Conditional Endorsement of Training Programs

Version voted on 10.03.2017

Conditional Endorsement of Training Programs in European Countries

1. which are not part of the European Union, the European Free Trade Association, Serbia or Turkey

2. in which the medical specialty of Physical and Rehabilitation Medicine (PRM) is either officially recognized or not

AND

3. the medical specialty of PRM is still under construction

 

Field of application:

This rule applies to PRM training programs in European Countries which

  • are not part of the European Union, the European Free Trade Association, Serbia or Turkey
  • in which the medical specialty of Physical and Rehabilitation Medicine (PRM) is either officially recognized or not

AND

  • the medical specialty of PRM is still under construction

 

Requirements for the Conditional Endorsement of a training program:

  • A specialist training program for medical doctors to become medical specialists in PRM is run on one or several training sites.

or

 A specialist training program for medical doctors to become medical specialists in PRM is under construction on one or several training sites.

 

  • In the case of an established training program for PRM medical specialists, the program must be recognized by the relevant National authority acting on behalf of the Government (unless no such recognition has been set up by the country in which the program takes place)

or

In the case of a training program for PRM medical specialists under construction, the program must fulfill the criteria established by the relevant National authority acting on behalf of the Government (unless no such criteria have been set up by the country in which the program takes place). Additionally, all the necessary steps to ensure that the National recognition will be obtained at the end of the construction process must have been taken.

  • The training program is coordinated and administered by the Medical Director and a Deputy Medical Director of the involved training sites who:

-       are recognized as medical specialists in PRM by the relevant National authority acting on behalf of the Government (unless no such recognition has been set up in the country in which the program takes place) and fulfil the criteria for EBPRM certified trainers

or

are medical specialists in a medical specialty recognized by the country in which the training program takes place and considered by the Jury of the EBPRM as having the necessary competencies and attitude for running a comprehensive training program for medical specialists in PRM

-       are recognized as trainers for medical specialists in PRM by the relevant National authority acting on behalf of the Government (unless no such recognition has been set up in the country in which the program takes place)

-       have extensive practice in one or several fields of physical and rehabilitation medicine

-       have a substantial experience in postgraduate teaching and specialist training

-    are authors of scientific papers at least in national peer-reviewed medical journals

-       are in substantive employment by the training site or the network of training sites (including private practice)

-       are practising rehabilitation medicine within a multi-professional rehabilitation team

-       are responsible for the rehabilitation team comprising medical rehabilitation specialists and at least 4 professions allied to rehabilitation medicine from the following list: rehabilitation nurses, physiotherapists, occupational therapists, clinical psychologists, neuropsychologists, speech therapists, social workers, technicians in prosthetics and orthotics etc.

Under special circumstances at the start of the program, the Executive Committee of the European Board of PRM can accept a multiprofessional rehabilitation team comprising only 3 professions allied to rehabilitation medicine. This exception from the rules can be granted for a limited time only and cannot last longer than 6 years.

  • If the training program includes more than one training site, each training site not directly cared for by the Medical Director or the Deputy Medical Director must be directed by a Program Coordinator who:

-       is recognized as medical specialists in PRM by the relevant National authority acting on behalf of the Government (unless no such recognition has been set up in the country in which the program takes place) and fulfil the criteria for EBPRM certified trainers

or

is a medical specialist in a medical specialty recognized by the country in which the training program takes place and considered by the Jury of the EBPRM as having the necessary competencies and attitude for running a comprehensive training program for medical specialists in PRM

-       is recognized as a trainer for medical specialists in PRM by the relevant National authority acting on behalf of the Government (unless no such recognition has been set up in the country in which the program takes place)

-       has large practice in one or several fields of physical and rehabilitation medicine

-       has a significant experience in postgraduate teaching and specialist training

-       is in substantive employment by the training site or the network of training sites (including private practice)

-       is practising rehabilitation medicine within a multi-professional rehabilitation team

-       is responsible for the rehabilitation team comprising medical rehabilitation specialists and at least 4 professions allied to rehabilitation medicine from the following list: rehabilitation nurses, physiotherapists, occupational therapists, clinical psychologists, neuropsychologists, speech therapists, social workers, technicians in prosthetics and orthotics etc.

Under special circumstances at the start of the program, the Executive Committee of the European Board of PRM can accept a multiprofessional rehabilitation team comprising only 3 professions allied to rehabilitation medicine. This exception from the rules can be granted for a limited time only and cannot last longer than 6 years.

