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Contains fulltext : 238902.pdf (Publisher’s version ) (Closed access), AIMS: Tumour deposits (TDs) are an important prognostic marker in colorectal cancer. However, the classification, and inclusion in staging, of TDs has changed significantly in each tumour-node-metastasis (TNM) edition since their initial description in TNM-5, and terminology remains controversial. Expert consensus is needed to guide the future direction of precision staging. METHODS AND RESULTS: A modified Delphi consensus process was used. Statements were formulated and sent to participants as an online survey. Participants were asked to rate their agreement with each statement on a five-point Likert scale and also to suggest additional statements for discussion. These responses were circulated together with anonymised comments, and statements were modified prior to carrying out a second online round. Consensus was set at 70%. Overall, 32 statements reached consensus. There were concerns that TDs were currently incorrectly placed in the TNM system and that their prognostic importance was being underestimated. There were concerns regarding interobserver variation and it was felt that a clearer, more reproducible definition of TDs was needed. CONCLUSIONS: Our main recommendations are that the number of TDs should be recorded even if lymph node metastases (LNMs) are also present and that nodules with evidence of origin [extramural venous invasion (EMVI), perineural invasion (PNI), lymphatic invasion (LI)] should still be categorised as TDs and not excluded, as TNM-8 specifies. Whether TDs should continue to be included in the N category at all is controversial, and did not achieve consensus; however, participants agreed that TDs are prognostically worse than LNMs and the N1c category is suboptimal, as it does not reflect this.

Aim: With the resolution from April 28, 2014, the Bavarian state government in Germany decided to found a new medical school at Augsburg University, thereby requiring the development of a competency-based medical curriculum.Methods: Two interdisciplinary groups developed a spiral curriculum (following Harden) employing the model of Thumser-Dauth & Öchsner. The curriculum focuses on specifically defined competencies: medical expertise, independent scientific reasoning, argumentation and scholarship, as well as communication skills.Results: The spiral curriculum was developed as a hybrid curriculum. Its modular structure incorporates the mandatory subjects required by the German regulations for medical licensure (Approbationsordnung) into organ- and system-centered blocks which are integrated both horizontally and vertically. Basic preclinical sciences are covered in the blocks "Movement," "Balance" and "Contact." The clinical sciences are organized according to six pillars (conservative medicine, surgical medicine, men's-women's-children's medicine, the senses, the nervous system and the mind, and general medicine) which students revisit three times each over the course of the program. A longitudinal clinical course incorporates interdisciplinary education. A particular focus is on scientific education encompassing a longitudinal course in the sciences (including interdisciplinary classes with other university departments), block practicums, and two scientific projects.Conclusion: It is not only the degree of integration und intensity of the Augsburg University undergraduate medical degree program, but also its targeted advancement of academic, social and communication skills that have not yet been realized to such an extent elsewhere in Germany. On July 8, 2016, the German Council of Science and Humanities unanimously gave this concept a positive evaluation. Future research will examine and evaluate the Augsburg medical curriculum and the impact of the new medical s, Zielsetzung: Im Kabinett wurde am 28.4.2014 vom Freistaat Bayern die Gründung einer medizinischen Fakultät an der Universität Augsburg und die Umwandlung des kommunalen Klinikums Augsburg in ein staatliches Universitätsklinikum beschlossen. Hierfür sollte ein kompetenzorientiertes Modellcurriculum entwickelt werden.Methodik: In zwei interdisziplinären Arbeitsgruppen wurde gemäß dem Modell von Thumser-Dauth & Öchsner ein Spiralcurriculum (nach R. Harden) entwickelt, das sich an definierten Kompetenzbereichen orientiert: medizinische Fachkompetenz, selbständiges wissenschaftliches Denken, Argumentieren und Arbeiten sowie soziale und kommunikative Kompetenzen.Ergebnisse: Das Spiralcurriculum wurde als Hybridcurriculum angelegt. Der modulare Aufbau berücksichtigt den Fächerkanon der Approbationsordnung durch organ- und systemorientierte Blöcke, die horizontal und vertikal integriert gestaltet werden. Die Grundlagen sind in den Blöcken Bewegung, Gleichgewicht und Kontakt realisiert, während die klinische Medizin in 6 Säulen abgebildet ist, die jeweils dreimal durchlaufen werden (konservative Medizin, operative Medizin, Kind-Frau-Mann-Medizin, Sinnesmedizin, Medizin des Nervensystems und der Psyche, Allgemeine Medizin). Ergänzend wird ein klinischer Longitudinalkurs mit übergeordneten Inhalten realisiert. Besonderer Schwerpunkt liegt auf der wissenschaftlichen Ausbildung. Diese wird durch einen wissenschaftlichen Longitudinalkurs, zwei wissenschaftliche Blockpraktika und zwei Projektarbeiten realisiert. Hieran beteiligen sich auch andere, nicht-medizinische Fakultäten der Universität Augsburg. Schlussfolgerung: Insbesondere die Integration und Intensität der wissenschaftlichen Ausbildung, aber auch die gezielte Förderung wissenschaftlicher, sozialer und kommunikativer Kompetenzen werden im Augsburger Curriculum in bisher nicht beschriebener Weise realisiert. Das Konzept wurde am 8. Juli 2016 vom Wissenschaftsrat einstimmig positiv begutachtet. Neben der wissenschaftlichen