In Europe the specialty of EM has made remarkable progress during the last seven years. In 2001, the European Doctors’ Directive on the recognition of professional medical qualifications included only the UK and Ireland as recognising the specialty; more recent Directives (European Directives 2005/36/EC and 2006/100/EC) list nine EU nations under the heading of ‘Accident and Emergency Medicine’, the name by which EM was formerly known in the UK and Ireland. Another ten countries in Europe have more recently implemented a five-year training programme as required by the Doctors’ Directive or have developed a 2-3 year programme for training in EM as a supra-specialty.
European medical specialties are represented in Brussels by the Union Européenne des Médecins Spécialistes (UEMS), a non-governmental organisation promoting quality and standards of training with the purpose of harmonising care and promoting free movement of doctors within the EU. Emergency Medicine is represented in the UEMS by a Multidisciplinary Joint Committee and by the European Board of Emergency Medicine (link to the page).
The recommended content and format of a Core Curriculum for EM were previously published in this journal in December 20021. This document was discussed by the UEMS MJC(EM) and it was decided to revise and enlarge the curriculum to reflect developments in the specialty and recent educational principles. EUSEM therefore established a Task Force with a representative from each of the national societies included in the Federation at the Fourth European Congress on Emergency Medicine in September 2006. Roberta Petrino (Italy) served as chairman and the group was composed of 18 members from different countries.
The first meeting of the Task Force was held in Novara, Italy, in February 2007, followed by four further meetings up to April 2008. The final draft of the curriculum was the main agenda item at a MJC(EM) meeting in Brussels the following month.
The fundamental first statement of the Curriculum is the distinction of the specialty of EM from the emergency medical care which is within the province and expertise of medical practitioners in many other specialties. It confirms the EUSEM Policy Statement that EM is ‘…a medical specialty based on the knowledge and skills required for the prevention, diagnosis and management of urgent and emergency aspects of illness and injury affecting patients of all age groups with a full spectrum of undifferentiated physical and behavioural disorders. It is a specialty in which time is critical’. The essential features of a clinical specialty include a unique field of action, a defined body of knowledge and a rigorous training programme. EM has a unique field of action, both within the emergency department and the community, and the revised curriculum document incorporates both the relevant body of knowledge and associated competencies, but also establishes the essential principles for a rigorous training programme.
After the Curriculum was completed it was presented to the EUSEM Council, to the Presidents of the Federation of European National Societies of EM and to the MJC(EM) of UEMS with requests for amendments and approval. It was officially accepted as a EUSEM document during the Fifth European Congress on Emergency Medicine held in Munich in September 2008. The spirit of multinational cooperation which enabled this complex document to be developed and agreed within a period of just 15 months reflects the harmony which links emergency physicians across Europe.
The main objective of the Curriculum is to serve as a guide and a standard for all European countries seeking to train future emergency physicians.