A shortcut of the current minimal requirements of orthopaedic training in Austria
In a federal law („Medical Profession Act“) general basics of training valid for all specialities are declared. It includes, that the trainee has to appropriate knowledge, experience and skills, both in theoretical education and in practical training.
Training centers need at least 30 beds and 2 senior doctors to train one trainee, for every further trainee one additional senior doctor. Responsible for the correct execution is the head of the department, but he is allowed to delegate the realisation to one or more senior doctors (tutor). If clearly defined minimal requirements are fulfit, the Austrian Medical Chamber awards a training center, if a visitation is unsatisfactory, the training licence can be striped until the minimal requirements are demonstrable fulfit again.(The foundation of an orthopaedic department is a federal duty).
The training for orthopaedic surgeons takes 4 years, additional 12 months general surgery, 6 months traumatology, 3 months pediatry and 3 months neurology are compulsatory. Working time is 35 hours core time, additional night shifts and overtime hours, the maximum are 72 hours a week. Part-time is theoretically possible, but not entitled by law and not common until yet.
In a so called „Rasterzeugnis“ (grid or raster certificate) the knowledge and skills of learned training contents will be confirmed by the head of the department at the end of the time of collaboration or inbetween. The control of the achievment of knowledge and practical abilities takes place constantly, tests or interviews are not provided during the training, the trainee only has to perform a list of operations.
The performance of the training was delegated by law to the Austrian Medical Chamber and the Medical Chamber cooperates as far as possible with the scientific societies and delegates responsibilty again.
So the national Society of Orthopaedic Surgery developed a curriculum with completely listed aims and a connected logbook.Alocal problem is, that many training centers are too small, to be able to teach all the designated topics on the suspected level. So the society of orthopaedic surgery organises already for many years free training sessions about those topics, which either are only treated in specialized centers or about basic science.
In 2010 these training sessions were totally relaunched. They are still free of charge and still voluntary, but extremly helpful for the final exam and done by every trainee.The orthopaedic society started a very close collaboration with a private university
( „Donauuniversität Krems“) declaring the items, the universityperformes teaching and organisation on an independent and professional level. The sessions itselve take place in different orthopaedic departments all over the country, the teachers are either of the host department or invited.
The sessions are summarised in moduls, each taking one week. There is no compulsatory sequence and each modul is offered once a year.
The moduls are
- „basics“ (basic science of the locomotive system, osteosynthesis, legal and
insurance aspects),
- „additiv“ (rheumatology and rheumatoid surgery, sport orthopaedics),
-„ consolidation part 1“ (hand surgery, spine surgery, pedriatic orthopaedics, tumours)
-„consolidation part 2“ (foot surgery, shoulder surgery, neuroorthopaedics, joint replacement)
-„konservativ treatment“ (non-operative orthopaedic treatments, orthoses and prostheses, rehabilitation)
-„pharmacology“ (osteology, pain treatment)
All these moduls are also part of a general certified program. If you pass all of these and the final exam and you want to, you can study further on and finish at the university a MSc-training („MSc orthopedics“). The first graduate is suspected at the end of 2012.
In Austria traumatology is totally seperated from orthopaedics, but therefore the whole non-operative treatment of the locomotor system is done by orthopaedics, essentially by specialists in their surgeries.
The final exam takes place within the last year of training, once a year. In order by the Medical Chamber it is organised and done by the orthopeadic society, considering fixed rules. It is split up in a written part (120 MQ-questions within 4 hours) and an oral (discussion of 4 cases), there is no practical part. If the exam is not passed, the trainee has to wait until the next regular exam in the following year. The training contract ends with the appointment as an specialist, so he has the chance to stay in his department and improve his knowledge and skills for an other try.
Motycka, 12-2011