30 years of UEG: What has been achieved and what does the future hold?

Abstract

The 30th UEG Week took place in Vienna at the Messe Wien Exhibition and Congress Center between 8 and 11 October 2022. It was the first face to face meeting of UEG for 3 years, the previous two UEG Weeks having been delivered in the virtual format. The participants were delighted to return to the vibrant, friendly, family atmosphere they had come to love, with the total number of attendees returning almost to pre‐Covid levels. It was a triumph. There were frequent reminders that this was a significant anniversary meeting which included clinical topic based 30 year reviews and teatime treats in the social spaces, culminating in an anniversary scientific session which reviewed the outstanding progress that had be made during the last 3 decades in managing four of the most challenging diseases in gastroenterology and hepatology; hepatitis C, pancreatic cancer, gastric cancer, and inflammatory bowel disease. Following these high‐quality scientific papers, I gave a brief account of UEG's history, focusing predominantly on progress made during the last 3 years which is described below. The session closed with a short musical interlude and a firework display!.

IN THE BEGINNING…

The United European Gastroenterology Federation (UEGF) was established formally in 1992, ¹ although the need for European collaboration in gastroenterology probably dates back much earlier to 1935 when Georges Brohee, the Belgian surgeon and radiologist, organised the First International Congress of Gastroenterology in Brussels ² It is generally accepted that the concept of a pan‐European federation of gastroenterology began to evolve in Rome during the International Congress of Gastroenterology in 1988, the prime mover being the late Aldo Torsoli (1924–2002) who was Professor of Gastroenterology at La Sapienza University, Rome and President of the Congress. Torsoli was a highly respected man of vision, whose interpersonal skills and persistence were able to persuade colleagues from seven leading European Gastroenterology Societies, the so‐called ‘Seven Sisters’, during 4 years of tough discussion, to create the new Federation. ² , ³ This is a long gestation period by all standards; even the elephant only takes 2 years to deliver its young! The only animal that can match UEGF is the frilled shark, named because of the morphology of its gills. This shark was around at the time of the dinosaurs and is extremely long lived, which hopefully bodes well for UEG!.

The story of those early days of UEGF has been told exquisitely by one of the committed supporters of the Federation and the organiser of the first UEGF week in Athens, 1992, the late Constantine Arvanitakis (1939–2017). ² , ³ He deals delicately with some of the sensitivities that needed to be worked through by the Interim Coordinating Council that worked tirelessly under Torsoli's leadership during the period 1988–92. Other insights emerge during the excellent review of the Federation's history in the document produced to celebrate the first 20 years which is available on the UEG website. ³ , ⁴ Although there was a shared vision that the creation of a Federation of gastroenterology societies in Europe would speak with one voice and thereby increase its reach and impact, there were concerns about possible loss of autonomy and sovereignty of individual partners, and for some there was a desire to continue their own annual meetings in addition to contributing to UEG Week.

THE WEEK…

At the start, the main priority for UEGF was to establish the annual conference which from the beginning was branded as UEG Week. The first meeting was hosted by the Hellenic Society of Gastroenterology under the leadership of Constantine Arvanitakis. It was held in the Stadium of Peace and Friendship outside Athens close to the port of Piraeus, an idyllic setting. The official foundation of UEGF took place during this meeting at Pnyx Hill, the site of the Assembly of ancient Athens. During the 6 years that followed, The Week was hosted in Barcelona, Oslo, Berlin, Paris, Birmingham and Rome. The philosophy during this early period was that the meeting should move around the capitals of Europe, each hosted by the relevant National Society, with responsibility for The Week being allocated through a bidding process which gave the local organizing committee up to 4 years to prepare. This approach was effective in maximising the engagement of both National Societies and the seven, founding pan‐European specialist societies.

As the week became more established, there was a desire to formalise the structure of the meeting. An important stage in achieving this goal was to establish in 2001 a Scientific Committee, with Christoph Beglinger as its first Chair. The Geneva UEG Week in 2002 was delivered to this format, leading to the establishment of a template which could be used as the framework for future meetings. The Postgraduate Teaching Programme within The Week also began to evolve at this time by consolidating all former contributing specialist courses into a single integrated 2 day postgraduate programme.

As the week developed and the number of attendees increased throughout the first 10–15 years. Until around 2003, the administrative structure that underpinned UEGF was relatively slim, reliant on a small team in Barcelona with additional support from a core Professional Conference Organiser (PCO) working together with a local PCO appointed in the city where the week would take place. In 2003 it was decided to move the administration of the Scientific Committee to Vienna and award the contract to a local Association Management Company, which would work alongside a core PCO that would be responsible for the onsite delivery of UEG Week. Again, this brought both consistency and continuity to the administration of both UEGF and The Week.

In 2006 the administrative base of UEGF moved in its entirety to Vienna. During the remainder of UEGF's second decade, The Week's participants continued to increase reaching steady state at about 13,000, at the same time increasing its international reach and scientific esteem. By the time UEG Week was celebrating its 20^th anniversary in Amsterdam in 2012, the central administration was taking increasing responsibility for the meeting, ensuring that the high standards achieved during the previous decade were maintained and at the same time providing excellent value for money.

