Contact EURACT

E-mail

Phone
(32) 16 33 74 64

FAX
(32) 16 33 74 80

Council meeting - Maastricht, The Netherlands, April 2002 Report of the Meeting

Council Reports Contents

Wednesday 10 April 2002

Pre-Council Executive Board Meeting

The Executive Board held before the Council Meeting discussed several issues and made decisions as well as proposals for the Council decisions in following matters:

• EURACT activities will be advertised during coming WONCA 2002 European Congress in London. There will be a booth run by Agnes Goethuys. EURACT will be responsible for her travel and hotel costs. No registration fee will be charged by the organisers. Prof. Heyrman will produce a new poster for the booth. There will be also 500 copies of new EURACT statements on selection of trainers printed for this event.
• The statement on trainer selection is going to be printed and published on the EURACT web-site. Printing will be done in Estonia. Agnes Goethuys is going to contact dr. Margus Lember and inform him about this decision. Printed copies will be distributed through national representatives.
• There is a shortage of travel reimbursement funds. Applications for the current meeting exceeded 3000 EURO. This time all the applicants will be paid on the old basis (90% of reimbursement), however for the second 2002 Council Meeting reimbursement may be lower. The applicants will be informed in advance by the treasurer about the level of reimbursement, calculated on the basis of actual applications received, keeping the annual limit of 6000 EURO.
• There was a misunderstanding about the country reports. Not all Council members produced the usual one and the response to the new questionnaire. So, the first session will have to be organised differently, beginning with 10 minutes discussion in pairs and then 60second reports to the plenary are to be organised. After 10 reports five minutes for clarification questions will be permitted. Dr. Adam Windak will be responsible for timing.
• Still there is no Portuguese Council Member. New efforts to attract one are going to be undertaken. In Russia there is conflict of interests between Moscow and St. Petersburg. The election procedure has been stopped, because the only one candidate received only one signature in support.
• Dr. Athanasios Simeonidis has informed about technical arrangements to organise a telephone conference through Internet. Only purchase of very simple equipment is needed and it would result in serious costs reduction. Panos is going to develop written instruction how to install the equipment and how to use it.
• According to the application of dr. Mladenka Vrcic-Keglevic, starting from 2003 the Dubrovnik course is going to be organised under the patronage of EURACT.
• Prof. Lesley Southgate is going to organise the course on assessment methodology. The course will consist of three parts, each run in different parts of Europe. These events will also be organised under the umbrella of EURACT.
  

Together with country reports, the data on the current situation in vocational training is planned to be collected this time. In future meetings other areas are planned (BME, CPD). The purpose of this exercise is to develop a current database on specific problems related to teaching in general practice in Europe, which can be put on the Web-site. Prof. Jan Heyrman presented the overview of the situation in Vocational Training in the form it has been existed until now. He asked for review and corrections. Based on it, a new version will be developed and put on the Web-site.

Dr. Justin Allen welcomed dr. Philip Evans – President of WONCA Europe. He introduced the purpose of his participation as being to understand better the way of working of EURACT and identify the opportunities to use the results of EURACT work with the work of other networks and WONCA Europe. He thanked EURACT for the efforts taken to develop new definition of general practice and core competence documents. He announced that that both documents will affect future development of the discipline and are going to be published in one of the peer-reviewed journals. Dr. Evans wants also learn about the reaction of EURACT towards the statements included in the letter of Nordic Countries.

