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The European Society of Anaesthesiology (ESA): aims and initiatives

5 June, 2009  

Since becoming fully established in January 2006, the ESA has been the sole organisation representing all anaesthesiologists in Europe. It now provides a full range of activities to support European anaesthesiology

Sir Peter Simpson, MD FRCA FRCP FRCS(Hon), FCARCSI(Hon)
Immediate Past-President European Society of Anaesthesiology

Honorary Member, German and The Netherlands,
Societies of Anaesthesiology

A relatively new organisation, the European Society of Anaesthesiology (ESA)  was formed in 2005 by the amalgamation of three pre-existing European organisations: the European Academy of Anaesthesiology, the European Society of Anaesthesiologists and CENSA, the Confederation of National European Societies of Anaesthesiology, which was effectively the European Section of the World Federation
of Societies of Anaesthesiology. Since becoming fully established in January 2006, it has been the sole organisation representing all anaesthesiologists in Europe. The ESA works closely alongside the Board and Section of Anaesthesiology of the European Union of Medical Specialties (UEMS), the medical advisory body to the European Union. The main objectives of the ESA are:

  • To sustain and enhance the safety, efficacy and quality of care of patients.
  • To promote and protect the interests of its members.
  • The exchange and dissemination of information of interest and with an impact on the fields of anaesthesiology, critical care, emergency medicine and pain medicine.
  • To encourage education, research and scientific progress by raising and harmonising the standards of anaesthesiology across Europe.

Since the main responsibilities and objectives of the preceding organisations were essentially different and complementary, this allowed a strong and comprehensive new organisation to be established right from the start. The ESA now provides a full range of activities to support European anaesthesiology and to achieve its aims. It facilitates the exchange and dissemination of information through its website and publications and by the organisation of the Annual Euroanaesthesia Congress, which is attended by members and non-members representing more than 80 countries from around the world.

This, together with other regional and national meetings, offers a comprehensive scientific programme of refresher course lectures, symposia and workshops, together with presentation and discussion of the latest research undertaken in Europe in particular and is organised with active participation of the National Anaesthesiology Societies.

The ESA encourages research and scientific progress both in academic meetings, by developing European standards, guidelines and protocols, by the awarding of grants and fellowships and by publishing the European Journal of
Anaesthesiology. It has a key role in delivering training, together with continuous medical education and accreditation of anaesthetists both through educational programmes, the European Diploma and in-service training examinations and through the Hospital Visiting and Accreditation Programme run jointly with UEMS. It is a truly international organisation, representing many different countries and cultures, each with different healthcare priorities and vastly different resources and funding.

The close working together of the ESA and UEMS presents considerable opportunity for political influence as the only major international organisations representing anaesthesiology across the whole of Europe. The incorporation of CENSA into the ESA, which has now evolved into the National Anaesthesia Societies Committee (ESA National), allows every European country to be represented. It is devising ways of working with and for everyone, whatever the constraints, by organising a variety of activities and initiatives to cater for this. The ESA has a strong academic foundation that is a vital part of future development and strategy. Despite being a limited priority at present for some countries and governments by comparison with clinical patient throughput, it is the means by which the longterm quality of care is improved.

Through our research committee and related activities, we actively support research, both by encouraging international collaboration and by funding specific research grants, fellowships and projects. The ESA provides a variety of educational opportunities relevant to everyone. In addition Euroanaesthesia, to supporting research and the organising the EDA, the ESA is involved in creating and distributing educational material either on CD-ROM, web-based or  e-learning, or by running small meetings on more specific rare and relevant topics.

A Board of Directors, a Council and the General Assembly govern the Society. The Council is elected by the Active members of the Society, one from each European country with a minimum of 25 Active members (currently 30 countries). The Board of Directors and the Officers (President, Vice-President, Secretary, Treasurer plus three additional members) are elected by Council for a total of up to 4 years. The General Assembly convenes at the time of the ESA Annual Meeting. The Society includes Individual Members and Society Members. Society members are represented within the ESA by the (ESA National), which is represented on the Board of Directors and maintains direct links with the World Federation (WFSA). The ESA Secretariat is based in our own delightful headquarters building in Brussels. We employ 13 full-time staff led by our Executive Director, Mr Michel de Bisschop, who deal with all aspects of the ESA’s work, both administrative and specific. These include membership services, the organisation of Euroanaesthesia and other meetings that are done in-house, the organisation of the European Diploma examination, the hospital visiting programme and the publication of a variety of material, including the Newsletter.

