EC4 European Syllabus for Post-Graduate Training in Clinical Chemistry and Laboratory Medicine: Version 3 – 2005
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Article in press - uncorrected proof Clin Chem Lab Med 2006;44(1):110–120 ᮊ 2006 by Walter de Gruyter • Berlin • New York. DOI 10.1515/CCLM.2006.021 2006/397 EC4 European Syllabus for Post-Graduate Training in Clinical Chemistry and Laboratory Medicine: version 3 – 2005 Simone Zerah1,*, Janet McMurray2, Bernard 18 Laboratoire National, Luxembourg, Luxembourg Bousquet3, Hannsjorg Baum4, Graham H. 19 Department of Clinical Pathophysiology, Clinical Beastall5, Vic Blaton6, Marie-Jose` phe Cals7, Biochemistry Unit, Florence, Italy Danielle Duchassaing8, Marie-Francoise¸ 20 Hospital de la Santa Creu i Sant Pau, Servei de Gaudeau-Toussaint8, Aimo Harmoinen9, Hans Bioquimica, Barcelona, Spain Hoffmann10, Rob T. Jansen11, Desmond 21 R. de Cedofeita 347 18 Esq, Porto, Portugal Kenny12, Klaus P. Kohse13, Ursula Ko¨ ller14, 22 77 Polytechniou St, Iraklion, Greece Jean-Ge´ rard Gobert15, Christine Linget8, Erik 23 General Hospital Vienna, Wien, Austria Lund16, Giuseppe Nubile17, Matthias Opp18, 24 Hoˆ pital Beaujon, Clichy, France Mario Pazzagli19, Georges Pinon8, Jose´ M. 25 Department of Clinical Chemistry, Medialab AB, Queralto20, Henrique Reguengo21, Demetrios Taby, Sweden Rizos22, Thomas Szekeres23, Michel Vidaud24 and Hans Wallinder25 (European Communities of Clinical Chemistry, EC4 Register Abstract Commission) 1 Laboratoire d’analyses de biologie me´ dicale, The EC4 Syllabus for Postgraduate Training is the Bagnolet, France, SFBC, EC4 Register Committee basis for the European Register of Specialists in Clin- 2 Hope Hospital, Clinical Biochemistry Department, ical Chemistry and Laboratory Medicine. The syllabus: Salford, United Kingdom 3 Hoˆ pital Saint-Louis, Service de Biochimie A et • Indicates the level of requirements in postgraduate Neurobiologie, Paris, France training to harmonise the postgraduate education 4 Institut fu¨ r Klinische Chemie und Pathobiochemie, in the European Union (EU); Munchen, Germany • Indicates the level of content of national training 5 Royal Infirmary, Department of Clinical programmes to obtain adequate knowledge and Biochemistry, Glasgow, United Kingdom experience; 6 AZ Sint Jan Hospital, Department of Clinical • Is approved by all EU societies for clinical chem- Chemistry, Brugge, Belgium istry and laboratory medicine. 7 Hoˆ pital Corentin Celton, Issy-Les-Moulineaux, The syllabus is not primarily meant to be a training France guide, but on the basis of the overview given (com- 8 Syndicat National des Biologistes des Hoˆ pitaux, mon minimal programme), national societies should Paris, France formulate programmes that indicate where knowl- 9 Savonlinnan keskussairaala, Savolinna, Finland edge and experience is needed. 10 Department of Clinical Chemistry Catharine The main points of this programme are: Hospital, Eindhoven, The Netherlands 11 St. Anna Hospital, Department of Clinical • Knowledge in biochemistry, haematology, immu- Chemistry, Geldrop, The Netherlands nology, etc.; 12 Our Lady’s Hospital for Sick Children, Department • Pre-analytical conditions; of Clinical Biochemistry, Crumlin, Dublin, Ireland • Evaluation of results; 13 Sta¨ dtische Kliniken Oldenburg, Institut fu¨ r • Interpretations (post-analytical phase); • Laboratoriumsdiagnose und Mikrobiologie, Laboratory management; and • Quality insurance management. Oldenburg, Germany 14 Institute for Medical and Chemical Laboratory The aim of this version of the syllabus is to be in Diagnostics, Klagenfurt, Austria accordance with the Directive of Professional Qualifi- 15 G.H. Pitie´ -Salpe´ trie` re, Paris, France cations published on 30 September 2005. 16 Vejle County Hospital, Department of Clinical To prepare the common platforms planned in this Chemistry, Vejle, Denmark directive, the disciplines are divided into four 17 Laboratorio Analisi Ospedale G. Bernabeo di categories: Ortona, Ortona (Chieti), Italy • General chemistry, encompassing biochemistry, *Corresponding author: Dr. Simone Zerah, Laboratoire endocrinology, chemical (humoral), immunology, d’analyses de biologie me´ dicale, 7 rue Raymond Lefebvre, toxicology, and therapeutic drug monitoring; 93170 Bagnolet, France, SFBC, EC4 Register Committee, Bagnolet, France • Haematology, covering cells, transfusion serology, E-mail: [email protected] coagulation, and cellular immunology; Article in press - uncorrected proof Zerah et al.: EC4 European Syllabus for Post-Graduate Training in CCLM 111 • Microbiology, involving bacteriology, virology, reported to provide information; and, most impor- parasitology, and mycology; tantly, interpretation of the significance and conse- • Genetics and IVF. quences of the laboratory data obtained (clinical authorisation). As the results of laboratory