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The purpose of this article is to describe the regulatory framework of the radiotherapy practice in France., (Copyright © 2021. Published by Elsevier Masson SAS.)

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

With the conversion of law decree no. 34 of 19 May 2020, bearing urgent measures concerning health, support to work and the economy, as well as social policies related to CoViD-19 epidemiological emergency, thanks to the approval of an amendment to legislative decree "Rilancio" signed by Giorgio Trizzino, the Specialization school in medicine and palliative care will be established starting from a.y. 2021-2022. Additionally, a course in pediatric palliative care will be introduced in pediatrics specialization schools. The news has been welcomed with enthusiasm by the scientific community and the main stakeholders, some of which have made a strong contribution to this result: the Italian Society for Palliative Care, the Italian Federation for Palliative Care, the Maruzza Levebvre d'Ovidio Foundation, as well as the many professionals, institutions, and NPOs that have been supporting for the past forty years the progress of palliative care in Italy. An assessment of the impact of such a measure and its effects entails due process and contextualization in different areas: first of all, that of demand and current supply, followed by the historical-cultural, the social, and the normative.

Competing Interests: Disclosure The authors report no conflicts of interest in this work.

Background: The national competence-based catalogue of learning-goals in surgery (NKLC) defines competence levels for each of its 230 goals, including "competence level in 1: factual knowledge" up to "competence level 3: independent action". Aside from the cumulative examinations influencing the learning behaviour of students, those teaching targets do not affect the second state examination. This study analyses the extent to which the questions of the German second medical licensing examination compiled by the IMPP (central German institute for medical and pharmaceutical examinations) are congruent with the trauma-surgical and orthopaedic learning goals in the NKLC, in which this thematic focus is emphasised., Material and Methods: Exam questions from autumn 2009 to autumn 2014 (n = 11) were retrospectively analysed. Orthopaedic and trauma-surgical teaching targets defined in NKLC were identified by five senior orthopaedic physicians and trauma surgery experts. All questions addressing one of these learning goals were identified and analysed (re: the number of learning goals, the number of questions addressing a trauma-surgical, or orthopaedic goal, as well as different competency levels)., Results: We found 113 learning goals of NKLC (49.1% of the overall NKLC learning goals) identified as orthopaedic or trauma surgery subjects. During the study period, 543 questions included teaching targets referring to orthopaedic or trauma surgery subjects (15.6% of the total of 3480 questions). Per exam, a mean of 49.36 ± 14.1 questions (minimum 30; maximum 80) was identified that addressed a learning goal referring to these issues. For each exam, 13.45 ± 6.39 (minimum 6; maximum 24) questions referred to learning goals of competence level 3a and b, 21.45 ± 9.94 (minimum 9; maximum 39) questions referred to learning goals of competence level 2, and 14.45 ± 6.36 (minimum 6; maximum 25) questions referred to learning goals of competence level 1. Most questions addressed the topic: "disorders of the rheumatic spectrum" (n = 16 questions in autumn 2009)., Conclusion: Questions focusing on orthopaedic and trauma surgery appeared sufficiently often during the second state examination. There is a thematic imbalance, and important clinical learning goals tagged with high competence levels were not addressed in a satisfactory manner. This indicates that a clear adjustment between the state examination and NKLC is necessary., Competing Interests: Die Autoren geben an, dass kein Interessenkonflikt vorliegt., (Georg Thieme Verlag KG Stuttgart · New York.)

Objective: To assess public knowledge and expectations of the ways to assess doctors' competence to ensure patient safety., Design Setting and Participants: Telephone survey of a random sample of 1000 non-institutionalized Hong Kong residents., Measures and Results: Only 5% of public were correct that doctors are not required to periodically be assessed, and 9% were correct that the doctors are not required to update knowledge and skills for renewing their license. These results echo international studies showing a low public knowledge of medical regulation. The public overwhelmingly felt a periodic assessment (92%) and requirements for continuous medical education (91%) were important processes for assuring doctors' competence. A high proportion of the public felt that lay representation in the Medical Council was insufficient., Conclusion: There is a significant gap between public expectations and understanding of the existing medical regulation and the actual policies and practices. Despite a lack of public knowledge, the public thought it important to have an ongoing structured monitoring and assessment mechanism to assure doctors' competence. The public also expects a greater involvement in the regulatory processes as members of the Medical Council. There is a need to review and enhance the current regulatory system to meet public expectation and ensure accountability for the privilege and trust granted by the State in professional self-regulation. In the context of our complex health system, a thorough understanding on the dynamic interactions between different institutions and their complementary roles in a meta-regulatory framework is required in assuring patient safety.

