Europe encompasses not only fifty or more different languages and cultures, but also a similar number of different systems of health care and medical practice. Each country has different medical traditions, different systems of professional registration and differing lists of medical specialties. This latter problem has been addressed in part by the European Union and, in particular, by the Department or Directorate-General which deals with the Internal Market and which includes the mutual recognition of diplomas and other free movement issues. The relevant EU Directive for medical qualifications is known as the ‘Doctors’ Directive’ and was first issued as 1993/16/EC, but most recently updated as 2006/100/EC.
The Directive recognises 53 different hospital medical specialties within the countries of the European Union and one of the lists is headed ‘Accident and Emergency Medicine’, the name by which the specialty was initially known in the UK and Ireland. Unfortunately this heading still remains, even though the UK and Ireland have officially changed their title to ‘Emergency Medicine’. They have now been joined on the list by seven of the countries which have joined the EU since 2004, namely Bulgaria, Czech Republic, Hungary, Malta, Poland, Romania and Slovakia.
The Directive requires that the period of training for Emergency Medicine should be a minimum of five years and several more EU countries have now recognised Emergency Medicine as a primary specialty with these training requirements (Belgium, Estonia, Italy, Latvia, Luxembourg and Slovenia). Emergency Medicine also exists in several countries as a supra-specialty (Finland, France and Sweden, as well as Belgium, Czech Republic and Poland which have already been included in the previous listings).
Several of the remaining EU countries are making significant progress towards recognition of the specialty, but it can be a slow and arduous journey! Nonetheless, there has been a very significant increase in the recognition of Emergency Medicine as a primary specialty in Europe during the last decade and this is in line with the rest of the world where there is similar growth in recognition of the specialty.