[6 years after reformation of the specialty training reglementation--is there still room for improvement?].
OBJECTIVE
The specialty training reglementation in Germany is defined by a clear framework and aims regarding the obtainable specialty qualification. But its implementation is often difficult. The aim of the present study was to evaluate the demands of the new specialist qualification on the part of the trainers in Germany.


METHODS
An e-mail questionnaire was distributed via the offices of DGU (German Society of Traumatology) and DGOOC (German Society of Orthopaedics and Orthopaedic Surgery) to 954 head physicians. Questions referred to abilities that are subject to concrete specialty training. Questions 1-3 referred to basic knowledge of the trained specialty. Questions 4 and 5 focused on self-reliant work, questions 6 and 7 touched aspects of conservative orthopaedics and multiple trauma management whereas questions 8-10 referred to the achieved surgical skills.


RESULTS
220 questionnaires were evaluated overall in a period of 6 weeks. 132 questionnaires were returned by the DGOOC and 88 by the DGU. Questions 1-3: basic knowledge regarding diagnostics and treatment of diseases and injuries of the musculoskeletal system as well as communication in adequate medical terminology were presumed by 97% and 85% respectively. 72% of the questioned trainers expected a brand new specialist to give a detailed and qualified description of an X-ray. Questions 4 and 5: 67% postulated that a brand new specialist should be capable of indicating a routine surgical intervention correctly. But only 30% expected a specialist to manage a consultation. Questions 6 and 7: the self-reliant conservative treatment of back pain patients was assumed by 60%, whereas the organisation of the medical care of multiple trauma patients is requested by 40%. Questions 8-10: referring to the surgical skills, 52% expected that one should handle the standard surgical approaches to the large extremity joints. Only 24% expected that after completing his training, a specialist can perform standard surgical procedures, which are required in the specialty training reglementation, without supervision. On the other hand they were expected to assist.


CONCLUSIONS
Expectations of the head physicians concerning the skills of a new specialist did not match the expected skills defined in the specialty training reglementation regarding basic knowledge, self-reliant work, surgical skills as well as conservative orthopaedics and multiple trauma management. A reasonable structuring is necessary in order to implement the requested contents of the specialty training reglementation. This can only be achieved if demands on aims are compliant.
Niethard
M
M
Zentrum für Orthopädie und Unfallchirurgie, HELIOS Klinikum Berlin-Buch. maya.niethard@helios-kliniken.de
Depeweg
D
D
D002983:Clinical Competence / Q000592:standards; D003479:Curriculum / Q000592:standards; D004503:Education, Medical, Graduate / Q000592:standards*; D005858:Germany; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D009104:Multiple Trauma / Q000601:surgery*; D009313:National Health Programs; D009985:Orthopedics / Q000193:education*; D011785:Quality Assurance, Health Care / Q000592:standards; D012017:Referral and Consultation / Q000592:standards; D011795:Surveys and Questionnaires