Thursday 11 April 2002

Session 2: Business meeting

• At the beginning new Council members introduced themselves and shortly described the background of general practice in their countries. Dr. Stefan Wilm spoke about the situation in Germany. Dr. Roar Maagaard described his work as a GP in a suburb of Arhus in Denmark.
• Dr. Justin Allen shortly overviewed the report from Barcelona meeting, pointing out action points, especially those related to the London Conference.
• Short report from the European Society EB meeting was presented by its President. He stressed new, improving relationship with UEMO. Doubts are caused by the letter of Nordic countries considering too big role of the network organisations in the EB. This issue is going to be discussed further in London. Dr Evans reminded that the definition paper has still an internal status. It is going to be to be presented in London and published in form of a booklet available for all the colleges and university departments. Dr. Allen informed the Council about our contribution to the Noordwijk meeting which was aimed at review of the document by the colleges.
• Dr. Athanasios Simeonidis presented the new policy on reimbursement of travel costs – 6000 EURO for 2 meetings a year. For the first meeting we exceeded the amount of 3000 EURO. This means that for Dublin meeting less than 3000 EURO will be available. Four weeks before the meeting all those seeking funding should inform the treasurer about the amount of money they are going to apply for. Then the treasurer will calculate the percentage of reimbursement to be paid based on the amount available. This policy was approved by the Council.
• The treasurer presented the budget of the Council. The situation is relatively good, however we need to be careful with the expenditure. The budget overview is attached as an Annex 2.
• Dr. Allen presented the job description of the Council Member, developed during former meetings. It was reviewed and updated by the Executive Board and presented for formal approval to the Council. This formal policy is needed to solve problems with representation of some countries. This proposal was discussed by the Council Members, giving arguments pro and against strict regulations, which may result in exclusion of consistently absent members. Finally the Council approved the policy. The new job description is available as an Annex 3.
• In order to improve the relationships with national colleges the policy paper in this field was developed by the President. This paper stresses the needs for links to be established by every Council Member with his/her national college, university departments and network organisations in the country. Some of the members stressed that in their countries colleges are very unhappy with the current policy for election of the national representative. Dr. Allen answered that we are individual membership organisation and members who pay their fees should keep the right to elect their representatives. However still good working relationships with national colleges are needed. In order to consider this issue further a “5 minutes 1 slide” presentation is going to be given by Dr. Dolores Forés, Dr. Roar Maagaard and Prof. Anders Baerheim during the Saturday session.
• During last few meetings the issue of representativeness of the EURACT EB was raised. In order to resolve these issues the EB has developed a proposal for the new arrangements presented by the President. The new rules regulate the number of turns available for every position in the EB. This regulation was approved by the Council and is available as Annex 4.
• Dr. Evans raised the issue of the Nordic countries letter complaining about the role of the network organisations within the Executive of the European Society, which – according to the authors of the letter – is too great. The second issue raised in the letter is a gender issue (women are not represented in decision-making bodies). There were serious doubts about legal status of the letter (only one signature, others were missing). Other doubts were also expressed. The Council reflected on the arguments included in the letter of Nordic countries and rejected most of them. The President is going to write a letter to the European Society, reflecting our position on this.
• New proposals for committee working was presented by the President. Every Council Member can be a member only of one committee and should stick to it for at least three consecutive meetings. The committee leaders have been confirmed (Member Service Committee – Dr. Egle Zebiene, Specific Training Committee – Dr. Margus Lember, Basic Medical Education Committee – Dr. Yonah Yaphe, Continuous Medical Education Committee – Prof. Paula Vainiomäki). Dr. Fergus O'Kelly was appointed to be a journal contact person. Dr. Sakis Simeonidis was appointed as a Web-master and Dr. Dolores Forés as a Deputy Web-master.
• The lack of representatives from Portugal and Russia is a problem, although several steps have been madeto resolve it. Prof. Harry Crebolder is stepping down from the Council. The election of a new Dutch representative is going to be organised by the Secretariat. The new representative will be appointed till the end of the current term of the Council.
• 39 new applications for EURACT membership were presented. New members were approved. The list of new EURACT members is attached as Annex 8.
• There is a new proposal for EU Directives regulating recognition of professional qualifications including physicians. Many of the proposals developed by UEMO and other GP organisations are not included in the document. Dr. Allen is going to write a letter to European Society reflecting our position in this field. This is going to be discussed also during the Saturday session.
• The booklet on selection of trainers is going to be distributed by national representatives who will receive copies from Dr. Lember.
  

Session 3 and 4: Small group meetings

BME, VT, CPD and Member Service committees worked separately. They reported to the plenary session 5.

