The Seventeenth European Meeting of Trainees in Obstetrics and Gynaecology (ENTOG) took place in the Billroth House, Vienna, Austria. It is a venue steeped in history and we had the privilege to sit in the very lecture theatre in which Professor Wertheim taught his students. The grand beauty of the venue provided an excellent contrast for the day's topic of looking at modern assessment methods used in Obstetrics and Gynaecology training in Europe, Australia and the United States.
During the course of the day, exchange participants from Norway, Sweden and the UK provided us with a summary of their experiences in Austria and compared the Austrian medical system to their own countries. The overwhelming difference between Austria, the UK and Scandinavian systems was the tendency in Austria for longer inpatient stays and less use of the outpatients department for management and investigation of patients.
The first key note lecture of the day was held by Professor P. Speiser (Austria) who provided us with a detailed overview of the assessment tools used in Australian training and a summary of current Austrian training.
Unsurprisingly, the Australian training system is very similar to the UK. If anything, the recording of daily training activities is even more rigorous, but the overall 6 year training programme with 3 monthly appraisals, 6 monthly assessments and a log of experience echoes current practice in the UK.
In Austria, since 2002, the training consists of 4 years O&G and 2 years spent in related specialties. An MCQ examination has recently been introduced. Fifty two candidates took the exam in 2007 and the failure rate was only 3.85%. The exam consists on 120 MCQs over 4 hours. Log books have not been introduced as a mandatory part of training.
We then had an overview of how formal assessment is organised in Austria, Denmark and the USA. The overwhelming feeling was that all countries are adopting increasingly rigorous assessment techniques and that multiple methods of assessment are required to gain information on various areas of competence, from surgical skills to communication.
Our second key note lecture of the day was by Dr A. Goverde (Netherlands). It concentrated on the difficulties that we all face in providing our junior colleagues with teaching in the clinical setting while at the same time creating learning opportunities for ourselves. The discussion that followed highlighted the need for all clinicians to use even the smallest learning and teaching opportunities through our working day and never to forget the fact that teaching is one of the most effective ways of learning. Discussion also concentrated on the variety of strengths and weaknesses clinicians have as teachers. There was much debate about whether medical education should be the responsibility of all doctors or a specialist interest of a select few.
Following this we heard from speakers from Spain and Norway and from Dr Wendy Reid from the UK on assessment systems used in each country. Dr Reid discussed recently introduced assessment tools including DOPs, Mini CEX, OSATs etc. This was followed by a lively discussion, as the audience all appeared to agree that assessment is an integral part of training in O&G. The outcome of the discussion was that, as much as we are all working towards one ideal training system in Europe, it may be that there is no one size fits all system. The demands placed on an Obstetrician and Gynaecologist practicing in London will always be different to those experienced by a doctor working in the remote parts of North Norway with limited access to referral to colleagues. However, everyone agreed on the goal of wishing to produce safe clinicians with a high standard of patient care at the core of their practice.
Anni Innamaa