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U.E.M.S EBOT Union Européenne des Médecins Specialistes European Board of European Union of Medical Specialists Orthopaedics and Traumatology Section of Orthopaedics and Traumatology

MINUTES OF THE MEETING OF THE SECTION ON MAY 10TH-11TH 2013 AT THE MERRION HOTEL, DUBLIN, IRELAND

PRESENT: AUSTRIA Thomas Motycka Stefan Nehrer BELGIUM Nanni Allington CROATIA Marko Bergovec CYPRUS Andreas Tanos DENMARK Niels Wisbech Pedersen ESTONIA Aare Märtson Toomas Tein FINLAND Petri Virolainen FRANCE Dominique Chauveaux Patrice Papin GERMANY Joachim Grifka Dietrich Bornemann GREECE Aristides Zoubos Vassilios Bitounis IRELAND John Corrigan Derek Bennett ITALY Ernesto Ippolito Carlo Fabbriciani LUXEMBURG Henri Schlammes NORWAY Kari Indrekvam PORTUGAL Paulo Felicissimo ROMANIA Radu Radulescu SLOVAKIA Lubos Rehak SPAIN Jose Antonio Hermoso SWEDEN Hanne Hedin Li Felländer-Tsai Richard Wallensten TURKEY Haluk Berk UNITED KINGDOM Andy Cole John Albert EXAMINITATION COMMITTEE Jose Mineiro

President: John Albert Secretary: Thomas Motycka Treasurer: Henri Schlammes

FRIDAY MAY 10 TH , 2013 – GENERAL MEETING PART I

1. OPENING The president opened the meeting, welcomed the delegates to Dublin and thanked Derek Bennett for hosting the meeting. Bennett gave some general information about the meeting and the social programme and welcomed the delegates to Dublin. 2

2. APOLOGIES Ilkka Kiviranta, Carsten Mohrhardt, Benn Duus, Enis Guryel

3. WELCOME AND RESIGNATIONS 3.1. New delegates: we welcomed Marco Bergovec from Croatia, Jose Antonio Hermoso from Spain, Li Felländer-Tsai from Sweden and Andy Cole from the U.K. New elected but not present delegates are Enrique Guerado-Parra (Spain), Yiannis Efstathiades (Cyprus) and Cees Verheijen (The Netherlands) 3.2. Resignations: Jose Cordera (Spain), Jerdi Asunto (Spain), Petros Spastris (Cyprus), Richard Wallensten (Sweden), Frank von Oosterhout (The Netherlands)

4. MINUTES OF SECTION’S MEETING IN CYPRUS ON SEPT. 28TH-29TH 2013 No corrections, the minutes were approved by the delegates

5. COMMUNICATIONS 5.1. THE PRESIDENT Incoming and outgoing post The incoming post has concerned the exam, EFORT, MJCs and central UEMS. Most of the presented letters were discussed later, apposite to the item of the agenda

5.2. THE SECRETARY The secretary asked for corrections in the list of members and data of the new members. All communication with the delegates is only by e-mail, so it is of outmost importance to have an updated e-mail address list.

5.3. THE TREASURER 5.3.1. The treasurer presented an overview of the finances, which are healthy. At the moment the account is in credit by € 198.843.-(€ 54.539.- more since the last meeting!). EACCME accreditations still are the main income of the section. Nevertheless a number of members are still in arrears with payments (Czech Republic and Croatia since 2010, Italy since 2011, Belgium 2012). This time the president will remind the defaulters.. 5.3.2. The section agreed to spend more on educational activities: Decisions: - a prize will be found for the best examinee of the annual EBOT exam. - under the participants of the EBOT exam one participation in the next EFORT meeting will be choosen by a lottery. - a 4-week visiting fellowship will be advertised. This will be similar to the fellowships offered by EFORT , but under the auspices of UEMS. Selection will be determined by a subcommittee of EBOT. Details are yet to be determined. - in the future the expenses of the EBOT meeting of the secretary and the president will be refunded. The president will find out by contact with the central UEMS, if under these circumstances they stay classified as delegates and are allowed to vote. - The sponsoring of EBOT meetings will increase from € 3500.- to € 7000.- - The interim exam will be sponsored for 3 years, each with € 2000.- 5.3.3. The new financial management of central UEMS became reality: Because of the new law every transaction of every account has to be countersigned by central UEMS, all documents of financial transaction has to be sent within a month to Brussels. Until now EACCME accreditations have been paid into our new account, as next step our treasurer will try cashouts. If it works, it does not make any sense to keep the account in Luxembourg, it will be closed, even it is also allowed in future by central UEMS.

