Standardisation of ophthalmic qualifications in Europe

Europe, in its true geographical sense of a continent extending from the Atlantic to the Urals, has such a variety of languages and cultures as to defy description and make one only marvel at the success of the USA in unifying a similarly vast continent. This article is confined to Europe of the European Union (EU) and the prospective members of the EU—that is, the northern European countries; Austria, Belgium, Denmark, Finland, France, Germany, the Netherlands, Ireland, Luxembourg, Sweden, and UK, and the southern European countries; Greece, Italy, Portugal, and Spain. Norway and Switzerland, although not members of the EU, have been recognised as members of the UEMS and send a delegate to many organisations. This large and disparate group will require major concessions among ourselves to produce a truly European state. Medicine is in many ways one of the simpler areas of activity to standardise, as there is a fairly broad consensus as to what a trained specialist should be. Up to now each country has controlled its specialist training in a completely individual way. The European Board of Ophthalmology (EBO) has been established with the aim of addressing this specific issue and developing a ‘standard’ examination for trainee ophthalmic specialists (see below).

Basically there are three types of controlling authority. Some countries work through university departments controlled by a professor and Germany is at the forefront of this system. In addition, physician councils of the 16 federal states of Germany determine which non-university departments are allowed to train doctors. Other countries organise and control specialist training through elected colleges of ophthalmology of which the UK is the prime example. The third mechanism utilises an official state body and, perhaps, France would be the leader here.

Each system has its own merits and disadvantages. Professorial control, to be satisfactory, …