Message from the President

 

IFCPC Newsletter

Winter 2015-12-16

 

Dear Colleague

Winter is here, another year has passed, so quickly.  Poverty, population growth , war, social unrest and medical inadequacy prevail across much of the world.  It’s all very depressing.  It feels good to be working in a field where there is some progress and a positive end in sight.  We could actually see an end to cervical cancer in (some of) our lifetime.  The promise of vaccination is being realised in those countries which have instituted comprehensive vaccination programmes, for example,  Australia, Brasil, Malaysia and Rwanda,,they are encouraging examples.  But where eradication of the disease is most needed vaccination is sometimes least likely to happen.

And there is real reason to be hopeful, many LMICs have started screening programmes.  Many of these are using VIA and combine it with a see and treat approach for screen positive women, or at least for women in whom a local destructive treatment is appropriate, with referral to a colposcopy clinic for large or suspicious lesions.  Although this approach may not be not perfect it’s a beginning.

There will be a need to manage cervical precancer lesions for many years to come in those regions where cervical cancer rates are highest.  Of course excellent colposcopy practice doesn’t just happen.  Where excellence exists it is a reflection of properly structured training, quality assured assessment and continuing medical education.  To this end the Federation has expanded and improved its training course. The course overview may be seen on our website but essentially is comprises :

Training need

IFCPC / IARC Training programme

Theoretical knowledge

25 lectures delivered online with mandatory questions and answers after each lecture

Image recognition skills

50 still images with specific colposcopic characteristics in each one disseminated on line

Case management skills

100 video cases, each with online questions and answers, again delivered on line: these will develop case management skills

Colposcopy cases seen under supervision

Direct supervision of 50 cases in a colposcopy clinic with half of these being new cases and at least being high grade.

Colposcopy cases seen without direct supervision

Submission of 100 colposcopy case details to nominated trainer for review

The essential components of the IFCPC training programme include<

- A means of addressing each of an agreed list of core competencies
- A comprehensive theoretical course, delivered over the internet and / or during a three day theoretical training course
An image recognition module delivered before the trainee attends a colposcopy clinic.  The IFCPC and IARC still image libraries will be used for this purpose
- A case management module delivered partly in a recognized busy colposcopy clinic with devoted trainers who themselves have undergone a
“training the trainers” course.  Many case management skills may also be learned before attending a colposcopy clinic using video recorded interactive clinical cases.  Articulate software is appropriate for this.
- Acceptance by an agreed trainer for clinical training
- 50 new colposcopy cases managed under the direct supervision of a trainer, half of which should be high grade cases
- 100 cases managed without direct supervision but submitted to the trainer for review
- Documentation of all cases in a log book
- Attendance at a summary training / review course (perhaps one day)
- An OSCE exam for trainees who have satisfied their trainers and the requirements of the course
- For those who pass the OSCE a certificate of course completion or a certificate of training will be awarded.  This will not imply competence (which is a medico-legal nightmare).

Theoretical content

Twenty five core lectures have been created by recognized experts in five languages using camtasia video recording.  These lectures need to be updated regularly

Training the Trainers Courses

Before starting a course the Regional  course directors will  host a training the trainers seminar (TTS) using faculty from IFCPC and IARC to define the objectives and practicalities of the training course The TTSs will describe and discuss in detail the training and assessment needs of the course to the individual colposcopy clinic trainers involved in the course.  Appropriate TTS material has been generated for these courses and continues to evolve.

We now have the full lecture course created in English, Spanish, Portuguese, and French  and are preparing a full set in Russian.  The other course material that is delivered on line (still image and video cases) will also need explanatory and teaching notes to be translated and this is ongoing. 

We have a course taking place in Brazil right now and are about to start one in Spanish Latin America.  We will be launching one in Senegal for French speaking Africa in early March and one in English for the Indian subcontinent and for English speaking African countries in 2016 and a Russian cum English course for Eastern Europe next year also.  The course in Eastern Europe is going to be in collaboration with UNFPA.  All our courses are also in collabortion with the Screening Unit at IARC ( thanks to Drs Rengaswamy Sankaranarayanan and Partha Basu) and where possible with the regional colposcopy federation.  We offer a completion of course certificate for those delegates who successfully complete all aspects of the course and who pass the exam.  It is not a certificate of competence.

English speaking African countries in 2016 and a Russian cum English course for Eastern Europe next year also. The course in Eastern Europe is going to be in collaboration with UNFPA. All our courses are also in collabortion with the Screening Unit at IARC ( thanks to Drs Rengaswamy Sankaranarayanan and Partha Basu) and where possible with the regional colposcopy federation. We offer a completion of course certificate for those delegates who successfully complete all aspects of the course and who pass the exam. It is not a certificate of competence.

Many National Societies have clinical guidelines in colposcopy for colleagues in their country and some of these are on our website.  At the last Executive Officers meeting there was a proposal for our Federation to generate global guidelines and Pierre Martin-Hirsch has kindly agreed to draft a document that he will circulate to all board members.

In line with the ambition to reduce the burden of cervical cancer globally the next board meeting will be in Senegal on the 3rd and 4th of March at which time we will hold a training the trainers seminar and launch the Francophone Africa IFCPC/IARC  training course in Colposcopy.  There are 15 French speaking countries in Africa and we expect to recruit one colleague from each of these countries and to host the hands on colposcopy clinic component of the course in Dakar.  Prof Aziz Abdoul Kasse will kindly host us.

The next World Congress is just over a year away and we look forward to seeing as many of colleagues from every continent to Orlando in April 2017 (2nd to 7th April).  Please tell as many colleagues as you can about it and encourage them to come.  It will be a lovely time of year in Florida and the scientific programme is shaping up to be a superb meeting.  Alan Waxman and Pierre Martin-Hirsch are preparing an exciting programe and the venue really is of a very high standard.  The meeting will not disappoint.

Walter Prendiville

17th December 2015

 

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