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Mon Jun 8 18:42:18 BST 2009

Ken,

as so often your post offers plenty of insightful views and information.
Thank you very much for summing things up for us!

In addition to what others have already said (Tim, I concur your
experience of medical training in Europe) I would like to comment one
thing or the other.

> Many of the above medical professional persons are listed due to the  NON  
> STANDARDIZED nomenclature of physicians in Europe and the Middle  East.   
> Around the world, but especially in EUROPE there is a great  need for a 
> standardization of nomenclature as to what physicians are  called.
The ever bureaucratic monster of the EU is very slowly addressing this
by challenging its members to accept medical titles awarded by other
members. On the long run this will force a universal medical language.
However, there is already effort undertaken to make surgical training
within Europe (not only the EU!) comparable. You might want to have a
look here <http://www.uemssurg.org/index.jsp>.

> I was struck with the protectiveism of the word "trauma" and just who owned 
>  it.  

Sigh! Yes, you are so right. However, that is nothing against the battle
who is the genuine "general surgeon". Spinger's "Der Chirurg" filled
almost one issue with this a year or so ago.

>   In each country, different specialist tended to want to  "own" the 
> term "trauma" for their discipline.    No where did  this seem to be more 
> volatile than in Germany where the orthopedist who does  almost exclusively 
> bones, joints, and soft tissue wanted to continue to solely  own the term 
> trauma.   This may be an over simplification on my  understanding, but it seemed 
> to me that if the German orthopedic surgeons would  merely call themselves 
> orthopedic surgeons with interenst in "______" (pick any  term), much 
> progress would be made in Europe - snip -
As Frank has said so nicely - and were Marie-Anne is definitely wrong -
the decades long battle on who's the real trauma surgeon is slowly
coming to an end. About 20 years ago I started my training in
orthopedics. We had about 40% trauma patients then, including our share
in MVC victims. During this time "Unfallchirurgie", which perhaps is
best translated as accident surgery, started its rise. As far as I can
see under great influence of the US trauma system. And eventually both
specialties are in the process of melting up into one single profession.
It is just that - at least in my humble view - the question who will
eventually will be the leader in trauma remains open. If memory serves
it was you, Ken, who suggested the general surgeon as the natural leader
in trauma surgery - because he is a generalist; certainly from an
American point of view.

But that is - see above - another animal.

Just my 2 cents.

Mathias

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