Dear colleagues,

For over 10 years now, our specialty has been represented as an independent medical discipline within the Union of European Medical Specialists (UEMS). In 2004, after the establishment of the division of vascular surgery in 1992 as a subunit of the UEMS section of surgery, it was then time (finally) for the introduction of the UEMS Section and Board of Vascular Surgery (UEMS-SBVS) [5]. Politically, this was a tremendously important step that has helped many European countries to establish vascular surgery as a separate specialty on a national level. The most recent examples are Switzerland (since 2014) and Austria (since mid-2015).

The UEMS represents the national medical societies of the current 37 member states. To date there are 42 UEMS specialist sections (separate disciplines) and 10 UEMS specialist divisions (key areas within the independent disciplines). This latter group includes, for example, angiology (as a division of internal medicine), neuroradiology and interventional radiology (a division of radiology) and also thoracic surgery, which is still regarded as a part of general surgery in the UEMS. In addition, there are the so-called multidisciplinary joint committees (MJC) composed of experts from various specialties. These include, for example, phlebology and sports medicine [6].

The UEMS has the following remit:

  • Representation of the medical profession in the European Union (EU),

  • Accreditation of medical meetings, continuing medical education (CME) and continuing professional development (CPD) [7],

  • Promotion of free professional movement of all doctors within Europe,

  • Development of European standards in postgraduate medical education at the highest possible level [1, 8] and

  • Ensuring high quality of training and associated specialist standards via examinations.

From the outset, the latter objective was especially important for European vascular surgery. European vascular surgical examinations have been offered since 1996, initially as a European Board of Surgery Qualification in Vascular Surgery (EBSQ-VASC). Since 2005 examinations have been offered as a Fellow of the European Board in Vascular Surgery (FEBVS). The tests are voluntary in most European countries but in some countries, such as Switzerland and the Netherlands, they have now replaced the national specialist examination. Other countries are also in the process of accepting this European standard as a national standard (e.g. Romania, Austria and Sweden).

The European examination consists of a written section and a combined oral and practical examination. Candidates must be in possession of a national specialist title for surgery or vascular surgery (in countries with independent consultants). Applications must be made in writing giving details of open operative and endovascular experiences, where there are three levels of difficulty (i.e. basic, intermediate and advanced). A distinction is also made between assisted operations, independently performed surgery with assistance and actual independently performed surgical procedures without specialist tutorial assistance. This data is more sophisticated than, for example the surgical procedures catalogue required in Germany. All candidates admitted to the examination also have a 1-day oral and practical examination, which includes questioning of theoretical background knowledge and its practical application. This takes place mostly in the context of specific clinical case studies, as well as via practical examinations on lifelike models and the following procedures are examined: an infrarenal aortic anastomosis, a carotid endarterectomy (CEA) and a crural bypass anastomosis on pulsatile perfused lifelike models [3, 4, 10–12, 14]. In the endovascular part, the applicants ability to introduce a guide-wire into the renal artery is assessed [13]. Unlike many national tests, FEBVS candidates are also presented with a specialist English language publication, usually from the European Journal of Vascular and Endovascular Surgery (EJVES). This article is then discussed with two examiners with respect to quality as well as methodological and statistical content and significance. Many examination candidates fear this hurdle the most but in fact very few participants fail this part of the test.

Despite the challenging test procedures (or maybe because of them?) the number of participants in the European specialist examination for vascular surgery has steadily increased in recent years (Fig. 1). For this reason, since 2012, two examination sessions per year have been offered, one during the annual meeting of the European Society for Vascular Surgery (ESVS) and one at the European Vascular Course (EVC) in Maastricht. The failure rate each year fluctuates around 20%.

Fig. 1
figure 1

Numbers of participants in the European certification examination for the European Board of Surgery Qualification in Vascular Surgery (EBSQ-VASC 1996-2004) and the Fellow of the European Board of Vascular Surgery (FEBVS). Passed examinations (blue) and failed examinations (red)

Full size image

What advantages does the European specialist title offer?—10 advantages of the Fellow of the European Board of Vascular Surgery (FEBVS)

Whilst in German-speaking countries the UEMS examination is currently only compulsory in Switzerland, Germany and Austria, there is practically nothing to stop anyone following a career in vascular surgery without a European examination. There are a number of very good reasons not only for young medical specialists but also for experienced senior consultants or head physicians, to sit a European examination and acquire the title of Fellow of the European Board of Vascular Surgery (FEBVS):

  1. 1.

    Evidence of competency in job applications. Many managers know that the European examination is theoretically and practically challenging and comprehensive. Confidence in candidates (specialists and senior physicians) who have passed the European test is therefore higher and that in turn increases the chances of obtaining the desired position.

  2. 2.

    Evidence of competency against competing disciplines. The European specialist title strengthens confidence when in technical discussions with competing vascular specialities (e.g. radiology and neurology).

  3. 3.

    Verification of open surgical and endovascular skills (logbook). Filling in the logbook helps to maintain a transparent surgical endovascular portfolio. It is an extremely sophisticated tool to capture expertise and experience [9]. It is also important for staff meetings and applications.

  4. 4.

    Applying for jobs abroad is easier. The European specialist title is recognized everywhere. It is therefore potentially a deciding factor when applying for positions abroad.

  5. 5.

    Commitment to the need for a European standard for medical specialists. The UEMS has set itself the goal of setting a European standard for medical specialists at the highest level. The European specialist examination projects this. All FEBVSs support this goal via their application.

  6. 6.

    Commitment to academic knowledge-based vascular surgery. The European vascular surgery specialist examination covers theoretical background, knowledge of the main studies, basic academic skills and the ability to comprehensively apply this knowledge to case studies from the entire vascular field. By obtaining this examination, all FEBVSs confirm their commitment to an evidence-based approach to vascular surgery.

  7. 7.

    Willingness to collaborate with other European colleagues. At the European specialist examination one gets to meet colleagues from all over Europe, sometimes with significantly different training curricula; however, ultimately, the training represents proof of theoretical and practical competence. Although it may require a little courage to compete at a European-wide level (and in English) it will likely positively enhance the individuals self-confidence to have succeeded at a European level.

  8. 8.

    Desire to belong to the BEST. The European specialist examination is certainly more difficult than, for example, the friendly conversation with the General Medical Council in Germany. On the other hand, it offers an opportunity to belong to the European elite. You should go for it!

  9. 9.

    Personal ambition. Sometimes one hears it said that the “generation Y” has no personal ambition. I do not share this view! On the contrary, there are more than a few younger, as well as experienced colleagues, who are definitely looking for the challenge of an international examination.

  10. 10.

    Extremely fair examination. The European specialist examination is certainly one of the fairest tests of all. All examination sittings are presided over by two examiners who carry out their assessments independent of each other. During the course of the examination, each candidate is interviewed by approximately 10 examiners. The assessment is validated via evaluation forms. The auditors' communications skills are themselves judged by observers with respect to their communicative behavior. In the event of communication difficulties occurring observers are also consulted.

In summary, it makes a lot of sense to qualify as an FEBVS. Don’t hold back! The next set of examinations takes place in September in Porto. As a note: ESVS annual meetings always take place in the most beautiful cities, which could actually be the 11th reason for becoming a European specialist.

I would be extremely pleased to welcome as many medical specialists from German-speaking countries as possible there. More information can be found on the homepage of the Section and Board of Vascular Surgery of the UEMS [5].

Sincerely yours,

Univ. Prof. Dr. H.-H. Eckstein

President of the UEMS Section and Board of Vascular Surgery

figure a