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Council meeting - Leicester, United Kingdom, September 2003 Report of the Meeting

Council Reports Contents

Wednesday 10 September 2003

Pre-Council Executive Board Meeting

The Executive Board met before the Council Meeting and discussed the following issues:

• Prof. Jan Heyrman developed the project application for the ES to make an overview of VT over three years. The cost will be 4700 Euro. If the application is not approved, the EB will decide on possible financing from the EURACT budget.
• Prof. Igor Svab will send the final version of member's booklet to Agnes Goethuys. Dr. Justin Allen will write a welcome letter. Printing of 1000 copies will be done after elections. The booklet will be sent out to all members.
• Minutes from the EURACT General Meeting held in Ljubljana will be published on the web-site.
• Prof. Albert Hercek and Dr. Marten Kvist will remain auditors for the next two years.
• There is a need for an annual password for the resource part of the web-site. Dr. Athanasios Simeonidis will produce a simple discussion paper about the costs of different arrangements for it.
• Essential parts of the Council Meeting reports should be published on the web-site (from 2001).
• Web-links for organizations in collaboration will be put on the website if the e-mail address is provided by the Council Member.
• A certificate of membership will be designed for those countries, requiring one. Council Members will receive the electronic version and they will distribute it. EB will ask Dr. Filipe Gomes to design the template.
• EB will propose to the Council to co-opt Bernardina Wanrooij till the end of 2003.
• The application for 3000 EURO grant was submitted to European Society for organization of a Leonardo EURACT course. EURACT reserves 6000 Euro for this course (incl. 3000 from ES).
• A General Practice Teaching in Europe seminar will be conducted according to the original plan although we still have some problems. Prof. Igor Svab, Dr. Adam Windak and two English colleagues will facilitate workshops. Prof. Jan Heyrman will summarize the discussion.
• The Educational Agenda discussion will be led by Prof. Jan Heyrman. The work will start from the plenary session followed by work in three groups. At least Chapter 1 should be ready at the end of the current meeting. A clear strategy to continue should also be developed.
• 5 minutes/1 slide session will be chaired by Prof. Paula Vainiomäki. The ideas should be presented to her by Thursday evening.
• The Dutch Young Doctors Program will be discussed during the Madeira meeting of the Council.
• Winter EB meeting will take place on Feb 20/21, 2004 in London.
  

Session 1: Country reports

Dr. Justin Allen, President of EURACT, welcomed all the Council members to the meeting. He introduced the program of the meeting and practical arrangements. He informed the Council about the conference which is connected to the Council Meeting. During this conference the Council Members will work together with English colleagues. The President also described the social program. The country reports were discussed in trios. At the end every Council Member reported about their colleagues reports from the trio. The full text of the reports is available as Annex 1.

