Professor Helen Askitopoulou,
University Hospital of Heraklion, PO Box 1352, 711 10 Heraklion, Crete.

Introduction		Speciality of anaesthesiology in Greece
Educational Activities of the society

Greece is situated in the very south of Europe, a country with a long history and a civilisation that goes back more than 4000 years, well known for its many natural beauties and its 3000 islands. Modern Greece has almost 11,000,000 inhabitants, 70% of whom are living in the two big cities, Athens and Thessaloniki.

The Hellenic Society of Anaesthesiologists was founded in 1956, when the first anaesthesiologists who were trained in Europe came to Greece. Today the Society has almost 900 members, with another 200 in training (a number slowly decreasing with many posts vacant at present). The activities of the Society are mainly centred on educational aspects and training which have been steadily increasing over the past few years.
 
Educational activities of the Hellenic Society of Anaesthesiologists

• Postgraduate Courses: In 1964 the Society introduced an annual course for anaesthesia trainees, which has continued on a weekly basis in Athens. Postgraduate seminars and symposiums are also organised in different cities and also in other centres such as Thessaloniki and Crete. Since 1990 formal CME courses have been organised according to FEEA, first in Thessaloniki and afterwards in Athens.

• Anaesthesia Journals: In 1966 the publication of the Society's journal, Acta Hellenica Anaesthesiologica, commenced with three to four issues per year. In 1990 a second journal published by the Society of Anaesthesiology and Intensive Medicine for Northern Greece Themata of Anaesthesiology and Intensive Medicine was introduced mainly containing reviews.

• Panhellenic Anaesthesia Congress: In 1967 the Society organised the first Panhellenic Congress of Anaesthesiologists in Athens and since then there has been a Congress almost every two years in different cities.

• Specialty Examinations: In 1957 the first examinations for the specialty of anaesthesiology took place under examiner Cecil Gray from England. Between 1957 and 1976 the examinations were carried out by an Examination Committee appointed by the Ministry of Health with a surgeon acting as chairman. Since 1976 the three-member committee has been chaired by an anaesthesiologist. At present the examinations take place six times a year in four centres (Athens, Thessaloniki, Heraklion and Patras). Anaesthesiology, together with other specialities, forms the basic specialty for other supra-specialties like Intensive Care Medicine, with two years of training after the basic specialty diploma (since 1995) and Emergency Medicine with 400 hours of training after the Diploma of Anaesthesiology.

• Other Societies: Besides the Hellenic Society the following societies were developed and are active on similar aspects of the specialty:
  • The Society of Anaesthesiology and Intensive Medicine of Northern Greece was founded in 1983 with a journal, biannual congress and many postgraduate courses

  • The Hellenic Pain Society was organised in 1994 as a result of which the Greek chapter of IASP was founded one year later

  • The Greek Society of Cardiopulmonary Resuscitation was formed in 1994 and the Greek Resuscitation Council was founded in 1996 as the national representative to the European Resuscitation Council.

• Anaesthesia Departments: In Greece there are 119 state hospitals with an anaesthesia department (AD) and only a few private hospitals. There are 5 Academic Departments of Anaesthesia in Athens, Thessaloniki, Patras, Crete and Ionnina, in the 10 University Hospitals of the country and another 10 district hospitals, 72 provincial hospitals and 17 specialised hospitals (army, social security, maternity, etc.).

• Anaesthesia safety in Greece: One of the big issues in Greece over the last few years is safety, a topic which has been discussed at meetings and CME activities. As it was very difficult to determine serious morbidity or mortality in Greece because of fear of litigation, it was decided to study different aspects of anaesthesia resources relative to European and ITFAS standards by a nationwide cohort study conducted between 1993 and 1994 in the 119 state hospitals. The methodology used was based on a structured questionnaire (with 144 qualitative and quantitative questions) and an interview with the anaesthesiologist in charge of each AD during a personal visit or by telephone or by mail. There was a 91.6% response rate.

  It was found that a total of 313,867 anaesthetics were carried out in 1994 in the 507 state operating rooms. The larger hospitals were more efficient and productive with 70% of the operations performed there in the 46 hospitals of the two biggest cities. Only 43% of ORs had a recovery room, 25% of ADs ran some form of pain clinic, while 10 of the 44 existing ICUs were supervised by an anaesthesia department.

• Present state of Anaesthesiology in Greece: This study together with other sources has emphasised the need for:
  • an increase in the numbers of anaesthesia trainees by re-evaluation of anaesthesia training programmes, re-accreditation of hospitals and re-organisation of examinations

  • the improvement of medical and nursing manpower of anaesthesia departments

  • the upgrading of anaesthesia equipment.

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