UEMS Section of SurgeryUEMS Section of Surgery
Minimal Invasive Surgery (MIS) is a “transferable competency” which requires the acquisition of “Knowledge” in basic clinical sciences and operative skills as well as specialised “Knowledge and Skills” in managing congenital and acquired diseases and injuries of most organ systems, which are treated by operative and other interventions.
The “transferable competency” MIS covers acute and non-acute diseases and injuries and acute and elective procedures in patients of all ages.
It provides for the 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 specialised centers when this is indicated and possible, and where this is not possible because of time or geographical considerations, to possess the multi-specialty skills to carry out these interventions safely.
Minimal Invasive Surgery (MIS) cooperates with other surgical and medical specialties, e.g. anesthesia and intensive care, emergency surgery, gastroenterology, general surgery, internal medicine, radiology, neurology, pediatrics, oncology, obstetrics and gynecology, urology and others in the management of patients.
Videodocumentation of MIS procedures is an essential prerequisite for training, certification and quality control in surgical units performing MIS operations.
Endoscopy is another integral part of planning and performing laparoscopic/thoracoscopic interventions, increasingly more often done synchronously as combined access procedures.
Eligibility for “MIS centres” is usually defined by national surgical societies referring to number of procedures/endoscopies per year, number of specialized surgeons, adequate documentation, education and quality control.
If malignant diseases are treated by MIS it is essential for the MIS surgeon to cooperate with a multi-disciplinal team (“Onco-Board”) in order to guarantee optimal oncological outcome.
The surgeon must have acquired and must maintain specialised “Knowledge and Skills” (precisely defined in an additional catalogue) relating to the diagnosis, preoperative, operative and postoperative management in the following areas of primary responsibility:
The focus is on diagnosis and treatment, which comprises all non-instrumental and instrumental techniques including flexible endoscopy, radiology, sonography, computer tomography and magnetic resonance imaging.
The MIS surgeon must be capable of employing endoscopic techniques both for diagnostic and therapeutic purposes and must have the opportunity to gain knowledge and experience in evolving technological methods.
The MIS surgeon must be also capable of interpreting all types of surgery-related radiological examinations.
The MIS surgical activity covers the pre-, peri- and postoperative period including the principles of enhanced recovery and follow-up of patients. The specialty also includes individual and general preventive activities, rehabilitation, palliation and management of pain, especially in oncologic patients.
Minimal Invasive Surgery (MIS) is often performed in specialised centers, especially in oncological cases. When transferral is not possible because of time or geographical considerations, the MIS surgeon should possess the multi-specialty knowledge and skills to carry out these interventions safely.
Additionally, MIS surgeons are expected to have a knowledge of anatomy, physiology and biochemistry which enable them to understand the effects of common surgical disease and injuries upon the normal structure and function of the various systems of the body. They are expected to have a knowledge of cell biology which enable them to understand normal and disordered function of tissues and organs. They should have an understanding of the pathogenesis of the common correctable congenital abnormalities. They are expected to know the actions and toxic effects of drugs commonly used in perioperative and intraoperative care and in the management of critically ill surgical patients. They must also have an understanding of general pathology including the principles of immunology and microbiology in relation to surgical practice.
The MIS surgeon should have certified knowledge in basic technology of the used instruments, especially insufflation devices, monitors, cameras and light sources, ultrasound- and other energy-driven instruments and stapling and fixation devices.
The MIS surgeon must be trained in the economics of health care, in the assessment of research methods and scientific publications and be given the option of research in a clinical and relevant field of further training in another related specialty.
Minimal Invasive Surgery (MIS) is a Working Group 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 Minimal Invasive Surgery (MIS) within the UEMS countries for the benefit of training in MIS and patient care.
The “Working Group of MIS” is a non-profit organisation.
Minimal Invasive Surgery (MIS) is a Working Group 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 Minimal Invasive Surgery (MIS) within the UEMS countries for the benefit of training in MIS and patient care.
The “Working Group of MIS” is a non-profit organisation.
The section shall be known as the “Working Group of MIS” associated with the “Section of Surgery” of the “European Union of Medical Specialists” (UEMS) and the “European Board of Surgery” (EBS).
The “Working Group of MIS” with its “Board of MIS” is especially responsible for the MIS 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 “Working Group of MIS” 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 MIS 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 “Working Group of MIS” 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 “Working Group of MIS”.
3.6.The “Working Group of MIS” 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 “Working Group of MIS” 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 Working Group. The Secretary will then arrange a postal ballot to all members of the Working Group 6 months before the appointment will become active.