Medical science is constantly evolving. Teaching and training must keep pace with these innovations and react in a flexible fashion to new requirements. Model medical education programs, which are governed by the provisions of Sect. 41 of the Regulations for the Licensing of Medical Practitioners (ÄAppO), permit the piloting of innovative teaching programs, which support the continuous development of medical training through incorporation into the standard curricula. This paper reports on the model study programs at the University Medical Centre Hamburg-Eppendorf (iMED) and Charité - University Medicine Berlin (MSM). It describes the reform objectives, the curricula and selected projects accompanying both models and concludes by exploring the significance of various training concepts for the development of medical education.

In Germany, future physicians have to pass a national licensing examination at the end of their medical studies. Passing this examination is the requirement for the license to practice medicine. The Masterplan Medizinstudium 2020 with its 41 measures aims to shift the paradigm in medical education and medical licensing examinations.The main goals of the Masterplan include the development towards competency-based and practical medical education and examination as well as the strengthening of general medicine. The healthcare policy takes into account social developments, which are very important for the medical education and licensing examination.Seven measures of the Masterplan relate to the realignment of the licensing examinations. Their function to drive learning should better support students in achieving the study goal defined in the German Medical Licensure Act: to educate a medical doctor scientifically and practically who is qualified for autonomous and independent professional practice, postgraduate education and continuous training.

Through the years, a range of privately funded medical training opportunities has been established in Germany. Only a few of them operate along the German Medical Licensure Act and thus underlie quality assurance regulations in Germany. Most of the courses are a result of German hospitals cooperating with universities from other EU countries. The content of the courses and the examinations underlie the regulations of the university's home country. This article aims to give an overview of the private medical training opportunities offered in Germany and to show differences compared to state funded German medical schools. The authors discuss the opportunities of private medical training as well as its challenges and risks. Basic principles concerning finances and quality assurance of national and international private medical training are provided. Regardless of their mode of financing, the superior goal of the training, according to the German Medical Licensure Act, should always be to enable young doctors to pursue further professional training, so that they can maintain the best possible quality in patient care, research, and medical education.

Following the passage of TMA-supported legislation to loosen maintenance of certification (MOC) requirements, Texas is now a national leader in reducing the onerousness of MOC on physicians. What will the new law do once it takes effect at the beginning of 2018, and what could it do to keep more physicians in practice?

It is a physician's certified continuing medical education category-rather than their actual medical activity, in this case in the field of trauma surgery-that is decisive in filling statutory health insurance (SHI) practice vacancies. This evaluation arising from §16 of the requirement planning guideline applies accordingly when filling physician vacancies. Thus physician vacancies or statutory health insurance (SHI) practice places can only be filled by a physician in the same physician group in line with requirement planning. Scope for argumentation initially remains in the context of filling surgical SHI physician vacancies where the ceding physician is certified as an accident insurance consultant.

The authors provide information about the factors affecting the quality of medical care, recent changes in the regulatory framework in medical education and its development in Russia compared with developed countries. For healthcare leaders are described the risks for the implementation of these changes in public health practice, are given recommendations for leveling the risks and further improve the quality of medical care in the Russian Federation.

Background and Purpose: Application of ionizing radiation for the purpose of medical research in Germany needs to be approved by the national authority for radiation protection (Bundesamt für Strahlenschutz, BfS). For studies in the field of radiation oncology, differentiation between use of radiation for "medical care (Heilkunde)" versus "medical research" frequently leads to contradictions. The aim of this article is to provide principle investigators, individuals, and institutions involved in the process, as well as institutional review or ethics committees, with the necessary information for this assessment. Information on the legal frame and the approval procedures are also provided., Methods: A workshop was co-organized by the German Society for Radiation Oncology (DEGRO), the Working Party for Radiation Oncology (ARO) of the German Cancer Society (DKG), the German Society for Medical Physics (DGMP), and the German Cancer Consortium (DKTK) in October 2013. This paper summarizes the results of the workshop and the follow-up discussions between the organizers and the BfS., Results: Differentiating between "Heilkunde" which does not need to be approved by the BfS and "medical research" is whether the specific application of radiation (beam quality, dose, schedule, target volume, etc.) is a clinically established and recognized procedure. This must be answered by the qualified physician(s) ("fachkundiger Arzt" according to German radiation protection law) in charge of the study and the treatments of the patients within the study, taking into consideration of the best available evidence from clinical studies, guidelines and consensus papers. Among the important parameters for assessment are indication, total dose, and fractionation. Radiation treatments applied outside clinical trials do not require approval by the BfS, even if they are applied within a randomized or nonrandomized clinical trial. The decision-making by the "fachkundigem Arzt" may be supported on request by an opinion given by the DEGRO Expert Committee for clinical trials., Conclusion: An important aim for promoting clinical research and patient care in radiation oncology is to further professionalize planning and implementation of clinical trials in this field. Correct assessment, at an early stage, whether a trial needs to be approved by the BfS may reduce unnecessary costs and reduce the time needed for the approval procedure for those trials which need to be assessed by the BfS.

