Dr Goverde

2. Prof. Angelique Goverde
Consultant gynaecologist at the University Medical
Centre in Utrecht

3. Should colposcopy be a core skill for all
gynaecologists?
The European training curriculum in Obstetrics and
Gynaecology
Dr. Angelique J. Goverde
Chair EBCOG standing committee Training and Assessment
5th Satellite meeting European Federation for Colposcopy
Brussels, December 2017

4. Disclosures
University Medical Centre Utrecht, the Netherlands
• Senior consultant Reproductive Medicine and Paediatric and Adolescent
Gynaecology
• Programme co-director of postgraduate training
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

5. Disclosures
University Medical Centre Utrecht, the Netherlands
• Senior consultant Reproductive Medicine and Paediatric and Adolescent
Gynaecology
• Programme co-director of postgraduate training
EBCOG / UEMS
• Chair standing committee on Training and Assessment EBCOG
• Chair Project Board EBCOG Project on Achieving Consensus in Training
• Member European Training Requirements review committee UEMS
No financial conflict of interest
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

6. Should colposcopy be a core skill for all
gynaecologists?
The European training curriculum in Obstetrics and
Gynaecology
Dr. Angelique J. Goverde
Chair EBCOG standing committee Training and Assessment
5th Satellite meeting European Federation for Colposcopy
Brussels, December 2017

7. Should colposcopy be a core skill for all
gynaecologists?
YES according to the European training curriculum in
Obstetrics and Gynaecology it should
Dr. Angelique J. Goverde
Chair EBCOG standing committee Training and Assessment
5th Satellite meeting European Federation for Colposcopy
Brussels, December 2017

8. Background:
European legislation and
regulations
• Mutual Recognition Directive in 1975 EC Treaty
• European Directive 2005/36/EC, amended by Directive 2013/55/EC
• European Working time Directive
Certification and training
• UEMS Charter on Training of Medical Specialists in Europe
• EBCOG Recommendations of Training
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

9. Background:
European legislation and
regulations
• Mutual Recognition Directive in 1975 EC Treaty
• European Directive 2005/36/EC, amended by Directive 2013/55/EC
Certification and training
• UEMS Charter on Training of Medical Specialists in Europe
• EBCOG Recommendations of Training
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

10. Background:
European legislation and
regulations
• Mutual Recognition Directive in 1975 EC Treaty
• European Directive 2005/36/EC, amended by Directive 2013/55/EC
Certification and training
• UEMS Charter on Training of Medical Specialists in Europe
• EBCOG Recommendations of Training
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

11. Background:
Structure and role of EBCOG
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology
European Board and College of Obstetrics and Gynaecology
• Umbrella organisation of all national societies O&G in EU + associated
countries
• 37 countries
• Junior organisation
European Network of Trainees in Obstetrics
and Gynaecology

12. Background:
Structure and role of EBCOG
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

13. Background:
Structure and role of EBCOG
EFC EURAPAG
ESC ESGE
ISPOG ENTOG
subspecialty societies
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology
standing
committee
training
recognition
standing
committee
training and
assessment

14. Background:
Structure and role of EBCOG
Aims and goals
…. to improve the health of women and their babies in Europe
by promoting the highest possible standards of care in all
European countries….
Hence, a focus on standards of education and training
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

15. 1998 2005
Training recommendations additions to
Logbook training recommendations
15AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology
Developing a European curriculum

16. 1998 2005
Training recommendations additions to
Logbook training recommendations
trainee is able to carry out without supervision:
colposcopy + biopsy
conisation of cervix or similar treatment
16AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology
Developing a European curriculum

17. 1998
Training recommendations additions to
Logbook training recommendations
1999 hospital / training recognition 2009 TtT 2016 exam
“Train the trainers”
17AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology
Developing a European curriculum

18. Analysis:
training disparities in Europe
AJ Goverde: Colposcopy in European curriculum in Obstetrics and Gynaecology
ENTOG survey 2009, 2011
Disparities in training in Europe, 2011 methods of assessment
number of trainees per country, per
unit, per specialist
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

19. Societal changes: perspective on doctors’ roles and
training
• standardised theoretical training – foundation
• skills training using simulation
• shared decision making
• team training (collaborative practice)
• development of professionalism
• promotion of reflective practice
AJ Goverde: Colposcopy in European training curriculum in Obstetrics and Gynaecology

20. 1998 2005 2015 2018
Training recommendations additions to EBCOG-PACT
Logbook training recommendations
1999 hospital / training recognition 2009 TtT 2016 exam
“Train the trainers”
20AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology
Developing a European curriculum

21. Developing a European curriculum
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

22. Developing a European curriculum
Principle 1: minimum set of skills to work as a qualified
gynaecologist/obstetrician wherever in Europe
Principle 2: competency based training
Principle 3: continuous formative assessment and feedback
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

23. Developing a European curriculum: medical
content
Core
set of skills and subjects for every
gynaecologist in Europe
Electives
specific subjects
more in depth knowledge
based on national or personal needs
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

24. Developing a European curriculum: medical
content
Outcomes of training defined by
- Delphi procedure; consensus European gynaecologists & trainees,
EBCOG council expertise
- Bar set at 70%
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

25. Developing a European curriculum
EBCOG-PACT current status:
Training in OBGYN:
at least 5 years, 3-4 years core + 1-2 years elective
core + at least 1 elective
simulation training
general competencies
May 2017 EBCOG Council approval on medical curriculum (knowledge and
skills) content
November 2017 EBCOG Council approval on skills development
AJ Goverde: Colposcopy in European curriculum of Obstetrics and Gynaecology

26. Developing a European curriculum
Postgraduate training consists of core + ≥ 1 elective
Duration of training min. 5 years
3-4 year core curriculum training (max. 4 years)
1-2 years electives training
Simulation is part of skills training
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

27. Learning curve
training continued practice
proficient
expert
After Dreyfus & Dreyfus, 1986
competent
advanced
beginner

28. Developing a European curriculum
Delphi first round:
colposcopy and loop excision part of core training
Delphi third round:
conisation part of elective module
Concerns regarding quality: new training models and simulation
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

29. Developing a European curriculum:
Perspective: working towards an integrated view on training
Curriculum
Implementation & Faculty
quality assessment development
AJ Goverde: Colposcopy in European training curriculum of Obstetrics and Gynaecology

30. Should colposcopy be a core skill for all
gynaecologists?
YES according to the European training curriculum in
Obstetrics and Gynaecology it should!
ebcogpact@gmail.com

31. Developing a European curriculum in
Obstetrics and Gynaecology
ebcogpact@gmail.com
AJ Goverde: Developing a European curriculum in Obstetris and Gynaecology

32. Analysis:
training disparities in Europe
AJ Goverde: Developing a European curriculum in Obstetrics and Gynaecology
Average working time
ENTOG survey 2011
One on one supervision

33. Developing a European curriculum
AJ Goverde: Developing a European curriculum in Obstetrics and Gynaecology

34. Developing a European curriculum: medical
content
subspecialty
elective
core
AJ Goverde: Developing a European curriculum in Obstetrics and Gynaecology
increasingknowledgeandskills

35. Developing a European curriculum: generic
competencies
Generic competencies: collaboration (team work)
communication (shared decision making)
leadership
management of work
etc..
• input from societal stakeholders: nurses, midwives, patients, hospital
board members
AJ Goverde: Developing a European curriculum in Obstetrics and Gynaecology