Schlottmann Frederik, Schaaf Sebastian, Rösch Romina Maria, Dey Hazra Maria E, Herbolzheimer Marit, Drossard Sabine, Schuffert Louisa, Braun Benedikt J, Keller Sarah Lif, Motekallemi Arash, Mulorz Joscha, Menghesha Hruy, Lawson McLean Anna, Huber Tobias, Bouffleur Frederic, Freund Gerrit
Klinik für Plastische, Ästhetische, Hand- und Wiederherstellungschirurgie, Medizinische Hochschule Hannover, Junges Forum der Deutschen Gesellschaft für Plastische, Rekonstruktive und Ästhetische Chirurgie (DGPRÄC), Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
Klinik für Allgemein‑, Viszeral- und Thoraxchirurgie, Bundeswehrzentralkrankenhaus Koblenz, Perspektivforum Junge Chirurgie der Deutschen Gesellschaft für Chirurgie (DGCH) und Chirurgische Arbeitsgemeinschaft Junge Chirurgie (CAJC) der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV), Rübenacher Str. 170, 56072, Koblenz, Deutschland.
Chirurgie (Heidelb). 2025 Mar 17. doi: 10.1007/s00104-025-02269-0.
The hospital structural reform through the Hospital Treatment Remuneration Improvement Act (Krankenhausversorgungsverbesserungsgesetz, KHVVG) will fundamentally change the medical care landscape in Germany starting in 2025. Outpatient care and cross-sectoral care models will substantially influence advanced surgical training. In particular, comprehensive training networks between hospitals and outpatient facilities are being discussed as a core solution to ensure surgical training.
The aim of this position paper is to highlight the wishes and demands of young surgeons regarding training alliances. These should serve as guidelines for the stakeholders involved for a successful implementation.
The position paper is based on discussions of the Young Forums of surgical societies, analyses of current further training models and experiences from pilot projects. It describes measures that promote cross-sectoral structured further training with clear legal, financial and didactic framework conditions.
Successful models, such as rotation in outpatient facilities, show a positive effect on further training and practical experience. Necessary steps include simplifications of labor legislation, transparent curricula, adequate financing and certified didactic qualifications for those providing surgical residency training. Pilot projects underline the potential of intersectoral cooperation, while inadequate legal and financial structures have been identified as the main obstacles.
The introduction of mandatory continuous education networks is essential to ensure surgical residency training and improving the quality of surgical patient care. In addition to political action to finance and adapt the framework conditions, hospitals and outpatient facilities need to take the initiative. In the long term surgical continuing education in Germany should be of exceptional quality.
通过《医院治疗薪酬改善法案》(Krankenhausversorgungsverbesserungsgesetz,KHVVG)进行的医院结构改革将于2025年起从根本上改变德国的医疗格局。门诊护理和跨部门护理模式将对高级外科培训产生重大影响。特别是,医院与门诊机构之间的综合培训网络正在作为确保外科培训的核心解决方案进行讨论。
本立场文件的目的是突出年轻外科医生对培训联盟的愿望和要求。这些应作为相关利益者成功实施的指导方针。
本立场文件基于外科协会青年论坛的讨论、对当前继续培训模式的分析以及试点项目的经验。它描述了在明确的法律、财务和教学框架条件下促进跨部门结构化继续培训的措施。
成功的模式,如在门诊机构轮岗,对继续培训和实践经验有积极影响。必要步骤包括简化劳动立法、制定透明的课程、提供充足的资金以及为提供外科住院医师培训的人员提供经认证的教学资质。试点项目凸显了部门间合作的潜力,而法律和财务结构不完善被确定为主要障碍。
引入强制性的继续教育网络对于确保外科住院医师培训和提高外科患者护理质量至关重要。除了采取政治行动为框架条件提供资金并进行调整外,医院和门诊机构需要主动采取行动。从长远来看,德国的外科继续教育应具备卓越的质量。