1 Obstetrics and gynaecology training in Europe needs a next step 2 Fedde Scheele Q1 a, b, c, *, Ziva Novak a, b, d , Klaus Vetter a, e , Nicolette Caccia a, f, g , 3 Angelique Goverde a, b, h 4 a European Board and College of Obstetrics and Gynaecology, Q2 Standing Committee of Training and Assessment, The Netherlands 5 b European Board and College of Obstetrics and Q3 Gynaecology, Training the Trainers Working Party, The Netherlands 6 c Health Systems Innovation and Education VUmc University Medical Centre, Amsterdam, The Netherlands 7 d Obstetrics and Gynaecology, Slovenia 8 e Humboldt Universität, Berlin, Germany 9 f Department of Obstetrics & Gynecology, Q4 University of Toronto, Toronto, Canada 10 g Department of Obstetrics & Gynecology, McMaster University, Hamilton, Canada 11 h Department of Reproductive Medicine and Gynaecology, University Medical Center, Utrecht, the Netherlands A R T I C L E I N F O Article history: Received 8 February 2014 Accepted 8 April 2014 Keywords: Medical education Training Specialists Europe Competencies EBCOG A B S T R A C T Changing societal demands on doctors necessitate changes in the training of gynaecologists. Adapting this training will need well-thought-out and comprehensive planning that addresses the needs of the major stakeholders: society, patients, and doctors themselves. Doctors need to be cognizant of societal issues such as rapidly rising healthcare costs and budgetary crises, and be able to Q6 participate in the solutions. This demands effective medical leadership, which has been a neglected area in postgraduate training. It has become increasingly evident that a holistic view of the patient rooted in proper teamwork and systems-based practice is essential to provide patient-centered care. Specialists need to expand their skill set to participate in this kind of care. Furthermore, the feminisation of the medical profession and a new generation of doctors rejecting the constraints of the traditional model of medical care introduce new professional perspectives. This manuscript briefly reviews the challenges faced in the training of European gynaecologists in an effort to provoke discussion about how to best train the gynaecologists of the future. ã 2014 Published by Elsevier Ireland Ltd. 12 Introduction 13 The European Board and College of Obstetrics and Gynaecology 14 (EBCOG) does an important work in creating European standards 15 and in harmonising a high level of training for obstetricians and 16 gynaecologists all over Europe. With the objective ‘to improve the 17 health of women and their babies by promoting the highest 18 possible standards of care in all European countries’, ‘ . . . we 19 accredit training centres in OBGYN and in the subspecialties, have 20 produced logbooks and training curricula, again both in general 21 OBGYN and in the four subspecialties, and are currently focusing 22 on developing common European standards’ [1]. 23 The aim of this manuscript is to provoke the discussion about 24 the evolution of European training. Modernization of postgraduate 25 training is being initiated in most countries using a competency 26 framework, such as the British GMC framework, the Scottish 27 Doctor [2], the Canadian CanMEDs [3] or the American ACGME. 28 There are significant similarities among these frameworks, and the 29 specifics of the frameworks are all easily accessible on the internet. 30 Modern curricula combine clinical experiences [4] involving 31 simulation training of both technical skills [5] and effective and 32 safe teamwork [6]. Direct observation with formative feedback 33 plays an important role in directing training. Access to the 34 theoretical aspects of the practice of medicine is an evolving 35 process facilitated by classic journals, internet sources and specific 36 courses fostering ‘just in time learning’. In addition to the use of 37 these competency frameworks and more comprehensive training 38 methods, sophisticated programs for workplace-based assessment 39 have been designed [7,8]. ‘Entrustment of professional activities’ 40 [9] as a summative endpoint, has been embraced by many 41 designers of training programs (curricula) and many curricula 42 incorporate quality improvement programmes [10]. 43 Competency frameworks introduce the paradigm of system- 44 based practice [11], in which the gynaecologist is a member of a 45 health network serving the needs of the community. This health Q7 46 network is subjected to the direction of a higher order * Corresponding author at: Department of Obstetrics and gynaecology, Q5 St. Lucas Andreas Hospital, Jan Tooropstraat 164, 1071GC, The Netherlands. Tel.: +31 615640929. E-mail addresses: f.scheele@slaz.nl, fedde.scheele@gmail.com (F. Scheele). http://dx.doi.org/10.1016/j.ejogrb.2014.04.014 0301-2115/ ã 2014 Published by Elsevier Ireland Ltd. European Journal of Obstetrics & Gynecology and Reproductive Biology xxx (2014) xxx–xxx G Model EURO 8529 1–3 Please cite this article in press as: Scheele F, et al. Obstetrics and gynaecology training in Europe needs a next step. Eur J Obstet Gynecol (2014), http://dx.doi.org/10.1016/j.ejogrb.2014.04.014 Contents lists available at ScienceDirect European Journal of Obstetrics & Gynecology and Reproductive Biology journal homepage: www.elsevier.com/locate/ejogrb