Frankfurt University. Germany: Anyone who becomes seriously ill or has an accident while on holiday
would like to be treated as well as they are at home. It is vitally
important for the patient that the doctor has been well trained, in
particular in intensive care medicine.
A commission at the European
Union under the leadership of Prof. Kai Zacharowski, the Director of the
Clinic for Anaesthesiology, Intensive Care Medicine and Pain Therapy at
the Goethe University Frankfurt is striving for uniform standards
across Europe. This commission - shortened to MJC ICM for Multiple Joint
Committee Intensive Care Medicine - has worked out general guidelines,
which the member states are now expected to ratify. This will certainly
not happen without compromises.
"United in diversity" - this is
the motto of the European Union. At the level of professional training
this diversity can also be obstructive, as it restricts the freedom
there actually is in this diversity. And in the field of medicine
diversity can also become a disadvantage to the patient. The regulations
in intensive care medicine are particularly inconsistent. For example,
in Germany medical practitioners initially finish their specialist
medical training before they can be further trained as a practitioner in
intensive care medicine, while in Spain, intensive care medicine is a
specialist medical training directly connected to study. It's not
surprising that a change within Europe for practitioners of intensive
care medicine might be difficult.
"Young doctors do not want to
commit themselves for their whole professional life to the field of
intensive care medicine", Kai Zacharowski gives the reasons for the
organisation of training in Germany. Shift work and the considerable
psychological strain suggest that doctors should not commit themselves
to intensive care medicine at too early a stage, according to the
professor, who also represents Germany in the Union Européene des
Médicins Spécialistes (UEmS). He considers a training period of a total
of seven years to be essential: "After three years we cannot allow a
young colleague to work independently". In the end, however, the length
of training remains a matter for the individual states. There should,
however, be uniform standards in the contents. Guidelines for the
medical professions are drawn up nationally, by health ministries or by
professional associations. There are already obligatory general
requirements for subjects such as heart surgery, anaesthesia or
neurosurgery. Now there is also to be a new European framework for
intensive care medicine, which was worked out in agreement with the
national professional associations.
"Intensive care medicine has
changed a lot in the last few years", says Zacharowski: "We can now
revive people, who would certainly have died ten years ago". This is
resulting in new challenges for intensive care medicine and nursing
treatment. A medical practitioner on the intensive care ward must
competently manage the whole spectrum required in working with
critically ill people: the replacement of organ functions, dialysis,
artificial ventilation, the recognition and treatment of different types
of blood poisoning, the correct use of antibiotics, the management of
blood transfusions - and, not least, dealing with relatives.
On
the basis of the EU-sponsored programme, CoBaTriCE, a paper was drawn
up, which Zacharowski presented to the European Commission at the end of
2014 . Before parliament decides on the guidelines, the various
national authorities must have ruled on them. Zacharowski is expecting a
conclusion by the end of the year, before then, however, he will have
to have many discussions. Individual countries such as Great Britain
have already indicated a positive response, reports Zacharowski.
Nevertheless, compromises will have to be reached, as in the end a more
extensive training also means higher costs. It is certain, however: If
Europe is to draw closer, a uniform training is essential.
Information: Prof. Dr. Dr. mailto:Direktion.Anaesthesie@kgu.deKai Zacharowski, Direktion.Anaesthesie@kgu.de