Session 5: Reports from small group meetings

Member Service Committee – the report was presented by Dr. Egle Zebiene. The group is going to propose to continue the sponsorship of Bled and Riom courses. There are however some problems with Riom course, because the contents and programme of the course is not announced in advance. For the future we should also sponsor Dubrovnik course, which is going to be a EURACT course as well. The President of RCGP Prof. Leslie Southgate has proposed to organise a course on assessment consisting of three parts given in three different settings in Europe, starting in London. Dr. Justin Allen was appointed a contact person to develop the idea further.

The group stressed the need to make more tight contacts between the national representative and his/her national members. EURACT is to be involved with Romania through a project submitted by Dr. Iuliana Popa.
The group is going to develop and submit the proposal to the Leonardo da Vinci funds for the project provisionally called “EURACT master of education”.

Basic Medical Education Committee – the report was presented by Dr. Yonah Yaphe. The group made an overview of possible activities and prioritised them. They selected the issue of selection of new teachers for BME. Checklist, contents and assessment were the three topics selected for the further development. The group divided into three subgroups, which are going to work on each of the subjects. The members of the group are going to communicate through e-mails. The final goal of the group is to prepare a workshop to be ready for Ljubljana WONCA meeting in 2003.

Specific Training Committee – the report was presented by Dr. Fergus O'Kelly. The group reviewed the newly published document on selection of trainers and teaching practices. The group is looking for a feed-back from the Council Members. Special questionnaire is going to be developed and distributed. The group considered possible ways to produce and distribute the document on new definition of general practice and core content competencies. Another issue is a review of the current status of assessment of trainees. The questionnaire is going to be developed by Dr. Dolores Forés. The next issue is teaching of teachers. The group is considering preparation of a handbook or “work-book” which could be of assistance for the countries without experience in this field.

Continuing Medical Education Committee – the report was presented by Prof. Paula Vainiomäki. The group worked with the presence of the guest from EQuiP – dr. Luc Sentijens The group discussed the document which is under common production of EURACT and EQuiP. Links between CME and quality assurance have been sought since several years. It is not easy to find a common ground for the issue, acceptable for both groups.

• Dr. Iuliana Popa presented Rumanian proposal on continuing education. The core of the proposal is a conference in Rumania on continuing medical education, financed by European Union. The Ministry of Health and Centre for Studies in Family Medicine would be the partners in the project. The aim of the conference is to produce a position paper. EURACT can support applications with the name of organisation and CV of individual members. Further to that some EURACT members would be prepared to take part in the conference. The CME group will start to work on recommendations during the Dublin meeting.
• Dr. Francesco Carelli presented his ideas on spreading information about EURACT in Italy. He has already written several articles and sent a lot of information by e-mail. Shortly the meeting of three network organisations will be organised in Palma. More meetings are going to be organised in different parts of the country devoted to educational issues. Dr. Carelli asked the Council for permission to use EURACT “patronage” during these conferences. The idea was generally accepted for all the countries wishing to do this. The EB should be first notified and feed-back should be provided.
• Dr. Anders Baerheim raised the issue of representatives of the Council. Being the organisation with individual membership we are losing proper connections with the colleges. He argued that colleges are essential for dissemination of the results of our work. Better relationship with the colleges would help to make links strengthening our position.
• Prof. Igor Švab presented the opposite view. His arguments are related to the tradition and to the nature of our work which is based on individual expertise of individual members. Too big influence of the colleges and selection procedure of representatives can also be irrelevant due to the fact that colleges are usually not involved in BME.
• Dr. Justin Allen said that both positions have a lot of important arguments. The issue is important and deserves more attraction. It is going to be discussed further, first by EB, later by the whole Council, probably during one of the following meetings.
• Dr. Justin Allen summarised once again the EU proposal. The crucial points are as follows:
  - there will be no specialist registration of family medicine
  - the advisory committee is going to be abolished
  - the training of GP from 2006 will be minimum 3 years with minimum 6 months in general practice
  - part-time training will be at least 50%
  There is no mention of quality of training, competencies or patient safety. The document is rather disappointing to the society of general practice. The results of 10 years work are not reflected in the proposals. The new proposals are only in line with the idea of free movement of doctors.