5.4. UEMS 5.4.1. For years the “Domus Medica” in Brussels will not be ready to move into it. After a local election the building permit has to be renogotiated.

5.5 EFFORT At the EFORT congress in Istanbul there are already 8000 registrations, a third of 3

all presentations are from the U.K. as a result of its training regulations.

6. INFORMATION ABOUT THE WEBSITE 6.1. Dietrich Bornemann explained our website www.uems-ortho.org. All documents concerning our meetings will exclusively be put on our homepage in advance, all documents of the meeting itself retrospectively in a separated subfile. The access to the private area is protected by a password, which is the name of the recent president in small letters. 6.2. Central UEMS asked all sections to participate in the new official website (www.uems.net) and for its categories and functionalities to harmonise its basis structures. Until yet, the website works only partly, the creation of a test webside is planned for June 2013, the final version for October 2013. Still uncertain is the independence of the contents, the future of the protected area and the financial aspect (until now the costs are about 500€/year, sponsored by the german association) Decision: At the moment our website is the vital communication tool of our section, which we do not want to put at risk. As a first step we will offer a link to our website and will carefully watch the further progress.

7. EACCME Since 1.1.2013 exist new criterias. At the moment Zoubos, Tein and Bornemann are our reviewers, still under supervision of Günter Abt, every year there are 2 reviewer meetings. In generally, accreditations are increasing rapidly (1755 applications in 2012), interested volunteers are urgently required

8. CESMA 8.1. computer based examinations are popular with candidates and particularly useful for in-training assessment, the UEMS would like a common platform. Prof. Bax (Sheffield) presented an inhouse electronic portfolio for undergraduated, called “Minerva” 8.2. A system of visitations for organisations doing exam will be established Decision: Albert invites CESMA to observe the EBOT exam

9. MULTIDISCIPLINARY JOINT COMMITTEES MJC spine: The MJC is still planning a common European Spine Surgery curriculum, separated in a basic and a higher degree. It was fixed which organisations are allowed to deliver the curriculum, EBOT is one of them. The tuition will be evaluated by CESMA and EACCME. Six module workgroups will be established, until now, it is not fixed, who will be allowed to participate MJC sport medicine: van Oosterhout resigned and will be replaced by Hermoso. Until yet a contact is not requested, Hermoso will make an application MJC hand surgery: Massimo Ceruso, EBHS president, will represent EBOT until further notice. At the spring meeting financial accounts has been discussed, at the autumn meeting the constitution. Nevertheless we are still looking for a new delegate, who is also a hand surgeon, to represent us at this MJC in future. MJC pain medicine: The Vice-President of the Section and Board of Anaesthesiology, Elisabeth van Gessel, asked to participate in the foundation of this MCJ, the response at the kick-off meeting last year was limited. Decision: The president will answer, that we are interested in cooperation and will nominate a delegate upon request Manual medicine became a MJC

10. PRESENTATION OF THE NATIONAL SOCIETIES. WHAT IS NEW IN YOUR SOCIETY SINCE LAST PRESENTATION? 10.1. Paulo Felicissimo presented the situation in Portugal. The unemployment rate is 17,7%, until yet no doctors, even though there is a rapid and continuous increase of medical students and doctors (including orthopaedic surgeons), since 2010 there is a majority of female doctors. Recertification, since 1976 in public hospitals, is now compulsory to all doctors. 4

