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Council meeting - Dublin, Ireland, September 2002 Report of the Meeting

Council Reports Contents

Wednesday 25 September 2002

Pre-Council Executive Board Meeting

The Executive Board met just before the Council Meeting and discussed several issues. Subjects discussed and decisions made are as follows:

• The survey of current situation in Vocational Training will be available on our Web-site in a few weeks. The survey of CME should be ready after the coming Council meeting. These overviews will be updated once a year (before the Council meeting). At the moment only 16 replies have been received. This work needs to be completed soon. The Situation with BME is much more complicated. The BME Group needs to consider the possibility to find an acceptable scheme.
• Portuguese representative – Dr Gomes is coming to the meeting although he is not a EURACT member yet. First the Council needs to accept the Portuguese members and then the election will be organized.
• The situation in Russia is still unclear. Talks with Dr. Kuzniecowa did not produce any results. We have probably explored most of the possibilities and we need to stop our efforts at this stage.
• Dr. Athanasios Simeonidis and Dr. Justin Allen tried to use Internet connection to have a telephone conference. It worked, but we do not know how it will work with a bigger number of participants. In October we will try to connect all EB members together. Dr. Simeonidis will be responsible for it.
• No message from Iuliana Popa. The Rumanian Conference was cancelled. At the moment there is no further action planned.
• There is very little progress on the assessment course. Dr. Justin Allen talked to Prof. Lesley Southgate who is going to work on it, but the results cannot be expected earlier than at the end of 2003. The Member Service Committee is going to explore the possibility to organize something instead of it.
• Dr. Mladenka Vrcic-Keglevic, as a course director, is unhappy with the status of EURACT in relation to the Dubrovnik course. She cannot accept the term “patronage”, she only accepts the words “in collaboration”. In general it is acceptable, but the rules should be clear. It will be discussed at the Member Service Committee meeting.
• The new EU directive is changing from the free movement of doctors to the safety and no barriers for patients' position. This is on the agenda for this Council meeting.
• The European Society EB set up a working party to consider the status of three networks. Dr. Justin Allen represents EURACT in this working party. This is in line with our discussion about methods of representation. There is a new letter from the Nordic colleges signed by all presidents except Finland's . The meaning of this letter is more or less the same as before. EURACT is going to discuss it during the current Council meeting. Dr. Justin Allen will bring the message to the working party. Then EURACT EB is going to reflect on it first during the telephone conference. The final decision of the European Society Executive Board is expected after its spring meeting.
• Due to high costs since that meeting only a short version of the Council Meeting report will be available on our web-site. The full report will be availableonly on request from the Honorary Secretary.
• The level of travel reimbursement is uncertain at the moment. It can be only 46%. In case of no shows , it can be slightly higher. The situation needs however further attention and discussion during one of the next EB meetings.
• Future meetings – Next Council Meeting will be in Vilnius, Lithuania. The General Meeting of EURACT will take place during the WONCA Congress in Ljubljana, Slovenia.. The exact date needs to be established with Congress organisers. The Council needs to consider also our involvement in preparation to the WONCA Europe Congress in Amsterdam in 2004. Important issues related to these subjects will be discussed during the coming Council meeting
  

Session 1: Country Reports

Dr. Justin Allen, President of the EURACT, welcomed all the Council members, who came to Dublin. He shortly described programme and main goals of the meeting. The country reports were distributed and read by all present. Further discussion was in small groups of four Council members followed by a general one. Questions for clarification were asked. Written reports are attached to this Report as Annex 1.

The President welcomed with specially warm words Dr. Gertraud Rothe who recovered and rejoined the Council. Dr. Jos Op 't Root from the Netherlands, who is a new Dutch representative, introduced himself. As an academic teacher and researcher at the Maastricht University he declared his will to continue the work of his predecessor Prof. Harry Crebolder.

Another new participant was Dr. Luis Filipe Gomes from Portugal, who was welcomed as a EURACT observer. He declared to do his best to re-establish working relations with teachers of family medicine in Portugal. Many of them sent already their membership applications to EURACT. After their approval formal election procedure for Portuguese representative will be started. Dr. Gomes is a serious candidate for this post.

Thursday 26 September 2002

Session 2: Business meeting

• The report from the previous Council Meeting in Maastricht has been approved.
• The President informed the Council about several issues discussed during the last WONCA Europe Executive Board meeting. The following subject were considered:
  
  • The President informed the Council on the progress of the work on a conflict around the special position of EURACT and other network organizations within WONCA Europe. In order to solve the problem WONCA Europe EB established the working party with the participation of EURACT's President. Terms of reference for the working party were prepared by WONCA Europe's President. The working party will meet in November and prepare the position paper for EB meeting which is going to take place in March, 2003. The final decision is going to be taken by the European Council in June 2003. Several Council members reacted on their personal situation within their country. Many colleges still feel uncomfortable paying for travel expenses and not controlling the election process. Often EURACT is seen as a club of private friends. Different options were presented as well. The next meeting of the EURACT EB in Spring 2003 will be partially devoted to this problem.
    