Thursday 11 September 2003

Session 2: Business meeting

• The meeting started with a review of the decisions from the Vilnius meeting. At the beginning Prof. Jan Heyrman presented the state of the art of the work on VT and CPD review in Europe. It was stressed that those Council Members who have not already done so should provide Agnes with the names of second informants. Some Council Members indicated that the process of data collection from two informants is too long. According to the President this is mainly due to the delay of provision of names of several informants.
• The Members' booklet is the second issue remaining from the previous meeting. The President informed us that the new members booklet would be printed after elections at the beginning of the new year.
• Dr. Filipe Gomes will produce a membership certificate template. Agnes will collect the names of Council Members who want to receive it. The electronic version will be sent to Council members. They will distribute the certificates next year.
• The chairman of the Member Service Committee dr Egle Zebiene presented the rolling course development. The new and official name will be Leonardo EURACT course. Dr. Zebiene informed us that the first course would take place in May 2004 in Poland for Lithuania, Latvia, Estonia, Poland, Slovakia and Czech Republic. The Council stressed the need for continuation in other regions of Europe.
• The President presented notes from the General Meeting held in Slovenia. They will be published on the web-site and are available as Annex 5. The President briefly reported on his activities as a EURACT officer. He stressed his function in the Executive Board of the European Society of GP/FM. He also reported his talks about the Young Doctors Program for Amsterdam Conference. EURACT is to provide 6 facilitators. There is an issue of their conference fees. Prof. Job Metsemakers is going to clarify this with the organizing committee in the Dutch College. On that occasion EURACT's contribution to the WONCA Europe meeting in Amsterdam was also regarded. This is going to be considered further during the group discussions. Another issue is the collaboration with two other big European networks. There was a meeting attended by the President and Prof. Vainiomäki. One of the results is a potential common forum with the networks during one of the European Conferences, possibly 2005 in Greece. The collaboration with UEMO was another issue. There are some contacts, but their results are still unknown. A possible field of collaboration is the duration of VT in Europe.
• Next year the new Council is going to be elected. The President is finishing his first term and Prof. Svab his second term as EB member. The Council should consider new candidates for officer posts.
• The Treasurer presented his report. EURACT's current financial situation is relatively good. The full report is available as Annex 2.
• There were 18 new applications for membership of EURACT presented to the Council. Eight of them from Italy, 3 from Portugal, 1 from Sweden, 1 from Hungary, 2 from Austria and 3 from Turkey. All applicants were approved as new EURACT members (see Annex 3).
• In the part of “any other business” Prof. Jan Heyrman informed us about the International Conference on Communication in Healthcare 2004, which is going to be held in Bruges, Belgium on Sept. 14–17, 2004. He encouraged the Council members to advertise this Conference in their countries. Some Council members proposed to make a link on our web-site. The procedure is to inform Agnes on such initiatives was approved. She will approve this with the President.

General Practice Teaching in Europe: The State of the Art

The rest of the day was devoted to the seminar “General Practice Teaching in Europe: The State of the Art”. The president of EURACT opened the seminar attended by the Council members and teachers of general practice from United Kingdom. Keynote lectures related to the topic were presented during the first part of the meeting. At the end of plenary session the participants continued the work in four small groups. The four groups were expected to present 3 examples of good education for general practice from UK and other European countries. At the end participants reunified into plenary and presented results of their work in form of bullets points. These were as follows:

Group I

1. Early Clinical Experience (PBL) Maastricht, Turkey, UK – Leicester
   
2. Trainees teaching students Turkey, Israel
   
3. Courses across primary and secondary care Albania, Turkey, UK – Leicester pediatric training
   
4. Research options
   
5. Countries in transition – more towards full generalization
   

1. Foundation GP for all (Denmark)
   
2. Early career review mandatory (Denmark)
   
3. Flexibility within career pathway
   
4. One to one relationship (training, support) (UK)
   
5. High quality trainers in practice environment (UK)
   
6. Patient simulation (UK)
   

1. Exposure to GP throughout
   a. Learning in the community
   b. Early introduction
   c. GP day (Sweden)
   d. Foundation rotation (UK, Denmark)
   
2. Interactive learning
   a. Patient centered (Sweden, UK)
   b. Small group interactive learning (Romania)
   c. Content to process (Belgium)
   
3. Teaching the teachers
   a. Program in Slovenia involving about 20% of GPs
   b. Warwick teaching certificate (UK)
   c. International comparisons (Belgium, UK)
   
4. Palliative care
   a. Targeted courses for postgraduates
       i. Teamwork
       ii. Specialists advice
   b. all GP registers trained in this field in Warwick
   

1. Research
   a. Training for trainers course as a base for school for research in GP (Greece)
   b. in Croatia quite developed program for all GPs
   c. in Warwick University (UK) most of GPs should go on through the special training in this field
   
2. Communication
   a. General practice is a leading specialty in this field
   
3. QA
   a. School of tutors to start the work on accreditation in Poland

Prof. Jan Heyrman summarized the discussion. He stressed the enormous potential of EURACT as a group gathering together large expertise from different countries and systems. He also stressed our responsibility for the changes which we are taking part in. Evidence Based Medicine seems to become the kind of “gold standard” for practicing medicine. It seems that it is not enough for family medicine. Perhaps complexity is an even more relevant but more complicated aspect for most GPs.

