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Report of ENTOG exchange and Council meeting, Slovenia 2017

The 27th ENTOG exchange and meeting was held between May 29 and June 3 2017 in Slovenia.

Background

The exchange was organized by a team of local trainees headed up by Jure Klanjšček and Andrej Cokan. Two trainees from the UK joined 40 other European trainees from 22 countries across Europe for a four-day exchange across 14 hospitals in Slovenia.

Alongside a social programme, exchange trainees participated in staff meetings, medical rounds, surgery, outpatient clinics and on the delivery wards. At the end of the exchange, all trainees travelled to Slovenia’s capital city Ljubljana where a welcome reception was organized by the Mayor of the city and the following day a full day scientific meeting was held.

Slovenia

Slovenia is a country in southern Central Europe, located at the crossroads of main European cultural and trade routes gaining independence from Yugoslavia in 1991. It is bordered by Italy to the west, Austria to the north, Hungary to the northeast, Croatia to the south and southeast, and the Adriatic Sea to the southwest. It covers 20,273 square kilometers and has a population of approximately 2 million people.

There are approximately 20,000 births per year in Slovenia (compared to just under 600,000 in the UK) with a cesarean section rate of about 22% (about 25% in the UK), maternal mortality similar to the UK (9 per 100,000) and a perinatal mortality rate of 1 in 1000. They have a particular interest in gynaecologic surgery with an emphasis on minimally invasive procedures.

Scientific meeting

The scientific meeting was a full day event and the topics for discussion included instrumental vaginal delivery and ‘soft skill training’ which were managing burnout and dealing with conflict. The day opened with a debate on the use of forceps (only UK and France use this instrument routinely in their practice).

Whilst many trainees across Europe acknowledge that using forceps is a valuable tool, they lack training opportunities as so few of their trainers use forceps as a tool to deliver in the second stage.

After the debate, the rest of the day was broken into small group workshops with simulation to teach forceps delivery. Dr. Maud van de Venne, a consultant obstetrician and gynaecologist from the UK taught this workshop with the help of myself and the other two UK trainees.

The other two workshops on burnout and conflict were very well received. In the UK, there is currently a 20% attrition rate amongst trainees and these topic areas are of particular interest and it is also notable that our European counterparts have much the same problems with retention.

This was followed by the ENTOG council held by the ENTOG Executive.

ENTOG Council 2017

We heard from three trainees that had attended the exchange: Dr. Jurgis Vitols from Latvia, Dr. Gotnur Topcu from Turkey and Dr. Paula Turtianen from Finland. They offered us their experiences and comparisons of practice and education.

At the Council, the EBCOG PACT (Project for Achieving Consensus in Training) was once again discussed. This project is supported by an Erasmus Grant from the European Commission and was launched in September 2015 and will run until August 2018. The desire is to be able to create free movement of specialists across Europe, creating comparable skills and training to ensure patient safety. They have utilized a competency based framework and curriculum which includes the trifecta of skills training, portfolio and assessment. The full curriculum is to be launched at the EBCOG meeting in Paris 2018.

The current President, Dr. Anne Aabake from Denmark, informed us of the activities of the ENTOG executive. She reminded us that the values of ENTOG are to allow for international networking, to evaluate and compare training and to represent trainees in Europe and at EBCOG. The main responsibilities of the ENTOG executive is to support the annual exchange. In May 2017, a short term fellowship was organized through ENTOG and the Turkish Society of Trainees in Obstetrics and Gynaecology (TSOG). This was funded by TSOG and seven fellowships were awarded – one UK trainee attended the event in Antalya in May 2017.

Dr. Aabake also reminded us that EBCOG offers three fellowships of 3000 Euro for trainees to apply and experience training in another European country. This year, two have been awarded – Dr. Murrat Yassa from Turkey will travel to Dublin and Dr. Auni Lindgren from Finland will travel to Leuven in Belgium.

At the Council, two new member countries were elected to join – Switzerland and Croatia who will now have trainee representation through ENTOG in Europe. Additionally, there were hotly contested elections as we bid farewell to Dr. Aabake after six years on the ENTOG executive (four as Secretary General and two as President). Dr. Agnieszka Horala, from Poland was elected as President, Dr. Gotnur Topcu from Turkey was elected as Secretary General and Dr. Vladimir Dvorak from Czech Republic.

The next exchange will be held with EBCOG in March 2018 in Paris and in Poland in 2019. For Paris, the exchange dates will be 5-10 March 2018 and held in three cities across France – Lille, Paris and Marseilles. If you are interested in being part of an exchange then please look out for the invitation for applications which will be emailed to you by your trainee representative. There will also be an opportunity to present work or attend the congress in Paris. Applications will open in Autumn 2017.

Dr. Reena Aggarwal
UK ENTOG Representative