European otorhinolaryngology training programs: results of a European survey about training satisfaction, work environment and conditions in six countries
T he European Union (EU) has progressively expanded the number of its member nations throughout the years. Since its founding in 1993, the number of its members has grown from the initial 6 nations to 28 nations (EU28) in 2013, therefore including more than one-half of the nations belonging to geopolitical Europe. This political achievement has been paralleled in many European nations by the emergence of cultural values awareness and strong feelings for the preservation of the various local cultural profiles, including traditions, history, and cultural roots. The preservation of the identitarian profiles and cultural diversity of the local systems, which characterize Europe, is generally assumed as a capital for its development and often may influence the decisions in many fields, including medical education. The equation of how to amalgamate a multiplicity of consolidated cultural backgrounds, all becoming acceptable to each local reality and its historical profile, will keep the EU institutions busy for many years. Of course, several additional factors must be taken in account when discussing cultural diversities vs homologation, which we would leave to a more extended study. It is also not an easy task to find examples in different geopolitical areas that could inspire solutions on how to deal with diversities and differences that often are difficult to be reconciled. This is the articulated basic scenario that provides the stage for the analysis of the current status and future perspectives of many institutional structures in Europe, including medical education, specifically postgraduate education. The management of medical education in the EU28 would require appropriate coordination, backed by an adequate cultural knowledge, a balanced strategic vision, and constant supervision. EU does not have a clearly identified administrative structure devoted specifically to medical education, and the responsibilities in this area are shared by different departments or agencies of the European Commission, including the Directorates General of Education and Culture, Health and Consumers, Internal Market and Services, and the EU Education, Audiovisual, and Culture Executive Agency.