Anna Maria Belli, professor of Interventional Radiology and consultant radiologist, St George’s Healthcare NHS Trust, London, UK and CIRSE president 2013–2015 spoke to Interventional News about the Europe-wide interventional radiology curriculum and syllabus that CIRSE recently presented. The curriculum was created by a task force, chaired by Belli, and covers the specific areas with which a well-trained interventional radiologist should be familiar.
Why is it necessary to have a pan-European curriculum?
There are several factors. The curriculum was necessary to support the European Board of Interventional Radiology (EBIR) examination in interventional radiology. It also helped interventional radiology to achieve subspecialty status by the European Union of Medical Specialists (UEMS) in Europe. However, the most important factor for this curriculum was to harmonise training in Europe where training varies markedly between countries. Many countries do not follow a standardised interventional radiology training programme and may not have established mechanisms of assessment before trainees are accredited as specialists. The curriculum and examination are important steps to ensure patients are treated safely and effectively throughout Europe. Its aim is to ensure that all European interventional radiologists are competent to provide a high quality service to their patients.
At what stage in an interventional radiologist’s career is the curriculum aimed at?
The interventional radiology curriculum is aimed at trainees who have completed their training in diagnostic radiology. The first three years of training in radiology is generic. Interventional radiology subspecialty training builds on the core knowledge and skills of diagnostic radiology after these three years and a minimum of two years of interventional radiology training is required.
Are there any other such continent-wide/national curricula in other parts of the world? What are your recommendations for non-European regions that do not have such a curriculum on how they could adapt and adopt this one?
There are several curricula covering large parts of their continent eg. USA, Canada. Although this curriculum was written for the benefit of Europe, CIRSE has many non-European group members who can take this curriculum and adapt it for their own use and translate it into their own language.
How can all European interventional radiologists be persuaded to take up the EBIR examination?
Only a few countries have examinations in interventional radiology. So, trainees from these countries who wish to have an interventional radiology qualification to demonstrate that they have undergone appropriate training and achieved the required standard will take this examination. Eg. In the UK we have a good system for training but no plans for an examination, so we encourage our young interventional radiologists to take the exam. In Germany, they have incorporated EBIR into their national interventional radiology exams. I do not think we will have a problem in encouraging people to take the exam. So far, all the examinations are full and there is a waiting list.
All patients expect their doctors to be competent and are increasingly demanding evidence of this, hence the interest in league tables and published outcomes and performance. Successfully completing a training programme and passing an examination is one way of demonstrating competence.
The curriculum makes the point that it is important to recognise that interventional radiology training institutions need to meet a certain basic standard so that they are “fit for purpose”. How can this be achieved?
Training centres in interventional radiology take place within recognised radiology training programmes, which have to comply with local national requirements. These centres have to be able to supply a sufficient mix of cases for training purposes and have at least two experienced full-time interventional radiologists, one of whom should be EBIR certified. Currently, recognition of training centres is under the auspices of national training bodies, but it is hoped that in the future, an accrediting body for interventional radiology training will be instituted and which will inspect training centres on request. CIRSE eventually aims to collate information about each European training programme into a central register which they will maintain.