Diversity and differences of postgraduate training in general and subspecialty pediatrics in the European Union.

The profound diversities among the EU28 postgraduate pediatric programs have been analyzed in this study. In general they are attributable to a multiplicity of factors, which are descrtibed in the paper. The original data included in the article show how the postgraduate pediatric training is currently (2014) performed in the EU28 nations. The 28 different national programs last from 4 to 8 years and present strikingly diversities. We have arbitrarily divided the nations into two groups: Group A includes nations that offer a 4-year basic course in general pediatrics and in some cases an additional 1-3 years optional training in selected pediatric subspecialties, and Group B includes nations that offer a 5- to 8-year basic course in pediatrics, including general pediatrics and part of pediatric subspecialties, which in some cases may be further expanded by 1-3 years of specific subspecialty training. The educational system in the Group B nations is intended to ensure that primary care pediatricians are prepared for the diversity of clinical and social problems that they will encounter and that specialist pediatricians receive sufficient training in rare and complex disorders. In conclusion, the evidence of a profound diversity of postgraduate pediatric training programs among the EU28 should be carefully considered and addressed, as a propaedeutic approach to ensure the appropriateness and feasibility of any QA and QI assessment program and ultimately to ensure a satisfactory and appropriate level of pediatric health care for European children in future decades.