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Background: Even now the further training in surgery faces considerable challenges. The planned hospital structural reform will result in new bureaucratic and organizational hurdles, which could lead to a considerable loss of quality in advanced surgical training across all disciplines. Objective: The aim of this position paper is to describe the current and future challenges for advanced surgical training and to identify possible approaches and opportunities for the further development against the background of the planned hospital structural reform. Material and methods: For the development of this position paper a committee of representatives of the Young Forums of the German surgical societies identified and critically discussed current problems and challenges of the present residency training system and formulated a list of demands for a sustainable residency training concept. Results: The planned shift to outpatient treatment and centralization were identified as central challenges for surgical residency training. Surgical training must be considered consistently and from the outset in all political reform efforts. In addition to a transparent and cost-appropriate financing of residency training, we call for the involvement of all German surgical societies in the reform process. Furthermore, the social framework conditions for junior surgeons should be considered. Conclusion: The structural change in the hospital landscape in Germany, which is being forced by politicians, harbors the risk of a further loss of quality and experience in surgical treatment and training. At the same time, the planned hospital reform offers a unique opportunity to address existing problems and challenges in surgical training and to consider them as a starting point for structural changes which are fit for the future. [ABSTRACT FROM AUTHOR]

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Background: The young generation of surgeons sets new requirements for educational and working conditions. This is frequently interpreted as a lack of motivation to perform; however, instead there is a claim for high-quality training with the aim of acquiring competence in the operative and perioperative setting as well as for responsible working time models. Objective: Aim of this article is to present expectations of surgical residents regarding residency training under current influencing factors, such as a high workload, the new training regulations or expected changes in the hospital landscape and to identify options for optimizing training and working conditions. Material and methods: In addition to an extensive literature search, this article is based on published opinions and survey results as well as lectures and discussions at congresses held in the past year. Results and discussion: To ensure a modern high-quality education and to maintain enthusiasm for surgery, the need for adjustments and innovation must be recognized and long-requested modifictions to established structures must be implemented. Flexible working models, the structured and transparent implementation of surgical residency training and modern training units, long-term planning of training curricula and new personnel structures with an expansion of teaching and feedback culture are options for improvement. [ABSTRACT FROM AUTHOR]

Background Around one in 20 patients in family practice brings at least one genetically influenced health condition into consultation. To ensure comprehensive health care, knowledge of genetic aspects of diseases should be imparted in post-graduate training programs in family medicine. The topic of genetics is already anchored in some international curricula in the field of family medicine. The aim of the study was to determine which topics and competencies regarding genetics are relevant during post-graduate training from the point of view of family physicians in Germany. Methods A cross-sectional postal survey was carried out in the period between 11/2018 and 02/2019 by using a questionnaire that was sent to 2,012 family physicians in Germany. Beside sociodemographic aspects, the confidence to carry out genetic tasks as well as interpreting pedigrees were questioned with a Likert scale from 1 (strongly agree) to 6 (strongly disagree). In addition, relevance of various post-graduate training content on genetic topics was requested using a Likert scale from 1 (very relevant) to 6 (not relevant at all). The analysis of the data was carried out using SPSS 27.0 (IBM). Results A total of 292 (15 %) family physicians took part in the survey. 52 % of the participants were female and the average age was 53. In the mean of 3.2 (SD 1.5) family physicians felt confident in interpreting pedigrees. 25 of the participants (9 %) created a pedigree in the last twelve months. Cancer (M 1.6; SD 0.7) and multifactorial diseases with a genetic component (M 1.7; SD 0.9) were graded most relevant to post-graduate training. Conclusions There is a heterogeneous awareness of genetically (co-)determined diseases in family practice. Based on existing uncertainties in dealing with associated consultation issues as well as genetic topics identified as relevant for post-graduate medical education, knowledge and skills competencies on specific genetic topics should be taken up. [ABSTRACT FROM AUTHOR]