Europe

Europe encompasses many different models of healthcare systems, but in most cases there is a mixture of state and privately-delivered provision. Publically-delivered healthcare predominates. But the ways in which care is provided and patients access that care vary greatly, influenced by levels of taxation, economic strength, and a multitude of historical factors.  

Training

In the main, undergraduate training is managed by large, mainly city-based University teaching hospitals.  Although the provision of postgraduate training is mostly delivered in urban hospitals, there are also examples of more an experiential approach, with training in the community, or in smaller centres.  There is also enormous variability in assessment methods, accreditation processes and regulation of clinical standards.  

Current challenges for European medicine

Despite different health systems, many of the challenges of delivering service and providing teaching and training are similar across the region:

• Dealing with increasing patient expectations and the need to improve clinical standards.
• Dealing with latest European legislation and its impact on junior medical staff.
• The management of the medical workforce. 

Increased mobility of workers throughout the region, a more flexible regulatory framework, the knock-on effects of the European Working Time Directive EWTD) and major differences in the level of remuneration available for physicians in different countries, there is an increasing movement of physicians within and out of the region.