Friday 12 September 2003

Sessions 3 & 4: Educational Agenda

wo consecutive sessions were devoted to the work on Educational Agenda. Prof. Jan Heyrman explained the current structure and content of the document and introduced the work on the subject. He informed us that the introduction which was added and the text boxes, need further development. For the current sessions Chapter 1 is the central topic. The work started from informal discussions in trios focused on the question: “For whom are we writing this document?” In the plenary discussion, which followed the trios' considerations, different ideas and options were presented. The first major group mentioned was course organizers and GP educators. A Second group of readers would be politicians and decision makers of different levels, e.g. university, health care authorities, ministries of education and health etc. The next group consists of vocational trainers. In general the common opinion was that the document should be readable for all groups, however one document should not contain too many versions which can cause confusion. It was also agreed that the general aim of this document is to harmonize educational programs at different levels across Europe.

After a plenary introduction the Council was divided into three groups working separately on two subchapters of chapter 1. The groups were composed of the same members as at the last meeting in Vilnius.

At the end of those sessions the group leaders reported on the work done. Then the concept for the further work was discussed. The clarity of the format to be used in the subchapters of Chapter 1 was achieved. It was agreed that the copies of the texts of each subchapter should be provided according to the agreed template by November 1^st, 2003. The editorial board will look at the texts and will harmonize them. 2-5 ordinary teachers of FM will be asked to make a pilot review of the text. The editorial board will consist of Dr. Yonah Yaphe, Prof. Igor Svab, Dr. Egle Zebiene, Prof. Jan Heyrman and Dr. Justin Allen. Prof. Jan Heyrman will collect all the copies of the subchapters (by Nov. 1^st, 2003).

The template proposed by one of the groups was as follows:

1. Aim: “The doctor will be able to…”
2. Specific learning objectives: “This will require a list of knowledge, skills, attitudes etc.”
3. Teaching and learning methods: “Methods to achieve this include…”
4. Assessment: “This can be assessed by…”
   - knowledge
   - competence
   - performance
   

Session 5 & 6: Committee meetings

These two sessions were devoted to the work of the committees, which worked separately. At the end of the Session 6 the chairmen reported back to the plenary about the progress.

BME: The group is going to finish the checklist for course organizers. There is a plan for new project, which originates from the workshop held in Ljubljana. This project will be focused on early exposure to family medicine to increase positive choice of career. Several other subjects were considered as a relevant topic for EURACT workshop in Amsterdam. The structure of the workshop was already planned.

VT: The group discussed the survey done on the methods used in VT. The group plans to produce a document on different assessment methods. There are plans to work on it further in Madeira and before the meeting. Next issue discussed was the problem of selection of trainees. The input for discussion came from the workshop held in Ljubljana. The questionnaire on this subject is planned for the next Council Meeting.

CPD: The group worked on the implementation strategy of the document on CPD developed jointly with EQuiP. The strategy consists of several steps starting from distribution, translation if needed, application of articles in local journals, presentation on conferences followed by different actions like collaboration with national colleges and other bodies, accreditation processes. The group would appreciate the reports from all Council members what did they do to promote the document. The group feels that the special workshop for Amsterdam can be prepared to discuss this further.

Member Service: The group discussed the practicalities related to the Leonardo-EURACT course for trainers in family medicine. The requirements for potential participants were discussed. The deadline for application was agreed by December 1^st , 2003. The next issue discussed by the committee was lack of proper applications for sponsored places to our courses. There were many procedural mistakes in the applications. From many countries there were no applications at all. The group also discussed the problems related to the CNGE courses. The special problem is lack of data on the preparation, content etc. so the decision was to stop the sponsorship places from 2004.