BEYOND THE WEEK…

During UEG's second decade its mission began to extend beyond that of an international congress and its closely aligned postgraduate teaching programme. The Federation enlarged, growing its membership to 17 specialist member societies from the original seven. In addition, 48 National Societies of Gastroenterology also formally joined the Federation which led to the disaggregation of the association for national societies of gastroenterology (Association des Société’s Nationales Européenes et Méditerranéennes de Gastroenterologie, ASNEMGE), one of the founding ‘Seven Sisters’. This required some changes in the rules to ensure that all current members, whether founding or new, had a voice within the Federation. Growth in membership had an important effect on strengthening the United European voice of gastroenterology and hepatology.

With progressive growth there was an urgent need to strengthen the Federation's central administrative capability. This process had some ‘ups and downs’ which have been sensitively summarised in the 20th Anniversary document. ³ This move led to a progressive centralisation of all administrative activities to Vienna which led eventually to the establishment of a permanent home for UEG, the European House of Gastroenterology, which opened in 2012. Located in an elegant district in central Vienna, it became the administrative hub and the registered office for our tax and legal affairs. Perhaps most importantly, it provided a familiar, friendly place for the many business meetings, including Council, throughout the year. During this second decade a series of new work themes began to emerge.

EMERGING THEMES…

The leadership of UEGF appreciated early on that an important contribution would be to foster and support the gastroenterologists of the future. An early important initiative was the Rising Stars programme starting in 2003, which aimed to identify and fully recognise the research leaders of the future. Initially it was the brainchild of ASNEMGE but was soon embraced across the Federation. To date over 170 young Rising Stars have been identified many of whom have gone on to even greater achievements. Further realisation of the importance of the upcoming generations is exemplified by the establishment of the Young Talent Group in 2013 which was given the brief to identify and promote the needs of trainees and young gastroenterologists. YTG now has an extremely important voice in UEG, and whose Chair has a place on council. ⁵

It was also soon evident that women were increasingly represented across gastroenterology and its subdisciplines and therefore needed to be visible and active in leadership roles within UEG. To ensure that progress was made rapidly, an Equality and Diversity Task Force was established in 2015. The task force should be proud of some impressive early achievements including the increasing numbers of women serving on UEG committees which includes the current Chair of the Scientific Committee, the appointment of the first female President and the first female Secretary General in 2022 and finally a sex balanced Council membership.

In 2021 UEG membership grew again through the creation of myUEG Associates programme. This was an important new development which sent a strong signal of inclusivity across the GI community. ⁶

THE LAST 10 YEARS—MATURATION OF THE MISSION

The last decade of the life of UEG, having established UEG Week as a stable, high quality high ranking international annual meeting, it focused on organisational development, governance, and a sustainable expansion of the mission. This involved the creation of new workstreams driven by strong committees, some recently created, working to an ambitious new strategy.

At around the time of the 20th anniversary in 2012, a rebranding exercise was undertaken and UEGF became just UEG to recognise that the original Federation had grown to involve many more partner organisations, had a mature unifying administrative structure and a different legal and financial basis. It was also an opportunity to emphasise the five dominant areas of endeavour, in addition to The Week, that UEG was then supporting, namely education, research, the newly created UEG Journal, public affairs, and quality of care.

Education

The UEG Education Committee was created in 2004 with a brief to promote and offer support to educational events in Europe outside of the annual meeting. In 2009, the committee was given an annual budget to award support grants to member societies to deliver postgraduate courses and other educational activities outside of UEG Week. In the same year it delivered the first UEG Webcast. The following year it led the first TIGER meeting (Training Innovation in Gastroenterology & Educational Resources) and launched OLGa (Online Learning in Gastroenterology). In 2014 it established the Postgraduate Teaching Curriculum, and 2016 saw the beginning of a new initiative, Mistakes in… published in Digibook, accessible through the UEG website. The first Webinar took place in 2020 and the first blended learning Masterclass in 2021.

Research

The importance of research excellence is a key component of UEG Week and was one of the founding principles of the Federation. A major, high‐value research prize was introduced in 2008 and there has been an annual award every year since. One of the responsibilities of the Research Committee has been to assemble the necessary data to help make the case for increased research funding for gastroenterology and hepatology in the European Union and nationally. In 2014, the first major survey of digestive health was published which provided detailed information on the relative importance of the burden of digestive diseases in Europe and it also exposed some important health inequalities in clinical care and mortality across Europe. ⁷ The survey has recently been repeated and published as the Second ‘White Book’ entitled the burden of Digestive Diseases in Europe in 2022. ⁸ , ⁹ The Committee also oversees the allocation of Horizon Europe support grants and the planning of UEG research webinars. ¹⁰

UEG Journal

After extensive debate examining the pros and cons of starting a new European journal of gastroenterology and hepatology, Council approved the initiative on the basis that UEG Week was now attracting some of the best research papers from Europe and beyond and that the journal would offer another route by which UEG could communicate with its member organisations. The first issue appeared in February 2013 and within 2 years the impact factor had risen above 2, a significant achievement within a crowded and competitive specialty. The first editor, Jan Tack, recognised the importance of ensuring that the journal was relevant to young gastroenterologists and in 2019 following the appointment of the second Editor‐in‐Chief, Joost Drenth, trainee editors were recruited into the editorial team. In 2021 Journal had a change of publisher from Sage to Wiley and transitioned to become an open access journal. ¹¹ Over the last 5 years UEGJ has grown from 6 to 10 issues each year, has a rising impact factor and is now an undoubted success in the competitive field of gastroenterology journals. ¹² I have to admit that as a former editor of another GI journal, I was concerned that there might not be space for a new entrant. But I was wrong!.

