How the BAST was founded
In Belgium the surgical trainees united themselves in the Belgian Association of Surgical Trainees (BAST), which was founded on October 30th 1998.
The BAST initially was an idea of Patrick Itterbeek, M.D, our first President. He managed to motivate about 30 Surgical Trainees to set up our Association.
The BAST is open for General Surgery Trainees as well as Trainees in Neurosurgery, Urology, Orthopedics and Traumatology, Plastic - Aesthetic and Reconstructive Surgery and Gynecology, who follow their truncus communis.
The council is formed by Surgical Trainees from the different universities in Belgium, as well as the truncus communis Trainees and the Trainees with a "free" training program.
Two reasons of existence
The first reason was the feeling of the trainees that the structure of their surgical training didn't follow the recent changes in the surgical world. The second reason was the extensive workload, which didn't let no place for scientific work, study and family life.
The problem of workload, sometimes difficult working circumstances and a reasonable financial recompensation is recently being dealed with by "the law Colla". The implementation of the law requires a profound restructuration in many hospitals, which will be difficult to achieve. However, the Belgian government is working out a procedure to survey the implementation of this law.
The BAST is now recognizes by the leading surgical organizations in Belgium: The Royal Belgian Society of Surgery (Who supported us from the beginning on, also through financial support. Thank you!), the Professional Union of Belgian Surgeons (BBC/UPCB), the National Supervisory Board (Hoge Raad / Conseil Supérieur), and the two Specialty Boards (Erkenningscommissie / Commission d'Agrément).
In collaboration with the RBSS the BAST organized a symposium on "Controversies in Surgical Training", during which our National Survey on Surgical Training was presented.
This symposium should be the start of a continued dialogue between the different organizations in the surgical hierarchical tree.
Why do we insist on a profound dialogue ?
Well, one of the two main reasons of our existence, namely the structure of the surgical training, has to be totally revised.
The main problems can be divided in two categories.
The first is the theoretical part of the training. Until now no theoretical courses at all exist (neither for classic Open Surgery as for the Minimal Invasive Surgery).
The second category is the practical one. Many surgical trainees experience difficulties in obtaining a sufficient number of operations performed as first surgeon, especially the French speaking community, as their logbook recently became more exigent. As for the theoretical training, their isn't a structured training in surgery, which is a major problem, because of the number of classic surgical procedures has importantly diminished in favor of the minimal invasive procedures, who continue to be performed by our Instructors themselves.
Examples abroad
The Bast is especially impressed by the structure (theoretical and practical) of the training of our colleagues in the United Kingdom and Ireland, in which the Association of Surgeons In Training (ASIT) (founded in 1977 ! ) and the Northern Ireland Surgical training (NIST) played a major role.
Also the Netherlands achieved a well structured surgical training program. Evenso their workload has been worked out very well.
In contrast, our German colleagues seem to face the same problems as we do. The BAST spoke on the Assistentenforum ("Assistenzarzte zwischen Anspruch und Realitat: Wie machen es unsere Nachbarn") during the annual meeting of the "Niederrheinisch-westfalischer Chirurgenkongress", to present the Belgian "example".
As you see, the BAST is convinced that we should go abroad to see how our neighbors "do it". Maybe, all together, we could develop a European standardized structure of surgical training.
If you know engaged Surgical Trainees or Trainee Associations in (or outside) Europe, please let us know.
The council of the BAST expresses the hope that this website may help us to keep the Belgian Surgical Trainees up to date with the developments in their beautiful job. Also, we hope that through this medium we can achieve Surgical Trainees throughout our globe and exchange our experiences.
Dr. Jan Nijs, 1999