XVI National Congress of the Italian Society of Neonatology

1. Education and Research in the Mediterranean area: can we find a common track? Hercília Guimarães ,on behalf of UENPS Bari, 19-22th May 2010 XVI Congresso Nazionale-Societá Italiana de Neonatologia XVI National Congress of the Italian Society of Neonatology

2. Education and Research in the Mediterranean area Education Paediatric Section of the Union of European Medical Specialists & ESN THE EUROPEAN SOCIETY FOR NEONATOLOGY EUROPEAN CURRICULUM AND SYLLABUS FOR TRAINING IN NEONATOLOGY (Second edition – Version 3; 2 January 2007)

3. Education and Research in the Mediterranean area Education • Neonatology is a highly technical and rapidly evolving area of paediatric medicine, which is established as an independent specialty in most European countries. • In different countries the form and duration of the training, as well as process for accrediting training centres and monitoring the quality of training, vary markedly.

4. Education and Research in the Mediterranean area European CV may be utilised to: Harmonise training in Neonatology between different European countries. Establish clearly-defined standards of knowledge and skills required to practice Neonatology at a tertiary care level. Foster the development of a European network of proficient tertiary care centres for Neonatology. Through these measures, the curriculum and assessment framework will improve the quality of care for severely ill newborn babies and enhance European contribution to international scientific progress in the field of Neonatology.

5. Education and Research in the Mediterranean area The perinatal unit providing training Obstetrics A hospital offering training for neonatologists must be part of a perinatal centre: The institution, or one closely linked to it, must be equipped for prenatal diagnosis of fetal disorders, management, admission and delivery of pregnant women with maternal or fetal high risk disorders, facilities for receiving maternal and infant transfers, delivery and caesarean section room with facilities for resuscitation of the newborn infant. Other Specialities Each unit providing training in Neonatology should have defined lines of communication and access within the institution to specialist advice from the following: Neonatal surgery and anaesthesia, paediatric cardiology, paediatric respiratory medicine, radiology (including ultrasound), ophthalmology, laboratory services for clinical chemistry, microbiology, and haematology & transfusion, child development centre (clinical genetics, paediatric neurology and neurophysiology), paediatric nephrology, audiology and other surgical specialists (ENT, orthopaedics, neurosurgery). There should be access to necropsy by a trained perinatal/ paediatric pathologist.

6. Education and Research in the Mediterranean area Size of the NICU providing training At a Neonatology training institution the number of patients and their care must be of such a standard as to be able to meet the training requirements within the time set. The institution should provide care for a majority of the range of neonatal diseases and must admit at least 50 VLBW/year. Specifically the trainee will be expected to demonstrate experience of primary care and/or resuscitation for at least 25 VLBW infants (less than 1500 g) including at least 10 ELBW infants (<1000 g).

7. Education and Research in the Mediterranean area DURATION OF THE TRAINING The recommended minimum training period as a neonatal specialist is 2 years (following a common trunk of paediatric training of 3 years) and it is strongly recommended that at least one year of training should be in a tertiary academic centre.

8. Education and Research in the Mediterranean area EXAMINATIONS At present there are no plans for a centrally administered examination to licence practice as a Neonatologist. Several European member countries currently have such certification and we anticipate that these processes will be recognised. Certification of medical practitioners occurs on a national basis Individuals holding their national Certificate of Completion of Specialist Training (or equivalent) are eligible to work in other EU states. .

9. Education and Research in the Mediterranean area Questionnaire Education 1. How is defined the Training in Neonatology in your country? 2. Did your country adopt the document of UEMS and ESN (where the recommended minimum training period as a neonatal specialist is 2 years (following common trunk paediatric training of 3 years) and it is strongly recommended that at least one year of training should be in a tertiary academic centre)? 3. What do you think about on-line postgraduate educational programme in neonatology? 3.1. Advantages, Disadvantages, Difficulties Research 1. How many research centers exist in your country? 1.1. basic research and 1.2. paediatric / neonatal 2. Publications per year of each center 2.1. Publications per year of each center in international revues 2.2. Publications per year of each center in international revues IF>2.5 3. Budget per year to Research 4. Time given by the institution to do research per person per week Comments

10. Education and Research in the Mediterranean area DURATION OF THE TRAINING IN EUROPE Belgium: 1 yearfollowing 5 years of paediatric training (1 in Neonatology) Bosnia: 1 yearfollowing 4 years of paediatric training. Denmark: 3 yearsfollowing 5 years of paediatric training. Germany: 3 years following 5 years of paediatric training. Latvia: 2 yearsfollowing 3 years of paediatric training. Norway: No formal education in neonatology. Poland: 5 years (neonatal training following a common trunk) Portugal: 18 monthsfollowing 5 years of paediatric training Spain: No official training; 1 year after 3 years in paediatrics.

11. Education and Research in the Mediterranean area Research centers (Neonatology) Belgium: 2 of 7 Bosnia: 2 of 5 universities Denmark: 7 of 17 pediatric departments Germany: 33 Latvia: 2 universities Norway: 5 Poland: 11 academic centres Portugal: at least 5. Spain: at least 7, in basic research

12. Education and Research in the Mediterranean area Publications Belgium: no figures Bosnia: no figures; 5 of 8 journals registered in Medline (each of them, 4 issues per year) Denmark:12 per year in Rigshospitalet Copenhagen Latvia: no figures Germany: no figures Norway: 30-40 per year (Oslo) Poland : no figures Portugal: 10 per year (the best centre). Spain: no figures

13. Education and Research in the Mediterranean area Budget to research Belgium: no figures Bosnia: no figures Denmark: 220.000 per year in Rigshospitalet Copenhagen Germany: no figures Latvia: State Grants (?) Norway: 500.000 € per year + grants to pay full time fellows Poland: grants (?) (State Committee for Scientific Research) Portugal: 500.000 € per year ( the best centre) Spain: no figures

14. Education and Research in the Mediterranean area Time to research Belgium: 1 day / week Bosnia: ? Denmark: 10% (specialist doctors); 25% (professors) of working hours per person per week Germany: ? Latvia: no time Norway: ?; best centre - grants to full time fellows Poland: no time Portugal: no time; best centre - grants to full time fellows Spain: ?

15. Education and Research in the Mediterranean area Regionalization in Europe Scientific and Academic Societies/Parents Associations European and Local Health Authorities working together will define the methodology to achieve our aims that could be to act in these 3 key points: 1 - Organization of Healthcare in Perinatal Medicine in each country 2 - Neonatal/Perinatal European Networks 3 - Post graduation of Paediatricians in Neonatology

16. XVI National Congress of the Italian Society of Neonatology Education and Research in the Mediterranean area: can we find a common track? It will be not easy… but UENPS must contribute to find it in collaboration with ESN/ESPR !