutiny to the UEMS Council and brought on the agenda of the Council meeting on October 8 2011 in Naples (5). During this meeting the document was accepted unanimously by voting by the representatives of National Medical Associations of the EU member countries, of which the majority was present.
During the meeting of the ESCMID Professional Affairs Workshop in Rome on October 9th 2008 a proposal was presented for modernizing the training programme for clinical microbiology including the CanMEDS competence based model (6). The CanMEDS model defines seven competences which are applicable to any practicing medical specialist (see table 2). For implementing such a model it will be needed to define more in detail the main themes in the specialty of clinical microbiology (see fig. 1). The next step will be to create a matrix format in which competences and specialty specific themes can be detailed. In parallel a scheme should be made in which can be shown how an assessment of theme specific competences can be made between trainer and trainee.
In a number of countries experience has been gained at different levels with such an approach. The UEMS Section of Medical Microbiology will explore the possibilities of implementing this model on a broader scale. According to the UEMS Chapter 6 document a Central Monitoring Authority has to be established, which will lay down and monitor general standards for specialty recognition and quality assessment, including developing a European exam. Since all begins with defining the standards for training, the Section will focus on a modern training model in the first place. ESCMID and the Section of Medical Microbiology could very well be partners in the Central Monitoring Authority to be.
An inquiry in the training in the different main fields of clinical and scientific interest in microbiology (see fig. 1), held in 2010, revealed that , although these fields are generally covered, the differences in time spent for training are showing a wide variety in the different EU countries. A long but important way to go in order to achieve our common goal in Europe is still laying ahead of us.
Further information can be found on the Section’s website.
ESCMID News 2007; issue 2: 14-17
ESCMID News 2007; issue 3: 10-12
ESCMID News 2008; issue 2: 23
UEMS Charter on Training of Medical Specialists in the European Community, October 1993
UEMS Charter on Training of Medical Specialists in the EC-Medical Microbiology, Naples, October 2011