Variations in assessment and certification in postgraduate anaesthesia training: a European survey

Background: Postgraduate specialty training has traditionally been based on a time-and rotation-based model, but competency-based models are emerging. Because anaesthesia training evolves differently across Europe, variations in assessment and certification processes are expected, but the extent of similarities and differences is unknown. The aim of this study was to compare anaesthesia training programmes in Europe, focusing on assessment and certification processes. Methods: We performed an online survey among national representatives of the Union of European Medical Specialists/European Board of Anaesthesiology. Results: All 36 countries participated. Duration of training had a median of 5 yr (range 2.75-7). Mean number of different assessment tools was 7.45 (range 4-13), with more tools being used in competency-based programmes [mean 9.1 (SD 2.97) vs 7.0 (SD 1.97); P = 0.03]. Most countries had a nationally uniform certification process. Based on a qualitative analysis of the survey findings, a categorization of countries emerged, reflecting the approach to assessment and certification. We observed two main streams of countries with an underlying knowledge or procedural focus within a time-and rotation-based apprenticeship model. These main streams are evolving, to different extents, towards a third orientation, competency-based training. Conclusions: Assessment and certification processes in European anaesthesia training are diverse. In many countries, a time-based apprenticeship model is evolving towards a competency-based certification process. This diversity precludes comparison of competence of graduating anaesthetists across Europe.