Francisco Maraver Patrick Carpentier Pedro Cantista

Doctors and health professionals

involved in Balneotherapy:

practice and training

Special thanks 2

Dr Christian CORNE

Président de la F.T.C.F.

Président d’EHTTA

Thierry DUBOIS

Président du CNETH

Trésorier d’ESPA

3

Scientific coordination: Prof. CF Roques, Afreth

3 QUESTIONS

EDUCATION /TRAINING

QUALIFICATION

CERTIFICATION

Area: 92.389 km2

Population: 10.500.000 inhabitants ~

Capital: Lisbon

Official language: Portuguese

Life expectancy: 80 years ~

Area: 504.645 km2

Population: 46.661.950 inhabitants ~

Capital: Madrid

Official language: Español o Castellano

Life expectancy: 81,9 years ~

• Speciality (examples: Family Medicine, Rheumatology, Internal Medicine, Physical and Rehabilitation Medicine, Dermatology, Vascular Surgery, Paediatrics, etc.)

• Competence (“Medical Hydrology” is a “Competence”, OTHER: Pain medicine, Medical Acupunctures, Emergency Medicine)

Medical Certification:

Titles in Portugal

• Speciality (examples: “Medical Hydrology”, Sport Medicine, Family Medicine, Rheumatology, Internal Medicine, Physical and Rehabilitation Medicine, Dermatology, Vascular Surgery, Paediatrics, etc.)

Medical Certification:

Titles in Spain

PORTUGUESE HYDROLOGIST DOCTORS - total time needed to get the TITLLE:

(COMPETENCE)

• MEDICAL SCHOOL 6 YEARS

• GENERAL PRACTICE 1 YEARS

• SPECIALITY 4-6 YEARS

• HYDROLOGY POST GRADUATE COURSE 1 YEAR

• HYDROLOGY PRACTICE (20 hours per week) 2 YEARS

SPANISH HYDROLOGIST DOCTORS

- total time needed to get the TITLLE: (SPECIALITY)

• MEDICAL SCHOOL 6 YEARS

• GENERAL PRACTICE 1 YEARS

• SPECIALITY 2 YEARS

HYDROLOGY COURSE - PORTUGAL (ONE YEAR POST GRADUATE UNIVERSITARY STUDIES)

HYDROLOGY INSTITUTS

OF THE UNIVERSITIES OF

• OPORTO

• LISBON

• COIMBRA

DISCIPLINES

• GENERAL HYDROLOGY

• HYDROLOGYC THERAPY

• PHYSICAL AND REHAB. MEDICINE

• CLIMATOLOGY

• CHEMISTRY

• GEOLOGY

• PUBLIC HEALTH Total:100 hours

HYDROLOGY COURSE - SPAIN (TWO YEARS UNIVERSITARY STUDIES)

PROFESSIONAL SCHOOL

OF MEDICAL HYDROLOGY

OF UNIVERSITY OF

• COMPLUTENSE OF MADRID

DISCIPLINES

• GENERAL HYDROLOGY

• HYDROLOGYC THERAPY

• PHYSICAL AND REHAB. MEDICINE

• CLIMATOLOGY

• CHEMISTRY

• GEOLOGY

• PUBLIC HEALTH Total: 520 hours

Speciality Examination Portugal

Residency – Final Examination

A - Curriculum Exam

B - Practical Exam

C - Theoretical Exam

yearly examination and classification

Speciality Examination Spain

Residency – Final Examination

A - Curriculum Exam

B - Practical Exam

C - Theoretical Exam

yearly examination and classification

Competence Examination Portugal

Final Examination

A - Curriculum Presentation

. Post Graduation Course

. Thermal Clinical Practice

B - Monographic Presentation (Paper)

Portugal accepts equivalence

No equivalence admitted in Spain

Medical Hydrology

• Spain: Specialty

• Portugal: Competence

In 20% of the countries it is a medical “speciality”

In 24% is considered a medical “competence”

In 56% it is included in another medical specialities (e.g. PRM, Rheumatology, mainly).

