federation of orthopaedic trainees in europedear member on behalf of forte i have just attended a meeting held by the european union of medical specialists (uems). the orthopaedic section of the uems hold two meetings per year and representatives from each country within the european union attend. much of the discussions involve training, the ebot exam and manpower planning, and therefore it is important that trainees are represented at these meetings. each european country aims to train and produce suitably qualified orthopaedic surgeons able to work independently in a manner that is safe and professional. one of the founding principles of the uems was that in order for specialists to move between eu countries there has to be a mutual recognition between these countries and this has created a strong incentive for the harmonisation of education. clearly it would be wrong to expect each country to train in an identical manner. however, some believe that issuing a certificate of completion of training and entrance onto the specialist register should be via a process that is transparent and accepted across europe. currently we have a situation in which each country has its own method of regulation that varies enormously. whilst some countries have a system of yearly in-training assessments, logbook evaluation and compulsory final exams others rely on individual mentoring and voluntary exams. in some countries the final exam is set and marked by the university in which the training occurred whilst in other countries the exam is set nationally and has a standards setting committee. sometimes the pass mark is determined purely by a flat pass rate (e.g. 50%) whilst others set a pass mark determined by a standards committee. results of a survey presented at the uems meeting illustrated the overall situation: 60% of countries have a compulsory exam, 70% have a specialist exit exam and 90% do some form of evaluation of surgical skills. on this basis i believe that it is very difficult to assess standards of training across europe when sometimes there aren't even standards within the same country! we mustn't forget that at the heart of this are our patients,