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[Closer examination of specialization training in urology in German-speaking countries : Differences, similarities, advantages, disadvantages, and future perspectives]. UROLOGIE (HEIDELBERG, GERMANY) 2023; 62:494-502. [PMID: 36939863 PMCID: PMC10160198 DOI: 10.1007/s00120-023-02058-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Accepted: 01/31/2023] [Indexed: 03/21/2023]
Abstract
BACKGROUND Specialist titles are mutually recognized in the DACH (Germany [D], Austria [A], and Switzerland [CH]) region. During continuing education, however, there are significant differences in structure, organization and content. OBJECTIVES Organization, formalities and responsibilities, as well as admission requirements for the final examinations, in particular the examination formats in the DACH countries will be examined. In addition, these will be critically examined from the perspective of modern medical education. MATERIALS AND METHODS Documents publicly available on the Internet from the responsible authorities for continuing medical education in the DACH region were analyzed. In addition, a narrative review of the literature in medical databases on the topic of continuing medical education in urology was performed. RESULTS The minimum duration of residency is 5 (D) to 6 years (A, CH). Basic (surgical) training is mandatory in Austria and Switzerland. In Switzerland, the training site must be changed at least once. Part-time training is possible in all countries. Research and participation in annual congresses are mandatory only in Switzerland. Formative examinations are only required in Switzerland. In all countries, at least one summative examination is required to obtain the specialist title. In Austria and Switzerland, the written part of the European Board of Urology (EBU) examination must be passed. CONCLUSION From a medical education perspective, Switzerland currently offers and demands the most modern elements in specialist training. The certified structured continuing education modelled on the "Deutschen Gesellschaft für Urologie" (DGU; "Weiterbildungscurriculum Urologie", WECU) in Germany integrates modern approaches in Germany. With timely implementation of, for example, entrustable professional activities (EPAs), urology in German-speaking countries could be pioneering nations and disciplines internationally.
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Arnold H, Fassbach M, Mattigk A, Zehe V, Beck A, Wundrack F, Bellut L, König J, Siech C. [Training and work conditions of residents in urology in Germany : Results of the second German Society of Residents in Urology e. V. (GeSRU) residency survey from 2020]. Urologe A 2021; 60:1025-1034. [PMID: 34259878 PMCID: PMC8278189 DOI: 10.1007/s00120-021-01608-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Residency is the fundation for high-quality medical care and also for career development of young urologists. In 2015 the GeSRU (German Society of Residents in Urology) carried out the first nationwide survey among young physicians in urology and described the status quo of their residency. This revised follow-up examination draws an updated picture of the training and working conditions of residents in urology and assesses the development. METHODS In 2020 the GeSRU conducted an online-based survey of all residents in urology; therefore, the 2015 questionnaire was expanded. The model of the professional gratification crisis was used again. RESULTS A total of 332 questionnaires were analyzed. Major findings have not changed since 2015. The daily working routine is characterized by high pace and workload and economic considerations. Family- and research-friendly working conditions are largely lacking. 35% of the respondents draw professional consequences. The psychosocial strain remains very high and conveys a risk for physicians' health and patients' quality of care. CONCLUSION These results demonstrate that there are still systemically immanent burdens for residents in urology, which require adjustments to the working and training conditions. A structured, transparent curriculum for urological residency, remuneration and time for training and models which enable work-life balance should be established.
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Affiliation(s)
- H Arnold
- Facharztpraxis, Urologie Dr. Hannah Arnold, Gesundheitszentrum Senden, Hauptstraße 11 c, 89250, Senden, Deutschland.
