About the EBNR
EBNR
The European Board of Neuroradiology / EBNR was a function of ESNR being built and organised to develop and apply standards of training and practice of Neuroradiology in Europe. EBNR now has been disbanded and some of its functions are taken over by the UEMS Division of Neuroradiology.
Neuroradiology in UEMS
Dear Colleagues,
The Council of UEMS took a, for European Neuroradiology, landmark decision in it’s meeting in Bratislava in October 2007 when it approved the proposal of organising a “Division of Neuroradiology”. This was unanimously supported by the UEMS Section of Radiology when it met in Vienna during ECR in March of 2008. In an inaugural meeting in Brussels on September 13th 2008, the “Division of Neuroradiology” was formed. The officers of the Division were elected and Professor Olof Flodmark of the Karolinska Institutet in Stockholm was elected as the first President of this division. Professor Massimo Galluci from Italy was elected General Secretary and Prof Peter Barsi of Hungary was elected Treasurer. Neuroradiology is to this date, the only division formed within the “family” of Radiology.
UEMS - Union Européenne des médecins spécialistes/European union of medical specialists - is a lobby and consulting organisation representing physicians trained in a medical speciality in all those countries that are members of the European Union (together with Norway, Switzerland and Iceland) – EU. UEMS is organised in sections, each speciality represented by a section. There are sections of radiology, neurosurgery and neurology, just to mention a few pertinent specialities. The Section chairmen are members of a General Assembly of UEMS and the Council of UEMS is the Executive committee of the organisation.
The power and importance of UEMS can be exemplified with the newly announced Directive of Electro magnetic radiation which, if passed, would effectively have prevented the performance of diagnostic MRI in many patients. The lobbying carried out by the UEMS Section of Radiology supported by the Scientific Societies of Radiology and Medical Physicists in Europe, effectively blocked this directive and it was returned to the drawing board. UEMS has a clearly expressed aim to harmonize postgraduate specialist training and practice throughout EU. This is an important step to facilitate free movement of services and professionals across European borders.
Although management of national health care systems is decided by each of the EU member states for themselves, the European Court of Justice has ruled that: “EU treaties apply also to health care”. Hence:
EU directives (!) supersede national law even if this has implications for national health care. To the European Commission and the Directorate Generals there are only a few relevant groups representing doctors in the EU to consult with, the most important for us being UEMS. For practical reasons, the scientific organizations representing the >39 medical specialties, are not consulted on a routine basis
This is why it is so important to be represented in UEMS as a vehicle to get our message across to the European politicians.
To have achieved the goal of forming a Division of Neuroradiology is probably the most important event in the history of European Neuroradiology. The “Division of Neuroradiology” effectively provides Neuroradiology with a “face and voice” in Brussels. We are now recognised as a radiological speciality defined by a training program and a body of knowledge that is specific for Neuroradiology. The “Division of Neuroradiology” is the first recognised speciality within Radiology. It is also made clear that the Division of Neuroradiology encompasses both diagnostic and interventional Neuroradiology.
UEMS is an organisation with a political agenda. The mode of operation is that of democracy. It is therefore important that the “Division of Neuroradiology” has a clearly defined composition and that the delegates to this Division are properly appointed and have been given the appropriate mandate to represent their country. Hence it is important to follow in detail the procedure of appointing the delegates.
The members of UEMS are the National Medical Associations. (A list of members is available. [Link]) Members of UEMS are in most cases the National Medical Associations and they are the organisations appointing the national delegates to the “Division of Neuroradiology”! The proper procedure to appoint a delegate to the Division of Neuroradiology will be for the National Societies of Neuroradiology to contact the member of UEMS in their respective country and propose their choice of delegates to the UEMS “Division of Neuroradiology”. The delegates must be actively working in neuroradiology, i.e. can not be retired or having their practice within another area of radiology. It is suggested that each member country appoints two delegates, representing “universities and practising neuroradiologists on an equal footing”. They shall be confirmed by their country’s National Medical Organisation recognised by UEMS.
There are European countries with neuroradiologists but without a National Society of Neuroradiology. Belgium is one such an example. It is assumed that the role of the national neuroradiological society will be taken over by a section of Neuroradiology within the national radiological society. In such a case it is important to remember that the appointed delegates must still be neuroradiologists in active practice.