Public affairs

The Public Affairs Committee was created in 2006. Its work was divided between disease‐related promotional activities during UEG Week, raising awareness more widely and campaigning in Brussels. The chosen areas of activity generally related to important challenging clinical areas in the specialty, usually diseases with high incidence and high mortality such as colorectal cancer. ¹³ In 2010 the committee was responsible for the first written declaration to the European Parliament on colorectal cancer which stressed the importance of raising public awareness of the disease particularly the success of screening. The following year UEG was invited to join the European Medicines Agency Healthcare Professionals Working Party, an early sign that the UEG's united voice for gastroenterology in Europe was beginning to have impact. In 2016 the Committee hosted its first Digestive Health Awareness Campaign and in 2018 it initiated a European Parliament Interest Group on Digestive Health. This was followed in 2019 by a Manifesto on Digestive Health which was endorsed by 27 election candidates and translated into eight languages. The voice of UEG is now a force to be reckoned with across the European health scene.

Quality of care

While UEG has always been clear about its vision statement, namely, to Reduce the burden of Digestive Diseases and improve Digestive Health, it has, until relatively recently, promoted this as a thread running through all of its activities rather than identifying a discrete function within the organisation to champion this cause. In 2015 a Quality‐of‐Care Task Force was established that led a joint initiative with ESGE which focused on standards in endoscopy. The following year it developed a repository for clinical guidelines and standards of care and in 2017 awarded activity grants to support the dissemination of guidelines, including multidisciplinary, pan‐European guidelines. In 2020 the GI Guidelines App was launched of which there has now been more than 20,000 downloads, together with the first Guidelines webinar. ¹⁴

REFLECTION…

During the past 30 years UEG has established itself as one of the most effective and prestigious medical specialty organisations in the world. By bringing together a consortium of established European gastroenterology societies and the national societies across the continent, together with the recent inclusion of individual members, it has created the strongest possible voice which is now listened to globally. During the first decade of its existence, UEG's primary focus was on the establishment of a high quality, comprehensive European Congress on gastroenterology and hepatology which arguably is now the best international gastroenterology meeting worldwide. ¹⁵

During the second decade UEG Week matured and grew sustainably to around 13,000 participants. UEG Council progressively added breadth to the mission of the organisation with a focus on the development of trainees and young gastroenterologists, a drive to increase the number of educational opportunities which occurred outside of UEG Week and the establishment of an active programme of public engagement including promotional activities in the European Parliament.

During the third decade the importance of setting standards for clinical care rose up the agenda, UEG Journal was launched and went from strength to strength, and the importance of commissioning research on the burden of digestive diseases in Europe became a priority to inform lobbying activities in Brussels.

MAKING THE FUTURE…

In recent years, UEG has worked closely to its strategic plan which has been regularly updated and continues to be a roadmap for the future. UEG strongly believes that the future must be created and not just left to chance. Making the future depends on scanning the horizon for innovations in clinical care and training, particularly the ever‐increasing dependency on artificial intelligence. We also need to be constantly searching for future research challenges. Gastroenterologists and hepatologists need to engage with workforce planners to determine how many doctors will be needed by 2040 and what will be the nature of their work. I believe it would be reckless to disengage from this debate and leave it to the bureaucrats. The roles of all healthcare professionals will continue to evolve but as doctors, we need to be at the forefront of these discussions.

The ability to gather critical information about the trajectories of disease incidence and mortality within our discipline will be vital, not only in health services planning but in ensuring that sufficient funding continues to be available to research those conditions that are having a major impact on digestive health. UEG will also need to continue to campaign for research funding of challenge‐led research, particularly so‐called ‘blue skies’ research. I believe there will continue to be a pressing need to update the 2014 and 2022 White Books which assembled critical data on disease burden and health inequalities in Europe in GI disease. ⁸ , ⁹

To ensure that UEG continues to remain vibrant and creative, we need to continue to explore the Power of Difference, exploiting all aspects of the diversity of our membership and ensuring that this is reflected throughout the management structure of the organisation. And we should never forget John C. Maxwell's words from 2002, that ‘Teamwork makes the dream work’.

CONFLICT OF INTEREST

The author has no conflicts of interest to declare.

Farthing MJG. 30 years of UEG: What has been achieved and what does the future hold? United European Gastroenterol J. 2022;10(10):1194–8. 10.1002/ueg2.12333

DATA AVAILABILITY STATEMENT

Data sharing is not applicable to this article as no new data were created or analyzed in this study.