History of EJD
Adapted by: Kostas Roditis | Edited by: Francisco Ribeiro Mourão and Mathias Körner | Based on articles written by: Thomas E.Kennedy, Hans-Ueli Wuersten, Jesper Poulsen, Svend M. Christensen and Eduardo F. Marques.
The Standing Committee of Doctors of the European Community (CP) was formed in 1959, only two years after the Treaty of Rome created the Common Market. The 1950s and 1960s also saw the formation of organizations representing specialists (UEMS), general practicioners (UEMO), senior hospital physicians (AEMH), and doctors in salaried practice (FEMS). Junior doctors were slower to organize at international level than the other groups within the profession and it was not until the mid-1970s they set up their own body to represent them at international level.
After several exploratory meetings, representatives of ten national organizations of junior hospital doctors met in Paris in November 1975 and reached preliminary agreement for the founding of a European association of junior hospital doctors. It’s aims would be to forge closer links between their organizations and to represent the professional interests of junior hospital doctors at European level. From the start, the Group aimed to bridge the gap between European Economic Community (EEC) member countries and those that were outside the Community. At Bad-Nauheim,Germany, in May 1976, the final agreement was reached to form the Permanent Working Group of European Junior Hospital Doctors (PWG), and Dr. Per Vagn-Hansen of Denmark was elected as the first Co-ordinating Secretary.
It quickly became apparent that junior hospital doctors in different countries share common problems and experiences. Much time was spent in the early years exchanging information and ideas and identifying the PWG's main areas of interest. Medical workforce dominated the agenda from the start. Information from member organizations made it clear that large-scale unemployment among doctors was already a reality in some countries and would spread to others unless action was taken. Under the auspices of the PWG, a conference on "Health Manpower Planning" was held at Maastricht in the Netherlands in April 1982, bringing together politicians, planners, and the profession in an attempt to solve the problems.
From this has grown a general movement within the European medical profession in favor of planning the future supply of doctors to match the anticipated demand for their services. As a result of the Maastricht conference the PWG commissioned a further study of medical manpower data systems in western Europe, which culminated in a congress held in Florence on 31 October 1991:
Other areas of the PWG's interest have included the quality of specialist training, the temporary migration of doctors for an educational purpose, the working conditions of junior hospital doctors, and various ethical issues which affect medical practice. The PWG has developed its own policies on these, and has also successfully influenced the policies of other international medical associations.
In its first years, the PWG embarked on the important task of compiling information to facilitate the free-movement of doctors in training in Europe. The objective of this work was to provide true freedom of movement, in accordance with the principles established by the Medical Directives in 1976. The PWG’s greatest contribution was the publication of a series of booklets containing relevant information for doctors wishing to seek employment or complement their training in a foreign country.
In 1995, at its conference on “Postgraduate Training: a European Future”, the PWG publicly presented its most recent policy on this issue, which is still a reference for European doctors. This policy statement brings to light a significant number of principles concerning the structure and quality of this phase of medical education, which coincide with several points in one of the most important official documents on this issue, the 4th report of the Advisory Committee on Medical Training (ACMT), published in 1997. One of PWG’s projects, Research in Postgraduate Training, also provided a balanced development of its policy in the field of postgraduate training.
In 1997, the PWG had the opportunity of disseminating an important new paper on “Future Medical Work”, which has proven fully up-to-date. This paper concerns the organisation of work in health services and its influence on the working conditions of junior doctors. The greater expectations of patients, allied with factors such as ageing, migration and mobility, have led to a progressive increase in healthcare costs. As a result, most European countries have undermined doctors’ working conditions with policies of economic management and redistribution of resources. The PWG's recommendations include concepts such as the creation of a positive workplace, organisational development, project management and other strategies that enhance the structure, process and outcomes of health promotion for patients as well as doctors.
In May 2000, the PWG published a policy statement on Continuing Medical Education/Continuous Professional Development (CME/CPD) and organised a conference in which it was possible for experts from various European medical organisations to exchange their views on CME/CPD before an expert audience.
The PWG was actively involved in finding a solution to the problem that was created when the European Working Time Directive (Directive 93/104/EEC) excluded doctors in training from certain aspects of the organisation of working time. In December 1995, the PWG, in collaboration with the European Commission, organised a major conference in Brussels to address the issue of junior doctors’ working conditions. In the year 2000, after many years of intense negotiations with the European authorities, the European Parliament and the European Council finally agreed to include doctors in training within the scope of the European Working Time Directive (Directive 2000/034/EC). Although the PWG considered this agreement a positive step forward in protecting the health and safety of doctors and their patients, it deplored unnecessary delays to the full implementation of the Directive in several countries. The European Parliament and the European Council established a total transition period of nine years to reach the 48-hour week, which the PWG regarded as unnecessarily long because junior doctors often work until exhaustion in several European countries, jeopardising their health and safety, as well as that of their patients. Shockingly, after 22 years, this subject is still a reality nowadays and EJD continues to draw the attention of EU member states to the need for the full implementation of this Directive.
In accordance with the text of the new Directive regulating the recognition of diplomas, published in January 2001, the minimum period for specialty training in General Medical Practice was extended to three years. This was welcome news after supporting the general practitioners in this objective since 1991. Curiously, the organisation was founded as the “Permanent Working Group of European Junior Hospital Doctors”, which later proved inappropriate because the PWG included doctors in training in non-hospital fields and there was no organised body of junior doctors in the field of primary care. Therefore, in 1996, during an important revision of the PWG's statutes, by a working group coordinated by Dr. Kirsi Ailus (Finland), the word “hospital” was dropped and it became the Permanent Working Group of European Junior Doctors.
A further change occured in 2018, when the Statutes were changed once again, and the organisation’s name changed into the European Junior Doctors Association (EJD). This step was to pay respect to the professionalisation from a working group on specific topics to an organization that represents all junior doctors’ affairs across Europe. But the most recent change in EJD’s Statutes - partially because of the repercussions caused by the Brexit (ie. UK’s exit from the European Union) and also due to new Belgian legislation regarding non-profit associations - took place at the Extraordinary General Assembly held in Brussels in November 2021.
Another important landmark on EJD’s history was the beginning of a permanent secretariat staff member in 2021, after counting with the precious cooperation of Mr. Alex van Bolderen (Netherlands) during 37 years as EJD’s political advisor.
From the beginning, EJD has sought to develop productive relations with various European medical organisations and authorities. Formal relations with the Standing Committee of European Doctors (CP) have existed since 1983 and the EJD was granted consultative status in the Council of Europe in 1986. The EJD also has good relations with the Regional Office of the World Health Organisation, the European Parliament and the European Commission. It has had regular meetings with the most important European Medical and medical students’ organisations to coordinate activities and increase efficacy. In November 2000, these organisations approved a protocol governing the relations between them and the CP. The EJD is now a member of a group of institutions that speak with one voice and represent the medical profession in Europe, although it is aware of the fact that it must maintain its independence and capacity of negotiation with the European authorities. Many junior doctors from all over Europe have had greater or smaller roles in EJD’s work and some are now accredited leaders in national or European medical organisations. Some non-medical participants, who have witnessed the life of this organisation from the beginning, have generously placed their knowledge on issues of medical policy at EJD's disposal. The junior doctors of more than 20 European countries now have an influential organisation that defends their interests effectively and, due to the hard and dedicated work of many individuals, EJD is proud of its achievements. However, there is always much to be done and EJD is aware that the structure of the organisation must evolve if one wishes to maintain EJD's recognised role and capacity of intervention. The EJD is seen as an increasingly influential and effective organisation defending the current and future interests of European Junior Doctors in these times of rapid change.