Postgraduate specialist training in anaesthesiology in Switzerland

For more than 70 years, the Swiss Medical Association (Foederatio Medicorum Helveticorum, FMH) had conducted the training and certification of medical specialists. As the bilateral approach treaties between the EU and Switzerland came into effect in 2002, these matters were put under the control and supervision of the Swiss Confederation. Since then, the FMH has been responsible for the regulation of specialist training on behalf of the Federal Government. The relevant regulations of the FMH are contained in the Ordinance on Specialist Training (Weiterbildungsordnung, WBO) stipulating that the specialist societies are responsible for the development of training programmes, the organisation and management of examinations and hospital visitation programmes. In view of the coming into effect of the law on medical professions on 1st September 2007, the FMH, the Ordinance on Specialist Training and the 44 specialist training programmes were successfully accredited in 2005 by the Department of the Interior. Subsequently, the Swiss Society of Anaesthesiology and Reanimation (SSAR) was commissioned with revising its training programme in such a way that the minimal duration of training was reduced from 6 to 5 years by cancelling 1 year of non-anaesthesiology training. The current revision of the training programme in anaesthesiology is to be finished in 2008 and will take the changes in working conditions and legislation as well as new teaching aids into account. Intensive care medicine is an independent specialisation with a separate training programme. In 1986 an examination was made compulsory. It has two parts. Part I is a written examination identical to the part I examination for the European Diploma in Anaesthesiology and Intensive Care, part II consists of 2 vivas examining clinical cases and problems by means of guided questions. A Committee on Training Centres is in charge of the recognition and categorization of training centres by the FMH. In 2000, the SSAR formed a Committee on Evaluation of Training Centres and was the first specialist society that systematically visited all training centres according to the requirements of the Ordinance on Specialist Training. Since 1997 an annual enquiry of all residents on postgraduate medical training has been carried out by the FMH. The results permit comparisons between various specialisations and setting benchmarks for training centres. If a centre is judged below a given lower mark by the trainees it has, in principle, to be revisited. The extent of responsibility of specialist societies for their training programmes, mandatory examinations, the hospital visiting programmes and the working atmosphere may be considered strengths of postgraduate training in Switzerland. Data obtained from comparative enquiries show that Swiss trainees rank the quality of their postgraduate training in anaesthesiology higher than German trainees do.