IS THE ADVANCED TRAINING OF OPHTHALMOLOGI STS IN GERMANY EUROCOMPATIBLE

The advanced training of medical specialists is determined by federal regulation called '(Muster)Weiterbildungs-Ordnung'. As education and c ultural affairs are subject of federal sovereignty, that regulation of postgraduate training is to be determined by the minister for educati on and culture in each of those 16 german federal states. To get an ut most identical regulation for Germany the federal councils of physicia ns have handed over the task of evaluation and upgrading of that regul ation to the Bundesarztekammer (BAK). The BAK designs the novel of pos tgraduated training regulations as a kind of frame-work for all federa l councils. That frame-work is called examplary regulation. On the lev el of each federal country only editorial changes are added or submitt ed. Federal regulation is proposed to each federal minister for educat ional affairs and turned into validity by federal law. The renewed reg ulation, dated by late summer 1992, prescribes a minimum duration of t raining for ophthalmology of 5 years, which can be done in any acknowl edged institution (university eye hospital, county hospital, municipal hospital or office of any eye-doctor, acknowledged for medical traini ng). Two years of those five years duration may even be done in the of fice of any physician, who got the right for medical training. In addi tion to the essential regulation of ophthalmic training there are supp lementary demands for special knowledge and abilities which should be fulfilled by each applicant for a specialist's diploma. Those demands precisely prescribe the number and degree of difficulty of special med ical procedures as well as the degree of responsability of the trainee for his activities. To get an adequate imboursement by social and hea lth-care organisations a certain number of supplementary procedures of higher difficulty must be executed in a special minimal duration of t ime beside the regular training. As those highly specialised knowledge cannot be covered by the regular training, a prolongation of the regu lar five years of training will result. The regular duration of traini ng for five years plus at least 2 years (or more) is exceeding the act ual demand of the European Commission, which got the minimal duration for ophthalmic training fixed on four (4) years by the Advisery Counci l for Medical Training (ACMT). This prolongation of the training in Ge rmany as well as some overaccurate prescription of numbers and depth o f medical procedures and interventions turns the actual german regulat ion for medical (specialists) training into an examplary regulation th at could not at all be compatible to actual and further European regul ations. The later looks for highest level of medical qualification pos sible as a result of four (4) years training under an accurate but glo bal frame-work of scientific and professional demands.