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About PWG |
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The Permanent Working Group of European Junior Doctors (PWG) was formally created in Bad-Nauheim, Germany, in May 1976. Since then, the PWG has become the European medical organisation with the most comprehensive national membership, representing the junior doctors of 26 European countries. The PWG's initial objectives include safeguarding the interests of the junior doctors in Europe, improving relations between its member organisations and narrowing the gap between the junior doctors of the European Union and those of other European countries. Over the last three decades, the PWG has actively intervened in defence of the medical profession in Europe with the purpose of contributing to the development of junior doctors' work and education and has had an important role as a background group for the organisations of junior doctors in countries preparing to join the European Union. From the beginning of the PWG's existence, it became evident that the junior doctors of the various countries have many similar experiences and difficulties. Therefore, after pooling the information and exchanging ideas, the PWG was able to identify the main areas of interest to junior doctors in Europe.
The status of the medical workforce was one of the most important issues in the PWG's early years. The PWG conducted several studies that drew the medical profession's attention to the fact that this issue is not static and that long-term planning, though difficult, is essential. The different perspectives within the European Union influence the migration of doctors as well as the working conditions, quality of training and quality of patient care. Therefore, the PWG has endeavoured to gain a better insight of the workforce policy of its member countries in order to, where necessary, influence policy makers by providing examples of more successful planning. Other major areas of interest to junior doctors, and to the PWG, have been temporary migration for educational purposes, postgraduate training, continuing medical education, future medical work and working conditions. In its first years, the PWG embarked on the important task of compiling information to facilitate the migration of doctors in training in Europe. The objective of this work was to provide true freedom of movement, in accordance with the principles established by the Medical Directives in 1976. The PWG's greatest contribution was the publication of a series of booklets containing relevant information for doctors wishing to seek employment or complement their training in a foreign country.
In 1995, at its conference on "Postgraduate Training: a European Future", the PWG publicly presented its most recent policy on this issue, which is still a reference for European doctors. This policy statement brings to light a significant number of principles concerning the structure and quality of this phase of medical education, which coincide with several points in one of the most important official documents on this issue, the 4th report of the Advisory Committee on Medical Training (ACMT), published in 1997. In the same year we had the opportunity of disseminating an important new paper on "Future Medical Work", which has proven fully up-to-date. This paper concerns the organisation of work in health services and its influence on the working conditions of junior doctors. The greater expectations of patients, allied with factors such as ageing, migration and mobility, have led to a progressive increase in healthcare costs. As a result, most European countries have undermined doctors' working conditions with policies of economic management and redistribution of resources. Our recommendations include concepts such as the creation of a positive workplace, organisational development, project management and other strategies that enhance the structure, process and outcomes of health promotion for patients as well as doctors.
In May 2000, the PWG published a policy statement on Continuing Medical Education/Continuous Professional Development (CME/CPD) and organised a conference in which it was possible for experts from various European medical organisations to exchange their views on CME/CPD before an expert audience. We have recently witnessed the publication of several different documents on CME/CPD that generally defend the principles that became evident during the Conference. Fundamentally, the medical profession believes that CME/CPD is both a moral obligation and a right, and that access to appropriate CME/CPD must be ensured for all doctors, including those in training. The PWG's Policy Statement opposes a system of recertification and states that it is a misconception that such a system would contribute to the identification of unsuitable doctors, hence defending the concept of quality improvement, as opposed to quality control.
The PWG was actively involved in finding a solution to the problem that was created when the European Working Time Directive (Directive 93/104/EEC) excluded doctors in training from certain aspects of the organisation of working time. In December 1995, the PWG, in collaboration with the European Commission, organised a major conference in Brussels to address the issue of junior doctors' working conditions. In the year 2000, after many years of intense negotiations with the European authorities, the European Parliament and the European Council finally agreed to include doctors in training within the scope of the European Working Time Directive (Directive 2000/034/EC). Although the PWG considers this agreement a positive step forward in protecting the health and safety of doctors and their patients, it deplores the unnecessary delays to the full implementation of the Directive. The European Parliament and the European Council established a total transition period of nine years to reach the 48-hour week, which the PWG regards as unnecessarily long because junior doctors often work until exhaustion in several European countries, jeopardising their health and safety, as well as that of their patients. The PWG continues to draw the attention of EU member states to the need for real reductions in junior doctor's working hours and the full implementation of this Directive within the shortest possible time.
Curiously, our organisation was founded as the "Permanent Working Group of European Junior Hospital Doctors", which later proved inappropriate because the PWG includes doctors in training in non-hospital fields and there was no organised body of junior doctors in the field of primary care. Therefore, in 1996, during an important revision of our statutes, by a working group coordinated by Dr. Kirsi Ailus (SF), we dropped the word "hospital" and became the Permanent Working Group of European Junior Doctors.
From the beginning, the PWG has sought to develop productive relations with various European medical organisations and authorities. We have had formal relations with the Standing Committee of European Doctors (CPME) since 1983 and we were granted consultative status in the Council of Europe in 1986. We also have good relations with the Regional Office of the World Health Organisation, the European Parliament and the European Commission. Since 1991 each UEMS Specialist Section and European Board has welcomed a representative from PWG to represent European doctors in training. At the Executive meeting of UEMS in May 2007 it was agreed that PWG delegates also are invited to represent doctors in training in UEMS Multidisciplinary Joint Committees. The PWG has regular meetings with the most important European medical and medical students' organisations to coordinate activities and increase efficacy. In November 2000, these organisations approved a protocol governing the relations between them and the CPME. The PWG is now a member of a group of institutions that speak with one voice and represent the medical profession in Europe, although it is aware of the fact that it must maintain its independence and capacity of negotiation with the European authorities.
Our top project at the moment is the EuroMedMobility; this a joint PWG/EMSA project that, among other objectives, aims to improve the mobility of doctors in training within European countries, increasing the diversity in training opportunities for all European medical professionals.
During the first 31 years of the PWG's existence, it has organised numerous plenary Assemblies all over Europe and the rotation of meetings has ensured mutual understanding and the exchange of information.
Since its beginning, in Bad-Nauheim in 1976, the PWG has been presided by Dr. Per Vagn-Hansen (DK), the first Coordinating Secretary of the PWG for the 1976-1979 triennium, followed by Dr. Anton Seiler (CH), Mr. Douglas Gentleman (UK) and Dr. Hans-Ueli Würsten (CH). Dr. Jesper Poulsen (DK) was the first person to be elected President of the PWG (1994-1997), an indication of the positive development of this organisation. Eduardo Marques (P) was the second President of the PWG (until 2001) and the Dr. Nina Tiainen (SF) as the third (2001-2005). Rui Guimaraes was the fourth President from 2005-2009. At the moment the PWG President is Bernardo Pinto (PT), elected in 2009. Many junior doctors from all over Europe have had greater or smaller roles in the PWG's work and some are now accredited leaders in national or European medical organisations. Some non-medical participants, who have witnessed the life of this organisation from the beginning, have generously placed their knowledge on issues of medical policy at our disposal. The junior doctors of 26 European countries now have an influential organisation that defends their interests effectively and, due to the hard and dedicated work of many individuals, we are all proud of its achievements. However, there is always much to be done and we are aware that the structure of our organisation must evolve if we wish to maintain our recognised role and capacity of intervention.
Bernardo Pinto
PWG President