Since the advent of IVF, the status of clinical embryologists has been a problem within the medical profession. This may seem strange, as we are indispensable in the treatment of infertility with MAR. One of the main reasons for this situation is the paucity of nationally recognised postgraduate training programmes in clinical embryology. Where MSc degrees exist, they may cover the theory but do not include any organised practical training in ART with active involvement of trainees in the routine practice of MAR procedures.
ESHRE has already described the embryologists’ professional status and the absence of organised practical training in embryology in European countries (1)(2). In a few countries, attempts have been made to fill this gap. This has either been via national professional societies, who have prescribed recommendations for minimum educational standards, or by faculties offering short-term MSc courses in clinical embryology. However, for the most part, neither can supply national health systems with embryologists who have a formal status because there is no legal basis for doing so.
Twenty years ago, the embryologists on ESHRE’s Executive Committee (ExCo) discussed the need for a recognition of clinical embryologists. In 2005, the ExCo decided to develop a system for an ESHRE Certification for Clinical Embryologists. The first ESHRE exam was held in 2008. A steering committee was formed – the Clinical Embryologists’ Certification Committee (EmCC) which has evolved over the years since. In 2017, the EmCC succeeded in having the ESHRE exams externally appraised and accredited by the UEMS-CESMA (the European Union of Medical Specialists Council for European Specialist Medical Assessment).
However, a practical training programme with a tutor system, like the one in place for medical specialties, was still missing. In 2020, another steering group (ATCE) was established to produce syllabuses for core and advanced training programmes and associated logbooks. This included setting up a system for accreditation of training centres (https://www.eshre.eu/Accreditation-and-Certification/Accreditation-of-training-centres-in-clinical-embryology).
It was only a matter of time before someone would use all the ESHRE tools on offer and successfully present them to the relevant national authority. Now this has happened in Slovenia. The Slovenian Society for Reproductive Medicine (SSRM) has made some key moves to recognise embryology. Firstly, the formal status of embryologists within the medical professional association had to be regulated. This way, a formal communication between SIG Embryology and the Ministry of Health was made possible. A working group of embryologists and gynaecologists was tasked with reviewing the existing legal basis for the specialisation and preparing the substantive programme. This was helped by Slovenia already having a regulation on specialisation for health professionals and associates, which is different from the regulation on specialisation for doctors.
The SSRM working group has taken advantage of what ESHRE has to offer and asked ExCo for permission to use existing ESHRE documents (Curriculum, syllabus, logbooks) and their translation into Slovenian. Following approval, a proposal for an ordinance on specialisation in medical embryology was written, based on ESHRE documents, and submitted to the Ministry of Health. The professional part was accepted in its entirety because it met the specialisation format standards and had been approved by ESHRE and CESMA. The proposal was finally approved, as this ensures that educational standards are met to enhance the safety and quality of patient treatment in such a sensitive area as MAR.
The ordinance lays down the criteria for authorised specialisation providers, coordinators, and tutors. All specialisation posts are approved by the Ministry of Health on the initiative of the health institutions. Candidates with a master’s degree in life sciences can apply for the four-year specialisation programme after completing a two-year internship in ART and passing the Health Professional Examination. Trainees are required to complete logbooks, which were developed by ESHRE. The tutoring system checks the competence of trainees in the individual modules listed in the ESHRE training syllabus.
The Ministry of Health can appoint a board for the specialist examination, but prefers to recommend the ESHRE Clinical Embryologist exam, which is recognised as a specialist examination.
The road to get here has been long and winding, but was made easier by the fact that most of the required documents had already been produced by ESHRE. Slovenian embryologists have come to this point through the combined efforts of many visionary ESHRE members who have spent years building this system and deserve our thanks.
References
1 Kovačič B, Plas C, Woodward BJ, Verheyen G, Prados FJ, Hreinsson J, De los Santos MJ, Magli MC, Lundin K, Plancha CE. The educational and professional status of clinical embryology and clinical embryologists in Europe. Hum Reprod. 2015 Aug;30(8):1755-62. Doi.org/10.1093/humrep/dev118
2 ESHRE Working Group on Embryologist Training Analysis; Scarica C, Woodward BJ, De Santis L, Kovačič B. Training and competency assessment of Clinical Embryologists and licensing of the profession in European countries. Hum Reprod Open. 2023 Feb 11;2023(1):hoad001. Doi.org/10.1093/hropen/hoad001
You have to be logged in and an ESHRE member in order to comment.