UEMS SurgeryUEMS Surgery
General Surgery is a large specialty requiring knowledge of basic sciences, specialised knowledge and skills in managing congenital and acquired diseases and injuries of most organ systems, which are treated by surgical methods.
It provides for the operative and non-operative management, i.e., prevention, diagnosis, evaluation, treatment, intensive care and rehabilitation of patients with pathological processes that affect these organs, including the management of pain.
It also involves the necessary knowledge and expertise leading to referral to specialized centres when this is indicated and possible.
Where this is not possible because of time and geographical considerations, the General Surgeon must possess the multi-specialty skills necessary to carry out these interventions safely.
General Surgeons co-operate closely with other surgical specialists in the fields of Anaesthesiology, Intensive Care, Emergency Medicine, Radiology and Interventional Radiology, Neurology, Paediatrics, Internal Medicine, Geriatrics, Rehabilitation Medicine, Obstetrics and Gynaecology and also Pharmacy.
This involves a high level of competence in non-technical skills and a commitment to Continuous Professional Development.
In 1994, the UEMS adopted its “Charter on Training of Medical Specialists” with an aim to outline the guiding principles for high level Medical Training. This Charter sets the basis for the European approach in the field of Post Graduate Training.
The UEMS Division of General Surgery has completed this Charter with its European Training Requirements in General Surgery which can be found here and which is regularly updated to reflect scientific and medical progress.
The EBSQ General Surgery Examination delivered by the UEMS and leading to the conferment of Fellow of the European Board of Surgery in General Surgery (FEBS General Surgery), is a quality mark for training in General Surgery.
It is an ‘Exit Examination’ which constitutes the final rite of passage for Specialist Trainees in General Surgery who have satisfied the requirements of the UEMS EBSQ General Surgery Syllabus and Curriculum.
Successful candidates are awarded the Qualification and may add the title “Fellow of the European Board of Surgery in General Surgery (FEBS General Surgery)” to their name.
Like other specialties within the European Union (EU), General Surgery is regulated by the EU Professional Qualifications Directive 2005/36/EC, which provides for automatic mutual recognition in the European Community for European nationals whose name appear on their national Specialist register. The UEMS EBSQ – General Surgery Qualification does not lead to automatic recognition for specialist registration within the EU. Neither does it give the right to practice in any UEMS member country (Glasgow Declaration: Appendix 1; point 3); such a right is only granted by the relevant National Authority.
By providing supporting evidence, the Qualification may be an important factor in the eligibility process for a Certificate of Completion of Training (CCT, CCST), in countries where this constitutes the system of Specialist Registration. However, passing the UEMS EBSQ General Surgery Examination, leading to FEBS, in itself, does not lead to automatic conferment of the CCT (CCST). It is part of the application process where this applies.
In some countries, for trainees having completed the relevant training programme and satisfied all the requirements of the relevant Curriculum, the FEBS may lead to eligibility for CCT (CCST).
In countries where such a decision was adopted unilaterally or following bilateral agreements, the UEMS EBSQ General Surgery Examination has substituted the National Examination as a pre-requisite for Specialist Registration.
In some countries, the FEBS may facilitate eligibility for independent practice. This is of course entirely subject to authorisation by the national relevant body.
In some countries, the UEMS EBSQ General Surgery Qualification it is taken into consideration in surgical appointments.
Outside Europe, and particularly in the Middle East, the EBSQ Qualification is increasingly recognized as a quality mark.
In Pakistan, the Pakistan Medical Council has recognised the F.E.B.S as a post graduate qualification.
It is important that, if in any doubt, applicants for or holders of the Qualification seek clarification from the regulatory authority of the country where they are planning to practice.
General Surgery is a large specialty. It requires the acquisition of knowledge in basic sciences, the development of clinical and operative skills, as well as specialized knowledge and skills. It includes the management of congenital and acquired diseases and injuries of most organ systems.
It provides for operative and non-operative management, i.e. prevention, diagnosis, evaluation, decision making, treatment, intensive care and rehabilitation of patients with pathological processes that affect these organs, including the management of pain.
