Certification Sub-specialty Centres
A diversified specialty
Like most medical specialities, urology has become more advanced, diversified and technically demanding, and over the years urology has branched into several subspecialties. Since not all urological disorders can be successfully treated in a medical institution and with the wide range of various techniques not available or taught in every department this has led to the emergence of subspecialised medical centres.
Sub-specialty centre certification
A Centre meeting the EBU criteria is certified as a high-performing sub-specialty (referral) centre in Europe. This is significant and important considering the cross border health care directive that was adopted by the European Commission in 2011. The EBU system is the sole system providing this kind of quality control and is endorsed by the U.E.M.S.
The high performing centres should be able to share of their knowledge and skill and must therefore be able to provide a Fellow-ship programme, a postgraduate training for certified urologists.
The Doctor/Urologist applying for Fellowship training in an EBU Certified Centre can rely on the EBU quality mark. After completion of a Fellowship Programme, the doctor is entitled to receive a Certificate of Completion issued by the EBU Certified Centre.
A one-year Fellowship in an EBU Certified Centre is eligible for 50 CME credits (cat 3).
In order to meet the increased interest in this type of certification and to maintain a high quality of the evaluations, a new evaluation process is developed which is based on peer-review. Peer-review committees are now being composed of high-performing urologists/experts in each of the following sub specialty fields:
• Stones in the urinary tract
• Urothelial cancer
• Prostate cancer
• Renal cancer
• Testicular cancer
• Penile cancer
• Neuro-urology
• Female urology and incontinence
• BPH
• Andrology
• Paediatric urology
• Renal failure with renal transplantation
Fellowship Programme
A Fellowship Programme in an EBU-certified subspecialty centre must be a post-graduate programme wherein the potential candidate is a qualified urologist aiming for a deeper understanding of, knowledge and skill in a certain sub-specialty. If the programme, which should last for a minimum of three months, is focused on a certain technique, the fellow, after completing the programme, should have the proven ability to implement and adapt the acquired knowledge and skills in a wider context.
A fellowship programme aims to provide a systematic understanding of the subspecialty and its practices, including research proficiency. Prospective applicants are required to submit a written description, based on a given template, of the programme. The description should clearly state the general aim, specific goals and the various methods involved in completing the fellowship.
Criteria and requirements
For sub-specialty certification, the EBU’s Urological Training Programme Committee (UTPC) has identified four areas in which a sub-specialised centre should demonstrate the required expertise.
The main areas with the corresponding qualities are:
1) Institutional organisation and performance
The centre should have an adequate number of cases to maintain a high level of results and pursue research and clinical studies on a specific topic. Results achieved by the centre should be on par with other international high-performing institutions. Furthermore, the centre should have at least two consultants who are experts, and a dedicated staff in the sub-specialty. Resources and a strategic plan to offer post-graduate teaching of a special proficiency, which cannot be attained at a standard urological department, should be available. Moreover, the centre provides care to an adequate number and variety of patients for it to offer a comprehensive and practical training in the given specialty.
2) Facilities and resources
The centre is equipped with all adequate technical equipment and updated routines that enable it to be thoroughly capable in offering relevant developments in the specialty. Moreover, the centre must have ready access to supporting specialties and other resources needed to run its operations in a modern and professional manner.
If there are several treatment modalities for a certain kind of disease or diagnose, it is preferable that all these modalities are available at the centre. In case this capacity is lacking, the centre must have good knowledge of all relevant treatment modalities and a functioning collaboration with another centre within the same hospital/institute where these modalities are available.
3) Research and clinical studies
The centre should stay updated on national and international research being done on the specialty. Not only does the centre take a dynamic role in the international debate regarding the specialty, it also performs its own research/studies.
4) Fellowship programme
A fellowship programme including surgical training or other types of manual skills must offer good and adequate hands-on training. When needed, the host centre should also extend assistance to the applicant in obtaining the certificates required to perform hands-on training. For a fellowship that also includes practical training on operative skills, no more than one fellow per supervising consultant should be accepted at the same time. If the centre trains urology residents, there should be no more than one resident and one fellow for every supervising consultant.
The certification process is as follows:
1) Application
When applying for Sub-specialty Certification, the applicant submits the following information online:
• Application form
• Fellowship programme description
• Curriculum Vitae’s for 2 sub-specialised consultants
• Publication list with up to 25 publications in peer-reviewed journals, during the last 10 years
Are you interested in applying for EBU Certification? Please contact Mrs. Wilma Gietman at w.gietman@ebu.com
2) Evaluation procedure
a) Technical evaluation
EBU’s Urological Training Programme Committee evaluates if the application meets the application criteria.
b) Scientific/Professional evaluation
A peer-review committee, consisting of four experts in the respective sub specialty field, performs an individual single blinded evaluation to assess if the application meets the certification criteria.
The EBU Sub Specialty peer-review process is performed through the Internet; it is straightforward and is fairly easy to complete. It is an objective assessment as each application is assessed by four independent peer-reviewers. This online peer-review process will not involve any travelling or participation in meetings.
3) Certification
The centre will be certified for a period of five years when all 4 peer-reviewers agree that the certification criteria are met. If 3 of the 4 peer-reviewers agree that the criteria are met, the EBU will compare the 4 evaluations and comment; involving a 5th peer-reviewer for a second opinion may be considered. No certification is granted when only 2 of the 4 peer-reviewers agree that the application meets the criteria.