investigations and con- Keywords: clinical chemistry and laboratory medi- sultations of the clinical chemist1) have a direct and cine; postgraduate education; professional qualifica- important influence on treatment of the patient, it is tions; quality. to the benefit of the public that the profession of the clinical chemist1) is duly regulated. Introduction Clinical Chemistry and Laboratory Medicine In modern medicine the undeniable value and indis- pensability of scientific investigations are now uni- Definition versally recognised both for diagnostic purposes and monitoring of disease and in basic epidemiology. The Clinical Chemistry and Laboratory Medicine is a direct treatment of patients is an undeniable task of scientific discipline within medicine. It includes the doctors in medicine. Progress in laboratory science is analysis of body fluids, cells and tissues, and inter- largely the result of contributions by scientists (gen- pretation of the results in relation to health and eral meaning) with an appropriate education and spe- disease. cialisation in the field, i.e., by specialists in clinical The exact content of the specialty of clinical chem- chemistry and laboratory medicine1). Clinical labora- istry varies considerably from country to country and tory science has developed on a broad front through- a modular approach appears essential for suitable out the European Union, resulting in significant integration into the national contexts. differences in what constitutes a national clinical lab- The discipline encompasses fundamental and oratory service in each state. Clinical chemistry is the applied research into the biological and physiological medical discipline devoted to obtaining, exploring processes of human and animal life, and application and employing biological knowledge and methods of of the resulting knowledge and understanding to the investigation to obtain knowledge about normal and diagnosis, treatment and prevention of disease. abnormal biological processes in man. These pro- cesses are studied on a general level to obtain an Syllabus insight into human health and disease, and on a patient-specific level for diagnostic or monitoring pur- This syllabus provides a short description of the pro- poses. The delineation of clinical chemistry varies fession of clinical chemistry. The name clinical chem- 1) from country to country, since there is no sharp ist is used throughout, although it is realised that boundary to biochemistry, haematology, immunolo- different names exist in different countries to describe gy, microbiology, genetics and the biology of repro- the profession according to the definitions of the ductive medicine. International Federation of Clinical Chemistry and One of the main tasks of the clinical chemist1) is the Laboratory Medicine (IFCC). direction and supervision of a laboratory department The scope of clinical chemistry is not solely con- in a hospital or health service (public or private), fined to laboratory activities as such, but in daily prac- where his or her role involves bridging the gap tice is strongly interrelated with patient care and between rapidly developing laboratory science and treatment. Moreover, medical laboratory activities are technology and growing knowledge on the character- not purely of a chemical nature, but also involve the istics of disease. He or she must possess fundamental practice and study of biochemistry and molecular biological knowledge and have the ability to use this biology, haematology, immunology, microbiology knowledge most appropriately as applied to clinical (bacteriology and virology), parasitology (including requirements, i.e., diagnosis of disease, and planning mycology), genetics and the biology of reproductive and monitoring of therapy. Apart from providing a medicine. competent laboratory service, the clinical chemist1) This syllabus does not consider the different struc- must be able to function as a consultant to his or her tures of medical laboratories as developed in their clinical colleagues and liaise with them in the inter- national environments. It is meant to describe the pretation of laboratory results. His or her advice and minimum scientific content for professional knowl- professional consultations have at least three aspects: edge and training, appreciating the national authority choosing the most appropriate laboratory investiga- and responsibility of each member state to organise tion in a particular case; ensuring that analyses are laboratory medicine within in its own national health- performed in the best possible way and correctly care system. Although significant differences exist in the devel- opment of clinical chemistry throughout the European 1) Abbreviated in this paper to clinical chemist: i.e., Specialist Union, in all cases there are some core elements. As in Clinical