It also involves the necessary knowledge and expertise leading to referral to specialized centres when this is indicated and possible. Where this is not possible because of time and geographical considerations, the General Surgeon must possess the multi-specialty skills necessary to carry out these interventions safely.
The General Surgeon must be able to decide on whether a surgical treatment or a conservative management will serve the patient best.
The General Surgeon must be equipped to carry out a wide range of interventions safely and/or to refer patients to specialized colleagues or centres when indicated and possible.
In the management of patients, General Surgeons are often called to co-operate closely with other surgical specialists in the fields of Anaesthesiology, Intensive Care, Emergency Medicine, Radiology and Interventional Radiology, Neurology, Paediatrics, Internal Medicine, Geriatrics, Rehabilitation Medicine, Obstetrics and Gynaecology and also Pharmacy.
Good communication skills are essential, in full respect of confidentiality.
The General Surgeon should also be able to treat and/or refer trauma and emergency patients depending on personal abilities, geographical situation and other regional modalities.
To make appropriate decisions, General Surgeons must keep their knowledge and skills up to date and be involved in Continuous Professional Development.
For a definition of all acronyms and of all the terms used in these pages, please read the following:
General Surgery (GenSurg) is a Division within the “Section of Surgery” which was formed in 2015 to prepare specific advice on issues relating to training, harmonisation, standardisation of training and professional practice in General Surgery (GenSurg) within the UEMS countries for the benefit of training in GenSurg and patient care.
The “Division of General Surgery” is a non-profit organisation.
The section shall be known as the “Division of General Surgery” associated with the “Section of Surgery” of the “European Union of Medical Specialists” (UEMS) and the “European Board of Surgery” (EBS).
The “Division of General Surgery” with its “Board of General Surgery” is especially responsible for the GenSurg Board Examination of the EBS.
3.1. There shall be up to two representatives from each member state of the UEMS who shall be nominated by the competent national professional medical organisation(s), which can be the national scientific society and/or professional organisation in official communication with the UEMS and the EBS.
3.2. In any voting process, each country is entitled to only one vote. If a country has two members and one of them is present at the time of a vote, this member is entitled to vote without consulting the second member. If both members are present and consensus cannot be achieved, the most senior (longer serving member) is entitled to vote.
In the event of a full member being unable to attend a meeting, he/she may nominate a deputy previously nominated by the national medical organization to attend in his place, subject to the prior approval of the chairperson.
3.3. The “Division of General Surgery” may include non-voting delegates representing e.g. the major European scientific societies, associations for surgeons in training and representatives of the associated and observer countries of the UEMS.
Official national organisations for GenSurg surgeons in associated and observer UEMS countries may be invited to nominate representatives to attend meetings at the discretion of the President. Representatives of these countries shall not have entitlement to vote.
3.4. The tenure of each full member shall be for 4 years. The mandate shall be renewable.
Following completion of their term, the members of the “Division of General Surgery” are responsible for ensuring their succession following consultation with their professional organisations. This is to ensure proper representation of all countries at any given time.
3.5. The President of the UEMS Section of Surgery and the President of the European Board of Surgery shall be voting members of the “Division of General Surgery”.
3.6. The “Division of General Surgery” shall elect an Executive Committee from amongst its members, which will include the Chairperson, Vice Chairperson, a Secretary and a Treasurer. The last two offices may be held by the same person.
3.7. The Chairperson and Vice Chairperson shall have a tenure of 4 years and shall be eligible for re-election. The Chairperson and Vice Chairperson shall not be elected at the same time. The tenure of the Secretary will be for 4 years, renewable for up to two further terms of 4 years.
The Vice Chairperson and Secretary/Treasurer shall be eligible for election as Chairperson.
A Founding and/or Honorary President can be full-voting member of the Executive Committee.
3.8. Official representatives of full EU member states shall be eligible for election to office.
For the election of Executive Officers the Secretary will notify members of the “Division of General Surgery” of an impending vacancy one year in advance and ask for nominations at the same time.