  • The President informed us that the last WONCA Europe Conference produced a loss of about 200,000 €. There were several reasons for it, but this is a threatening situation for future conferences.
    
  • The European Journal of General Practice is seeking new policy to be distributed more widely. There is going to be a pilot distribution of the journal in local languages (Greece, Turkey and Poland?). Dr. Fergus O'Kelly is going to consider the form and content of the communication section to be filled in by EURACT. All Council members should be prepared to respond to his request for contribution.
    
  • The President raised the issue of collaboration with other network organizations. One possible way would be to invite the observers. Several Council members reacted that first the objectives for collaboration should be established. One of the examples would be our current work with EQuiP on CPD. Other ideas were presented as well. For example we could present a paper on educational research for one of the EGPRW meetings. We could also collaborate with EGPRW on preparation of the course on methodology of educational research. Another possibility would be to collaborate on specific projects. In any case, communication should be established. The Council regards collaboration as relevant and a more efficient way will be sought.
• The treasurer presented an overview of the budget. He complained that Council members did not respond to his queries. Without information from every Council member he is unable to produce a reliable report. However the report is urgently needed to apply for a grant to the European Society. The surplus for 2001 was 33,000 €. At the end of this year we can expect similar surplus. Expenses of the Council increased in administrative part and in costs of the Council meetings organization. The details are available in Annex 2. It was clarified that all the membership fees are due from the 1st of January of the ongoing year but must be transferred to the Treasurer before or at the spring meeting of the following year. Every Council member is responsible for his/her own policy. The idea of a diploma confirming membership of EURACT was raised. Dr. Filipe Gomes and Dr. Dolores Fores are going to present the proposal of such a diploma during the next meeting.
• There is a problem of reimbursement of travel expenses. The amount of 6000 € was devoted for each year. For the spring meeting over 4200 € was spent. This caused the situation that current reimbursement would be on the level of 46%. By chance some of the applicants did not appear, so reimbursement will be higher. However this situation needs reflection. Several members reported on their problems and costs not only due to the tickets, but also to get a visa. The President proposed to create special working party with him and treasurer and some members from 5 € countries to consider this problem further. Other members would be Llukan Rrumbullaku, Margus Lember and Eva Jurgova. This working party is going to prepare proposals to be considered by EB meeting next spring.
• The Council approved the job description of the Council Member which is attached to the Maastricht meeting report.
• New members from the following countries were approved: Bosnia 6, Denmark 3, Italy 3, Slovenia 4, Germany 2, Finland 1, Turkey 2, Czech Republic 1, Poland 1, Portugal 11, Great Britain 2 + 1 org, Uzbekistan 3 (associate members). The full list of approved members is available as Annex 3.
• It was decided that new membership booklet would be produced. The President will prepare the welcome letter for it.
• There is a new proposal from UEMO about family medicine as a specialization. This is going to be discussed further in groups.
  

• Due to the fact that several committees plan to distribute the questionnaires and Prof. Crebolder stepped down from the Council, a new committee for review of the questionnaires was appointed and now consists of Prof. Igor Švab and Prof. Jan Heyrman. All potential questionnaires should be first reviewed by this committee.
  

Friday 27 September 2002

Session 4: EURACT as a membership organization and Colleges/associations

Dr. Dolores Fores and Anders Baerheim developed the paper with arguments for new Council members' election policy. The main focus of this paper is on the shift to the system in which national representatives would be elected by Colleges, not directly by members. This could strengthen the position of the Council member within the country. They argued that present situation could be regarded as a “private club of friends”. In some countries due to the policy of selection of representatives some of them have problems with support for the travel expenses and problems with dissemination of the results of our work. At the same time authors of the proposals recommend to stick to the existing policy of direct election by members in these countries, which would regard it more appropriate. Dr. Justin Allen and Prof. Igor Švab responded to the proposals. The President stressed that it is not easy to change. Especially it would be extremely difficult to have a mixed system in which some Council members are elected by members, other by Colleges. Who would decide about selection of the election procedure in the particular country? What would happen if we had Colleges directly asked to nominate? According to the President, we should continue the direct election with a new stress on good relationship with Colleges. Prof. Švab supported this position and added that not only Colleges play an important role in education. Also universities are interested in our work. If the representative was elected by the College he would be regarded as less important by universities. According to him having close links to the Colleges is not a problem. Exclusive links are the problem. Several Council members presented many other arguments. Prof. Jan Heyrman stressed that during the election time Colleges should be informed that there is time to influence the selection of candidates. Dr. Egle Zebiene stressed that election through Colleges would cause loss of direct members. This would have a financial impact. Prof. Jan Heyrman proposed to make more publicity around this issue and invite societies to be involved in the election process. Dr. Roar Maagaard proposed to send EURACT Council Member Job Description to all Colleges. The President proposed to collect information about the real action of Council members to establish working relations with Colleges.

