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What is the period over which the required volume per year per training centre is calculated?
The Curriculum hasn't defined a period of time over which the Centre needs to reach a mean volume per year. The volume criteria apply to the time of, or rather the year prior to the request for accreditation.
Although the fellowship duration is still 2 years, what is the max period of time in which the fellow would have to achieve the number of procedures required?
The programme may indeed be 2 to 3 years, with a maximum time allowed to meet both the quantitative and qualitative criteria of 4 years. There is one exception, and that is for the ESGO exam, which can be passed up to 6 years after the start of the fellowship, to allow fellows to repeat the exam which until now can only be sat once a year. But even when a fellow need to postpone the exam, the rest of the training programme should have been finished within 4 years.
The portfolio must be completed within 4 years, does it mean that the fellowship will last 4 years now?
No, the fellowship programme should be between 2 and 3 years FTE, but we allow prolongation due to e.g.part-time training or paternity/maternity leave upto 4 years.
What can I do or obtain if I have only partly met the required skills during 2 years of subspecialisation.
A first pre-requisite is that you will have registered with ESGO and submit your training programme. Skills and modules that you have already achieved, e.g. during an elective or during an unregistered fellowship can be documented in the portfolio.In any case, to obtain certification, one has to fullfill at least 2 years in a pre-registered programme. On the other hand, if you haven't met the criteria during a registered programme, you may extend the training period to a maximum of 4 years.
Does the curriculum specify the qualifications of the supervisor in addition to the criteria set for a centre?
Yes, in this new curriculum we also define the qualifications of supervisors or tutors (Training Programme Director and Educational Supervisors). E.g. they should have taken part in a teach-the-teachers course. In addition their responsabilities are now clearly defined.
Can two centres join together in order to accomplish the new minimum criteria for a centre and get the accreditation for a centre?
Actually NO. Two centres may join, but should each invidually meet the ESGO criteria and be accredited. However, once accredited, centres may join to optimally use their joint volume.
How will I register procedures performed before the launch of the E-portfolio?
During a transition phase for those not yet in their last year of training, all procedures, skills and training activities that one has already acquired may be documented retrospectively. As long as the E-portfolio is not yet available this should be done on paper and may later be copied into the E-portfolio.
How can senior attending doctors be certified?
ESGO has not proposed a so called grand-father/grand-mother transition. Attending doctors and consultants who already work as a gynaecological oncologist cannot be certified retrospectively. However, since there is no age limitation, they can opt for participation in a fellowship programme of at least 2 year, including the ESGO exam.
Can the fellow open his own portfolio?
The fellow will be able to open the portfolio with a password. ESGO is currently examining how and with what restrictions the Training Programme Director and Educational Supervisors will be able to access the fellow's portfolio.
How can I as a supervisor monitor the fellows portfolio?
You will be able to add and review the results of formative and summative assessment. As soon as the on-line e-Portfolio will be up and running, the portfolio will also automatically calculate and show summaries, e.g.by using spiderweb graphs to follow progress in competencies and column graphs to show how far the fellow is from reaching volume criteria.
Is Part Time fellowship possible?
Part-time fellowship is possible as long as the total fellowship does not exceed 4 years. E.g. half-time training for a 2-year programme would be allowed and would mean a period of 4 years of training.
Which organizations/countries have agreed that their curriculum is equivalent to the ESGO's one and they are happy to give their national certification to ESGO's trainees?
In fact it is the other way around, as it is ESGO who decides which national training programmes comply with our accreditation rules. So far, only the United Kingdom and The Netherlands have such an ESGO recognised national training programme. However, as part of the introduction of this new Curriculum, ESGO's Educational Committee has also started to review all European countries to assess whether also other countries qualify for ESGO recognition.
If I come from outside Europe can I be trained in Europe and how would I know which centres would be available for training?
Indeed, fellows from outside Europe are welcome to apply to ESGO individual certification. It is possible by spending at least one year at an ESGO accredited centre. The list of all ESGO accredited centres can be found at the ESGO webpage. As a matter of fact we recently also accredited two (2) centre outside Europe (in India). Fellows and centres should be aware that the rules of the new Curriculum will apply equally to foreign centres and fellows. Fellows are, however, reminded that they will personally be responsible to comply with European regulations for workers/students from outside Europe (visa, working permit, registration with medical councils or boards etc).
In some countries there is no official accreditation and training may have taken place in different centres over a long period of time. Can skills and procedures from such training be entered into the portfolio retrospectively?
In principle retrospective registration of skills and procedures is not allowed, except if they have been acquired and certified during an elective year as part of general training. We are aware that there are countries without accredited training, and this is exactly why ESGO has embarked on this Curriculum project to be spread over Europe.