Annual Euroanaesthesia Meeting: next
meeting Milan 6–9 June 2009
One of the major strengths of the ESA is its ability to run major meetings such as Euroanaesthesia, attracting in excess of 6,000 delegates annually. This annual Congress forms a focal point for the international activities of the ESA and now rivals the World Congress, which only occurs every four years. Simultaneous sessions for both research and education take place over a fourday meeting in a major capital city of Europe. The ESA’s Scientific Programme Committee (SPC) is the main structure through which its academic activities are developed and the programme for Euroanaesthesia and other meetings is devised. Eighteen specialist subcommittees of the SPC address all areas of anaesthesiology, critical care and pain management, and their membership comes from a wide spectrum of specialist anaesthesiologists. This ensures that the expertise of the committees is sustained and enhanced and its relevance across the whole of the Europe is maintained.

A further important component of the Congress comprises the Refresher Course Lectures, given by experts in particular fields and summarised in a book and CD-ROM produced free, for the benefit of everyone. Euroanaesthesia is an increasingly popular meeting and one that the ESA intends to develop still further in the future. However, we are conscious that many are unable
to attend this meeting for a variety of reasons and there is still a major need for the dissemination of research and educational material by alternative routes such as smaller regional or national meetings or by web-based learning.

Education and Training

The ESA is also looking at a new ways of education and training in a number of areas. These include the organisation of dedicated training courses linked to specific areas of anaesthesiology practice, in conjunction with some of the specialist societies. The development and expansion of web-based educational material is a key area for the future, and we are looking in detail at the expansion of online teaching and research tools such as online education, e-learning and assessment, links to related sites to avoid duplication of effort and the creation of online research directories to provide information on fields of interest and research activities, which are ongoing throughout Europe.

Standards and guidelines

The creation of standards and guidelines is a crucial part of the ESA’s work, either alone or working in conjunction with the UEMS Board. Optimising patient safety and clinical care within a realistic economic framework is an important responsibility. While the ESA is responsible for clinical, therapeutic and scientific guidelines, UEMS is concerned with those relating to service organisation and provision across Europe. Thus key standards and guidelines are currently being worked on in several important areas, which will result in the regular production of guidelines related to drug and therapeutics, clinical care and the provision of anaesthesiology equipment and monitoring.

European Diploma of Anaesthesiology
and Intensive Care (EDA)
The EDA is the flagship of the ESA’s educational activity. Introduced in 1984, it is a two-part examination intended as a comprehensive test of knowledge of anaesthesiology, critical care and pain management, and in excess of 1,000 candidates entered the different parts of the examination in 2008. It provides an international European standard that allows  harmonisation of training and knowledge assessment across all European countries, and Part 1 is used by some (Switzerland, Hungary, Poland and Austria) as part of their internal examination structure. Both parts of the exam take place in a number of designated centres across Europe depending on demand.

Part 1 consists of two, multilingual multiplechoice question papers available in English, French, German, Italian, Spanish and Russian, while Part 2 consists of four oral examinations, again multilingual and each with two examiners moderating one another. Success in Part 2, which is an end-of-training examination, qualifies the candidate to receive the European Diploma of anaesthesiology and Intensive Care. However, since the examination is predominantly a test of anaesthetic knowledge, comprehensive assessment requires that the candidates’ anaesthetic skills and behaviour be also tested as part of their national training programme. Thus a candidate needs to be registered on the Specialist Register of their own country before they can actually be awarded the European Diploma.

ESA/UEMS Joint Hospital Visiting
and Accreditation Programme
This initiative, which has been in place since 1996, is a joint venture between the ESA and the European Board, its main goal being to encourage and enhance training standards across Europe and to ensure that an academic institution meets the prerequisites of training in anaesthesiology as set out in the training guidelines of the European Board. The visiting programme serves to improve and harmonise the overall quality of anaesthesiology training throughout Europe. Visits consist of a detailed presentation of the staffing and organisational structure of the hospital, and the structure of the training programme. This forms the basis for a discussion and evaluation of all aspects of the teaching and training process with staff members involved to complement and build upon the strengths, to encourage development and change and to address areas of weakness. It is hoped and anticipated that the combined initiatives of the European Diploma examination, the harmonisation of training programmes and the Hospital Visiting and Accreditation Programme will do much in the future to allow accredited specialists to move seamlessly between different European countries while maintaining the high quality and safety of patient care, which we have all come to expect.

European Journal of Anaesthesiology (EJA)

The EJA, published monthly, is the official journal of the ESA and is distributed to all its members as part of their subscription. It is also the official journal of a variety of related organisations and is published and owned by the ESA. The EJA has two main functions: the publishing of peerreviewed original articles and reviews in the field of anaesthesiology, pain, emergency medicine and critical care, together with the ensuing correspondence and the provision of educational material with appropriate methods of selfassessment for ESA members and its readers.


The ESA also publishes a Newsletter four times a year; separate from the EJA and containing items of interest to ESA members together with information and formal announcements.