Lack of Accredited Clinical Training in Movement Disorders in Europe, Egypt, and Tunisia

Article type: Research Article

Authors: Tamás, Gertrúd^a | Fabbri, Margherita^{b; c; d} | Falup-Pecurariu, Cristian^e | Teodoro, Tiago^{c; f; g} | Kurtis, Mónica M.^h | Aliyev, Rahimⁱ | Bonello, Michael^j | Brozova, Hana^k | Coelho, Miguel Soares^{c; d; l} | Contarino, Maria Fiorella^{m; n} | Corvol, Jean-Christophe^o | Dietrichs, Espen^p | Ben Djebara, Mouna^q | Elmgreen, Søren Bruno^r | Groppa, Sergiu^s | Kadastik-Eerme, Liis^{t; u} | Khatiashvili, Irine^v | Kostić, Vladimir^w | Krismer, Florian^x | Hassan Mansour, Alia^y | Odin, Per^z | Gavriliuc, Olga^aa | Olszewska, Diana Angelika^ab | Relja, Maja^ac | Scheperjans, Filip^ad | Skorvanek, Matej^{ae; af} | Smilowska, Katarzyna^ag | Taba, Pille^{t; u} | Tavadyan, Zaruhi^{ah; ai} | Valante, Ramona^aj | Vujovic, Balsa^ak | Waldvogel, Daniel^al | Yalcin-Cakmakli, Gul^am | Chitnis, Shilpa^an | Ferreira, Joaquim J.^{c; d; ao; *}

Affiliations: [a] Department of Neurology, Semmelweis University, Budapest, Hungary | [b] Department of Neuroscience “Rita Levi Montalcini”, University of Turin, Italy | [c] Instituto de Medicina Molecular, Lisbon, Portugal | [d] Laboratory of Clinical Pharmacology and Therapeutics, Faculdade de Medicina, Universidade de Lisboa, Portugal | [e] Department of Neurology, Transilvania University, Braşov, Romania | [f] Neurosciences Research Centre, Molecular and Clinical Sciences Research Institute, St George’s, University of London, London, UK | [g] Ashford and St Peter’s Hospital NHS Trust, Chertsey, Surrey, UK | [h] Movement Disorders Unit, Neurology Department, Hospital Ruber Internacional, Madrid, Spain | [i] Department of Neurology and Clinical Neurophysiology, Azerbaijan State Advanced Training Institute for Doctors named after A. Aliyev, Baku, Republic of Azerbaijan | [j] Department of Neurology, The Walton Centre NHS Foundation Trust, Liverpool, UK | [k] Department of Neurology and Center of Clinical Neuroscience, Charles University, First Faculty of Medicine, Prague, Czech Republic | [l] Department of Neurosciences, Neurology Service, Hospital Santa Maria, Lisbon, Portugal | [m] Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands | [n] Department of Neurology, Haga Teaching Hospital, The Hague, The Netherlands | [o] Department of Neurology, Sorbonne Université, Assistance Publique Hôpitaux de Paris, Inserm, CNRS, Hôpital Pitié-Salpêtrière, Institut du Cerveau et de la Moelle, Paris, France | [p] Department of Neurology, Oslo University Hospital and University of Oslo, Oslo, Norway | [q] Department of Neurology, Razi Hospital, Faculté de Médecine de Tunis, University Tunis-El Manar, Tunisia | [r] Department of Neurology, Aalborg University Hospital, Aalborg, Denmark | [s] Department of Neurology, Movement Disorders, Imaging and Neurostimulation, University Medical Center of the Johannes Gutenberg University, Mainz, Germany | [t] Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia | [u] Department of Neurology, Tartu University Hospital, Tartu, Estonia | [v] Department of Clinical Neurology, Tbilisi State Medical University, Tbilisi, Georgia | [w] Department of Neurology CCS, University of Belgrade, Belgrade, Serbia | [x] Department of Neurology, Medical University Innsbruck, Innsbruck, Austria | [y] Department of Neurology, Faculty of Medicine, Ain Shams University, Cairo, Egypt | [z] Department of Clinical Sciences, Division of Neurology, Lund University, Lund, Sweden | [aa] Department of Neurology, State University of Medicine and Pharmacy Nicolae Testemitanu, Chisinau, Republic of Moldova | [ab] Department of Neurology, Dublin Neurological Institute at the Mater Misericordiae University Hospital, Dublin, Ireland | [ac] Croatian Academy of Medical Sciences and School of Medicine, Zagreb University, Zagreb, Croatia | [ad] Department of Neurology, Helsinki University Hospital, and Department of Neurological Sciences (Neurology), University of Helsinki, Helsinki, Finland | [ae] Department of Neurology, Faculty of Medicine, P. J. Safarik University, Kosice, Slovak Republic | [af] Department of Neurology, University Hospital L. Pasteur, Kosice, Slovak Republic | [ag] Silesian Center of Neurology, Katowice, Poland | [ah] Department of Neurology and Neurosurgery, National Institute of Health, Yerevan, Armenia | [ai] “Somnus” Sleep and Movement Disorders Clinic, Yerevan, Armenia | [aj] Department of Neurology, Pauls Stradiņš Clinical University Hospital, Riga, Latvia | [ak] Department of Neurology, Clinical Center of Montenegro, Podgorica, Montenegro | [al] Department of Neurology, University Hospital Zurich, Zurich, Switzerland | [am] Department of Neurology, Hacettepe University, Ankara, Turkey | [an] Department of Neurology and Neurotherapeutics, Southwestern Medical Center, University of Texas, Dallas, Texas, US | [ao] CNS – Campus Neurológico Sénior, Torres Vedras, Portugal

Correspondence: [*] Correspondence to: Joaquim J. Ferreira, MD, PhD, Laboratorio de Farmacologia Clínica e Terapêutica, Faculdade de Medicina de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal. Tel.: +351 21 7802120; Fax: +351 21 7802129; E-mail: [email protected]

Abstract: Background:Little information is available on the official postgraduate and subspecialty training programs in movement disorders (MD) in Europe and North Africa. Objective:To survey the accessible MD clinical training in these regions. Methods:We designed a survey on clinical training in MD in different medical fields, at postgraduate and specialized levels. We assessed the characteristics of the participants and the facilities for MD care in their respective countries. We examined whether there are structured, or even accredited postgraduate, or subspecialty MD training programs in neurology, neurosurgery, internal medicine, geriatrics, neuroradiology, neuropediatrics, and general practice. Participants also shared their suggestions and needs. Results:The survey was completed in 31/49 countries. Structured postgraduate MD programs in neurology exist in 20 countries; structured neurology subspecialty training exists in 14 countries and is being developed in two additional countries. Certified neurology subspecialty training was reported to exist in 7 countries. Recommended reading lists, printed books, and other materials are the most popular educational tools, while courses, lectures, webinars, and case presentations are the most popular learning formats. Mandatory activities and skills to be certified were not defined in 15/31 countries. Most participants expressed their need for a mandatory postgraduate MD program and for certified MD sub-specialization programs in neurology. Conclusion:Certified postgraduate and subspecialty training exists only in a minority of European countries and was not found in the surveyed Egypt and Tunisia. MD training should be improved in many countries.

Keywords: Movement disorders, Parkinson’s disease, education, curriculum, neurology

DOI: 10.3233/JPD-202000

Journal: Journal of Parkinson's Disease, vol. 10, no. 4, pp. 1833-1843, 2020