Specialist training in infectious diseases in Europe

Clin Microbiol Infect. 2024 Dec 24:S1198-743X(24)00614-1. doi: 10.1016/j.cmi.2024.12.026. Online ahead of print.

Abstract

Objectives: The objectives were to determine the structure of training programmes and assessment of physicians training to become infectious disease (ID) specialists in Europe in early 2024, and to document the provision of specialists, trainees and training centres in each country.

Methods: Delegates to the ID Section and Board of the European Union of Medical Specialists (UEMS) entered national data on a web-based survey tool in late 2023-early 2024. Results were compared to UEMS recommendations on the structure and content of postgraduate training in ID in Europe (2018), and to results of a similar survey in early 2021.

Results: Responses were received from all 35 countries; 27/35 (77%) recognise ID as an independent speciality and 7/35 (20%) as a subspeciality. Spain does not officially recognise the speciality. In Cyprus, Iceland, and Luxembourg, despite official recognition of the sub-/speciality, ID training must be completed abroad. Paediatric ID was recognised in 16/35 (46%) countries. The number of adult ID specialists varied from 78.8 per million inhabitants in Sweden to 0.6 in Germany. Only 7/31 (23%) national programmes provide the minimum recommended 6 months of training in medical microbiology. Assessment methods included logbooks/portfolios in 25/31 (81%), final examinations in 25/31 (81%) and workplace-based assessments in 21/31 (68%).

Conclusion: There has been little change since 2021 in speciality status or in structure and content of training programmes across Europe. There have been large increases in training position numbers in several countries, possibly in response to COVID-19. Continued low compliance with the 2018 recommendations to increase exposure to medical microbiology during training highlights the slow pace of change. Logistic barriers to change and to harmonization across Europe remain and are discussed in the context of published concerns of trainees.

Keywords: evaluation mechanisms; infectious diseases; medical education; preparedness; specialization; training programs.