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Education and training in gastroenterology. Report from the OMGE symposia at the International Congress of Gastroenterology, Lisbon, Portugal, September 1984, and at the 8th World Congress of Gastroenterology, São Paulo, Brazil, September 1986.

Gastroenterology is recognized as a speciality in most countries, especially in Europe and North America. The requirements for being acknowledged as a specialist vary from 1 1/2 to 4 years of training and education in gastroenterology in addition to 1-6 years of training and education in internal medicine/surgery. The requirement of theoretical education varying from 40 to 300 h is practiced in some countries only. In some countries training in endoscopy is separated from gastroenterology. A formal examination and post-specialization training program is required in only some of the countries answering the questionnaire. The number of centres per million inhabitants recognized for training and education also varied greatly. The number of specialists per million inhabitants was 3.6 to 15. In the Middle and Far East the organisation of gastroenterology was much inferior to that in Europe and North America because of insufficient education and organization programs and lack of economic support to perform them. The answers from the gastroenterological associations and personal reporters agreed on the following: A speciality in medical and surgical gastroenterology should be established in all countries around the world. Programs for training and education should be agreed upon in recognized teaching and training institutions of gastroenterology, probably of 3 years' duration in combination with a speciality in internal medicine. A gastroenterologist will in most cases be dealing with other diseases as well. The number of specialists per million inhabitants may be estimated to 10, the exact number not being possible to determine at present. In most countries the post-specialization programs were not required but were offered, a problem that has to be clarified.(ABSTRACT TRUNCATED AT 250 WORDS)

Congresses as Topic↗

Career prospects in medical gastroenterology in the United Kingdom. A report prepared for the Committee on Gastroenterology of the Royal College of Physicians (London).

There are about 270 physicians with a special interest in gastroenterology distributed throughout the United Kingdom; most of them (91%) are members of the British Society of Gastroenterology. Two-thirds of these physicians regard their post as that of general physician with a special interest in gastroenterology and a quarter as general physician. Very few physicians (nine) practise gastroenterology alone. Most physicians devote between three and six sessions to gastroenterology; this time is divided between inpatient care, outpatient consultation, and endoscopy in roughly equal proportions. Most physicians spend one to two sessions performing endoscopy. Nearly all district general hospitals, except the smallest with a staff of two or three physicians, have a physician with a special interest in gastroenterology on their staff. Some district general hospitals and most university hospitals have two such physicians. The number of likely consultant vacancies by retirement on grounds of age is small in the next five years (14) and then rises progressively, reaching about eight per annum in 1991-95 and more than 10 per annum thereafter. There are about 90 trainees of senior registrar status who aspire to a career as consultant physician with a special interest in gastroenterology, or an academic career in gastroenterology, distributed throughout the country. There are also eight trainees of senior registrar status who wish to obtain a post as general physician with gastroenterology as one of two or more special interests. There are known to be about 70 trainees of registrar status who wish to train in general medicine with a special interest in gastroenterology and another 24 who wish to make gastroenterology one of their special interests.

Career Mobility↗

Specialist training in gastroenterology in the European Community: the case for European boards. European Board of Gastroenterology.

Gastroenterological training differs so greatly from country to country in Europe it is impossible to believe that training is equally good in each one. This in turn, provides a barrier to the free migration of doctors with the European Community. These differences also create confusion for migrating patients, and call into question the validity of the European Commission directives, which pronounce all qualifications obtained in European Community countries to be equally acceptable within the community. The European Commission does not have the power to unify medical training, but the medical profession itself acting in concert as a European body could harmonise the differences to ensure acceptable standards of training across the community. The Union of European Medical Specialists (UEMS) is the representative body of national medical specialists bodies, which reports to the European Commission. The European Board of Gastroenterology, a working party of the Gastroenterology Section of the UEMS has agreed acceptable and fair standards of training for gastroenterologists, and has developed a system for external assessment of training centres and faculty. All three, candidates, faculty, and centre would, in the event of a successful application, be awarded the European Diploma of Gastroenterology or, in full, the Diploma of Recognition of Quality of Training in Gastroenterology. This paper discusses these problems, some of their origins, and the proposals of the European Board.

Education, Medical, Graduate↗

[25th anniversary of the Gastroenterology Society of East Germany. III. Organization of the sub-specialty gastroenterology].

The designation of "gastroenterology" was coined in 1896 by Hemmeter. In this article, the foundation of the first gastroenterological societies in the USA, in Japan, and in Poland is reported; the foundation of international societies of this specialty is mentioned too. The establishment of gastroenterological journals in Japan and in France is pointed out. Finally, the arrangement of the governmental acknowledgement of the sub-specialization in gastroenterology in the German Democratic Republic is described.

Gastroenterology↗

Fifty landmark discoveries in gastroenterology during the past 50 years. A brief history of modern gastroenterology at the millennium: Part I. Gastrointestinal procedures and upper gastrointestinal disorders.

During the last half century, many outstanding discoverers have revolutionized the clinical practice and science of gastroenterology. Whereas the scientific results are widely disseminated, the discoverers have received inadequate recognition, and the history of their discoveries is poorly known. At the millennium, a committee selected the 50 landmark discoveries in gastroenterology during the past 50 years. A brief history of each landmark discovery is presented. Part I presents the landmark discoveries in gastrointestinal (GI) procedures and in upper GI disorders. Part II of this presentation, which covers landmark discoveries in other areas of gastroenterology, will publish in Part II of the volume on High Risk Gastrointestinal Bleeding.

Gastroenterology↗

Fifty landmark discoveries in gastroenterology during the past 50 years. A brief history of modern gastroenterology at the millennium: Part II. Gastrointestinal motility, nutrition, and diseases of the lower gastrointestinal tract, liver, and pancreas.

During the last half century, many outstanding discoveries have revolutionized the clinical practice and science of gastroenterology. Although the scientific results are widely disseminated, the discoverers have received inadequate recognition and the history of their discoveries is largely unstudied and unknown. At the millennium, a committee selected 50 landmark discoveries in gastroenterology during the past 50 years. A brief history of each landmark discovery is presented. Part I was presented in the previous issue of Gastroenterology Clinics of North America. Part II presents landmark discoveries in gastrointerintal (GI) motility, clinical trials, nutrition, and diseases of the lower GI tract, liver, biliary tree, and pancreas.

Endoscopy, Digestive System↗

The impact of health care reform on gastroenterology fellows: are training programs preparing them for the future? American College of Gastroenterology Educational Affairs Subcommittee on Training.

OBJECTIVE: Health care reform is dramatically changing the practice and delivery of medical care. The goal of this investigation was to examine gastroenterology trainees' outlook on the impact of health care reform on training programs. METHODS: A 24-question survey was mailed in February 1996 to 780 GI fellows obtained from the comprehensive American College of Gastroenterology (ACG) database. RESULTS: A total of 362 fellows responded (46%): 85% were male, 57% Caucasian, 75% married, and 86% were university-based. Ninety-six percent of fellows believed that health care reform is adversely affecting the quality of health care and 94.1% felt that it was adversely affecting fellowship training. Eighty-eight percent expressed concern over the impact of health care reform on practice opportunities. Only 9% of fellows reported that their training program had established a specific educational program addressing health care reform, whereas 83% of fellows felt that their program should do so. CONCLUSION: Gastroenterology fellows are concerned about the impact of health care reform on the quality of care and the quality of their fellowship training. Trainees believe that programs are not providing sufficient education to help them respond to the changes in health care.

Education, Medical, Graduate↗