ADDENDUM 2


U E M S
SPECIALIST SECTION OF PATHOLOGY
EUROPEAN BOARD OF PATHOLOGY

MINUTES OF THE 23rd MEETING HELD IN GHENT IN BELGIUM ON JUNE 2, 2007


Date: Saturday, June 2, 2007, 9.00 am

Location: ‘Het Pand’, Onderbergen 1, Ghent, Belgium

Host: Prof. Claude Cuvelier

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1. OPENING, WELCOME AND APOLOGIES FOR ABSENCE

Professor Cuvelier welcomed the delegates to Ghent.
Professor Dirk Ruiter gave his thanks to the hosts, opened the session at 9.00 a.m. and welcomed the delegates.

Present: Claude Cuvelier (BE), Sven Seiverth (HR), Martin Tötsch (DE), Efstratios Patsouris (GR), Calypso Barbatis (GR), Lazlo Vass (HU), Carlo Capella (IT), René Scheiden (LU), Peter Furness (UK), Nigel Kirkham (UK), Nesimi Buyukbabani (TR), Gamze Mocan Kuzey (TR), Christer Sundström (SE), Javier Pardo (ES), Nina Zidar (SI), Nils Petter Aardal (NO), Borghild Roald (NO), Piet Slotweg (NL), Felix Cruz-Sanchez (EURO-CNS/ES), Bernard Maillet (USMS), and Veli-Pekka Lehto (FI).

Apologies for absence: Gisela Kempny (DE), Peter Kelly (IE), Francoise Thivolet-Bejui (FR), Cecilie Alfsen (NO), Etienne Marbaix (BE), Denis Laedlein-Greilsammer (FR), Olli Carpén (FI), Trine Thorborg (Junior Pathologists/DK), Carsten Rygaard (DK), Birgitte Bruun Rasmussen (DK), Anna Kadar (HU), Arvydas Laurinavicius (LT).


2. APPROVAL OF THE AGENDA

The agenda was approved as circulated.


3. INTRODUCTION OF NEW MEMBERS AND DELEGATES

Prof. Ruiter introduced and welcomed Professor Piet Slootweg as new Dutch delegate (replacing Professor van den Tweel) and Professor Peter Furness as new UK delegate (replacing Professor James Underwood).

Prof. Ruiter thanked the outgoing delegates Dr. Peter Kelly (IE) Dr. Robert Maurer (SW) for their excellent work for the Section/Board.

Dr. Gamze Mocan Kuzey informed about the reorganization of the Turkish pathology societies and a formation of a new Federation of National Pathology Associations. The Turkish delegates have a status of representatives of the new Federation.


4. MINUTES OF THE ATHENS MEETING

The minutes of the 22nd meeting held in Athens were accepted as presented (Add. 1).


5. REPORTS OF THE WORKING GROUPS

5.1. Subsection with emphasis on neuropathology/Cruz-Sanchez

Professor Cruz-Sanchez presented the outcome of the discussions between the members of the working group (Cruz-Sanchez, Patsouris, Pardo, Thivolet-Bejui. See Add. 2.

The role of Euro-CNS as central monitoring authority for neuropathology at EU level was emphasized.

There was a lively discussion especially concerning the criteria of a sub speciality/competence area forming a subsection. It was noted that several aspects need to be taken into consideration, such as economies, economies of scale, common trunk on training versus specialized training, pressure from politicians concerning the length of training and the policies of UEMS as an organization. As a new organizational arrangement also a 'division' is an option.

During the discussion it became obvious that the training charter of the Section/Board is outdated and is in dire need of revision. On the other hand, the training charter is central in determining the statuses of various subspecialties and competence areas and, consequently, the optimal organizational form of the Section/Board. It was concluded that final decisions have to be postponed until an updated training charter has been worked out. 'Division' as a new internal organizational form was generally welcomed as a way to recognize the specificities of a subspecialty/competence area without risking a loss of coherence of pathology as a unified discipline.

5.2 Subsection with emphasis on cytology/Cuvelier

Professor Cuvelier presented the Memo (Add. 3) based on the discussions between the members of the working group (Cuvalier Aardal, Barbatis, Tötsch, Vass, Verhest, Viehl).

In the discussion the following aspects we covered: the role of clinicians in cytological diagnostics, different training requirements in different countries, different role of examinations in different countries.

Also concerning cytopathology as a sub speciality, it was concluded that its niche as well as its organizational form within pathology, can only be evaluated appropriately against the backdrop of pathology training charter at large. In regard to the insufficiencies of the charter, as discussed above, it was agreed that further decisions concerning the internal organizational form of the Section/Board as to the role of cytopathology has to await rewriting and modernization of the training charter of pathology as a speciality.

5.3. Training requirements/revision of the charter/Cuvelier

Professor Cuvelier presented the Memo (Add. 4) based on the discussions between the members of the working group (Cuvalier, Kirkham, Thorborg).

There was a lively discussion on this topic based not only on the memo presented by Professor Cuvelier but also on what presented in Items 5.1. and 5.2 concerning the deficiencies and insufficiencies of the present Charter.

The following points were addressed: The boundaries between specialities and sub specialities a not fixed but in a dynamic state of change. Charter should be a guide but also responsive to the changes, The role of European examination has to be reconsidered, preferably in collaboration with EAPCP. Quality issues are becoming ever more important. Testing of competence is becoming more important than recognition of fulfilling certain numerical requirements as to the specimens signed out during training. New angles into the arrangement of the training are core curriculum supplanted by training for sub specialization and /or training program composed of modules which enables a large variability according to the trainee's personal desires and competences. There are several new documents prepared by UEMS that have relevance and need to be taken into account in the modernization of the training charter of pathology.

