Abstract
BACKGROUND: The hospital structural reform through the Hospital Treatment Remuneration Improvement Act (Krankenhausversorgungsverbesserungsgesetz, KHVVG) will fundamentally change the medical care landscape in Germany starting in 2025. Outpatient care and cross-sectoral care models will substantially influence advanced surgical training. In particular, comprehensive training networks between hospitals and outpatient facilities are being discussed as a core solution to ensure surgical training. OBJECTIVE: The aim of this position paper is to highlight the wishes and demands of young surgeons regarding training alliances. These should serve as guidelines for the stakeholders involved for a successful implementation. MATERIAL AND METHODS: The position paper is based on discussions of the Young Forums of surgical societies, analyses of current further training models and experiences from pilot projects. It describes measures that promote cross-sectoral structured further training with clear legal, financial and didactic framework conditions. RESULTS: Successful models, such as rotation in outpatient facilities, show a positive effect on further training and practical experience. Necessary steps include simplifications of labor legislation, transparent curricula, adequate financing and certified didactic qualifications for those providing surgical residency training. Pilot projects underline the potential of intersectoral cooperation, while inadequate legal and financial structures have been identified as the main obstacles. CONCLUSION: The introduction of mandatory continuous education networks is essential to ensure surgical residency training and improving the quality of surgical patient care. In addition to political action to finance and adapt the framework conditions, hospitals and outpatient facilities need to take the initiative. In the long term surgical continuing education in Germany should be of exceptional quality.