Recruitment & Education in Orthopedics Survey among EBOT members Niels Wisbech Pedersen Denmark

21 of 25 (84%) of the listed members from 16 countries have answered There is still a chance to participate https://www.surveymonkey.com/s/6DJTPWL

Why do this survey? Impression from European colleagues that there are problems with recruitment Impression that there is a problem recruiting female doctors in Orthopedics Is there a connection between recruitment and education/working conditions/ recruitment initiatives? If possible make a catalogue on recruitment initiatives

Recruitment is not a widespread national problem! Germany Denmark Croatia

Recruitment is a common regional problem!

Recruitment problems – why? Too few students Low payment Working hours restriction Attraction of other health branches and administration Trainees in orthopedics have a heavy on call duty nights and weekends Bad reputation mainly among females, orthopedics considered hard, long on calls, rough atmosphere Only 3-4 weeks of education during the surgical term Long training period, low salary In fact, recruitment is not a problem but the fact that after or during residency a higher and higher percentage of them leave the country Many applicants don’t want to leave the capital area Socio-cultural differences between regions are major problems in recruiting residents to orthopedic departments in those areas Small hospitals in isolated areas without bigger cities

Some countries solve recruitment problems with foreign candidates Between 0 and 25 % of trainee positions are occupied by applicants from other countries

Exam is often needed – research is not a requirement

Are other qualifications evaluated for trainee positions Only formal requirements are medical school, internship, 21 months and license to practice Orthopedic residents are matched to orthopedic programs according to their performance and ranking in the general ''specialist training entrance exam'' 360 degree evaluation, cooporation Languages Individual after application in hospitals with accreditations for orthopedic training. Depends on the head of program whom he chooses The above are not mandatory but will gain points with scoring systems for short-listing before interview. Research, previous experience The trainee is chosen after a personal interview Graduated medical school

Most appointment procedures are performed at the hospitals

Individual job interviews are common

Most countries have a national competence based curriculum

Average working week for trainees: 48 hours

Almost all trainees have a supervisor

Most departments have a Education Responsible Doctor

Almost all have exams during trainee position

Most countries have specialist exams

Most have evaluation of knowledge and surgical skills during trainee position

Other evaluations of competences 360 evaluation and all 7 doctors competences evaluated (medical expert, academical, professional, health provider, leader and administrator, communicator, cooperator Log book for evaluation of skills in other medical fields and overview of per- formed or assisted surgeries. CME points from orthopedic meetings PBA (ankle fracture, prox. femur fracture, arthroscopy) Evaluations are not formalized and vary between hospitals Teaching Lecture presentations Tests after courses

Most have evaluation of knowledge, surgical skills and research before becoming a specialist

Other evaluations of competences These are optional but the majority of UK trainees will do some sort of fellowship training in a sub-speciality e.g. revision arthroplasty. This is done after passing the exam (FRCS T&O) and usually before CCT. Some trainees may do such a fellowship after CCT and before taking up a consultant position. You must either publish a paper in an orthopedic journal or write a theses on a specific orthopedic topic. Board exam with board from members of Universities, orthopedic society and Czech medical chamber 360 degree evaluation of doctors competences

Female doctors in Orthopedics

Female doctors in Orthopaedics

There seems to be a problem recruiting female doctors in Orthopaedics

Few countries accept part time work for female trainees - Few precautions following maternity leave - Little acceptance of leaving early to collect children from nursery school

Recruitment initiatives Medical students Basic doctors Trainees

Recruitment initiatives Medical students Presentations/meetings

Recruitment initiatives Medical students Workshops

Recruitment initiatives Basic doctors Presentations/meetings

Recruitment initiatives Basic doctors Workshops

Reduced fee Membership National Orthopedic Society

Other recruitment initiatives for basic doctors Residential positions in Universities Regional meetings for all trainees in one region with both scientific and social programs Locums during summer breaks in medical school Hands-on courses, cadaver courses, basic science summer schools Student information, summer school Meetings, workshops, website

Most countries have a National Board of Education

Half the countries have a National Board for Younger Doctors

Less than half have a website to facilitate recruitment

Recruitment doesn’t seem to be at significant national problem There are recruitment problems in regional areas in most countries The survey gives no explanation to regional recruitment problems

There are recruitment problems among female doctors Few precautions during pregnancy Few precautions following maternity leave Part time work among female doctors is not common The survey gives no other obvious explanations to recruitment problems

Most countries have exams on several educational levels Other competences seem to be of less importance except for surgical skills and to some extent research competences Most countries have taken several recruitment initiatives

Thank you for your help