The “Division of Neuroradiology” can have other individuals attending their meetings as observers. This will apply to those countries that are not yet members of the EU but are interested in the work of UEMS. It is also possible to invite representatives of other related specialities, such as neurology and neurosurgery, to the meetings of the “Division of Neuroradiology”.
It is expected that the “Division of Neuroradiology” will meet at least twice a year. It appears practical to organise these meetings so that at least one meeting is in conjunction with the Annual Congress of ESNR. The second meeting could be in early spring, customarily in a location that is changing. A possible alternative would be to meet during ECR in Vienna; however this alternative is less attractive.
The most important items on the early agendas for the “Division of Neuroradiology” are such topics as the Charter of training in diagnostic and interventional Neuroradiology, standards of training and practice, accreditation of training institutions and European Qualification Examination in Neuroradiology. These are all heavy items but much has already been prepared in the Provisional European Board of Neuroradiology - EBNR. EBNR, as we know it as a committee under ESNR has been dissolve and will be replaced by a European Board of Neuroradiology within UEMS.
Although the UEMS Division of Neuroradiology is at the service of all neuroradiologists in Europe, it is important to recognise the need for the UEMS Division of Neuroradiology to work closely with the scientific societies within Europe, the most important being ESNR and ESR. The goals are common and working together, the goals can be achieved.
The formation of the “Division of Neuroradiology” is a major achievement and will totally change the conditions for European Neuroradiology for years to come. It is a great honour for me to have been elected to take on this work as I know that great expectations are attached to the opportunity presented with the “UEMS Division of Neuroradiology”!
Stockholm March 20th 2009
Olof Flodmark, Professor
President of UEMS Division of Neuroradiology
Professor of Paediatric Neuroradiology
EBNR
A European Board was a body set up by the relevant UEMS/Specialized Section or any other institution, e.g. ESNR, with the purpose of guaranteeing the highest standards of care in the specialty concerned in the EU member states by ensuring that the training of specialists is raised to an adequate level. This aim was achieved by the following means:
- Recommendations for setting and maintaining standards of training,
- Recommendations for training quality,
- Recommendations for setting standards and recognition of training institutions, - Monitoring of the contents and quality and the evaluation of training in the EU member states,
- Facilitation of exchange of trainees between the EU member states,
- Facilitation of free movement of specialists in the EU.
European Board of Neuroradiology - EBNR
The European Board of Neuroradiology is such a European Board established by the European Society of Neuroradiology charged with the above tasks within the specialized medical field of Neuroradiology. Without authorisation by UEMS the EBNR can not issue any legally binding rules or regulations but may develop standards of training that can be recognized and followed on a voluntary basis by institutions training neuroradiologists within or outside EU.
Neuroradiology is in many European countries a sub-speciality under Radiology. Thus any neuroradiologists, except in Portugal, must first be a qualified radiologist and following additional training, may become a certified neuroradiologist. Thus certification of neuroradiologists is in many countries an issue for radiology.
The European Board of Neuroradiology has developed and adapted charters of training, examination, certification, continuing professional development, visitation and accreditation for neuroradiology. These documents are modelled on the corresponding UEMS documents. Further documents are under development.
The goal of European Society of Neuroradiology, through its EBNR, is to offer a European examination in neuroradiology that is being built on generally accepted charters of training and certification. This examination is not to replace the present national examinations, if available, but to offer an additional value by adhering to standards of training and practice that may be at a higher level than is used in some European countries today. The examination is voluntary and carries no legal status but is, most importantly, through EBNR approved, supported and generally accepted by leading neuroradiologists throughout Europe. The European Examination in Neuroradiology has several parts, its format regulated in detail by the examination committee. Access to the oral part of the examination is regulated by the Certification committee.
European Examination in Neuroradiology
a) Written examinations that are concluding each course in an entire cycle of ECNR or a single written examination concluding an entire cycle (4 courses) of ECNR.
b) An oral examination concluding the European Examination in Neuroradiology.
Master of Neuroradiology
This is an independent academic degree of which the program is developed in cooperation with EBNR and adopted by a European university or medical school. A mandatory part of this program is the attendance of a full cycle of ECNR and having passed the written part of the European Examination in Neuroradiology. For the time being, only one such program is available in Europe, at the Karolinska institute in Stockholm Sweden. A similar program is available at the Hospital de Sant Pau in Barcelona, Spain. More information about the Master of Neuroradiology in Stockholm is available below!
Olof Flodmark
Chairman of the European Board of Neuroradiology