Zentralblatt für Chirurgie
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Due to European law all examinations taken by officially recognized national boards have to be accepted in every member state. In 1958 the UEMS was founded on behalf of the European Council. Several Divisions in the "Section of Surgery" and the "European Board of Surgery" have to define the content and duration of their knowledge within the common trunk as well for the division's specialty itself. ⋯ East European countries start to harmonize their structure due to the demands of the UEMS. The charter on continuing Medical Education was established by the UEMS in 1998. This concept was also accepted by the national authorities in Germany and will be officially structured in our country very soon.
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Laparoscopy is very useful in penetrating abdominal trauma, in particular to exclude intraabdominal lesions in stab wounds. In blunt abdominal trauma laparoscopy is not the first choice of diagnostic means though it warrants comparable good results to CTscan and ultrasound. ⋯ In the future it has to be thought about laparoscopy in local anesthesia and in bedside procedure e.g. on the intensive care unit. Laparoscopy should be regarded as an integral part of diagnostic spectrum in blunt abdominal trauma.
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While substantial and practical qualification for medical practice within the framework of emergency medical services have to be proven by an advanced training, there are no special training programs for in-hospital emergency situations. As in the emergency room a transparent in-hospital emergency management has to be established including definite competencies to avoid time delays and inadequate treatment due to disputes about competence. ⋯ Thus, the physician working in ICUs needs professional qualification and specialized knowledge as well as marked competence to co-operate. In any case the final clinical responsibility has to be taken over by physicians who not only have performed their internship on a ICU but are highly qualified in the whole range of intensive care medicine including all topics required in advanced intensive care medicine curricula.
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Historical Article
[Surgery school. Tradition-transition-change in paradigm?].
First Schools in Surgery already at the antiquity. During the medieval some slow developments in this regard throughout Europe, especially in France and Italy. ⋯ Tremendous changes in our time with a break of the generations, new structures at the universities, far reaching separation into subdisciplines of surgery and explosive technical developments question the meaning of surgical schools in the old sense. But there will apparently be a continuation, even in a changed matter and this on the background of a shift of the paradigm.