| | - M Fassbach
- Klinik für Urologie, urologische Onkologie und Kinderurologie, Helios Klinikum Duisburg, Duisburg, Deutschland
| | - A Mattigk
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - V Zehe
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Ulm, Deutschland
| | - A Beck
- Klinik für Urologie, Katholisches Marienkrankenhaus Hamburg, Hamburg, Deutschland
| | - F Wundrack
- Klinik für Urologie, Helios Klinikum Berlin-Buch, Berlin-Buch, Deutschland
| | - L Bellut
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - J König
- Klinik für Urologie, Asklepios Stadtklinik Bad Tölz, Bad Tölz, Deutschland
| | - C Siech
- Klinik für Urologie, Universitätsklinikum Frankfurt, Frankfurt am Main, Deutschland
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Michel MS, Himmler M, Necknig U, Kriegmair M, Speck T, Fichtner J, Steffens J, Borgmann H, Bolenz C, Tuellmann M, Ruppin S, Petersilie F, Rebmann U, König J, Westphal J, Goebell P, Leyh H, Borchers H. [Certified residency curriculum for the specialization training in urology from the German Society of Urology according to the 2018 Training Regulations (version of 20. September 2019)]. Urologe A 2021; 59:135-140. [PMID: 33141266 PMCID: PMC7721681 DOI: 10.1007/s00120-020-01367-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- M S Michel
- Klinik für Urologie und Urochirurgie, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
| | - M Himmler
- Klinik für Urologie und Urochirurgie, Universitätsmedizin Mannheim, Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - U Necknig
- Abteilung für Urologie und Kinderurologie, Klinikum Garmisch-Partenkirchen, Auenstraße 6, 82467, Garmisch-Partenkirchen, Deutschland
| | - M Kriegmair
- Urologische Klinik München Planegg, Germeringer Str. 32, 82152, Planegg, Deutschland
| | - T Speck
- , Treskow Allee 103, 10318, Berlin, Deutschland
| | - J Fichtner
- Klinik für Urologie, Johanniter-Krankenhaus Oberhausen, Steinbrinkstraße 96a, 46245, Oberhausen, Deutschland
| | - J Steffens
- Klinik für Urologie und Kinderurologie, St.-Antonius Hospital, Akademisches Lehrkrankenhaus der RWTH Aachen, Dechant-Deckers-Straße 8, 52249, Eschweiler, Deutschland
| | - H Borgmann
- Klinik und Poliklinik für Urologie und Kinderurologie, Universitätsmedizin Mainz, Langenbeckstr. 1, 55131, Mainz, Deutschland
| | - C Bolenz
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Ulm, Albert-Einstein-Allee 23, 89081, Ulm, Deutschland
| | - M Tuellmann
- , Dr.-Henkel-Str. 2, 85435, Erding, Deutschland
| | - S Ruppin
- , Friedrichstr. 94, 10117, Berlin, Deutschland
| | - F Petersilie
- Deutsche Gesellschaft für Urologie, Martin-Buber-Str. 10, 14163, Berlin, Deutschland
| | - U Rebmann
- , Große Nikolaistr. 1, 06108, Halle, Deutschland
| | - J König
- Abteilung für Urologie, Asklepios Stadtklinik Bad Tölz, Schützenstraße 15, 83646, Bad Tölz, Deutschland
| | - J Westphal
- Klinik für Urologie und Kinderurologie, Krankenhaus Maria Hilf der Alexianer Krefeld GmbH, Dießemer Bruch 81, 47805, Krefeld, Deutschland
| | - P Goebell
- Urologische und Kinderurologische Universitätsklinik, Malteser Waldkrankenhaus St. Marien, Rathsberger Straße 57, 91054, Erlangen, Deutschland
| | - H Leyh
- Abteilung für Urologie und Kinderurologie, Klinikum Garmisch-Partenkirchen, Auenstraße 6, 82467, Garmisch-Partenkirchen, Deutschland
| | - H Borchers
- Deutsche Gesellschaft für Urologie, Martin-Buber-Str. 10, 14163, Berlin, Deutschland
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Necknig UH, Wolff I, Bründl J, Kriegmair MC, Marghawal D, Wagener N, Hegemann M, Eder E, Wülfing C, Burger M, Leyh H, May M, Kiesewetter J, Weidenbusch M. [Impact of the experience of urological senior physicians in Germany on professional and personal aspects]. Aktuelle Urol 2020; 53:331-342. [PMID: 32722826 DOI: 10.1055/a-1194-3611] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Urological senior physicians in Germany are a heterogeneous group with various clinical priorities and career objectives. To date, there are no reliable data concerning the impact of the time span for which senior physicians have been holding their position on professional, personal and position-linked aspects. MATERIAL AND METHODS The objective of this study was a comparative analysis of perspectives, private and professional settings, specific job-related activities and individual professional goals of urological senior physicians in Germany based on their experience in this position assessed as number of years (dichotomised at 8 years as senior physician). As part of a cross-sectional study, a 55-item web-based questionnaire was designed, which was sent via a link to members of a mailing list of the German Society of Urology. The survey was available for urological senior physicians between February and April 2019. Group differences were evaluated using multivariate regression models. RESULTS 107 of 192 evaluable questionnaires were completed by senior physicians holding this position for less than 8 years (< 8y senior physicians), 85 were completed by senior physicians holding this position for at least 8 years (≥ 8y senior physicians). < 8y senior physicians worked significantly more often at university hospitals (42.1 % vs. 18.8 %, p = 0.002). Overall, 82.4 % of ≥ 8y senior physicians assessed themselves autonomously safe in performing open surgery, compared to 39.3 % among < 8y senior physicians (p < 0.001). No significant differences concerning the self-assessment were found for endourological procedures (94.1 % vs. 87.9 %) and for the overall lower-rated self-assessment concerning laparoscopy (29.4 % vs. 20.6 %) and robotic surgery (14.1 % vs. 10.3 %). Despite the high management responsibility associated with their position, only about one third of participants (34.8 %) had received specific postgraduate education preparing them for managing and executive tasks. CONCLUSION This study shows significant differences among senior physicians regarding surgical skills depending on the time span they hold their position. Moreover, there is considerable dissatisfaction regarding the development of leadership skills and the preparation for managing tasks. In order to ensure availability of senior staff members for the field of urology in the future, it is important to consider their professional needs and to overcome existing shortcomings by education programs within well-orchestrated human resources development strategies.
