Open Facilities for Training in European Neurology (OFTEN): a European Board of Neurology initiative

World Federation of Neurology

BACKGROUND AND PURPOSE

To acknowledge the occasion of the 10th anniversary of the formation of the European Academy of Neurology (EAN), the World Federation of Neurology was invited to contribute its perspective on the formation of the EAN and its activities over the past decade.

METHODS

This article is based on the experiences of the author in several functions with the European Union of Medical Specialists, the European Federation of Neurology and the European Neurological Society and with the World Federation of Neurology as a trustee since 2009. This article is supported by the author's own archive as well as by several publications.

RESULTS

The formation of the EAN was influenced by the activities of the two main predecessor societies, the European Neurological Society and European Federation of Neurology, which left an imprint on the structure of the EAN. The newly formed EAN underwent rigorous structural and organizational changes and has been acting as a successful and independent regional society, expanding increasingly in worldwide activities.

CONCLUSION

The EAN, with its 47 member countries, strong democratic leadership and structure, is an excellent example of a regional society with expanding global influence that uses its advocacy skills to influence and improve the structure of neurology in Europe.

Partnership and cooperation is necessary to improve and expand neurology

BACKGROUND

Brain disorders have a large impact on society, representing one third of the total burden of disease. Neurology is more than before divided into fields of highly specialized branches.

OBJECTIVE

To assess the need for co-operation in neuromedicine to achieve optimal results for patient treatment, diagnosis and care.

DISCUSSION

Co-operation regarding patients with disorders in the brain and nervous system should involve medical specialists, general practitioners, other professionals, patients and carers. Optimal co-operation represents both an institutional and personal challenge. The principle of joint action between several subspecialists should also have consequences for educational systems and requirements. Formalised co-operation is well established in medical research, and principles for good practice in neuroscience have relevance also for clinical medicine. How to organise the optimal treatment is therefore not only a challenge for neurologists, but also for the total health system within hospitals and in society.

CONCLUSION

Open-handedness and a willingness to co-operate should be a hallmark for neurologists.

One Europe, one neurologist?

In recent years, there has been a major shift in emphasis within neurology from being a largely diagnostic discipline to one much more actively involved in treating disease. There have been major scientific advances leading to new and effective treatments. There is also a much greater awareness of the burden of neurological disease (Olesen J, Leonardi M. European Journal of Neurology 2003; 10: 471) and informed sufferers are requesting specific intervention. There is wide variation in the delivery of neurological services throughout Europe. This is reflected in manpower levels, the place of neurology related to other medical specialties and different mixes of hospital and private office practice. These differences have been thrown into sharper focus by the recent expansion of the European Union (EU). Initial training in neurology is given to undergraduate/pre-graduate students. Post-graduate education is delivered within a residency program leading to specialist qualification and certification. We now recognize that this is only the beginning of a life long program of continuous education and development (CME/CPD). National and international exchange programs facilitate the growth of knowledge and promote professional harmony and cooperation. The free migration of medical specialists has been an aspiration but remains limited by cultural, linguistic, personal, professional, political and economic factors. Two bodies, the European Board of Neurology (EBN-UEMS) http://www.uems-neuroboard.org (Union Européenne des Médecins Spécialistes) and the European Federation of Neurological Societies (EFNS) http://www.efns.org are actively involved in harmonising and developing neurology at the European level.

Quality of neurology residency programmes: an Italian survey

In recent years there has been a growing interest in medical and particularly neurological education and how this should be related to the needs for patient care. To evaluate neurological training in Italy, we conducted a survey of the residency programmes aimed at different aspects of training. The survey was conducted in the 38 neurological Italian teaching hospitals and 27 of these answered. Six of the 27 centres organized all of the scheduled teaching courses. The quality of courses was considered 'not sufficient' in 11 schools and 'good' in 12. Seminars were regularly performed in 18 centres but in 60% of these the number was <1 per week. Questionnaires to evaluate the quality of teaching were lacking in all centres. Regarding the procedures performed by each resident there was a large variation between the different schools. A regular rotation of each resident in the neurophysiology services was performed in 14 schools. Ward and out patient activity varied widely and details are given. We conclude that there is marked heterogeneity in training programmes between different centres. Some important activities such as seminars and rotation in neurophysiology are performed poorly.