1. The Curriculum Project European Hematology Association Eva Hellström Lindberg, president-elect EHA National Societies Meeting June 1 st, 2005 Stockholm

2. EUROPEAN HEMATOLOGY ASSOCIATION Board and Councilors EHA EDUCATION COMMITTEE Present chair: DiDi Jasmin Chair from June 2005: Tony Green Pan-European Survey Pan-European Harmonization (EU project) European Hematology CME system EHA Curriculum Committee Professional issues Partner Organizations: EBMT ESH National Societies European Commission CME Workshops CME Self-learning Tools EHA Education Overview

3. Members and Responsibilities Chair: Didi Jasmin Project Leaders: Eva Hellström-Lindberg (CME Survey) Dimitris Loukopoulos (CME/ECAH) Robin Foà (EHATol) Laurent Degos (EHA Curriculum Committee) Members: Jane Apperley, Harmut Döhner, Alvaro Urbano EHA President: Emili Montserrat Facilitators: Wieslaw Jedrzejczak (UEMS) Adrian Newland (National Recognition of EHA CME) EHA Education Committee National Societies Meeting June 1 st, 2005 Stockholm

4. Project Leader: Eva Hellström-Lindberg Full results: www.ehaweb.orgwww.ehaweb.org “What is a hematologist?” 2002-2003 Pan-European CME Survey in Hematology National Societies Meeting June 1 st, 2005 Stockholm

5. CME Survey Respondents n =29 1.Sweden 2.Denmark 3.Iceland 4.Finland 5.Norway 6.Latvia 7.Lithuania 8.Poland 9.Ireland 10.United Kingdom 11.The Netherlands 12.Belgium 13.Germany 14.Switzerland 15.Austria 16.France 17.Italy 18.Spain 19.Portugal 20.Hungary 21.Czech Republic 22.Albania 23.Bulgaria 24.Croatia 25.Romania 26.Greece 27.Israel 28.Turkey 29.Ukraine National Societies Meeting June 1 st, 2005 Stockholm

6. Not recognized as a formal separate specialty 2 countries Only one (hematology) with different sub-spec. 17 countries >One (clin. hematology, transfusion medicine, medical oncology, hemato-pathology, clinical immunology, coagulation medicine)10 Not answered 2 CME Survey Results National Societies Meeting June 1 st, 2005 Stockholm

7. CME Survey Length of specialist training Specialist in Hematology + Internal medicine Specialist in Hematology only 0 1 2 3 4 5 6 7 8 YEARS 1 2 3 4 5 6 7 8 9 Years of training in internal medicine Years of total specialist training period

8. CME Survey Hematology vs. Hematology + Internal medicine,5 1 1,5 2 2,5 3 3,5 4 4,5 5 5,5 Years of hematology Hem onlyHem + IM 0 1 2 3 4 5 6 7 8 Months of transplantation Hem onlyHem + IM Hematology + internal medicine Hematology Hematology training (y) Transplantation training (mo)

9. CME Survey Specialist training in different types of countries 1 2 3 4 5 6 7 8 9 YEARS Internal medicine Total training EU members EU candidates Non-members National Societies Meeting June 1 st, 2005 Stockholm

10. CME Survey National systems for CME, etc. VariableYESNO Obligatory exam524 Guidelines for CME1116 Obligatory CME general920 Obligatory CME hem821 CME point systemexist1613 OK one point / hour222 National Societies Meeting June 1 st, 2005 Stockholm

11. CME Survey Summary Two main types of hematological specialists Including specialty in internal medicine Only hematology, but with more lab training Median total training time 6 years (4 - 8 y) Median training in IM 2.5 years (0.5 - 6 y) No clear differences between different types of European countries Overall positive reactions to European CME credit point system and OK for 1 point / hour National Societies Meeting June 1 st, 2005 Stockholm

12. Curriculum Project Basic statement Hematology is a mono-specialty including clinical & laboratory competences National Societies Meeting June 1 st, 2005 Stockholm

13. The Curriculum Project Harmonization of Specialist Training Project Leader: Laurent Degos Vice-Project Leaders: Eva Hellström-Lindberg Alvaro Urbano Mike Greaves Dimitris Loukopoulos Wolf Dieter Ludwig EHA Office Nancy Hamilton National Societies Meeting June 1 st, 2005 Stockholm

14. Senior and junior hematologists from various countries + some with other competences EHA-Curriculum Committee Sub-Committees: National Societies Meeting June 1 st, 2005 Stockholm

15. EHA Curriculum Project Update of activities May 2005 Appointment of project leaders April 2004 First meeting project leaders May 2004 Request to national partners to nominate committee members - formation of CC June 2004 CC meeting (25 junior - senior - lab - clinical hematologists + others) September 2004 First CC draft, approved by EHA board and partners Feb 2005 Pan-European CC draft sent our for review by national societies March - May 1 2005 EU report and printing fall 2005 National Societies Meeting June 1 st, 2005 Stockholm

16. EHA Curriculum Project Basic statements Hematology is a monospeciality including both clinical and laboratory competences There is a vast European diversity that needs to be considered and respected The total recommended training period of 6 years, whereof 2 in internal medicine, equals the European median value The curriculum could be used as a support for national development National Societies Meeting June 1 st, 2005 Stockholm

17. EHA Curriculum Basic Principles Tick-box system Descriptive rather than evaluating Focused to give information that facilitates mobility Acceptance of European differences Three skill levels (Competence, Knowledge, Awareness) Written with the background knowledge of the US curriculum National Societies Meeting June 1 st, 2005 Stockholm

18. EHA Curriculum CV Skill Levels Each item in the Curriculum is assigned a skill level: 1.Awareness 2.Knowledge 3.Competence National Societies Meeting June 1 st, 2005 Stockholm

19. EHA Curriculum CV Definitions of Skill Levels 1.Awareness (A): Basic notions 2.Knowledge (K): Updated concepts on patho-physiology, epidemiology, diagnosis, prognosis, different therapeutic approaches. 3.Competence (C): Adequate understanding and practical integration of knowledge and skills for optimal diagnosis and treatment of patients at any phase of their disease. (T - Technical knowledge of the procedure, I - Interpretation of the results) 4.Technical Competence (TC): Ability to carry out independently specific laboratory tests. In the Diagnosis and Transfusion Medicine sections, the competence is subdivided in technical competence (T - knowledge of the procedure and ability to carry out independently specific laboratory tests) and interpretation competence (I – interpretation of the results).

20. EHA Curriculum CV Clinical Section

21. EHA Curriculum CV Diagnosis Section

22. EHA Curriculum CV Thrombosis and Hemostasis Section

23. EHA Curriculum CV Transfusion Section

24. EHA Curriculum CV General Skills

25. The EHA - Leonardo da Vinci project has finalized a draft for a European curriculum for hematological training Hematology is a clinical and biological mono- specialty The individual cv should be based on a sum of defined knowledge The validity of the CV has to be tested and updated regularly. EHA Curriculum Project Conclusions National Societies Meeting June 1 st, 2005 Stockholm

26. EHA Curriculum Project Questions for the future 1.How should the printed version be circulated / disseminated? 2.Better definition of basic pediatric training. 3.How to become a super specialist? 4.What is the role of the mentor? 5.How often should the curriculum be updated? 6.How should training centers be accredited? National Societies Meeting June 1 st, 2005 Stockholm