Session 5: “5 minutes 1 slide”

• Prof. Jan Heyrman presented the Hipocrates project designed by dr. Kalerup from Denmark. He explained that there is not enough money to support it, so WONCA proposes to continue it by Internet. Local coordinators are needed to run the project within the countries. EURACT can play a role of clearing house for the project. We could publish information about the progress of the project on our web-site.
• Dr. Justin Allen presented the standardized procedure of selection of trainees, adapted by UK There is a formal competency based on review of the information provided by the applicant on special form followed by a long interview. The final result is a score which falls into one of the three categories: red, yellow, green. The last category are successful candidates, and red one rejected by the training institutions from all over the country. This system allows the training institutions to avoid candidates rejected by others.
• Dr. Anders Baerheim proposed to produce country reports not every half-year, but every second meeting, i.e. annually. He argued that it is a lot of work to prepare the report each time and there is not so much to report. Dr. Fergus O'Kelly proposed to divide the Council into two groups. One could report on spring and second on autumn meeting. Dr. Gertraud Rothe and Prof. Paula Vainiomäki stressed the value of the reports and a pleasure to read them. Finally the Council decided to keep the reports as before, i.e. twice a year.
• Stefan Wilm presented a project aimed at evaluation of existing situation on CPD within European Countries. This project could be dome together with EGPRW. Everybody interested in it is invited to join the group.
  

Session 6: Common EURACT and EQuiP statement on CPD

Prof. Paula Vainiomäki presented the document on CPD which is a result of common work of EURACT and EQuiP. The document is going to be printed with 3000 copies. The European Society will provide a financial grant for it. The next important issue is the implementation of the document. The document is approved by the Council and will be put on our web-site. The full text of the document is available as an attachment to this report in Annex ??? The document is reported as a working paper to be subject for further works.

Saturday 28 September 2002

Session 7: Educational agenda

Prof. Jan Heyrman explained the meaning of the term educational agenda. This is going to be a “state of the art” document which should help the potential author to design the agenda. This document will be of use for EURACT itself and should help collaboration with EQuiP and EGPRW. The document should provide links to the “definition document”, cover the lifelong learning spectrum from BME to HPE and CPD. Core content elements should be in it as well as different approaches to different learning styles. Dr. Justin Allen prefers more clear links to the core content elements. Otherwise the document would be regarded as a completely independent one. Dr. Anders Baerheim presented his view, based on the learning cycle, staring from one-to-one tutor/learner principle. This should be done according to the adults learning principles and reflect different contents from practice management to clinical aspects. There was a wide discussion about the purpose of this document. Most of the Council members seem to prefer this document as help for program designers in different countries to implement six core competences to the teaching programs. Prof. Igor Švab proposed the structure of the chapters based on three essential steps: a) objectives, b) methods, c) assessment. Each chapter would be devoted to one core competence. Six chapters would be followed by clear recommendations.

The Council was divided into four groups working separately. Each group made a draft plan for further work, divided responsibility and made arrangements. At this stage the precise arrangements were done for Introduction and competencies 1, 2 and 5. However the division of the responsibility for other particular chapters (core competencies) was also done and looks as follows:

• Intro – Dr. Anders Baerheim
• Competence 1 – Dr. Yonah Yaphe
• Competence 2 – Prof. Jan Heyrman
• Competence 3 – Dr. Yonah Yaphe
• Competence 4 – Dr. Ivanka Bogrova
• Competence 5 – Prof. Igor Svab
• Competence 6 – Dr. Egle Zebiene
• Recommendations – (to be decided later)
• Curriculum construction – Dr. Adam Windak
• EURACT position – (to be decided later)

