Specialist training in Europe: introduction to a special issue of the Journal of Thoracic Disease

Specialist training is a critical issue in Europe and worldwide. The trainee is a future colleague from whom we expect that he will deliver the best ever possible quality of care. This best quality of care encompasses a huge number of prerequisites. On the front line appear knowledge and cognitive skills, and psychomotor procedural skills; competence is demonstrated by appropriate decision-making and application of technical skills. During his training, a trainee is expected to progressively escalate the top of the famous Miller’s pyramid (1). As opposed to technical skills, which are tested in national or European board examinations, best quality of care requires a broad spectrum of non-technical skills including empathy, team playing, leadership, cost control among other. The Royal College of Physicians of Canada has prepared and published a guideline document called “CanMEDS glossary”, which describes 7 fundamentals, yet overlapping areas of competence, centred by medical expertise: communicator, collaborator, leader, health advocate, scholar, and professional (2).