Session 7: Teaching agenda

As a result of new definition and core competencies the new teaching agenda should be developed. Prof. Heyrman proposed to continue the work on it in three groups:

• AIMS
• CHAPTER STRUCTURE
• PLANNING OF FURTHER WORK

The result of the work should be a “derived agenda” for teaching. This means that it is going to be a never-ending process with clear recommendations based on the “state of the art” review. Developing the teaching agenda we need to take into the consideration also the position of EGPRW and EQuiP. This agenda has to cover full “lifelong learning” spectrum including BME, VT, HPE and CPD. The consultation with the patients should serve as a backbone of this agenda, which should be also done according to learning principles based on scientific evidence. The teaching agenda should facilitate constructing a local curriculum, reflecting specificity of local situation. For further development the existing evidence on education should be consistently collected. This is perhaps a challenge for EURACT.

The aims and general structure of the document were discussed in three groups. Further development of this work was discussed. In general it was agreed that at the beginning that the general framework of the document should be agreed by the Council together with bullet points for every chapter. Editors of the document should be appointed and authors of different parts as well. All Council Members decided on the part of the document they want to work further on (see Annex 7). Each group will have a leader responsible for development of the text by August 15. Further work is going to be done in Dublin.

Session 8: Summary of the meeting

• Future meetings:
  Dublin: Sept 25–29, 2002
  Vilnius: Spring 2003 (April or May)
  Leicester: Autumn 2003
  Boat from Stockholm and Turku: Spring 2004
  Combined Czech and Slovak meeting: Autumn 2004
• The Dublin meeting will take place in Trinity College in Dublin. Due to the local meeting this is going to be a meeting of normal length starting on Wednesday and stopping on Sunday.
• Dr. Justin Allen will write to the President of European Society about our position towards “Nordic letter” stating that we are essential part of ES, as democratic as any other.
• New rules for reimbursement of travel expenses were agreed and are going to be reviewed in the future.
• Both personal reports should always be provided alongside with a review of specific career (like VT).
• Missing reports from the countries must be sent to Agnes Goethuys.
• New working style seems to be successful. This is especially related to bigger contribution of small group rank instead of plenary session. All Council Members were satisfied with the results of the meeting.
• As an amendment to the business meeting election of Honorary Treasurer was conducted. Dr. Athanasios Simeonidis was elected for his second term for the period of next three years.
• President of EURACT Dr. Justin Allen thanked Prof. Harry Crebolder for excellent arrangements for the meeting and the creation of exceptional atmosphere during the meeting.