Session 8: Future meetings

• WONCA Europe Congress 2004 will take place in Amsterdam and will be held as a three-network conference. EURACT is ready to use certain parts of the program and fill in with workshops. A proposal for Junior Doctor Project was sent to EURACT President. The project focuses on young doctors in training who are unable to cover high costs of the participation in the conference. EURACT is ready to give a support to the project. Dr. Justin Allen and Dr. Egle Zebiene will be contact persons for this project.
• Next Council meetings will take place in the following locations and times:
  Vilnius, Lithuania: May 7–11, 2003
  Leicester, United Kingdom: September 10–14, 2003
• The next WONCA Europe Congress will take place in Ljubljana, Slovenia in June 18–21, 2003. The abstracts deadline is October 31^st, 2002. Abstracts can be submitted also for the network sessions. EURACT is going to present four workshops. The following Council members are responsible for preparation of the abstract: Dr. Roar Maagaard, Dr. Yonah Yaphe, Dr. Philip Gomes. Dr. Justin Allen. All abstracts should be sent to Dr. Adam Windak for review and common submission. General Meeting of EURACT will take place during the Congress. Dr. Adam Windak will contact organisers to agree the time and venue of the meeting. All other practical information about the Congress is available on the Congress web-site: www.woncaeurope2003.org
  

At the end all the Council members reflected on the meeting. Most of them expressed their happiness with the arrangements, and the good balance in the scientific and social programme. On behalf of the Council the President thanked Dr. Fergus O'Kelly for his efforts and their results.

Post-Council EB meeting

• Written reports will be prepared and distributed during the meeting and attached to the report. The tables with the overview of CPD and VT will be reviewed once a year. Agnes Goethuys will send this table before the meeting for review. New heading “What have I done as an EURACT representative in my country?” There will be structured overview of the existing relationship with national organizations. Overview of the country situations will be done during the first session of each Council meeting in groups of four.
• The treasurer report will be produced as before twice a year : in autumn – forecast and in spring – actual data. The treasurer needs to collect data for it also twice a year. All Council members should respond to his query promptly.
• Council Member Job Description will be sent to all national colleges. The distribution will be done by the WONCA Europe secretariat.
• Prof. Igor Svab will review the existing booklet for members and introduce the necessary corrections. Dr. Justin Allen will write a welcome letter for it. The booklet will be sent to all newly approved members of EURACT.
• Dr. Justin Allen will write a supporting letter to UEMO about their position on family medicine as speciality.
• A clear decision about Dubrovnik course was taken. If EURACT provides patronage, sponsored places will be provided. If EURACT is mentioned only as an organisation in “collaboration”, we would only advertise the course among our members.
• Chairmen of Member Service Committee – Dr. Egle Zebiene is responsible for development of the plan for sponsoring for 2003.
• The proposals for a rolling course will be prepared. The Member Service Committee will apply for a grant to the European Society. EURACT will invest 5000 € in it.
• Prof. Igor Svab will represent EURACT on research conference in Canada.
• Next Executive Board meeting will take place in London on February 28 – March 2, 2003.
• The teleconference time is December 16, 2002: at 2 p.m. CET in case of Internet connection or at 8 p.m. CET in case of traditional phone connection. Technical possibilities will be tried out by Dr. Athanasios Simeonidis.
• The travel reimbursement for the Dublin meeting is as follows:

Summary of EURACT Council decisions – Dublin 2002

• The surveys of current situation in VT and CME available on our Web-site soon
  
• Next General Meeting of EURACT in Ljubljana
  
• The membership fees are due from the 1st of January of the ongoing year
  
• Proposal for EURACT membership certificate will be presented in Vilnius
  
• The working party to create proposals for travel reimbursement policy consists of Dr. Justin Allen, Dr. Athanasios Simeonidis, Dr. Llukan Rrumbullaku, Dr. Margus Lember and Dr. Eva Jurgova
  
• New Council Member Job Description has been approved
  
• 38 new individual members from 12 different countries and one organisation in collaboration have been approved
  
• New, more precise rules for sponsorship to participate in EURACT courses
  
• New committee on review of the questionnaires
  
• Country reports need to be produced for each Council meeting
  
• CPD document approved by the Council
  
• Division of responsibility for paper on educational agenda
  
• Dr. Justin Allen and Dr. Egle Zebiene contact persons for Junior Doctors Project
  
• Preparations to WONCA Europe Congress in Ljubljana
  
• New heading: “What have I done as an EURACT representative in my country?” to be added to the regular country reports
  
• Reports on membership fee collection and budget overview twice a year
  
• Council Member Job Description to be distributed by the WONCA Europe secretariat
• New membership booklet to be produced
• EURACT supports the UEMO position on family medicine as speciality
  
• Dubrovnik course – “patronage” or “collaboration” – means sponsored places or advertisement only
  
• 2003 plan for EURACT courses sponsored places
  
• Application the European Society grant for the rolling course EURACT participation 5000 €
  
• Arrangements for next teleconference and EB meeting