Can I register as a Fellow if my centre is not accredited as a training centre but there is a certified gynaecological oncologist working there?
And if we would get accredited in 1-2 years, would the portfolio be valid if I activate it before the centre will have been accredited?
You may register in the ESGO training programme before your centre will be accredited, and your activities can be counted for 1 to 3 years. However, at least 1 (additional) consecutive year must be spent in the same or other ESGO accredited centre, and surgical procedures must be performed there.
Trainees who are currently in the 2nd or 3 rd year - can they enter cases already done or only prospectively from Jan 2021?
You may register all procedures, skills and training activities that you have already acquired as part of your training retrospectively during this transition phase. More specifically, those who are in their last year of training have the choice of finishing their training according to the rules and the portfolio of the old Curriculum, all others have to fullfill the criteria of the new Curriculum in the remainer of their training.
If I am working as a gynaeoclogical oncologist in a country that has not (yet) an accreditation system and doesn't recognize the ESGO Certficate, can I still sit for the ESGO exam?
Of course you can sit for the ESGO exam, even if you have no certificate or training in an ESGO accredited centre. If passed you will be issued a certificate stating that you have passed the exam, but you cannot be issued teh ESGO diploma of a certified gynaecological oncologist. Attending doctors and consultants who already work as a gynaecological oncologist cannot be certfied retrospectively.
If one trainee in our center is on maternal leave, is it possible for an other collegue to "take over" her spot as trainee?
Centres will be accredited for a certain number of traines per year. As long as they comply with this restriction, centres may divide these position over more fellows, e.g. as part of a part time programme or due to maternity or paternity leave. The individual fellowships may, however, not exceed the period of 4 years!
Will the fellow log in on all assessments, or will the supervisor have her/his own log in possiblilites?
Of course, the portfolio is open for the fellow, who will be able to open it with a password as any locked file. The fellow will log in each time he requests or wants to document an assessment. ESGO is currently examining how and with what restrictions the Training Programme Director and Educational Supervisors will be able to access the fellow's portfolio.
How many times can you do the exam?
In principle the exam can be taken as many times as needed to pass the exam. However, the exam should be passed within 6 years from registration of the start of the fellowship. This effectively means that from the start of the fellowship, the (upto now) yearly exam can be taken 6 times.
Is it possible to make only 1 of the two or 3 years in an ESGO-accredited Gynaecological Oncology unit?
In principle all training should be in an ESGO recognised centre. It is possible to make only 1 of the 2 or 3 years, only if the the rest of the training will be in a recognized centre outside Europe.
Are not the volume criteria for hospital accreditation too high?
- 10 new vulvar cancer cases per year?
- 40 cytoreductive surgeries per year?
As a matter of fact the general volume criteria of 150 new cases and 100 cases of radical surgery, as established by consensus, are rarther low to ensure adequate exposure for the fellow. It was therefore decided to distinguish TRAINING centres from other ONCOLOGICAL centres by defining in particular criteria for a rare tumour (vulval cacer) and a very common and increasingly important procedure (cytoreduction). Especially the latter will form the mean stay of our work and needs therefore be taught in sufficient number.
Are the bars for individual certification not too high? In particular to have 2 peer reviewed publications seems to be demanding as subspeciality training doesn't aim at a PhD!
Yes, the bars are high as our patients deserve to be treated safely and to the highest standards. There has been some discussion about publications, but since there are nowadays so many possibilities to publish, that even for fellows in countries with little means this should be feasible. Also the new Curriculum stresses the necessity to address all competences, not only the technical, surgical one. Thus, a fellow should also get at least some experience in e.g. organisation and communication.
Assessments look complicated, though sophisticated. Will senior staff not be discouraged with all the additional paperwork.
The new ESGO Curriculum aims to align with the best and most modern means for teaching. In general, there is a trend in Europe and outside Europe to perform regular, systematic and structured assessments for each new activity which requires some training and technical skills. Admittedly, it may seem a lot of paperwork, but an OSATS will take virtually only a few minutes, especially when available online.
What is the definition of cytoreductive surgery? Can we include even advanced endometrial cancer or recurrent disease or pelvic exenteration?
Yes. Radical surgical procedures are well defined in the Curriculum and so is cytoreductive surgery. The latter procedures may be for any tumour type.
If I do not attend the entire fellowship in the same centre, who is my Supervisor ? Does he/she change according to the Centre, or must be only one ? Does he/need must be ESGO certified?
Yes, the supervisor(s) will change with the centre as they have been defined and accredited per centre. At this moment not all European Gynaecological Oncologists have been ESGO certified, but at the review during the accreditation visit staff is also being reviewed as to their ability to train.