It was decided that a new working group is formed. Its task is to revise Pathology Training Charter. Optionally, the working group may take a form of a standing committee with a task to monitor the development on the field of pathology with a task to present revisions and changes to the Section/Board for approval. This would guarantee continuous development of the Charter in response to the changes in the society and in medicine as reflected upon pathology as a diagnostic discipline.

The members of the working group are:

Cuvelier (Chair) Claude.Cuvelier@ugent.be
Capella carlo.capella@ospedale.varese.it
Kuzey gm_kuzey@yahoo.com
Seiwerth seiwerth@mef.hr
Roald borghild.roald@medisin.uio.no
Zidar nina.zidar@mf.uni-lj.si
Pardo jpardo@unav.es
Barbatis calbar@hol.gr
Patsuris epatsour@med.uoa.gr
Tötsch martin.toetsch@medizin.uni-essen.de
Cruz-Sanchez felixcruzsanchez@hotmail.com
Kirkham Nigel.Kirkham@nuth.nhs.uk

5.4 Quality assessment in pathology/Kelly

Dr. Kelly, on behalf of a working group (Kelly, Kempny, Cuvelier and Lehto) had prepared a position paper entitled "External Quality Assurance in Histopathology and a Pan-European Context". The paper was presented by Professor Ruiter (Add. 5).

The paper was discussed especially in regard to pros and cons as itemized in the position paper. Professor Furness told about the situation in the UK and about the first UK quality schemes.

It was decided not to take any specific measures at this point. However, it was considered important to discuss this matter further. Professor Furness kindly agreed to give a presentation on the UK quality scheme(s) in the next Section/Board meeting.

5.5. Medical regulation/Kirkham

Dr. Kirkham, on behalf of a working group (Kirkham, Kelly, Sundström), had prepared a presentation concerning current aspects of medical regulation in the UK (Add. 6).

In the discussion that followed, the situation in other European countries was addressed. Based on a rapid survey, it was obvious that the situation varies widely; some countries have regulatory systems in place, some are experimenting and in some countries there are no formal regulatory measures.

It was decided to keep abreast of the developments in this important area and, for the time being, not to take any specific measures.


6. ONGOING MATTERS

6.1. European Examination; Memo/Cuvelier

Professor Cuvelier gave a presentation about the current situation with the European Examination. The problems remain - a low participation and the no-formal status of the examination. Prof. Cuvelier also told about the details of the"Glasgow Declaration" which is meant to be complementary to national regulations.

In the discussion, doubts were raised about the functionality of the Glasgow Declaration due to the strictly guarded national interests in mandating the graduation criteria. Several suggestions were made to improve the situation of a Section/Board-driven examination:
1) Improving the visibility
- rewards/prizes or some other recognition for successful candidates
2) Incentives
- formally binding status
Despite the problems. it was unanimously agreed that the Section/Board should go on with the development of the Examination. Preferably, this should take place in collaboration with the EAPCP. Also support and new initiatives from the UEMS were considered important.

6.2. Dermatopathology Examination; Memo/Bruun Rasmussen

Dr. Bruun Rasmussen's report on the recent Dermatopathology Examination was read by Prof. Ruiter. The Examination has bee a success with 81 participants. In the meeting in Helsinki, an agreement concerning a joint Examination in Dermatopathology negotiated between the Section/Board of Pathology and the UEMS Section of Dermato-Venereology was accepted. For the details of the arrangements and the rules, see ANNEX 6.

6.3. CME credit points/EACCME; update/Lehto

Professor Lehto reported about the new credit point awarding scheme of EACCME. Section/Board of Pathology receives approximately ten applications per year for assessment and approval. The number of applications is increasing. Subsection/Board receives a small honorarium for the handling of the applications. In the discussion it was considered important to urge the national societies to be more active in submitting their applications for credit points to EACCME.

6.4. EAPCP; update/Lehto

Due to a tight schedule, this item was left out.

6.5. New and future member countries; update/Lehto

Due to a tight schedule, this item was left out.

7. EMERGING TOPIC

7.1. Ownership, storage and release of pathology results

Due to a tight schedule, this item was left out.

7.2. E-learning in pathology

Due to a tight schedule, this item was left out

7.3. Cross-border health and telepathology

Due to a tight schedule, this item was left out.


8. EUROPEAN ISSUES- Secretary General of UEMS Dr. Maillet

Dr. Maillet, Secretary General of UEMS gave a presentation on the Working time directive.
The topic was discussed especially concerning to what extent the 48-hour limit can be considered realistic and enforceable.

9. ELECTION OF PRESIDENT-ELECT

Professor Claude Cuvelier had kindly agreed to stand as candidate for the position of President-Elect of the Section/Board of Pathology. His candidacy was supported unanimously.

10. FINANCIAL CONTRIBUTION

Professor Ruiter presented the report 2006 and status 2007

11. VARIA

Professor Lehto informed about the upcoming 50th Anniversary of the UEMS.

12. NEXT MEETING

Dr. Peter Kelly kindly offered Dublin as the site of the next meeting. This was welcomed and accepted conditional to outcome of further discussions. Preliminary dates are May 24 and May 31.

13. CLOSE OF THE MEETING

Professor Ruiter thanked the delegates and closed the meeting at 3 p.m.