Any nomination should be proposed and seconded by two members of the Division. The Secretary will then arrange a postal ballot to all members of the Division 6 months before the appointment will become active.
3.9. The Chairperson and Secretary of the Division shall attend meetings of the Speciality Section of Surgery of the UEMS and the EBS as ex-officio members. If the Chairperson or the Secretary cannot attend the meeting, the Chairperson can authorise any other member of the Executive Committee to represent the “Division of General Surgery”.
3.10. The Division may appoint working parties or comGenSurgsions to prepare draft documents or recommendations on specific topics for consideration by the full “Division of General Surgery”.
4.1. To prepare advice concerning all aspects of professional practice in GenSurg in the context of the EU for the benefit of the EU political administration through the UEMS structure and ensuring that training in GenSurg is maintained at the highest level.
5.1. The “Division of General Surgery” shall report to the UEMS Management Council through the UEMS Section of Surgery and the EBS.
5.2. Relations with any organization or institution outside the UEMS shall be in accordance with the current UEMS rules of procedure.
6.1. The “Division of General Surgery” shall meet at least once per year and the minutes of the meeting shall be forwarded to the UEMS Section of Surgery and the EBS. The date and place of every meeting is to be decided at the end of the previous meeting.
The Division meetings can be in conjunction with the UEMS Section of Surgery as common trunk to all Boards is an issue.
The business meeting of the Division can be linked to a EBS GenSurg examination process and to the relevant location.
Extraordinary meetings can be called by the Executive Committee or following the request of one or more members and approval by the Executive Committee.
6.2. Meetings will be made known to the Section of Surgery.
6.3. Meetings shall be organised in such a way that will allow the maximum possible number of members to attend and to entail the minimum of expense.
6.4. Meetings may be attended by the General Secretary of the UEMS or a nominated deputy who shall be a member of the Management Council.
Meetings may also be attended by the President of the UEMS Section of Surgery or the President of the EBS or a nominated deputy who is a member of the Management Council of the UEMS Section of Surgery.
6.5. The agenda shall consist of subjects proposed by the members of the Division, officers of the UEMS Section and Board.
6.6. The agenda shall be circulated to the members and the Secretary General of the UEMS, the UEMS Section of Surgery and the EBS at least 1 month before the meeting.
6.7. The minutes of the meetings shall be circulated to all members, the President and Secretary of the UEMS Section of Surgery, the President of the EBS, the General Secretary of the UEMS and the Management Council of the UEMS within 1 month of the meeting.
7.1. The “Division of General Surgery” is a non-profit organization and is financed by the fees of the applicants for the two parts of the GenSurg EBS Eligibility I and II accreditation process.
The Division is also financed by any legal financial benefits for its contribution to various professional/scientific activities (i.e. meetings, publications).
The Division can accept legal public (i.e. EU bodies, national government bodies, professional/scientific organisations) or private (i.e. gifts, contribution by the commercial sector) contributions donations.
A financial contribution/donation to the Division can only be accepted under the strict rule that is offered in order to help the Division to achieve its objectives and without any obligation of the Division towards the body(ies)/organisation(s)/person(s) offering the contribution/donation.
7.2. The Division shall hold a subaccount in Euros according to the statutes regulation of the UEMS.
The Treasurer and one more nominated person by the Executive Committee are the authorised users of the account.
The Treasurer and the second nominated user of the account have to present at the annual meeting of the Division a signed report of the account as well as copies of the bank statements of the account.
The Treasurer and the second nominated user must also forward each annual report to the Treasurer of the Section of Surgery of the UEMS and the EBS.
The national scientific societies and/or the official national organisations and/or professional organisations shall be responsible for the travel and accommodation expenses to enable its representative to attend the meetings.
9.1. The “Division of General Surgery” shall create a “Board of General Surgery” that will be entrusted with the problems of training, EBSQ Board Examination, Continuing Medical Education (CME), Continous Professional Development (CPD) and quality management for the accreditation of GenSurg surgeons and specialised organisational structures (e.g. Department for GenSurg Surgery).