The paper considers the functional aspects of a biological component in programs for training specialists in the area of Parasitology for accreditation within the current enactments, including those on modernization of public health and additional professional education. The working program of the module "Fundamental Disciplines" has been used as an example to outline approaches to molding a medical parasitologist's capacity and readiness to solve professional tasks on the basis of knowledge of fundamental disciplines: biology, immunology, and medical geography. Education fundamentalization is shown to suggest more unsupervised work of a learner in the teaching process. The fundamental constituent of a biological component of the 'programs for training learners in the specialty of Parasitology for accreditation is shown in the interaction of all sections of this area with special and allied subjects.

Professional medical education is most cost-based when training highly skilled personnel. This is associated with expensive material and technical resources and a high labor-to-output ratio of practicing programs. The network model makes it possible to blaze new trails to achieve the quality of training the staff and the governmental support of its educational programs strengthens the coordination between higher educational establishments, research organizations, and professional learning communities. By using the training of medical parasitologists as an example, the paper shows a network model how to implement the educational program.

Continuing professional development (CPD) is a new approach to continuing medical education and is based on: the assessment of the practitioner needs, pedagogy centered on practices and the consideration of the practitioner social accountability. In France, CPD became mandatory for all health professionals in 2009. However, we observe a delay in its implementation, due to several regulatory aspects. The main obstacles are the unique model of CPD for all occupations, the constraint of a single operator and the lack of scale quantifying the professional investment. By correcting these drawbacks, the CPD could really contribute to the continuous improvement of the quality and safety of care., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

The paper discusses current approaches to diagnosing in an internal medicine clinic and to improving diagnostic tactics. It gives prospects for training physicians in current diagnostic approaches in the framework of the continuing medical education system.

Introduction: In recognition of the advances and evidence based changes in clinical practice that have occurred in recent years and taking into account the knowledge and experience accumulated through the voluntary breast unit certification programme, Eusoma has produced this up-dated and revised guidelines on the requirements of a Specialist Breast Centre (BC)., Methods: The content of these guidelines is based on evidence from the recent relevant peer reviewed literature and the consensus of a multidisciplinary team of European experts. The guidelines define the requirements for each breast service and for the specialists who work in specialist Breast Centres., Results: The guidelines identify the minimum requirements needed to set up a BC, these being an integrated Breast Centre, dealing with a sufficient number of cases to allow effective working and continuing expertise, dedicated specialists working with a multidisciplinary approach, providing all services throughout the patients pathway and data collection and audit. It is essential that the BC also guarantees the continuity of care for patients with advanced (metastatic) disease offering treatments according to multidisciplinary competencies and a high quality palliative care service. The BC must ensure that comprehensive support and expertise may be needed, not only through the core BC team, but also ensure that all other medical and paramedical expertise that may be necessary depending on the individual case are freely available, referring the patient to the specific care provider depending on the problem., Conclusions: Applying minimum requirements and quality indicators is essential to improve organisation, performance and outcome in breast care. Efficacy and compliance have to be constantly monitored to evaluate the quality of patient care and to allow appropriate corrective actions leading to improvements in patient care., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

Educational creativity is the key component of educational activity. The article is devoted to logical structure of educational creativity, difficulties and problems of formation and development of educational creativity in lecturers participating in educative process with participants of the Extension Course Institute for Medical Practitioners MUNKTs n. a. P.V. Mandryka. Heuristic activity and methods that are a huge part of educational creativity are emphasized. Specific features of heuristic activity are shown; classification of heuristic methods is presented. For the first time authors gave characteristic of qualitative levels of educational creativity.