ESCMID Online Lecture Library © by Author

CLINICAL MICROBIOLOGY AS PART OF POLYVALENT© by L ABORATORYauthor MEDICINE: AN OUTDATED CONCEPT Hilpi Rautelin MD PhD Professor of Clinical Bacteriology, University of Uppsala and ESCMIDUppsala Online University Hospital, Lecture Sweden Library President for UEMS Section of Medical Microbiology The views expressed in the presentation are personal and do not necessarily reflect those of UEMS UEMS SECTION OF LABORATORY MEDICINE/MEDICAL BIOPATHOLOGY

 UEMS Section of Laboratory Medicine founded in 1962  An umbrella for diagnostic and laboratory-related specialties  Histopathologists formed their own section in 1988  UEMS Section of Medical Biopathology  Practice in single specialties (monovalent)  Practice across multiple specialties (polyvalent)  In 2008 UEMS Section of Medical Microbiology  UEMS Section of Laboratory Medicine/Medical Biopathology  General Laboratory Medicine/Polyvalent© by author Medical Biopathology  Laboratory Medicine – Clinical Chemistry  Clinical and Laboratory Haematology and Transfusion ESCMIDMedicine Online Lecture Library  Clinical and Laboratory Immunology  Laboratory Genetics (Genetic pathology) www.uems-slm.org/uems/01-PDF/BB_2012May_Final.pdf GENERAL LABORATORY MEDICINE/POLYVALENT MEDICAL BIOPATHOLOGY

 A total training 5 yrs recommended  1 yr Internal Medicine/Pediatrics mandatory  4 yrs for example  2 yrs in Laboratory Haematology, Clinical Chemistry and Laboratory Immunology  18 months in Laboratory Microbiology and Virology  6 months in Laboratory  Laboratory Microbiology  Time allowance may vary according to the category of the training post  Training must take place© by either author in a microbiology laboratory (min 12 months) or in a general laboratory (min 24 months)  Syllabus in General Laboratory Medicine/Polyvalent ESCMIDMedical Biopathology Online – Laboratory Lecture Microbiology Library  Bacteriology, Virology, Mycology, Parasitology, Serology, Specific specialty knowledge, Medical knowledge

Recommended Standards for Training Specialists in Laboratory Medicine/Medical Biopathology, www.uems-slm.org/uems/01-PDF/BB_2012May_Final.pdf CURRENT POLYVALENTS

 Germany  Medical/Clinical Microbiology recognized as main specialty  About 700 active specialists in Medical Microbiology  Also trained in Infection control and Antimicrobial stewardship (increase in importance)  Many large hospitals  Polyvalents  1038 specialists in Laboratory Medicine (2012)  1.5 yrs training in Medical Microbiology (diagnostics)  Training most often in polyvalent laboratories with narrow range of diagnostic methods  In private (outsourced) laboratories, serving many small/medium sized hospitals  Belgium  Polyvalent Laboratory Medicine: 5 years training  Depending on available training positions: more univalent/more polyvalent training (0.5 – 4 yrs in Medical Microbiology)  “Functional monovalent” specialists with special interest in Medical Microbiology  Greece © by author  Medical Biopathology 5 years training  18 months in Medical Laboratory Microbiology (incl mandatory 6 months in infectious disease immunology) + Clinical Chemistry (12 mo) + Hematology and Transfusion Medicine (12 mo) + General Immunology (6 mo) + Internal Medicine (12 mo) ESCMID Further qualification inOnline Clinical Microbiology Lecture for 2 years Library  Laboratory training (6 mo) + Clinical training in Infectious Diseases (18 mo)  Only few positions available for this qualification  Portugal ANY FUTURE FOR POLYVALENT SPECIALTY?

 A new trend to establish polyvalent specialties??  More “broadly qualified” specialists to run hospital laboratories?  Only few (one) expensive Medical Specialists needed in the laboratory if all laboratory-related specialties “covered”  More versatile profile, more attractive laboratory-related specialty for MDs??  According to the size of the hospital  Monovalents in small/medium sized hospitals  Polyvalents in large/university© by hospitals/researchauthor

 Medical Microbiology still integrated part of LaboratoryESCMID Medicine?? Online Lecture Library  Longer training in Medical Microbiology in Laboratory Medicine  Hungary: 6 months  12 months IMPORTANT TO STRENGTHEN MEDICAL/CLINICAL MICROBIOLOGY AS MEDICAL SPECIALTY

 Medical/Clinical Microbiology recognized as independent specialty in most of the countries in Europe  Free movement of specialists in Europe  Progress also in countries currently without the specialty  France, Belgium  Importance of Medical/Clinical Microbiology steadily increasing  Increasing number of new microbial pathogens and detected infectious diseases  The field is bigger than© earlierby thoughtauthor  Novel powerful diagnostic methods rapidly change the field  Especially Hospital hygiene and Antimicrobial stewardship ESCMIDincreasing in importance Online Lecture Library  Short introduction to diagnostics is not enough  No way to go backward! ACKNOWLEDGEMENTS

 Stylianos Chatzipanagiotou  Alexander Friedrich  Koen Magerman  Elisabeth Nagy