title: [Cooperation model between an university clinic and a peripheral paediatric surgical department].
abstract: BACKGROUND
  The lack of young physicians in Germany, who are willing to train in surgery, is caused by several factors. Due to the demographic development and the specialisation in paediatric surgery in university institutions, attracting trained paediatric surgeons became difficult for non-specialised rural paediatric surgical departments, which is often also complicated by economic pressures. Strategies, such as cooperation between hospitals or departments, are required. We present a mid-term analysis of the first paediatric surgical cooperation between a university clinic and a rural paediatric surgical department in Lower Saxony.
  
  
  METHODS
  The Department of Pediatric Surgery, Hannover Medical School (MHH), is a university centre with a case load of about 1,700 surgical procedures per year with a case mix index (CMI) of 1.3. The Department of Paediatric Surgery, St. Bernward Hospital Hildesheim (BK), is a peripheral institution with about 1,200 surgical procedures per year and a CMI of 0.5. A cooperation project was inaugurated in October, 2004, between the two departments. The aim of the cooperation was to support the head of the paediatric surgical department at the BK by rotating trained paediatric surgeons from the MHH. Simultaneously, it was planned to offer attractive conditions for research at MHH for participating surgeons. The cooperation further included sufficient economic cover of 1.5 posts for rotating medical staff by the BK.
  
  
  RESULTS
  Three trained paediatric surgeons have so far been included in the rotation programme between the two cooperating paediatric surgical departments. The rotating medical staff costs were covered by the BK. Over a period of 2.5 years, MHH surgeons performed about 50 % of all surgical procedures at BK, while undertaking two-thirds of on-call duties there. Analysis of academic research revealed 3 accomplished experimental and 4 clinical studies, as well as 10 published articles.
  
  
  CONCLUSIONS
  The paediatric surgical cooperation was rated as a success by the rotating trained paediatric surgeons, the heads of both departments and the hospital administrations. The academic link to a university clinic also increased the attractiveness to work in a paediatric surgical department at a rural hospital.
authors.affiliation: Kinderchirurgische Klinik, Medizinische Hochschule Hannover, Hannover. metzelder.martin@mh-hannover.de
authors.forename: M L
authors.initials: ML
authors.lastname: Metzelder
authors.forename: C
authors.initials: C
authors.lastname: Engelmann
authors.forename: M
authors.initials: M
authors.lastname: Bottländer
authors.forename: M
authors.initials: M
authors.lastname: Dziuba
authors.forename: B M
authors.initials: BM
authors.lastname: Ure
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003299:Cooperative Behavior; D003479:Curriculum; D004503:Education, Medical, Graduate; D005260:Female; D013502:General Surgery / Q000193:education; D005858:Germany; D006776:Hospitals, Pediatric; D006780:Hospitals, Rural; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007400:Interprofessional Relations; D008297:Male; D010372:Pediatrics / Q000193:education; D012106:Research / Q000193:education; D013038:Specialization; D013514:Surgical Procedures, Operative