  • The Medical Director, the Deputy Medical Director and the Program Coordinators are assisted in their training tasks by Qualified Trainers who:

-       are recognized as medical specialists in PRM by the relevant National authority acting on behalf of the Government (unless no such recognition has been set up in the country in which the program takes place) and fulfil the criteria for EBPRM certified trainers

or

are medical specialists in a medical specialty recognized by the country in which the training program takes place and considered by the Jury of the EBPRM as having the necessary competencies and attitude for training medical specialists in PRM

-       are recognized as trainers for medical specialists in PRM by the relevant National authority acting on behalf of the Government (unless no such recognition has been set up in the country in which the program takes place)

-       have a significant practice in one or several fields of rehabilitation medicine

-       are in substantive employment by the training site or the network of training sites

-       are responsible for the rehabilitation team comprising medical rehabilitation specialists and at least 4 professions allied to rehabilitation medicine from the following list: rehabilitation nurses, physiotherapists, occupational therapists, clinical psychologists, neuropsychologists, speech therapists, social workers, technicians in prosthetics and orthotics etc.

Under special circumstances at the start of the program, the Executive Committee of the European Board of PRM can accept a multiprofessional rehabilitation team comprising only 3 professions allied to rehabilitation medicine. This exception from the rules can be granted for a limited time only and cannot last longer than 6 years.

  • The minimal duration of the training program is 5 years, which may include 1 year of general internal medicine in an appropriate department of an acute university hospital. The training program must allow the trainees to acquire all the knowledge, skills, attitudes and experience needed to practice independently PRM as a medical specialty.

Under special circumstances at the start of the program such as the necessity for a country to build up rapidly the necessary medical PRM workforce, an insufficient capacity of a country’s PRM schools to train the number of medical PRM specialists needed, a general shortage of teachers, trainers and instructors, etc., the Executive Committee of the European Board of PRM can accept a duration of 3 or 4 years. This exception from the rules can be granted for a limited time only and cannot last longer than 6 years. If a duration of training of 3 years has been accepted, these 3 years of training must take place exclusively in rehabilitation hospital wards. After the period of reduced duration of training the training period must be increased to 4 years for the next 6 years, then to 5 years. If a duration of training of 4 years has been accepted, the 4 years must include a minimum of 3 years of training in rehabilitation hospital wards and a maximum of 12 months of training in rehabilitation related acute medical disciplines.

  • The number of trainees of the program should generally not exceed the number of full time equivalents of trainers (including the Medical Director, the Deputy Medical Director and the Program Coordinators)
  • Endorsement of the content of the proposed Training Program by the Jury of the EBPRM following a thorough review.

The proposed Training Program must meet the standards laid down in the UEMS European Training requirements for Physical and Rehabilitation Medicine and be presented to the Jury of the EBPRM in a comprehensive document which includes:

-       a detailed description of the structural features of the training sites involved : beds for inpatients; outpatient clinics; number of patients treated, staffing levels; professions involved and their levels of competence; diagnostic, therapeutic and educational infrastructure; links between the training sites of a training network, status of recognition of the training program by the relevant national authority; links with other rehabilitation hospitals, acute hospitals, universities, research centres; links with medical rehabilitation practitioners and professions allied to rehabilitation medicine in the community, etc.

-       the detailed list of the learning objectives (knowledge, skills, competencies, attitudes, etc.) to be reached for each year of training and domain of rehabilitation

-       a complete description of the characteristics of the training activities and the educational infrastructure of the training site(s) : how the learning as a whole is organized, how the relevant knowledge, skills, competencies, attitudes, etc. are transmitted to the PRM trainees, which educative principles are applied, how the different training sites of the program contribute to the learning objectives if there is more than one, the organisation and frequency of case presentations, lectures, symposia, staff meetings and journal club meetings etc.

The description also indicates how the attainment of the learning objectives is guaranteed, how progress of knowledge and competences of the trainees is evaluated, the assessment methods used (Multiple Choice Questions - MCQ’s, Clinical Examination Exercises CEX’s, short Clinical Examination Exercises - mini CEX’s, Direct Observation of Procedural Skills - DOPS etc.), the content of intermediate and final examinations, etc.

-       a full description of how the training and the progress of the trainees are documented (logbooks, e-logbooks, portfolios etc.), the assessment methods used, the content of intermediate and final examinations, etc.

  • The training sites contain all the facilities to perform:

-                Diagnostic assessments and investigations relevant to the discipline of PRM

For each training site, a detailed description discloses the diagnostic facilities available, where they are located and how they are used. 

