The history of UEMS ORL Section

The European Union of Medical Specialists (UEMS) was founded in 1958, aligning with the establishment of the European Union. In 1962, UEMS created Specialist Sections for major disciplines, including ORL, in the Member States. The sections are composed of representatives of the national associations of the specialties concerned. The appointed members work to coordinate and harmonize specialist training and recognition criteria for medical specialists in Europe. Both UEMS Central and the Sections work in constant co-operation with the Standing Committee of European Doctors, created in 1959, bringing together the whole organized medical profession of the member states. The European Union published its initial directive on doctors in 1975, which was based on proposals from UEMS. The first specialist examination took place in 1984. It was in Anaesthesiology. In 1994 was the first Charter of Training of Medical Specialists created. Established in 1999, the European Accreditation Council (EACCME) grants CME credits for medical educational events. The Council for European Specialists Medical Assessment (CESMA) was established in 2007.

The mission of UEMS is post-graduate training with creation of high level harmonized European postgraduate training requirements, organisation of European examinations and accreditation of European Training centres. Furthermore, accreditation of medical educational events via on-site events, on-line events, and e-learning materials. Finally, advocacy for free movement of doctors, better conditions for medical practice and EU-founded projects. The free movement includes the right of patients to receive treatment across the borders of EU countries.

The UEMS ORL Section consists of representatives from all EU countries, Norway, Switzerland, Iceland, and Turkey. Each country has two representatives elected by the National ENT Specialist Organisation and nominated by the National Medical Association, representing both the Academic (University Hospitals) and the Professional part of the Specialty (private practice).

The objectives of the UEMS Sections include:

• Harmonization of the profession at the European level
• Definition and professional defence of the specialty
• Development and harmonisation of the training and education of the Specialty

The ENT-Head and Neck Surgery logbook began in 1995. The document was initially revised and approved in 2006, and it has since been translated into Finnish, German, Italian, Polish, Portuguese, Romanian, Spanish, Swedish, and Turkish. An increasing number of countries have adopted the UEMS ORL Section logbook as their national one.

Prior to 1995, the Section generated a limited number of documents pertaining to training and education. Several topics have been discussed at the annual Section meetings since 2006.

In 2007 and 2008 the idea of establishing a European ORL HNS exam under the umbrella of UEMS ORL Section was proposed by Professor Klaus Albegger (Austria), and Professor Karl Hörmann (Germany). The exam consisted of a written test with one hundred multiple-choice questions, followed by an oral exam with sixteen clinical scenarios for those who passed.

The initial written examination took place in Mannheim in 2008. Both organisers and candidates were highly satisfied with the exam, leading to the decision to hold the first oral exam in Vienna in 2009. The examination was evaluated during the annual Section meeting held in Malta in 2010. Also, with this exam there was a positive evaluation both from organizers and candidates. The examination undergoes an annual review during each Section meeting.

In 2007, a meeting in Norway on the “Hurtigruten” discussed the varying definitions of bachelor’s, master’s, and doctorate degrees among member countries. It was part of the Bologna Process, which ended without reaching a consensus.

The Clinical Practice Guidelines were officially established in 2006. The revision of Chapter 6 of the Charter on Training of Medical Specialists in Europe was completed in 2008.

The length of specialists training varies among the member states from 3 to 6 years. At the meeting in Izmir in 2011 Professor Reidar Grenman introduced working groups to harmonize the training time in Europe. In 2012, he highlighted the need for subspecialty training, leading to the formation of seven working groups at the Vilnius meeting to develop training programs in key subspecialties. The outcomes of the working groups were formally presented at the annual conference held in Geneva in 2013.

During my time as President from 2013 to 2016 the section finalized the subspecialty training programmes (Chairmen) in:  Head and Neck (Professor Antti Mäkitie, Finland), Otology/neurotology (Professor Rory McConn Walsh, Ireland) , Rhinology/allergology ( Mr. Adrian Agius, Malta), Phoniatrics (Professor Christiane Neuschaefer-Rube, Germany), Paediatrics (Professor Tomislav Baudoin, Croatia), Facial Plastics (Professor Fazil Apaydin, Turkey) and Audiology/Vestibulogy (Professor Ewa Raglan, UK). In 2015, Centre Accreditation was completed for Paediatrics, Rhinology, and Head and Neck. In 2015 started revision of our main logbook which at that time was 5 years old. The work took longer than expected and the new logbook was finalized in 2017 and later revised in 2019 and in 2024. In 2015, collaboration with CEORL-HNS intensified, leading to the creation of the first fellowship in Head and Neck Surgery. Additionally, work with UEMS Central European Skills Centres and Reference Groups for rare diseases also increased.

The Rules of Procedure document was issued in 2018. In 2020, the general UEMS ORL Section Statutes were completed and the European Training Requirements in Otorhinolaryngology were updated in 2021.

A yearly evaluation of the ORL workforce status (Manpower) throughout Europe has been systematically conducted for several years.

The EBEORL-HNS turned out to be a remarkable success and year after year the exam improved in quality. In 2015, a formal collaboration with CEORL-HNS began by appointing the President of EBEORL-HNS as a non-voting member of the Presidential Council of CEORL-HNS.

For the advancement of subspecialty training at a high level, the seven subspecialty groups were requested to prepare accreditation documents in their respective fields. Head and Neck Surgery and Rhinology were the first to be presented in Amsterdam in 2015.

Besides the main topics each annual meeting has dealt with EACCME, CESMA, MANPOWER, reports from UEMS Council meetings, Reports from EBEORL-HNS and many invited lecturers have participated throughout the years.

As delegate to the UEMS ORL Section representing Danish University Departments from 1999 to 2016, I have experienced an increasing workload in the section. Numerous important documents have been issued regarding education, accreditation of skills centres, logbooks, and European training requirements. It has been extremely interesting to be part of that development which is due to many very skilled and hardworking colleagues from all over Europe. This work is an ongoing process that will continue in the years ahead.

Finally, I would like to thank Dr. Otto Mollenhauer (Germany) and Dr. Maria de la Mota (Spain) for their particularly important contribution.

Ulrik Pedersen

Past President
UEMS ORL Section
Honorary and Past President
EBEORL-HNS