3.9. The Chairperson and Secretary of the Working Group 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 “Working Group of MIS”.
3.10. The Working Group may appoint working parties or commissions to prepare draft documents or recommendations on specific topics for consideration by the full “Working Group of MIS”.
4.1. To prepare advice concerning all aspects of professional practice in MIS in the context of the EU for the benefit of the EU political administration through the UEMS structure and ensuring that training in MIS is maintained at the highest level.
5.1. The “Working Group of MIS” 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 “Working Group of MIS” 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 Working Group 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 Working Group can be linked to a EBS MIS 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 Working Group, 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 “Working Group of MIS” is a non-profit organization and is financed by the fees of the applicants for the two parts of the MIS EBS Eligibility I and II accreditation process.
The Working Group is also financed by any legal financial benefits for its contribution to various professional/scientific activities (i.e. meetings, publications).
The Working Group 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 Working Group can only be accepted under the strict rule that is offered in order to help the Working Group to achieve its objectives and without any obligation of the Working Group towards the body(ies)/organisation(s)/person(s) offering the contribution/donation.
7.2. The Working Group 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 Working Group 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 “Working Group of MIS” shall create a “Board of MIS” 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 MIS surgeons and specialised organisational structures (e.g. Department for MIS Surgery).
9.2. The Board will have the responsibility to develop the necessary documents for defining the “transferable competency” of MIS by developing a syllabus including the content of training and learning outcome in MIS, 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 /MIS” (F.E.B.S. /MIS) 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 I and Eligibility II) can be amended following relevant suggestion by a member of the “Working Group of MIS” 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 Working Group should be represented.
All amendments shall be in accordance with the EBS standards and regulations for the Fellowship qualification process.
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 MIS (EBMIS)” is created within the “Working Group of MIS” and in association with the “European Board of Surgery” (EBS) and the “Section of Surgery” of the UEMS.
The EBMIS is constituted in accordance with the statutes, declarations and rules of procedure of the UEMS.
The members of the EBMIS 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 EBMIS 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 Minimal Invasive 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 EBMIS shall assess and report to the “Working Group of MIS”, 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 EBMIS 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 EBMIS 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 EBMIS shall recommend to the EBS the issuance of an European Board Fellowship in MIS.
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 EBMIS.
The EBMIS 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 EBMIS 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 “Working Group of MIS”.
The “Section of Surgery” and the Executive Bureau of the UEMS shall be entrusted with communicating all opinions issuing from the EBMIS and the “Working Group of MIS” to the competent UEMS bodies.
The “Working Group of MIS” shall submit through the “Section of Surgery” to the UEMS for ratification any changes to statutes relating to the membership and functioning of the EBMIS.
The EBMIS shall consist of one or two representatives of each member state. One representative shall be a member of the national delegation to the “Working Group of MIS”. The Working Group 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 EBMIS. 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 EBMIS member or his/her substitute may be decided by the respective National Society by withdrawing the nomination to the EBMIS. The replacement must be indicated to the “Working Group of MIS”. 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 EBMIS members. The latter is composed of a Chairperson and Vice-Chairperson. The Treasurer and Secretary are the same as those in the “Working Group of MIS”.
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 “Working Group of MIS” who shall be informed of the activities of the EBMIS 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 “Working Group of MIS”. Additional meetings may be convened by the Management Committee, in agreement with or at the instigation of the UEMS “Working Group of MIS”.
The agenda consists of items proposed by members of the EBMIS, by the Management Committee, by the “Working Group of MIS”/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 EBMIS 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 EBMIS to the Chairperson and the members of the EBMIS, to the President and the members of the Working Group, 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 EBMIS should be held at the same time and location as the meetings of the Working Group of Minimal Invasive 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 EBMIS 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 MIS (EBMIS)” within the “Working Group of MIS” is entrusted with the problems of training, EBSQ Board Examination, Continuing Medical Education (CME), Continuous Professional Development (CPD) and quality management for the accreditation of MIS surgeons and specialized organisational structures (e.g. Department for MIS).
The Board will have the responsibility to develop the necessary documents for defining the “transferable competency” of MIS by developing a syllabus including the content of training and learning outcome in MIS, 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 /Minimal Invasive Surgery(F.E.B.S./MIS) 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 EBMIS can designate committees, charged of the study and presentation of proposals concerning specific objectives of the EBMIS, 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 I and Eligibility II) can be amended following relevant suggestion by a member of the Working Group 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 Working Group should be represented.
All amendments shall be in accordance with the EBS standards and regulations for the Fellowship qualification process.
