General aspects of a training programme
The programme that can train paediatric urology fellows will be accredited by the Joint Committee of Peadiatric Urology (JCPU).
The training programme must be within the countries where the UEMS regulations applies.
Paediatric Urology Training programmes must apply directly to the Joint Committee on Paediatric Urology (JCPU) for certification. Applications should include detailed information concerning the institution(s), medical and academic facilities and the training programme including a written training programme for the whole fellowship period of 2 years and faculty. An application fee of 100,-- Euros has to be paid at the moment of application, additional 250,-- Euros at the time of the site visit and finally upon successful certification another 150,-- Euros.
Accreditation is based on the number of admissions to the training programme including day care, outpatient and inpatient care; number and diversity of all practical and surgical procedures; appropriate access to other relevant specialties; staff members, fellows under training and record of scientific publications.
Applications are reviewed by JCPU and if accepted site-visits will be performed. Upon review of the visitors report the JCPU is mandated to give accreditation. Each accredited programme must document academic and medical activities. Accreditation is valid for 5 years. In order to maintain accreditation, the training programme must reapply every 5 years to the JCPU.
Requirements for accreditation as a training programme
Paediatric Urology training should take place in an institution or a group of institutions, which are of sufficient size to offer the trainee a full range of medical and academic facilities concerning paediatric urology.
To be considered for accreditation, the institution must submit a statistical overview of the number of outpatient paediatric urological visits and the paediatric urology surgical procedures that have been performed during the 2 previous years. The institution should have access to radiographic, ultrasonographic, CT scan, MRI, nuclear medicine and urodynamic equipment.
The institution should have a 24-hour operating theatre and adequate operating theatre equipment for paediatric urology cases.
The training programme should be associated with the following departments which are also departments with a training programme.
- Paediatrics including nephrology, oncology, endocrinology, neurology, psychology and neonatal care divisions.
- Radiology with expertise in children.
- Foetal medicine.
- Nuclear medicine.
- Anaesthesiology with special responsibility for paediatric anaesthesia.
- Paediatric Surgery and Urology
- Physiotherapy and rehabilitation
- (Orthopaedics with special responsibility for paediatric cases.)
- (Neurosurgery with special responsibility for paediatric cases.)
A medical library should be available near the institution. Library services should include electronic retrieval of information and and should have collections of texts and journals easily accessible.
There should be a written training programme structured for each trainee in accordance with JCPU recommendations. The programme of training must give graded and progressive responsibility to the trainee. The programme should include educational components that are all related to certain goals.
The written training program should provide each trainee with :
- Experience and clinical competence in a variety of paediatric urology cases including inpatient and outpatient care.
- Experience in surgical aspects in a variety of paediatric urology cases
- Exposure to neonatal units and paediatric intensive care
- Familiarity with all contemporary imaging modalities
- Implementation and evaluation of urodynamic studies in children
- Experience in multidisciplinary management of nephrology cases
- Experience in multidisciplinary management of myelodysplasia cases.
- Experience in multidisciplinary management of problems related to sexual differentiation
- Exposure to foetal medicine
- Exposure to paediatric renal transplantation
The training programme should also support participation in clinical and experimental research. Active participation in local or international paediatric urology meetings (particularly with presentations) should be encouraged. The programme of training should be planned to maintain an ongoing scholarly activity including:
- Weekly clinical discussions and rounds
- Regular programme of teaching
- Regular journal clubs
- Regular clinical and experimental research conferences
- Discussions of morbidity and mortality.
Experience in clinical and operative aspects of paediatric urology and scholarly activity of the trainee should be recorded in a logbook (appendix A).
Requirement for faculty
The programme director should have been practicing in Paediatric Urology for at least 5 years after specialist accreditation in either Urology or Paediatric Surgery.
The head of the programme of paediatric urology must have a special interest in education and training in all aspects of paediatric urology. He/she must be willing to devote time to supervise trainees in outpatient clinics, surgery and research activity. He/she must give evidence to the JCPU of current and continuing scientific work. The head of the paediatric urology programme should be a Fellow of the European Academy of Paediatric Urology, certified by the JCPU.
The programme director is responsible for a training programme that includes the educational goals and the details of the educational components attributed. This should be a written statement and should be readily available for review.
The programme director is responsible for monitoring the quality of training and should make a regular evaluation of a trainee’s overall performance and make yearly reports to be included in trainee’s logbooks.
There should be a sufficient number of faculty with documented qualifications to instruct and supervise adequately all paediatric urology trainees in the programme. All members of the faculty should be able to devote sufficient time to meet the teaching needs of the programme. The head and the teachers should be practicing in Paediatric Urology in its full extent and should be involved with paediatric urology more than 80% of their full-time clinical responsibility.
The director of the paediatric urology programme must also be able to expose the trainee to paediatric urology for at least 80% of her/his clinical experience during regular hours.
There should be a written statement about the assignments and responsibilities of each member of the faculty. There should be regular staff meetings held by the faculty to review the programme goals, objectives and performance.
The programme director must apply to the JCPU for visitation. The JCPU will designate 2 or 3 delegates, preferably members of the EAPU. The applying centre must pay an application fee in addition to the actual costs of the travel expenses of the JCPU delegates. The travel expenses will be kept as low as possible (train, APEX air fare, medium level hotels). The payments will be done through the treasurer of the JCPU and original bills will be passed on to the applying centres.
Requirements for trainees
The trainee is a surgical specialist who has certification in Urology or in Paediatric Surgery. To build up his or her experience, the trainee should be involved in the treatment of sufficient number of in-patients and out-patients and perform a sufficient number of surgical and other practical procedures of sufficient diversity. He/she also must be willing to take part in the education of residents of the institution.
He/she must participate in research activities and produce a scientific output during his/her training.
The trainee should have sufficient linguistic ability to communicate with patients and colleagues and to study international literature .
The trainee should keep a personal logbook according to national rules and to the recommendations of the UEMS/ JCPU.
A copy of the surgical logbook should be sent every twelve months together with a review of the program to the JCPU.
At the end of the training a final report and evaluation should be sent to the JCPU. The logbook should contain detailed data about the trainee’s clinical and operative experience and academic performance.
1. Minimal requirements for operative experience
The candidate has to take active part ( as a supervised surgeon or performing the surgery ) in at least 250 paediatric urology operative procedures equally divided during the training period covering the entire field of paediatric urology as specified below. The surgical procedures should be divided among:
- surgical procedures on the kidney and the upper urinary tract (codes A1, A2)
- surgical procedures on the lower urinary tract (codes A3,A4)
- surgical procedures on the external genitalia (codeA5)
- endoscopic surgical procedures (including laparoscopy)(code C )
Also the candidate has to take active part in a large number of diagnostic procedures and minor procedures like diagnostic endoscopy, ultrasound studies and urodynamic studies (code D).
2. Minimal requirements for academic performance:
- have published or have been accepted for publication 1 articles (no abstracts) on paediatric urology topics in a peer-review international journal (as a first author).
- and have presented at least 2 papers or posters on a paediatric urology topic at an international scientific meeting (preferably ESPU meeting).
To be considered for certification as a Fellow of the European Academy of Paediatric Urology the trainees who finish two years of training in an accredited centre will present his/her logbook and the evaluation from the programme director to the JCPU.
Those trainees who are considered to have had sufficient training will be able to take the JCPU quality assessment for certification.
The format will be a written qualification exam going to be held annually during the ESPU meeting.
After successful completion of the quality assessment the JCPU will issue the trainee with the certificate of Fellow of the European Academy of Paediatric Urology (FEAPU).