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EURACT COUNCIL MEETING, AARHUS 21-9-04
Report by A. Simeonidis

The Dutch College of General Practitioners, which hosted the Wonca Europe 2004 conference, had the brilliant initiative to organize an Invitational Preconference for Junior Doctors. They invited national colleges and academies, members of Wonca Europe, to nominate delegations of young doctors, preferably members of boards or committees involved in the training schemes in their countries. Eleven countries nominated three delegates and these 33 representatives were matched with an equal number of trainees from the Netherlands. All participants were distributed in 6 international groups.

Each group had two tutors, a council member from Euract and a GP trainer, a senior staff member of the training scheme in the Netherlands.

A preparation for the conference was planned using Internet group- discussion-devices as medium. The aim was to make acquaintance in a virtual way and exchange relevant information on beforehand.

They were asked to describe the health care structure in their countries, with special emphasize on the position of the general practitioner in their system, and describe their training scheme and mention its strong and its weak sides. They were also asked to comment on: 'The European definition of General Practice/Family Medicine'.

The preconference was held the 31st of May and the 1st of June, and continued during the WONCA Regional conference on the 2nd and 3rd of June. After an opening address the participants worked for two days in their groups. There was an intensive exchange of thoughts and experiences. They recognized the great differences there are in the national health care systems and the position of GP/FP in these structures. They discussed the most relevant features as are described in 'the European Definition' as there are: the gate keeping function of the general practitioner; the importance of a cooperative and non-competitive relationship between GP's and specialist, with regard to the quality of care for their patients; the record holding for their patients and the importance of referral letters to specialists and reports from specialists examinations and interventions; the influence of reimbursement systems for GP's, capitation fee or fee for service systems. The participants were surprised when they recognized the consequences of these features for the efficiency and cost effectiveness, and their influence on the quality of care.

They also discussed the different training systems in their countries, and listed the advantages and disadvantages. Trainees were surprised to recognize the differences in personal guiding during their training episode. One of their conclusions was that trainees should have a personal trainer or tutor, taking care over her or his personal and professional development.

On the Wednesday afternoon the 3rd of June there was plenary session of all the participants. The conclusions of the discussions in the groups were exchanged. On the Thursday afternoon the 4th of June they presented in an open session for all the participants of the WONCA conference their overall conclusions.

The main points were:

• There should be more (political) actions to implement the European Definition of GP/FM in all the European countries.
• Participation of Junior Doctors in International conferences must be facilitated in the future.
• A reduced conference fee for Junior Doctors and a programme fitted to their needs will be very useful.
• Continuation of a Junior Doctor Programme for the next WONCA Europe Regional conferences is recommended.
• International exchange of trainers and training programmes could be stimulated.
• The most important result of this preconference meeting for Junior Doctors was their decision to found a European Network Structure for Junior Doctors. The network organisation should be part of and under the aegis of WONCA Region Europe.

The Greek Association of General Practitioners ( ELEGEIA ), the hosting organization of Wonca Europe 2005, being aware of the results of the JDP and recognizing the essential and extremely important role of the trainees and of their training, decided to explore the possibilities of organizing the continuation of the JDP in Kos.

Therefore, ELEGEIA addressed a letter to all Colleges and Associations of Europe and other continents asking them to support the participation of at least two trainees and Junior doctors of their country. A number of 10 countries has already responded.

At this point the Euract role and involvement in this project has to be underlined.

The important and effective role of the Euract council members who participated at the project was recognized by the Dutch College. The last 3-4 years, Euract proved its leading role in training mainly after its recent initiatives on the "new definition" and the coming "Educational Agenda" without forgetting the rolling course and several booklets.

May be conditions matured, and it is time Euract to snatch the opportunity to play its historical role: to get under its aegis the JDP and built bridges with trainees. This could be achieved by contribution to planning and organizing, by leadership in group working, by keeping in contact with junior doctor's network - through a working group.