Eur J Cardiothorac Surg 2004;25:149-150
© 2004 Elsevier Science NL
ESTS Presidential address |
Thoracic surgery: is the future optimistic?
Ion Bellenis*
Department of Thoracic and Vascular Surgery, Evangelismos Hospital, King George 24, 11635 Athens, Greece
* Tel.: +30-210-720-1506; fax: +30-210-722-4449
e-mail: ionbellenis{at}hotmail.com
It is a moving experience to have met again after 18 years in Vienna where the First Meeting of the EACTS took place. Following a long period of turbulence we again stand here united in a joint meeting, which promises abundantly for the future. Within these 18 years, a lot of discussions took place and many conflicts arose. However, our essential effort and concern has never been the fulfillment of personal vanity or ambition but the promotion of practicing levels of our specialization. Huge steps have already been taken in this direction but there is a lot more to be done. After all, the last decade has given rise to pressing needs and the number of issues we have to handle has increased dramatically.
The societies constitute the major channels for the communication of our ideas and the realisation of our hopes and pursuits in our professional and scientific future. At present the major demand is the standardisation of both training and practicing conditions across borders in Europe as concerns our area of interest. In the globalisation era we need an equalisation of working terms between Western and Eastern Europe as well as between the North and South. In order to formulate a unified scientific language on behalf of Europe the participation of all scientific teams and all countries is required. At the moment the conditions under which our specialty is practised are not equal across Europe. This is due to funding, educational and/or training, infrastructure and organisational, institutional and even cultural differences.
EACTS and ESTS could play an important role in the elimination of these differences through interaction and communication of their members. Naturally, we cannot have much impact on economic or financial differences as they depend on official governmental policies. Yet, we can create a framework for the education and life-long training of doctors in surgical centers of reference, new surgical techniques, new technologies and new modality treatments. There are several ways in which the societies have initiated or developed changes towards the improvement of quality standards and the development of our field in general.
- As refers to the institutional mission of the societies there can be an important contribution through the definition of objectives and content for our specialty in their constitution. It is well known that in several countries a large number of thoracic surgical procedures are performed by general surgeons and that in some cases thoracic surgery is considered a sub-specialty of general surgery. The societies' instituted principles for membership are required to become part of national legislations. Thoracic surgery includes the totality of the field of cardio-thoracic surgery and the specialty can only develop within this framework. Collaboration and co-operation should ensure that the definition of a thoracic surgeon is drafted up by us and not by irrelevant pressure groups.
- The European Thoracic Surgery Database Project is another step taken as it fulfills the requirements of a survey and it will facilitate founding high quality medical centers across Europe. Also, the establishment of European Boards allows the standardisation of qualifications for thoracic surgeons and helps towards the full recognition we are due.
- Continuous life-long training is an imperative demand of our times and it is essential that all generations of thoracic surgeons partake of the advantages it offers. Techno-College offered within the work of the annual conference provides technology-oriented information and the opportunity of practicing technically demanding methods. The European School for Cardio-Thoracic Surgery in Bergamo, Italy also offers postgraduate courses of high standard quality.
- Another important issue is the official organ of both societies, the European Journal of Cardio-thoracic Surgery. Its columns showcase the partnership between thoracic and cardiac surgeons and the well-educated and well-trained experts are encouraged and assisted in their development. The journal's overall quality, as well as its acceptance within Europe and elsewhere, has been greatly enhanced. However, the vision should be for the journal to become a central reference point for the international scientific community.
- Without playing down the practising character of our specialty we need to emphasise the importance of basic research and experimental facilities. Obviously this heavily depends on governmental funds but the societies could also reward and fund worthwhile projects so as to promote research activity and develop a research culture within our ranks.
I have tried to mention some of the issues of hot debate and activity in our field at present. However, what I would most like to promote is a sense of unity and confidence which can help us become leaders of change and initiators of development instead of followers of the ever changing times and external impact. We are at a point of development where we can assume responsibility for the development of cardio-thoracic surgery in Europe and, why not, in the world. The recent joining of strengths and the unobstructed co-operation and co-ordination of our members will ensure the powerful presence of our voice in the following years.