9.2. The Board will have the responsibility to develop the necessary documents for defining the “transferable competency” of GenSurg by developing a syllabus including the content of training and learning outcome in GenSurg, defining mandatory theoretical knowledge, practical and clinical skills (with a detailed catalogue of interventions, procedures and operations including provisional arrangements and compensatory rules), training requirements for recognition of trainers and training institutions and mechanisms for assessement and evaluation, all in cooperation with the EBS and following the standards and regulations provided by the EBS.
9.3. The Board will have the responsibility of organising the qualification process to be accredited as “Fellow of the European Board of Surgery /GenSurg” (F.E.B.S. /GenSurg) in cooperation with the EBS and following the standards and regulation provided by the EBS.
9.4. The Board shall implement all structures and processes for Eligibility and Examination quality management including the creation of an Eligibility Committee, an Examination Committee and a Credentials Committee following the regulations by the EBS.
The Board qualification process for Fellowship shall undergo a regular external quality control process and audit as provided e.g. by the CESMA (Council of European Specialist Medical Examinations).
9.5. The Board Examination shall include a MCQ test and an OSCE circuit according to the provisions and standards provided by the EBS.
9.6. Visitation and accreditation of Training Centers shall be performed according to the UEMS provisions.
9.7. The Board will have the responsibility to substantially cooperate in the harmonisation and standardisation process of European surgical training.
The Statutes as well as the EBS Fellowship qualification process (Eligibility and Examination) can be amended following relevant suggestion by a member of the “Division of General Surgery” and approval by 2/3 (two thirds) of the countries members which are represented at the time of the discussion of the amendment. For that 50% +1 of the countries members of the Division should be represented.
All amendments shall be in accordance with the EBS standards and regulations for the Fellowship qualification process.
| Arthur Felice President of the Division of General Surgery | Wolfgang Feil President of the European Board of Surgery Foundation & Honorary President of the Division of General Surgery |
The UEMS invited its specialist sections with the formation of their own European Boards for their respective specialties.
Members shall be leading representatives of the national organisations and scientific societies representing their country on a professional, scientific and university basis.
The foundation shall be constituted in accordance with these statutes and the rules of procedure of UEMS and the specialist sections.
The European Boards shall provide fresh impetus for achieving high quality medicine and completing arrangements for the free movement of specialist doctors.
The “European Board of GenSurg (EBGenSurg)” is created within the “Division of GenSurg” and in association with the “European Board of Surgery” (EBS) and the “Section of Surgery” of the UEMS.
The EBGenSurg is constituted in accordance with the statutes, declarations and rules of procedure of the UEMS.
The members of the EBGenSurg shall be elected from leading representatives of the national organisations and scientific societies of general surgery of UEMS full member countries on a professional, scientific and academic basis.
The EBGenSurg shall achieve its objectives by setting and recommending standards to the EBS and by encouraging health authorities, national and international scientific societies of general surgery to live up to such standards.
The main objective is to guarantee to the patients the highest standards of care in the field of General Surgery in the countries of the European Union (EU) by ensuring that the training of the general surgeon is raised and maintained to the highest possible level. This shall be achieved by the following means:
The EBGenSurg shall assess and report to the “Division of GenSurg”, the EBS and the Section of Surgery the current contents and quality of training in general surgery in the different countries of the EU.
The EBGenSurg shall define the contents of training of general surgeons (syllabus, log-book) and standards for training programs and shall implement mechanisms for the maintenance of these standards.
The EBGenSurg shall define the requirements to which the training institutions and teachers in general surgery should conform. Based on the agreement of participating institutions, requirements can be subjected to site-visit control.
After appropriate assessment of eligible candidates the EBGenSurg shall recommend to the EBS the issuance of an European Board Fellowship in GenSurg.
Assessment of the quality of training of general surgeons may take place at his/her request according to the different criteria laid down by the EBGenSurg.
The EBGenSurg shall facilitate the exchange of general surgical trainees between the training centers of the various countries of the EU to enable a better harmonisation and quality of training.
The EBGenSurg shall establish criteria of evaluation in Continuing Education.
Visitation and accreditation of Training Centers shall be performed according to the UEMS provisions.
