European networks
BMJ 2009; 339 doi: https://doi.org/10.1136/bmj.b4011 (Published 22 October 2009) Cite this as: BMJ 2009;339:b4011
- Shreelata Datta, specialist registrar in obstetrics and gynaecology1,
- Anni Innamaa, specialist registrar in obstetrics and gynaecology and ENTOG representative for the Royal College of Obstetricians and Gynaecologists trainees’ committee 2,
- Gloria Esegbona, specialist registrar in obstetrics and gynaecology3
- Correspondence to: S Datta statta{at}doctors.org.uk
Abstract
Shreelata Datta and colleagues look at cross-European interest groups and give their experience of the European Network of Trainees in Obstetrics and Gynaecology
The principles laid down in the 1975 European Medical Directives aimed to harmonise and improve the quality of higher medical specialist practice in Europe.1 This was reiterated by the charter produced by the European specialists’ organisation.2 Despite this, major differences remain in clinical and training practices across Europe.3 There has been a tradition of doctors creating organisations on a European scale to try to achieve high and comparable standards of specialist medical training.4 This has the benefit of providing trainees with the opportunity to train to equal standards within any European country. The table gives some examples.⇓
ENTOG
The European Network of Trainees in Obstetrics and Gynaecology (ENTOG) was formed in 1997 and is the only body representing the professional interests of obstetrics and gynaecology trainees within Europe that is run by trainees and young gynaecologists. The creation of this network has been an important step in developing collaboration between European trainees in obstetrics and gynaecology.
ENTOG is a non-governmental, independent, non-profit organisation and currently has 29 member states. It has an elected executive council that consists of five members voted in by all of the member states. All European countries are welcome to become members of ENTOG, but a prerequisite is that the country must have a national trainees’ committee.
One of the key aims of ENTOG is to promote the creation of trainees’ networks and committees in all European countries. It also promotes exchange and interaction between trainees of the various member countries, aiming to standardise clinical practice where possible and improve training to comparable standards in all countries in Europe. ENTOG has recently set up a long term exchange programme to encourage movement of trainees in obstetrics and gynaecology within Europe.
Setting up an overseas rotation can be fraught with difficulties, but ENTOG has taken on part of this responsibility and created a forum where trainees and interested departments can meet, thus facilitating the organisation of exchange programmes.
ENTOG works in close collaboration with its senior partner, the European Board and Congress of Obstetrics and Gynaecology, and is represented in their most important standing committees. The board represents senior consultants in obstetrics and gynaecology in matters concerning the training and education of trainees. ENTOG also has links with other European junior, senior, and international societies.
Attending the exchange programme and conference
One of the core activities of ENTOG is to organise an annual five day exchange programme to a European country. More than 15 ENTOG meetings have taken place so far, including Portugal in 1993, Germany in 1994, Greece in 1997, Italy in 1999, Czech Republic in 2002, Slovenia in 2004, and Hungary in 2009.
The exchange allows trainees to experience different clinical practice to that in their own countries and is followed by the European Meeting of Trainees in Obstetrics and Gynaecology. The meetings are organised by trainees in obstetrics and gynaecology and the topics cover current training issues and innovations.
Two places funded by the Royal College of Obstetricians and Gynaecologists travel award are available annually for UK graduates, although the annual ENTOG conference can be attended by any trainee. To qualify for the travel award a trainee must show an exceptional level of commitment to improving training in obstetrics and gynaecology and must be at specialty training year 3 level or above.
Hungary 2009: an exchange participant’s view
As well as experiencing a different clinical climate during my exchange in Hungary, I also gained an insight into different ways of working, the mechanics of the department and hospital, and the structure of training. I went to a department where all the doctors were male, Caucasian, and in white coats, and with many more doctors per patient than in the UK. My exchange lead met me at the station during a resident on-call starting on Friday at 0815 and finishing on Monday at 1700; it was clear that the European Working Time Directive was a world away from this little town.
Participating in the ENTOG exchange and European trainees’ meeting has broadened my insight into training and clinical practice of obstetrics and gynaecology, as well as giving me an appreciation of the healthcare system in the UK. I met some inspiring trainees, whose self belief and determination have reminded me of the part we each have to play in making a difference to our patients in our specialty.
The exchange programme has provided me with more benefits than I had imagined. Not only have I enriched my understanding of clinical obstetrics and gynaecology, but I have had time to reflect critically on my own practice, more confident in the knowledge that every action I perform can be justified as being best practice. I would recommend this opportunity to trainees with five years’ experience of clinical obstetrics and gynaecology, particularly at a time when training and service seem to be intertwined and the distinction between the two not always obvious.
—Shreelata Datta
Denmark 2006: an exchange participant’s view
At the time of my ENTOG exchange in Denmark there was a recruitment crisis in obstetrics and gynaecology in the UK. I was delighted to find that it is one of the most popular specialties in Denmark.
The structure of training in Denmark is different from that in the UK, and most departments offer a consultant (specialist) led service. The 37 hour working week is compliant with the European Working Time Directive, and trainees are happy with their work-life balance. Specialist training takes four years and includes six months of general surgery. For two years after this, a doctor will work as a specialist who can practise independently in their own right but does not have “named patients” under their care. This means that there is automatically a more senior doctor that a specialist can refer to for advice and support.
Although I do not believe the Danish model of training can directly be translated into UK practice, I was inspired by the fact that it seems possible to train efficiently in a shorter working week.
Being part of ENTOG has given me an optimistic view of our specialty and made me value the UK training system. Hearing about how trainees in some countries were working without a salary until 2007, how many hospitals are so underfunded that trainees have no access to the internet, and how the quality of training a trainee receives is determined by the single hospital where they spend all their training, has made me appreciate all of the positive things about my training.
—Anni Innamaa
No European unity
At present, all European countries run their own training programmes and there is no unified European training programme. However, there is guidance from the European Board and Congress of Obstetrics and Gynaecology on specialist training and a logbook that can be used as it is or as a template for developing one. The board is also working towards harmonising European training.
The Royal College of Obstetricians and Gynaecologists has a longstanding interest in international obstetrics and gynaecology training. As part of this agenda, two elected members of the college trainees’ committee represent the UK at ENTOG.
ENTOG is a clear example of what trainees can achieve through a structured and well organised network. Although this organisation promotes training in obstetrics and gynaecology within Europe, there is still plenty of work to be done. With the ENTOG exchange and conference being held in the UK in 2011 this will no doubt be an exciting and challenging time.
More information about ENTOG is available at: www.entog.org
If you want to read more about exchange participants’ experiences, visit the Royal College of Obstetricians and Gynaecologists website at: www.rcog.org.uk/our-profession/supporting-trainees/entog
Footnotes
Competing interests: None declared.