Saturday 13 September 2003

Session 7: Miscellaneous/“5 minutes 1 slide”

• President Justin Allen introduced the agreement from the Member Service Committee about our involvement in Young Doctors Program. There are two issues related to the subject. The first is to nominate 3 eligible countries and the second to appoint 6 facilitators to run the groups during the WONCA meeting. The Dutch College will be asked by EB to consider exemption from fee for facilitators. The Council agreed to select 3 countries on the basis of the biggest number of members: 2 from Central-Eastern and 1 from Southern Europe.
• Dr. Francesco Carelli presented an idea which could heighten the feeling of membership of EURACT. He described the initiative of preparation of a password protected EURACT members-only web-site introduced in Italy. He believes that a similar initiative could be successful on a general level. In the discussion, Council members presented different views on the subject. A final decision can be taken only after considering the costs and other consequences. The discussion paper on the subject will be prepared for EB by the task force lead by Dr. Simeonidis.
• Prof. Igor Svab described the experience from Bled and Dubrovnik courses. Many doctors participating in these courses showed interest in presentation of their achievements on the field of education. The idea is to organize a kind of symposium, which would follow one of our courses. Different options were presented. However the issue is not simple. Feasibility study perhaps would be needed. The EB is going to consider it further.
• Dr. Mladenka Vrcic-Keglevic introduced the issue of standardization of medical education, especially on the basic level. The World Federation for Medical Education undertook this issue. Dr. Keglevic proposed similar action towards the standardization of VT in family medicine in Europe. EURACT could play an essential role in it. According to the majority of Council Members we do not have enough capacity to conduct this work now.
• Dr. Bernardina Wanrooij presented the idea for the development of teaching the teachers courses in palliative care. She presented several questions related to this field. She asked about the need, feasibility, practicalities etc. There is quite big interest in the Council, however most of the questions could not be answered at this moment. The issue needs further consideration.

Higher Professional Education

The second part of this Session was devoted to the issue of Higher Professional Education. Prof. Heyrman reminded us of the results of the Utrecht conference on the topic two years ago. One of the results was the idea to write the document reflecting our position in this field together with the review of the state of the art. In Vilnius the Council decided to work further on the subject. This task needs more structured work. Many Council Members presented their view on this. Many arguments for as well as many against HPE as a concept were presented. Prof. Job Metsemakrers, Dr. Juliana Popa, Dr. Dolores Fores, Dr. Bernardina Wanrooij, Dr. Roar Maagaard and Dr. Justin Allen decided to work further this issue together with Prof. Jan Heyrman. The subject will be presented in Madeira.

Session 8: Future meetings

• WONCA Europe 2004 is the event in which EURACT plans to take active part. A list of several workshops was presented. Five of them were classified as EURACT workshops. The President added additional two subjects – educational agenda and Leonardo EURACT course for teachers of trainers. All the abstracts should be presented on official forms by October 15 to Prof. Job Metsemakers. Following Council members are responsible for preparation of the abstracts: BME – Dr. Yonah Yaphe, CPD – Prof. Jan Heyrman & Dr. Filipe Gomes, EQuiP – Dr. Mladenka Vrcic-Keglevic, Two other workshops – Dr. Francesco Carelli, Educational Agenda - EB, Leonardo EURACT course – Dr. Egle Zebiene and Dr. Adam Windak. The list of resource persons for Young Doctors program was agreed. This includes Prof. Jan Heyrman, Dr. Roar Maagaard, Dr. Mladenka Vrcic-Keglevic, Dr. Egle Zebiene, Dr. Athanasios Simeonidis and Dr. Filipe Gomes. Dr. Dolores Fores agreed to be a reserve person.
• WONCA 2005 will take place on September 3-7, 2005 on Kos Island. This is going to be a network conference. Our task will be to prepare key-note speakers, prepare workshops and other presentations and organize the forum together with other networks. Practical aspects with the proposal for keynote speakers will be considered further by EB.
  

