[Is the training and continuing education for urologists in Germany still up to date?]

[New approbation regulations-new concepts in urological undergraduate training?]

New research findings, changing health care structures and digitalisation are prompting further development of medical studies in Germany. The current amendment of the approbation regulations ("Ärztliche Approbationsordnung") focuses on the promotion of practical relevance and competence orientation of the course content and examinations, the redesign of the practical year and the expansion of general medicine in medical studies. This creates opportunities and challenges for urological training at the undergraduate level in Germany. In order to integrate basic scientific and clinical content, the existing curricula of the medical faculties must be adapted and further developed. There is an opportunity to implement innovative teaching and examination concepts in urological teaching and to attract the next generation of academics via scientific work in urology. In addition, the inclusion of teaching hospitals and outpatient areas can support university hospitals in urological training and show students the full range of the specialty. At the same time, given the limited time available for medical studies, there is the challenge of ensuring sufficient space for urology in the curricula. In order to fully implement the upcoming reform of medical studies, adequate financial and human resources are needed, as well as active commitment on the part of the teaching staff at the medical faculties.

Analyse von europäischen Weiterbildungskonzepten zum Facharzt für Urologie unter besonderer Berücksichtigung der intersektoralen Weiterbildung

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.

[Urology training in Germany: international comparison of educational concepts and satisfaction]

BACKGROUND

The training of residents in urology is challenged by global trends in surgical education, increasing technological developments, subspecialization of the field and working hour regulations for physicians. Currently, there is no standardized curriculum in Europe and significant international differences exist in the education of residents.

OBJECTIVES

We aimed to comprehensively map the state of urological training in an international comparison.

MATERIALS AND METHODS

A selective literature review was conducted using the following keywords: "urology, training, residents".

RESULTS

Recent surveys have shown that urology training in Germany is subject to relatively few regulations on content, time and space when compared to other countries. A lack of a structured curriculum is considered as the main factor leading to dissatisfaction of the residents. Increasing work load, lack of surgical training and limited flexibility in family or research planning have been mentioned as barriers for successful training.

CONCLUSION

Structured and validated competence assessments and not "minimum numbers of operations" may help improve surgical training. An objective nationwide examination at the end of residency may be useful for international benchmarking.

[Quality and objectifiability of training and advanced training in urology]

The attraction to study medicine has not changed, however we are facing a lack of trainees especially in surgical subspecialties like urology. Possible explanations are a 70% proportion of female students and different views on the work-life balance in the future. A high burden of theory and unrealistic multiple choice examinations support those who can learn but there are no objective and reproducible criteria to recognize the competence of a good physician early in the career. This problem continues during residency, especially in surgical subspecialities. The different medical boards in Germany responsible for the training programs have no concepts. Many attempts in other countries to objectively measure surgical skills have so far been ignored. If we do not want to lose our traditionally high competence in medicine we should join those who attempt to improve teaching and to use methods for selecting suitable candidates for surgery as soon and as objectively as possible.