The Board will have the responsibility to substantially cooperate in the harmonisation and standardisation process of European surgical training.
The Executive Bureau of the UEMS shall officially communicate with the EBS through the “Section of Surgery” and the “Division of GenSurg”.
The “Section of Surgery” and the Executive Bureau of the UEMS shall be entrusted with communicating all opinions issuing from the EBGenSurg and the “Division of GenSurg” to the competent UEMS bodies.
The “Division of GenSurg” shall submit through the “Section of Surgery” to the UEMS for ratification any changes to statutes relating to the membership and functioning of the EBGenSurg.
The EBGenSurg shall consist of one or two representatives of each member state. One representative shall be a member of the national delegation to the “Division of GenSurg”. The Division can appoint an additional representative, after inviting nomination from the relevant national professional bodies.
The EBS shall nominate one or two of its members to attend meetings of the EBGenSurg. They may send substitutes. The scientific and/ or professional societies of General Surgeons in the EU and representative organisations of general surgeons in training may be invited to nominate non-voting observers to attend meetings at the discretion of the Chairperson.
The Chairperson of the Management Committee may invite consulting experts in the context of its (their) activities, who have no voting rights.
The replacement of an EBGenSurg member or his/her substitute may be decided by the respective National Society by withdrawing the nomination to the EBGenSurg. The replacement must be indicated to the “Division of GenSurg”. The term of representation will be 4 years and will be renewable. The terms of the 2nd representative of a country follow the same scheme but will stagger with the terms of the 1st representative.
A Management Committee will be elected amongst the EBGenSurg members. The latter is composed of a Chairperson and Vice-Chairperson. The Treasurer and Secretary are the same as those in the “Division of GenSurg”.
The President of the European Board of Surgery shall be member of the Management Committee with full voting rights.
The Management Committee shall communicate with the General Secretary of the UEMS, the Section and Board of Surgery and the “Division of GenSurg” who shall be informed of the activities of the EBGenSurg as prescribed in the Statutes of the UEMS (minutes of plenary meetings decisions taken, all changes in the membership of the Boards, changes in Management Committee, etc.).
Duration of terms of office of the Management Committee: The Chairperson, the Vice-Chairperson shall remain in office for 4 years and the terms are renewable.
The funds of the Board shall be acquired by: contributions of the national associations and societies of general surgery – subsidies and donations – gifts, institutes of heir and legacies – other legal benefits – fees for European Board of Surgery Qualifications (EBSQ) assessments.
A session is held at least once a year in conjunction with the session of the “Division of GenSurg”. Additional meetings may be convened by the Management Committee, in agreement with or at the instigation of the UEMS “Division of GenSurg”.
The agenda consists of items proposed by members of the EBGenSurg, by the Management Committee, by the “Division of GenSurg”/Section of Surgery, by the EBS or by the UEMS Management Council or its Secretary General.
The agenda of the meeting shall be communicated to the EBGenSurg members at least one month before the meeting.
The minutes of the meetings, as well as all resolutions, recommendations, opinions, studies and other documents are to be sent after approval by the EBGenSurg to the Chairperson and the members of the EBGenSurg, to the President and the members of the Division, to the Secretary of the Section of Surgery, the secretary of the EBS and to the UEMS Secretary General.
The Management Committee meets at least every six months. The meetings are convened by the Chairperson and/or the Secretary. The agenda and the relevant information are described to the Management Committee members.
In order to save time and money the meetings of the EBGenSurg should be held at the same time and location as the meetings of the Division of General Surgery and the Section of Surgery. The agenda of these committees should be harmonised in advance to enhance effective project work.
Each country represented on the EBGenSurg has one vote. The EBS also has a single vote. Representatives of a UEMS associated or observer countries have a consultative voice only.
The “European Board of GenSurg (EBGenSurg)” within the “Division of GenSurg” is entrusted with the problems of training, EBSQ Board Examination, Continuing Medical Education (CME), Continous Professional Development (CPD) and quality management for the accreditation of GenSurg surgeons and specialised organisational structures (e.g. Department for GenSurg).