-                Assessment and measurement of functioning

For each training site, a detailed description specifies the methods available for the assessment of functioning (observation and quantification), where they are located and how they are used. 

-              Multiprofessional medically coordinated rehabilitation treatments by a rehabilitation team comprising at least 4 professions allied to rehabilitation medicine from the following list: rehabilitation nurses, physiotherapists, occupational therapists, clinical psychologists, neuropsychologists, speech therapists, social workers, technicians in prosthetics and orthotics etc. The team must be coached by PRM specialists or advanced trainees with adequate experience. Coaching of the team by other medical specialists with a solid background of rehabilitation medicine might be admitted for a limited time only.

For each training site, a detailed description indicates the professions involved in the multiprofessional rehabilitation team, how the different professions have been trained, their level of competence, how the team is organized and coordinated (coached) and how it functions (interprofessional work and coordination, sharing of assessments, goal setting, rehabilitation planning, decision making, discharge planning, documentation of the rehabilitation process in the patient file, etc.)

  • On all training sites, an ICF based rehabilitation process is practiced

For each training site, the rehabilitation process which takes place in the centre is described in detail: how the initial medical and rehabilitation assessments are performed, how the patients’ needs are determined, how rehabilitation goals relevant to these needs are set, how the professions to intervene are chosen, how the follow up takes place, how the end of the rehabilitation intervention is determined, how the discharge is planned and accomplished, etc.

  • The directors, coordinators and trainers of the training program maintain a network of contacts among clinical colleagues (rehabilitation medicine and other medical specialties) and professionals allied to medicine in hospital settings and services assisting the discharge of patients into the community. 
  • Research activity: The trainees have the opportunity to participate to the research activities of the training site or training network on which the training program is based
  • Access to knowledge: All the educational tools essential for reaching the training objectives are available on site or within the training network. There must be an unrestricted internet access to all current medical databases and to a wide range of e-books and PRM journals. The library must be sufficiently stocked with recent PRM textbooks and other relevant books, audio-visual aids for teaching etc.
  • Adherence to a site visit program comprising:

-                Preliminary assessment of the training program on file by the members of the Jury of the EBPRM (cf. above)

-                Initial site visit by at least 2 experts nominated by the Executive Committee of the EBPRM, of all the training sites involved by the specialist training program. One of the experts should speak the language used in the training centre.

-                Implementation of the recommendations and requests for modifications of the training program (content, organization, implementation etc.) made by the Jury after the site visit.

-                Monitoring of the progress of the implementation of the training program by a trusted expert nominated by the Executive Committee of the EBPRM ideally a national of the country where the training program takes place and / or speaking the national language.

-                Submission of a comprehensive progress report by the Program Director every year starting with the site visit.

-                Optional Follow up site visit 1 year after the initial site visit only if the Jury considers it essential to follow the implementation of the recommendations and requests made following the initial site visit. Alternatively, this optional site visit can be requested by the Director of the Specialist Training Program if there is a wish for a closer guidance by the EBPRM.

-                Follow up site visit 2 years after the initial site visit.

-                Follow up site visit 6 years after the Initial site visit unless the Jury of the EBPRM considers intermediate site visits necessary considering unfavourable progress reports, complaints by trainees and other information casting doubts about the quality of the training provided.

-                in case of 2 successive unfavourable reports from the EBPRM visitors, the Conditional Endorsement of the training program is suspended

Further provisions:

After 6 years of conditional endorsement the training program becomes Board certified provided 1) the training program is still or has become recognized by the relevant National authority acting on behalf of the Government of the country as a training program for PRM medical specialists (unless no such recognition has been set up by the country in which the program takes place), 2) the two last reports of the EBPRM visitors are favorable, 3) all trainees having completed the training program have applied for the EBPRM Examination and 4) 66 % of them pass successfully the EBPRM examination and become Fellow of the EBPRM. In case of doubts, the Jury of the EBPRM can supersede granting an unconditional certification and extend the duration of the conditional endorsement with yearly site visits at its discretion.

The unconditional certification is given for 3 to 5 years, with or without a new site visit as applicable for training sites in member states of the European Union and the European Free Trade Association, in Serbia and in Turkey.

The endorsement of the unconditional certification of the training centre by the Jury results in conferring certification as a fellow of the European Board of PRM and European trainer to the Medical Director, the Deputy Medical Director, the Program Coordinators and the Trainers, provided they were active within the training program for at least 5 years.

All trainees of the program who successfully pass the EBPRM examination become Fellows of the EBPRM.

11.03.2017