title: A Survey on Trauma Systems and Education in Europe.
abstract: OBJECTIVE
  To assess the current stage of trauma system development and trauma surgery training in Europe.
  
  
  METHODS
  Email-based survey from 53 physicians representing 25 European countries.
  
  
  RESULTS
  On a scale of 0-10, the mean (SD) score for trauma system development was 5.4 (2.4) and for trauma surgery specialization 4.1 (2.9). There was a significant positive correlation between trauma system development and trauma surgery specialization (p = 0.018). Countries with ties to the Austro-German surgical tradition had higher scores both in trauma system development (p = 0.003) and in trauma surgery specialization (p = 0.000), whereas the size, economic performance or geographical location were not associated with either.
  
  
  CONCLUSIONS
  Despite the great variation from country to country, three trends in developing trauma care and education can be identified: trauma system development based exclusively on major (life-threatening) trauma care (the old United States model), combining trauma and emergency surgery into a single regionalized system (the acute care surgery model), or maintaining the orthopedic surgery-orientated all-inclusive trauma care model as practiced in most central European countries today. Although each country and region might proceed along their own line depending on local circumstances, some kind of general guidelines and recommendations at least at the European Union level would be urgently needed.
authors.affiliation: Department of Surgery, Meilahti Hospital, University of Helsinki, Helsinki, Finland. ari.leppaniemi@hus.fi.|Department of Surgery, Meilahti Hospital, University of Helsinki, Haartmaninkatu 4, 340, FIN-00029 HUS, Helsinki, Finland. ari.leppaniemi@hus.fi.
authors.forename: Ari
authors.initials: A
authors.lastname: Leppäniemi
keywords: Europe; Surgical education; Trauma; Trauma centers; Trauma systems
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