10.2. Radu Radulescu presented the situation in Romania: the national orthopaedic organisation SOROT is still patronized and dominated by the national health authority. As an intended proposal, the SOROT president should not further be nominated by the Ministery of Health but elected by the members of the society

SATURDAY MAY 11 TH 2013 - GENERAL MEETING PART II

11. DEVELOPMENT OF A EUROPE WIDE CURRICULUM 11.1.Central UEMS wanted an update of the” training requirements” (adequate to the former “chapter 6”) in our section in a short and clear version, focused on a few key features. It was done by our working group, but central UEMS now prefers an extended version (20-30 pages). It will be revised and sent out for comments. 11.2. At the EFORT meeting in April an European platform for introducing a European curriculum was founded. As a first step, a questionnaire was done, partly the results were surprising ( 75% of the trainees do not participate in a CME program or do any research). First suggestions are the extension of our minimal requirements, the development of a knowledge syllabus and the use of MCQ-questions of the EBOT- exam also for all national exams. It is important to motivate national societies to change attitudes, as a next step on a new meeting progress will be promoted.

12. EBOT EXAM Mineiro presented new developments of the exam, : 12.1. The interim exam exists since 2011. It is run in English and on the same date all over Europe, taken in the local departments. The focus is not only on the personal result, but also on the local and national performance. 12.2. For the final exam it is planned for the future, to do the oral part on the same day, but in different languages with an increasing number of examiners. The basis should not be a text book, but a good training program. A third, clinical part, will be added. It will test professional behaviour and clinical skills and includes 2 short cases (5 minutes examination and 5 minutes discussion) and 4 long cases (15 minutes each). A direct input from each country will be required and it will be run by the local national faculty, but under the supervision of EBOT. The financing of this part is still unclear and has to be defined. 12.3. For writing exam questions 30 new examiners were recruited at the meeting in Berlin, but still more oral examiners are needed. In 2014 already 128 candidates are registered, the number is now every year increasing, All volunteers are welcome to contact Mineiro for cooperation 12.4. All together, the development of the exam is step by step, but satisfying. More and more the standards of the exam are being accepted

13. NEW TECHNOLOGY IN JOINT REPLACEMENT – WORTH THE PRICE John M. O´Byrne presented different aspects about the cost-benefit balance of implants and the possible influence of surgeons, but also industry and patients.

14. ELECTION OF A NEW PRESIDENT The president once again explained the tasks of this job and that a replacement will be needed at the next meeting. Delegates were again asked to send expressions of interest to the Secretary

15. FUTURE STRATEGY AND WORKING PROCEDURES FOR THE SECTION At the next meeting “Innovation in Osteoporosis” will be discussed. Bennett will ask Prof. O´Brien for a kick-off talk, if this is not possible, Wallensten will try to organise a Swedish expert. The discussion about management strategies will be moderated by Felicissimo and Papin. From now on it is decided, if a delegate wants a new item on the agenda, he/she has to introduce it by a short talk 5

16. NEXT MEETINGS Meeting in Budapest, Hungary, September 27-28 2013 The organisation is already ready, even for online-booking, but there still is a discussion about the amount of expenses. The delegates will be informed about the final offer. Meeting in Lissabon, Portugal, April 25-26 2014 Meeting in Luxembourg, September 26-27 2014

17. ANY OTHER BUSINESS Croatia will be a full member of EBOT, but must regularise its member fees.

18. CLOSURE OF THE MEETING Albert closed the meeting again thanking Derek Bennett and John Corrigan for hosting the meeting. He also thanked the former president Richard Wallensten for his intensive work over 16 years in our section, and all the delegates for coming to Dublin

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Dr. Thomas Motycka Dr. John Albert Secretary President

All relevant presentations of this meeting are shown on the webside www.uems-ortho.org under a subfile of “Dublin”. The number the title is starting with is ident with the number of the item on the agenda.

On Friday evening we had an excellent dinner in “The Cellar” of our hotel. After visiting the Guiness Storehouse on Saturday afternoon it followed an exceptional evening in Farmleigh House, an impressive building, a great dinner and a brief musical survey of traditional Irish instruments and tunes.