Speciality or Competence ? Europe Survey

CERTIFICATION

• Portugal : “Ordem dos Médicos” / Health Ministry

• Spain: Education and Health Ministries

• Several different national realities across our continent

• No “European level certification” exists

OTHER HEALTH PROFESSIONS Portugal

• NURSE...........................................................4 YEARS

• PHYSIOTHERAPIST.................................. 3+1 YEARS

• OCCUPATIONAL THERAPIST................. 3+1 YEARS

• PSYCHOLOGIST........................................ ...4 YEARS

• NUTRITIONIST........................................... ...4 YEARS

• PHYSICAL EDUCATION PROFESSORS............4+1 YEAR

OTHER HEALTH PROFESSIONS Spain

• NURSE...........................................................4 YEARS

• PHYSIOTHERAPIST.........................................4 YEARS

• OCCUPATIONAL THERAPIST...........................4 YEARS

• PSYCHOLOGIST..............................................4 YEARS

• NUTRITIONIST...............................................4 YEARS

MEDICAL ACT

IN OUR OPINION A PRESCRIPTION FOR BALNEOLOGIC TREATMENTS SHOULD BE SEEN AS A MEDICAL ACT !

On the occasion of its meeting in Munich on 21 & 22 October 2005,

UEMS Council adopted the following definition of the Medical Act:

“The medical act encompasses all the professional action, e.g. scientific,

teaching, training and educational, clinical and medico-technical steps,

performed to promote health, prevent diseases, provide diagnostic,

therapeutic or rehabilitation care to patients, individuals, groups or

communities and is the responsibility of, and must always be performed

by a registered medical doctor/physician or under his or her direct

supervision and/or prescription.”

EUROPEAN DEFINITION OF THE MEDICAL ACT

24

The role of the UEMS

1) The Union Européenne des Médecins Spécialistes/ European Union of Medical Specialists (UEMS) is the representative organisation for specialist doctors from the national associations of EU countries.

2) Its activities cover all issues associated with specialised medical practice, and are jointly carried out by doctors serving as representatives on its Council and on its more than thirty Specialist Sections and Boards.

Medical regulation

• Standards and Ethics

• Education

• Certification and Registration

• Ensuring training and practise

Besides that ... Why is UEMS so important ?

(Please let's look for the next two slides)

• European Union Organization

• UEMS Influence

European Directives

UE – How does it work ?

National governments

Committees Implementation

European Parliament* MEPs

EU Council* National Ministers (+ Commissioner)

EU citizens

European Commission* Commissioners

European level

National level

European Medical Organisations

AEMH European Association of Senior

Hospital Physicians

CPME Standing Committee of European

Doctors

CEOM European Conference of Medical Orders

EMSA European Medical Students' Association

FEMS European Federation of Salaried

Doctors

PWG Permanent Working Group of European

Junior Doctors

UEMO European Union of General

Practitioners

European level

UEMS Lobbying – How does it work ?

European Directives Committees Implementation

European Parliament* MEPs

EU Council* National Ministers (+ Commissioner)

European Commission* Commissioners

UEMS Opinion on legislative proposals

Active involvement

Contacts with

MEPs

National governments

Consultation

& Coordination

National level

EMOs:

AEMH

CPME

FEMS

PWG

UEMO

National Organisations

Representing medical

specialists in the EU-EFTA

UEMS Sections

Multidisciplinary Joint Committees

UEMS Working groups

European accreditation council

for continuing medical education

UEMS HANOVER’s MEETING

PROPOSAL

• A UEMS PRM Section STATEMENT

concerning hydrotherapy and balneology

(Hanover-2004)

STATEMENT (Hanover-19-02-2005)

• The UEMS PRM Section recognizes the importance of

Hydrotherapy, Balneology and Climatology in PRM practice

• Evidence based data is now growing in Balneology

• More research is needed

• The UEMS PRM Section promotes good clinical practice in

PRM activities.

• Create a Working Group on Balneology within the

Professional Affairs Committee

– Work with ISMH

– Define taxonomy

– Advise on science and education initiatives

Dr. Bernard Maillet

(Belgium – Pathology)

Secretary-General:

Cooperation

38

European Survey

39

• Implement the consensual definitions and standards (already

published)

• Develop the contents of a web data base

• Establish a network of experts and institutions involved in scientific

Balneology

• Implement Education and Research

• To develop the impact factor of our Scientific Journal

• Develop a European Curriculum for balneology – create a Board

• Describe the field of competence of balneologist

• Perhaps to write a “white BOOK” about it

• Define standards for treatment programs in balneotherapy

• Discuss and agree on methodology

• Organisation of a “BIG SAMPLE” multicentrIc study?

UEMS SUBDIVISION GOALS

41

Glossaries

Christoph Kirschner (Alemão - Inglês)

Maria Ángeles Ceballos Hernansanz (Várias Línguas)

BALNEOLOGY IN EUROPE: - RESULTS OF A NEW SURVEY

Pedro Cantista Tamás Bender

What about the Future ?

44

45

THANK YOU !