Dr. M. Tötsch Secretary General of the EFCS

Institute of Cytology University of Graz, Austria

8036 Graz Tel. ++43 316 385 12927

Fax: ++43 316 385 11213223 5926 E-Mail: martin.toetsch@klinium-graz.at

Cytology

• groups of persons involved

– MD (Pathologists, Gynecologists)

– CT/Technicians trained in cytology

– Biologists trained in cytology

• Problems similar/same

– Lifelong learning

– Lack of workforce

• groups of persons involved

– MD (Pathologists, Gynecologists)

– CT/Technicians trained in cytology

– Biologists trained in cytology

• Problems similar/same

– Lifelong learning

– Lack of workforce

Cytology

• University:

– Missing lobby, routine performed by older ones

– No Departments of Cytology

– No systematic teaching and research

• Schools for CT:

– idem

• University:

– Missing lobby, routine performed by older ones

– No Departments of Cytology

– No systematic teaching and research

• Schools for CT:

– idem

Cytology

• No more need ?

• New fields in Cytology:

– EUS/EBUS

• EUS: Pancreas, LN, adrenal glands

– ERCP-brushing of bile ducts

– Ancillary testings

• Immuno, in-situ-Hybridisation, PCR, ….

• No more need ?

• New fields in Cytology:

– EUS/EBUS

• EUS: Pancreas, LN, adrenal glands

– ERCP-brushing of bile ducts

– Ancillary testings

• Immuno, in-situ-Hybridisation, PCR, ….

Cytology

• Efforts at the local/national level

– Individual activities

– Workshops

– Seminars

– Tutorials

– Congresses

• Efforts at the local/national level

– Individual activities

– Workshops

– Seminars

– Tutorials

– Congresses

Prim. Univ. Doz. Dr. Martin Tötsch

Individual activities

Workshops

Seminars

Tutorials

Congresses

Individual activities

Workshops

Seminars

Tutorials

Congresses

2015 Milano 2016 Liverpool 2017 no congress 2018 Spain 2019 Sweden 2020 Marseille/France

Increasing financial risk Economics // ESP

EFCS annual tutorials

Cavtat, Croatia 2008 Wroclaw, Poland 2009 Kimi, Greece 2010

Trieste, Italy 2011 Trondheim, Norway 2012 Guimaraes, Portugal 2013

Istanbul, Turkey 2014

Billund, Denmark 2016 Followed by Belgium, Sweden

Ljubljana, Slovenia 2015

Place of tutorials in cytopathology training

• 92.2% thought pathologists reporting ‘specialist’ cytopathology need to be experienced in cytopathology as a whole

• 54.7% said cytology was reported by pathologists without specific training in cytopathology

• Tutorial provides a comprehensive overview of cytology for pathologists and cytotechnologists alike

QUality Assurance, Training and Examinations aptitude test

• International examination for cytotechnologists accredited in their own countries

• QUATE certifies a diagnostic ability on conventional cervical smears or liquid based cytology samples at a standardized level across Europe

• Traditional Papanicoloau, Surepath, or Thinprep • At least once a year (during the European Congress

of Cytology)

QUATE

Aims of the discussion

Evaluate comprehensive pan European teaching programme

Prospective European Cytopathology Diploma examination

Mainly influenced by the UK

Overall pass rate 73%

Major success by combining tutorials and QUATE

The Time is passing by …

Lack of workforce

Bad performance

Costs of CT and CP

Let´s start politics

• Allow CP and CT to work all over EU • Define standards in cytology (↑level of

competence)

• Specialists must have training in CP & HP of their chosen speciality

In general National Cytology Societies have no access to National Medical Chamber

EFCS

Proposing standards in Cytology Apply for acceptance by ….

Aim: Enforce cytology in Europe

Proposing standards in Cytology Apply for acceptance by ….

Aim: Enforce cytology in Europe

UEMS

Defining standards

Criteria for training in (Cyto)Pathology

Apply for/proposal to ….

