Zoe Garoufalia interviews Professor Gabrielle Van Ramshorst about her experience of EBSQ examinations.

ZG GvRESCP is focusing this month on the importance of European Board of Surgical Qualification (EBSQ) in Coloproctology. The EBSQ examination is the certifying examination leading to the Diploma of EBSQ (Coloproctology) of the European Union of Medical Specialists. This is the only form of certification in the speciality of coloproctology within Europe and candidates who successfully pass the examination are awarded the title 'Fellow of the European Board of Coloproctology'. The ultimate aim is assuring standards in the interest of patient safety and wellbeing.

Gabrielle Van Ramshorst (right), Associate Professor at Ghent University, Belgium, a world-renowned expert in pelvic oncology and also a Fellow of the European Board of Surgery in Coloproctology (FEBS) shares with the ESCP audience her experience and view of the EBSQ examinations.

Zoe Garoufalia (ZG): Thank you very much for agreeing to this interview Gabrielle. As you know, ESCP is dedicating November to the Coloproctology EBSQ examinations. Could please share with the ESCP audience when did you take these exams, meaning at which point of your career?

Gabrielle Van Ramshorst (GVR): Thank you for this honourable invitation, Zoe. Of course, I’m glad to help ESCP highlight the importance of the Coloproctology EBSQ examinations. Personally, I took and passed the examinations in September 2018 in Nice, France. Late 2018 marked the end of my two-and-a-half-year fellowship on pelvic oncology, which was sponsored by the Dutch Cancer Society.

ZG: You are a world-renowned colorectal expert; how did you decide to take this examination and how this certification impacted your career?

GVR: Thank you for that compliment. When I prepared for my fellowship application, I was aware of the existence of the EBSQ examinations by following the work of David Zimmerman. Convinced of the added value of this qualification, I decided to incorporate taking the EBSQ examination into my fellowship plan. It also guided my clinical work, as it helped me to focus on certain operations to complete the necessary operation categories for my logbook. I believe that my career was impacted in a positive way by the combinations of examinations I passed; I also qualified as Fellow of the European Committee for Sexual Medicine (FECSM) in early 2018 by passing the Multidisciplinary joint committee for Sexual Medicine (MJCSM) exam, and I passed the exam for the European Society for Gynaecological Oncology (ESGO) in 2019. This combination prepared me well for all different aspects of performing complex abdominopelvic surgery.

ZG: What kind of preparation was needed for this?

GVR: To be honest, the best preparation is your daily clinical work in colorectal surgery. Also, the multidisciplinary tumour board meetings and inflammatory bowel disease meetings in your institution should offer plenty of insights into the different treatment options of colorectal diseases and the follow-up. The European Manual of Medicine-Coloproctology (Eds. Herold, Lehur, Matzel, O’Connell) is available online, free for ESCP members. I ordered a hard copy of this and read this three times within the timespan of the four weeks preceding the exam. The genetical background of colorectal cancer, as well as the management of more rare conditions, were of added value to me.

ZG: Is this certification necessary for a specialised colorectal surgeon in Belgium?

GVR: So far, the following Belgian surgeons have become certified: Katrien Van de Steen, Stefanie Devriendt, Jan Colpaert, Gabriele Bislenghi, Jasper Stijns, Albert Wolthuis, Fabrice Corbisier, Anna Van Geloven, and Andre D’Hoore. I’m not stating that the certification is necessary, but there has been a noticeable increase in young, talented people taking the examination in recent years. In my opinion, surgeons with wide ranges of experience should feel encouraged to take the examination, as this will increase the number of UEMS-certified colorectal surgeons and will set a new standard.

ZG: What do you advise all the young ESCP members doing their fellowships now, should they take the EBSQ examinations? When and what this will add to their career and practice?

GVR: First of all, it is great that you are a member of ESCP and that you are enrolled in a fellowship program dedicated to the field. Fellowships come in all sizes and shapes, differing per country and even per institution. Try and gather support from your colleagues and supervisors to help you to fulfil the logbook criteria for the exam. Depending on your volume, it is probably best to plan the exam in the final year of your fellowship. Preparing for the examinations will deepen your learning experience and will benefit your patients, yourself, and your local team. I believe that the UEMS certification is the best way to demonstrate that your specific knowledge on colorectal surgery is up to a uniform, internationally acknowledged standard.

ZG: How do you envisage the future of colorectal specialization in Europe and what part EBSQ could have into that?

GVR: There has been a steady increase in the number of surgeons passing the EBSQ examinations over the past year, and I sense that taking the EBSQ examinations is slowly turning into ‘the new normal’. I envision that within a couple of years, taking these examinations will be the widely accepted marking of the end of a colorectal surgery fellowship. In many countries the centralisation of, e.g., rectal cancer surgery is a topic of debate. The UEMS certification will place candidates in a favourable position to continue to perform specialized colorectal surgery after completion of their fellowship.

ZG: Thank you very much for sharing your experience!

GVR: Thank you Zoe for this invitation and I hope that many ESCP members will apply for the upcoming EBSQ examinations in 2023!

Gabrielle Van Ramshorst is an Associate Professor at Ghent University, Belgium. She trained and gained extensive experience with tertiary oncological urology, oncological gynaecology and pelvic exenteration surgery at the Netherlands Cancer Institute in Amsterdam and the Royal Prince Alfred Hospital in Sydney. Her training in oncological gynaecology was focused on ovarian, endometrium and (regrowth) cervix cancer. She was also trained in laparoscopic colorectal surgery and HIPEC surgery at Amsterdam UMC-VUMC. After her fellowship, she worked as a locum consultant surgical oncology at Glasgow Royal Infirmary with a focus on advanced abdominopelvic oncology (oncological gynaecology and colorectal cancer) and minimally invasive surgery. As per October 2019, she is working as a consultant surgical oncologist at the Ghent University Hospital in Belgium.

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