Post-Conference EB meeting

• The plan agreed during the Pre- Council meeting was completed. The treasurer was re-elected. Deputies for the committees were appointed:
  - Dr. Fergus O' Kelly
  - Service – Prof. Igor Svab
  - Prof. Bengt Matsen
  - Dr. Eva Jurgova or Dr. Mladenka Vrcic-Kedlevic (to be decided in the future)
• The President is going to write to absent members and ask them about their preferences to be members of the committees.
• Dr. Dolores Fores was appointed as a deputy Web-master.
• Fergus O' Kelly is the person responsible for the communication section in the journal.
• Reports from the group meetings should be in form of a business plan, stating the outcome, sources, timetables etc.
• There is a need for coherent system of training after Vocational Training. A statement in this field is probably needed. This can be seen as a result of the thematic conference held in Utrecht. Minutes from this conference are expected and could serve as a basis for such a statement. The proposal for the statement will be developed by Executive Board. The terms need to be defined and the basic glossary must be agreed before any further action will be undertaken.
• Prof. Jan Heyrman will be the editor of the teaching document in collaboration with dr. Justin Allen and dr. Adam Windak. First the structure will be reviewed by the editorial group (May 15) and the clear tasks will be delegated. The text from the groups is expected by August 15. Two sessions in Dublin will be needed. It will start from the “5 minutes 1 slide” presentation from each of the groups followed by plenary and small group work. The document should be ready for Ljubljana WONCA Congress.
• The documents needed for a Council Meeting will be sent by an e-mail to Council Members two weeks before the meeting together with the list of documents which should be brought to the meeting.
• The common EURACT/EQuiP document on CPD is needed. The work should be finished and document should be officially approved by both organisations. This should be done by the end of this year. To do so, the final text is needed by August 15, to be approved by autumn meeting.
• The discussion on the nature of EURACT as an organisation will continue in Dublin based on two concept papers to be developed by Prof. Igor Svab/Dr. Justin Allen and Dr. Anders Baerheim /Dr. Dolores Fores by August 15.
• In Dublin the committees will be asked to plan a contribution to the Ljubljana Conference. In addition there will be a plenary session devoted to the educational agenda.
• For every new election of Council Members the job description of the Council Member will be attached to the information sent out to the the members. The letter inviting nominations is going to be modified , stressing the necessity to create equal chances for both gender representatives.
• The application and personal information form will be put on the Web-site. There should also be information that new applications must be submitted through the national representatives. In case of lack of the national representative for certain country, the application can be sent directly to Leuven Secretariat.
• Dr. Iuliana Popa will be reimbursed additionally – 90% of the costs of the ticket from Maastricht to Amsterdam due to the fact that train connection between these two cities early Sunday morning does not exist.
• Next EB meeting is in Dublin on Wednesday at 15.00 in Trinity College.
• EB members should have microphones to their PC in order to have a teleconference through Internet. The Honorary Treasurer will provide the detailed step-by-step instructions.
• The travel reimbursement for the Maastricht meeting is as follows:
  

Adam Windak	470	420
Iuliana Popa	585	525
Egle Zebiene	581,55	520
Ivana Bogrova	600	540
Muharem Zildic	850	765
Llukan Rrumbullaku	600	540
Eva Jurgova	482	435
Okay Basak	550	495
	4718,55	4240

Summary of EURACT Council decisions – Maastricht 2002

• The EURACT booth during WONCA 2002 European Congress in London will be run by Agnes Goethuys. EURACT pays for her travel and hotel costs
• Prof. Heyrman will produce a new poster for London Conference
• The statement on trainers selection is going to be printed in 500 copies in Estonia. Responsible – dr. Margus Lember. Distribution through national representatives
• Reimbursement of travel costs for the Council Meeting in Dublin up to the limit of 6000 EURO per year. Expected lower that 90% reimbursement rate. New policy and new procedure
• New telephone EB conferences will be done through internet according to the instruction to be developed by Panos
• Starting from 2003 the Dubrovnik course is going to be organised under the patronage of EURACT
• The course on assessment methodology, developed by Prof. Lesley Southgate will be organised under umbrella of EURACT
• A corrected version of the database on VT in Europe is going to be developed by Prof. Heyrman and put on the Web-site
• New job description of the Council Member
• New regulations for EB membership
• The President is going to write a letter to the European Society, reflecting the EURACT position towards the letter of Nordic countries
• New rules for committees work and new functions in the Council
• President's letter about new proposal for EU Directives regulating recognition of professional qualifications of physicians
• Dr. Justin Allen is a contact person to work with Professor Southgate on the assessment course
• New rules for EURACT patronage of educational meetings in member countries
• The next Council meeting will take place in Trinity College in Dublin on September 25 –29, 2002
• Prof. Jan Heyrman together with dr. Justin Allen and dr. Adam Windak will act as editors for the document on teaching agenda to be ready for Ljubljana Conference.
• Dr. Athanasios Simeonidis elected for the post of EURACT Honorary Treasurer for next three years
• Two pairs of Council Members – Dr. Justin Allen together with Prof. Igor Svab and Dr. Anders Baerheim together with Dr. Dolores Fores – will produce the discussion papers about the nature of EURACT as an organisation by August 15