Access to European parliament

Defining standards

Criteria for training in (Cyto)Pathology

Apply for/proposal to ….

Access to European parliament

U E M S SPECIALIST SECTION OF PATHOLOGY, EUROPEAN BOARD OF PATHOLOGY Members: 2 pathologists/country, 2 representatives of cyto-, neuro– and

dermatopathology

A History of failures and successes

Histopathology does not need Cytology

Pathology will not prosper without cytology Cytology can not survive without Histopathology

In Case Cytology is breaking down Histopathology will follow

Histopathology

Cytopathology

Both methods in favour of the patient, application due to situation at work, the case itself and possible outcome

Training in both mandatory

Cytopathology is regarded as integral part of pathology: in general, training in pathology takes five years and maintains a common trunk of four (minimum three) years where surgical pathology, autopsy pathology and basic knowledge of neuropathology, dermatopathology and cytopathology are adequately trained and assessed.

Training in so-called ‘areas of interests’ covers the remaining 12–24 months.

Certificates of ‘advanced level of competence’ remain within the authority of national boards

• Allow CP and CT to work all over EU

• Define standards in cytology (↑level of competence)

• Specialists must have training in CP & HP of their chosen speciality

EFCS : 28 Nat. Societies

12.000 members

8.500 CT

500 Cytologists

3.000 (Cyto)Pathologists

►►

• UEMS • ESP • EACC

• ►EU

• IAC

• UEMS • ESP • EACC

• ►EU

• IAC

The Eurocytology Project

LEONARDO 2013 – 2015 LEONARDO 2013 – 2015

R. Dina1, M. Totsch, A. Fassina, J. Duskova, B. Onnal, A. Capitanio, Interfase SrL, A Badger

(2013-15 call)

DV Coleman1, L Vass, W Olszweski , W Domegala, M Chosia, A Capitanio, G Morgan, A Bondi

(2006-08 call) 1 Imperial College Healthcare NHS Trust London, EFCS, Czech Cytology Society, Turkish Cytology Society, Interfase Srl,

Inbrook Ltd

Impereial College London, Hungarian Society of Cytology, Polish Society of Cytology, Pomeranian Medical University,

University College London, Karolinska Hospital and Institute, Swedish Society of Cytology, Italian Society of of Cytopathology

Eurocytology.eu

• Webatlas • Updated theoretical courses • Example virtual slide • Self-assessment test • QUATE mock examination

EUROCYTOLOGY

2015 so far around the world

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5,000

10,000

15,000

20,000

25,000

Page Views

Visits

Unique Visitors

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The Cy-TEST Project

• Cy-TEST is a 3 years project started in September 2014 funded by the ERASMUS + Programme of the European Commission, KA2 Strategic Partnership, VET (Vocational Educational Training)

• Project title: Cytological Training at European Standard through Telepathology

• Project Acronym: Cy-TEST

• Project Number: 2014-1-IT01-KA202-002607

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The Cy-TEST Partners

Countries: Austria, Italy, Portugal, United Kingdom

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The Cy-TEST Background

Diplomas in Cytology are released by single European Nations, but a single European Accreditation Test, certifying a diagnostic ability at a standardized level would no doubt be the preferred option.

EFCS (European Federation of Cytological Societes)

QUATE

e-QUATE

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The Cy-TEST project goals

Cy-TEST goals:

1) delivering a training course preparatory to afford the QUATE test

2) generating the e-QUATE test (Gyn/N-Gyn, later on Histology)

3) delivering highly interactive training material on cytology at different levels (Students, residents, CT, pathologists)

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CY-Test Virtual Microscope

Cytology of the future (incl. training and surveillance of competences) will have to be reallocated according priority of needs

additionally we must take major efforts to close the gap in between “pure” pathologists and “cytopathologists”.

We must offer younger ones attractive working conditions, no matter in which field of cytology and which country they are working.

Furthermore we have to keep older ones as teachers at our training centers in order to prevent losing their knowledge.

Thanks

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