Post-Council Executive Board meeting

• Prof. Jan Heyrman will apply for the project. The answer about possible EURACT backup of 3000 Euro will be taken at EB meeting in February 2004.
• Agnes Goethuys will explore the costs of printing of the membership booklet. Decision will be taken in February 2004.
• Publicity booklet will be prepared on the basis of membership booklet by Dr. Justin Allen.
• Notes and President's report on General Meeting will be published on the web-site.
• Dr. Athanasios Simeonidis will prepare the discussion paper about further development of the web-site. It will be considered further by EB in February 2004.
• Dr Filipe Gomes will produce the template for the EURACT certificate and will send the electronic version to Agnes Goethuys. The electronic signature of the President will be added and then send to the Council members.
• In EQuiP meeting in Heidelberg on November 12–14, 2003 the President will represent EURACT. If he is unable to attend the meeting the Hon. Secretary will replace him.
• Proposals for advertisement on the web-site must be submitted to the web-master and approved by the EB.
• Next EB meeting will be in London on February 20–22, 2004.
• Teleconference of EB will take place in December. The exact date will be confirmed later by Agnes.
• The President will discuss during WONCA Europe EB the issue of notification of colleges about the election of new Council.
• Reports from the selection procedure for the sponsored places for the courses will be prepared by the chairman of the Member Service Committee and distributed between the Council members.
• Turkey, Bosnia and Hungary are the countries recommended to the Young Doctors Program. The recommendation is based on the number of members of EURACT.
• Prof. Igor Svab with the help of the President will prepare the discussion paper on feasibility of educational conference for the EB meeting in February.
• Dr. Adam Windak is a link person for the Madeira meeting. Dr. Sakis Simeonidis is the link person for Arhus, Prof. Heyrman for the Czech-Slovak meeting.
• Reimbursement of 90% of the travel expenses:
  

  1. Ivana Bogrova	300	270
  2. Iuliana Popa	350	315
  3. Egle Zebiene	338	305
  4. Okay Basak	550	495
  5. Adam Windak	240	215
  6. Llukan Rrumbullaku	467	420
  7. Eva Jurgova	365	330
  Total	2610	2350

Summary of EURACT Council and EB decisions – Leicester 2003

• New member's booklet will be printed and distributed after elections in 2004
• The Certificate of membership, designed by Dr. Filipe Gomes will be available in electronic form for Council members
• The first edition of Leonardo EURACT course will take place in May, 2004 in Poland for Lithuania, Latvia, Estonia, Poland, Slovakia and Czech Republic. 6000 EURO is reserved for it. National representatives are responsible for selection of four candidates from each country. December 1^st is the deadline for the application
• The Council has approved 18 new EURACT members
  
• The editorial board of the document on Educational Agenda will consist of Dr. Yonah Yaphe, Prof. Igor Svab, Dr. Egle Zebiene, Prof. Jan Heyrman and Dr. Justin Allen
  
• EURACT sponsorship for CNGE courses stops in 2004
  
• List of EURACT workshops for WONCA Europe 2004 was agreed. Abstracts should be sent by October 15 to Prof. Job Metsemakers
  
• The discussion paper on the web-site development will be developed by Dr. Athanasios Simeonidis
  
• Prof. Igor Svab with the help of the President will prepare the discussion paper on feasibility of an educational conference for the EB meeting in February
  
• Turkey, Bosnia and Hungary are the countries recommended to the Young Doctors Program
  
• Prof. Jan Heyrman, Dr. Roar Maagaard, Dr. Mladenka Vrcic-Keglevic, Dr. Egle Zebiene, Dr. Athanasios Simeonidis and Dr. Filipe Gomes are EURACT resource persons for WONCA Europe 2004 Young Doctors Program
  
• EURACT will be represented at the next EQuiP meeting
  
• Winter EB meeting will take place on Feb 20/21, 2004 in London