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Pathology across Europe: differences and similarities. 2. Microbiology.

Organisation of services Eight of the 12 European Community (EC) countries recognise medical microbiology as a distinct specialty but its practice varies considerably in each of the member states. As might be expected, most university hospitals have Departments of Medical Microbiology that are responsible for teaching and research. Many also have variable but sometimes extensive service commitments. Although medical microbiology is not only recognised but almost invariably practised as a monospecialty in the United Kingdom, there being now only a very few general pathologists, this is not generally the case in the EC. Despite being designated as a monospecialty in eight member states, medical microbiology is often practised by those providing multidisciplinary services, particularly in smaller hospitals. In Britain non-medical scientists have an important role in academic units of medical microbiology as well as in specialist reference laboratories. They are not heads of hospital departments, however, and do not have important clinical responsibilities in diagnostic laboratories, regardless of the size of the hospitals concerned. In contrast, non-medical scientists often assume a greater degree of responsibility for providing services within the EC-for example, in France-where pharmacy graduates may have considerable service responsibilities. Close cooperation between microbiologists and clinicians, which is now very much part of the approach to the diagnosis and management of patients with infections in Britain, may therefore not occur in many smaller hospitals in many member states. Because of this, clinicians who may have little or no training in microbiology are more likely to be involved in developing antibiotic policies as well as infection control procedures. Needless to say, such activities are likely to be practised with a varying degree of competence.