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Passing specialty medical examinations enhances patient safety
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Currently it is possible for an orthopaedic trainee from a country outside Europe to be employed as a consultant in Europe without passing any kind of European examination. This situation can affect patient safety if the outside physician administers treatments not recognized in Europe or performs surgeries when not indicated or does not perform needed surgeries.
The dilemma is how to ensure that foreign colleagues are welcome in our clinics and possess the required knowledge and skills to practice as medical specialists in Europe. To me, the only answer is that these foreign trainees should pass an exam to verify their level of expertise in orthopaedic surgery.
Currently, medical trainees in most European nations must pass an exam at the end of training before being licensed as an orthopaedic specialist. Thus, the European Union of Medical Specialists has established specialist exams in all medical specialties. In orthopaedics, the European Board of Orthopaedics and Traumatology (EBOT) exam is taken annually by about 80 specialists, most of who are from outside Europe. Although results of the exam have no impact on whether someone can be licensed as a specialist, the results give the staff and colleagues at a center that potentially employs a foreign trainee a good idea of new physician’s skill level.
Per Kjaersgaard-Andersen
The requirement that physicians from foreign countries who decide to work in European clinics pass the EBOT exam or an equivalent has other benefits. It could minimize competition for clinical positions among applicants with varying levels of qualifications. If nothing is done to change the process of examining physicians who train elsewhere but practice in Europe, then qualified European trained and examined specialists could face unemployment as they are displaced from jobs. Although this is not a present problem, it could develop into one in the future if no action is taken now.
The best way to prevent these scenarios from becoming realities is to establish a mandatory exam which all European trainees must pass at the end of their training program. The next logical step is to develop an examination that foreign specialists must pass before they can be licensed to practice orthopaedic surgery in Europe.
The question of who must take the specialty medical examinations, and when, ultimately affects patient safety.
At the recent Scientific Kick-Off meeting for the 15th EFORT Congress, scheduled to be held in London in June 2014, it was agreed that the highlighted topic for the Congress should be patient safety. I agree. Many factors affect patient safety in orthopaedics — from the introduction of new implants to evidence-based treatments. But I believe a factor just as critical to patient safety is ensuring that foreign physicians entering the European workforce obtain an adequate level of education and training to practice as orthopaedic surgeons here.