The Board will have the responsibility to develop the necessary documents for defining the “transferable competency” of GenSurg by developing a syllabus including the content of training and learning outcome in GenSurg, defining mandatory theoretical knowledge, practical and clinical skills (with a detailed catalogue of interventions, procedures and operations including provisional arrangements and compensatory rules), training requirements for recognition of trainers and training institutions and mechanisms for assessement and evaluation, all in cooperation with the EBS and following the standards and regulations provided by the EBS.
The Board will have the responsibility of organising the qualification process to be accredited as “Fellow of the European Board of Surgery /General Surgery(F.E.B.S./GenSurg) in cooperation with the EBS and following the standards and regulation provided by the EBS.
The Board shall implement all structures and processes for Eligibility and Examination quality management including the creation of an “Eligibility Committee”, an “Examination Committee” and a “Credentials Committee” following the regulations by the EBS.
The Board qualification process for Fellowship shall undergo a regular external quality control process and audit as provided e.g. by the CESMA (Council of European Specialist Medical Examinations).
The Board Examination shall include a MCQ test and an OSCE circuit according to the provisions and standards provided by the EBS.
The EBGenSurg can designate committees, charged of the study and presentation of proposals concerning specific objectives of the EBGenSurg, always in accordance to the UEMS statutes and rules of procedure.
The committee(s) shall relate to the Management Committee.
The Statutes as well as the EBSQ Certification Process (Eligibility and Examination) can be amended following relevant suggestion by a member of the Division and approval by 2/3 (two thirds) of the countries members which are represented at the time of the discussion of the amendment For that 50% +1 of the countries members of the Division should be represented.
All amendments shall be in accordance with the EBS standards and regulations for the Fellowship qualification process.
A document confirming the cooperation between the UEMS Board of Surgery (EBS) and the Lebanese Society for General Surgery (LSGS) was signed on June 19th, 2014 in Beirut, Lebanon.
The objective of the European Board of surgery (EBS) of the UEMS is to assess, set standards for and progressively harmonize the content and quality of training and continuing medical education (CME) and professional development in all fields of surgery within the member states of the European Union (EU) and other UEMS states towards legislation.
The medical communities of the East Mediterranean and North Africa suffer from heterogeneity in their standards of surgical education and surgical practice, and, due to their proximity to the European continent, wish to cooperate with the European institutions to level these standards to those of Europe.
This can only lead to the advancement of the professional development of surgeons in the region to the highest standards with the relevant international recognition.
The standards of surgical education (Knowledges & Skills) are published elsewhere in the relevant documents. The catalogue is the basis for the examination, which consists in an Eligibility procedure and the Board Examination. Successful candidates are rewarded the qualification “Fellow of the European Board of Surgery (F.E.B.S.)”.
The Board Fellowship is a strategic key competency and steering tool to enhance personnel selection in the future. By that the EBS offers the application for the Board Fellowship to candidates from other countries in order to validate and monitor key competencies and the qualification of presumably migrating physicians.
The EBS closely cooperates with scientific societies (e.g. ESS) and the cooperation partners are integrated in the executive functional bodies of the Board. An outstanding feature of cooperation is to commonly conduct Board Examinations and Preparatory Courses.
The following General Provisions and Outlines are valid providing that the application of the Lebanese Order of Physicians for Observer Status in the UEMS is going to be accepted.
The UEMS Section and Board of Surgery and the LSGS are in the process of establishing and implementing a new memorandum of understanding regarding their future collaboration.
This agreement consists in the following steps:
This agreement, in case of success, will help Lebanon, the Eastern Mediterranean and the North African countries to improve their surgical healthcare standards and to level their professional surgical practice to that of the European countries. The medical care of the local population will, doubtlessly, profit from this progress.
On the other hand, the European interest in this geographical area will be increased, bringing more mutual understanding and peaceful cooperation between the people of both regions.
| Ghassan RAMADAN The President of the European Society of Surgery The President of the Lebanese Society for General Surgery | Wolfgang FEIL The President of the European Board of Surgery Chairman of the GenSurg Examination Board |