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Affiliation(s)
- Ulrike H. Necknig
- Klinikum Garmisch-Partenkirchen GmbH, Abteilung für Urologie & Kinderurologie, Garmisch-Partenkirchen
| | - Ingmar Wolff
- Universitätsmedizin Greifswald, Klinik und Poliklinik für Urologie, Greifswald
| | - Johannes Bründl
- Universitätsklinikum Regensburg, Klinik für Urologie, Caritas-Krankenhaus St. Josef, Regensburg
| | | | | | - Nina Wagener
- Asklepios Klinik Altona, Abteilung für Urologie, Hamburg
| | - Miriam Hegemann
- Klinikverbund Südwest GmbH, Urologische Klinik Sindelfingen, Sindelfingen
| | - Elisabeth Eder
- Klinikum Ingolstadt GmbH, Klinik für Urologie, Ingolstadt
| | | | - Maximilian Burger
- Universitätsklinikum Regensburg, Klinik für Urologie, Caritas-Krankenhaus St. Josef, Regensburg
| | - Herbert Leyh
- Klinikum Garmisch-Partenkirchen GmbH, Abteilung für Urologie & Kinderurologie, Garmisch-Partenkirchen
| | - Matthias May
- St. Elisabeth Klinikum Straubing, Klinik für Urologie, Straubing
| | - Jan Kiesewetter
- Institut für Didaktik und Ausbildungsforschung in der Medizin, Klinikum der LMU München, München
| | - Marc Weidenbusch
- Nephrologisches Zentrum, Medizinische Klinik und Poliklinik IV, Klinikum der LMU München, München
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Analyse von europäischen Weiterbildungskonzepten zum Facharzt für Urologie unter besonderer Berücksichtigung der intersektoralen Weiterbildung. Urologe A 2020; 59:931-940. [DOI: 10.1007/s00120-020-01273-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Zusammenfassung
Hintergrund
Ziele der Arbeit sind der Vergleich der deutschen Weiterbildung zum Facharzt für Urologie mit anderen europäischen Konzepten, die Analyse lokoregionaler Unterschiede, sowie der personellen Entwicklung der deutschen Urologie in den letzten 5 Jahren. Zudem sollen finanzielle Fördermöglichkeiten für Weiterbildungsassistenten im ambulanten Sektor evaluiert werden.
Material und Methoden
Nach Analyse der neuen Musterweiterbildungsordnung (MWBO) erfolgte die Untersuchung der aktuellen Weiterbildungssituation in Deutschland im europäischen Vergleich. Es wurde eine Trendanalyse der Entwicklung von Personalstrukturen in der Urologie in den letzten Jahren durchgeführt. Zudem wurde ein intersektorales Rotationskonzept entwickelt. Zuletzt wurden finanzielle Fördermöglichkeiten für urologische Weiterbildungsassistenten durch eine standardisierte Telefonbefragung evaluiert.
Ergebnisse
Im Vergleich zu anderen europäischen Weiterbildungsinhalten zeigt sich die positive Sonderstellung der deutschen Urologie mit ihrem enormen Spektrum. In einigen Bundesländern bestehen bereits finanzielle Fördermöglichkeiten für Weiterbildungsassistenten durch die regionalen Kassenärztlichen Vereinigungen.
Diskussion
Während in anderen europäischen Ländern eine einheitliche Weiterbildung auf Staatsebene üblich ist, herrscht in Deutschland durch die Länderhoheit Heterogenität. Durch die Verlagerung vieler Weiterbildungsinhalte in den ambulanten Sektor werden zukünftig Allianzen zwischen Kliniken und Praxen im Sinne der intersektoralen Weiterbildung immer wichtiger werden. Dafür ist die Nutzung bestehender Fördermittel und als Fernziel der flächendeckende Zugang zu solchen Fördermitteln wünschenswert.
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Carrion DM, Rodríguez-Socarrás ME, Mantica G, Pang KH, Esperto F, Mattigk A, Duijvesz D, Vásquez JL, Díez Sebastián J, Scarpa RM, Papalia R, Palou J, Gómez Rivas J. Interest and involvement of European urology residents in academic and research activities. An ESRU-ESU-ESUT collaborative study. MINERVA UROL NEFROL 2020; 72:384-387. [DOI: 10.23736/s0393-2249.20.03734-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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König J, Aeishen S, Cebulla A, Bellut L, Fassbach M, Westphal J, Struck JP. Qualität statt Quantität verbessert die Weiterbildung. Urologe A 2019; 58:877-880. [DOI: 10.1007/s00120-019-0987-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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