Kategorie: Information

JOIMAX® ANNOUNCES RELEASE OF FIRST ENDOSCOPIC AMA CPT CODE Company also releases newly designed joimax® homepage

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Irvine, CA – September 26, 2016 – The AMA (American Medical Association) released the CPT 2017 Codebook (Current Procedural Terminology), now containing the first endoscopic spinal surgery code no. 62380. This new code covers endoscopic decompression of the spinal cord, nerve root(s), including laminotomy, partial facetectomy, foraminotomy, discectomy and/or excision of herniated intervertebral disc, 1 interspace, lumbar, and will be enforced as of January 1st, 2017. Under this code the specific transforaminal (TESSYS®) and/or interlaminar (iLESSYS®) procedures are fully covered in the USA herewith, which are already marketed by joimax® in 45 countries.

“The definition of this new code in the CPT codebook 2017 is a major milestone towards the acceptance of endoscopic minimally invasive spine surgery techniques and its benefits to both the surgeon and their patients,” states Wolfgang Ries, Founder and CEO of joimax®. Since 2012 joimax®  had been driving this effort to obtain CPT codes as these procedures required submission to payors for reimbursement coverage which was granted only in single cases under temporary codes, so-called T-codes.

“joimax® has been instrumental in driving the effort to obtain full code coverage of endoscopic spinal surgery,” says Daniel Laich, DO, Swedish Convenant Hospital, Chicago, who had been participating and presenting in almost every AMA meeting over the last five years. Due to the high research and publication activities by key users like Albert Telfeian, MD, PhD, at Rhode Island Hospital at Brown University, and a group of users around him, strong evidence has been accepted by AMA authorities, justifying the release of this new CPT code.

Many papers and publications on joimax® products can now be downloaded from the newly released joimax® homepage. The completely redesigned website offers visitors richer insight into the company’s innovative products and systems. A quick and easy access to essential information and features is available, including the latest workshop and education activities, which are essential in endoscopic minimally-invasive spinal surgery.

Meanwhile joimax® offers basic and advanced workshop training courses mainly in the USA, Germany and Austria, and oversees a participation population of almost 3,000 physicians. Independent training courses are also performed in China and Korea to support the fast growing Asian markets. Detailed information about those courses are updated regularly at www.joimax.com.

The website uses the latest technology so the site is compatible with today’s browsers and mobile devices, such as smartphones and tablets. Visitors can also use the new website to stay informed with the latest company news. The new website goes live today and is located at the same address: https://www.joimax.com.

joimax® Launches Numerous Innovations at EuroSpine Milan From 19 To 21 October 2011

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Karlsruhe/Milan, October 17th, 2011. In its anniversary year joimax® presents numerous innovations – at EuroSpine Milan for the first time, opening up the series of the big autumn congresses and exhibitions.

For the first time joimax® presents the now complete product range for endoscopic spinal surgery, showing the novel pain therapy product “Multiuse”. The new Multiuse-Set comprises instruments for endoscopic facet joint denervation or so-called rhizotomy. Subsequent to the iLESSYS® system for 360° decompression launched in spring 2011, it completes the joimax® product range that was kicked off with TESSYS® years ago. Further special blades for the successfully launched Shrill® shaver-drill resection and ablation system will be introduced to the market also.

At EuroSpine joimax® will display its complete endoscopic system of the 3rd generation with Vitegra®3 for the first time. This is the most recent generation of fully integrated documentation systems. With D-Camsource® HD LED, the first fully integrated HD camera technology with LED light source will be introduced. The joimax® proprietary radio frequency system Endovapor® will be presented to the public with new bi-polar probes.

This rapid-fire launching of a variety of new products proves again the leading position of joimax® in the field of endoscopic spinal surgery. To accompany this, joimax® offers a lunch workshop on October 20th, 2011. Congress attendees can register directly at the joimax® booth. Members of the international joimax® faculty team will present their experiences when applying the joimax® instruments, devices and surgery methods.

Further important events right after EuroSpine on the joimax® agenda are the SMISS in Las Vegas, USA, the NASS in Chicago with a big workshop to be held at the renowned Chicago Back Institute, the MEDICA in Duesseldorf, Germany, the Rome Spine Conference in Italy and finally the DWG annual congress in Hamburg early December, with another lunch symposium and an evening reception celebrating the 10th anniversary of the company.

SDRI appoints joimax® as exclusive distributor for Synergy Cervical Disc in Germany, Austria and Switzerland

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TORONTO, Dec. 12, 2014 (GLOBE NEWSWIRE) — SDRI, developer of SYNERGY Disc and alternative spine technologies, enters into a five-year agreement with JOIMAX GmbH for exclusive rights to market and distribute the company’s SYNERGY family of products in Germany, Austria and Switzerland.

Karlsruhe-based Joimax, one of the leading medical device companies for minimally invasive spinal surgery, officially kicked off the alliance during an evening reception on December 11, during the 9th Annual German Spine Surgeons Meeting 2014 in Leipzig, Germany. Joimax also sponsored a luncheon symposium on December 12, where Dr. Thomas Bierstedt, and Dr. Bernd Illerhaus, both neurosurgeons from Orthopedic Neurosurgery Center (ONZ) in Datteln, shared their initial clinical experience and preliminary results utilizing the SYNERGY Disc for motion preservation procedures.

The SYNERGY Disc is the world’s first cervical disc replacement that is designed specifically to actively correct pre-operative deformity, prevent post-operative misalignment and provide optimal stability for multi-level procedures. The SYNERGY Disc incorporates a revolutionary geometry, offering multiple alignment corrections to provide surgeons with reliable and precise control of lordosis and sagittal balance.

The first clinical cases with the SYNERGY Disc were performed in 2009, in Europe. These pilot cases with the long-term, follow-up data have recently been submitted for publication.

“We are very excited with the initial results from Germany, which have validated our pilot cases,” commented SDRI’s Chief Executive Officer, Devesh Menawat. “We are eagerly anticipating the next follow-up periods and engaging in the next steps of our strategy designed to gain regulatory approval for our SYNERY Disc in the United States.”

Dr. Kemal Yucesoy, a neurosurgeon involved in the pilot study, stated: “The gold standard (cervical fusion) involves proper reconstruction of sagittal balance following decompression. Conventional disc replacements, however, do just the opposite; they restore range of motion but they have an unpredictable impact on sagittal balance. The Synergy Disc combines the best of both of these very successful treatments by restoring range of motion and normal sagittal balance to the patient. Restoring alignment of the spine is vital for long-term success of cervical disc replacements. Our long-term follow-up has demonstrated outstanding results. The SYNERGY Disc will help to expand the indications for cervical arthroplasty.”

“SDRI’s SYNERGY Disc addresses a significant unmet clinical need in patients suffering from alignment problems who, today, have no viable option,” said Wolfgang Ries, Joimax founder, chief executive officer and president. “We have begun to commercialize the product in Germany and early feedback from surgeons is very positive. We look forward to broadening the penetration for SYNERGY in German hospitals and delivering this surgical solution to doctors and hospitals in Austria and Switzerland.”

“Germany, Austria and Switzerland represent key international markets for our company,” added SDRI President Glenn Webb. “The size of these markets for spine products, combined with Joimax’s reputation for delivering relevant solutions and effective training for spine surgeons, provides us with a great opportunity for growth and to expand the adoption of our Synergy technologies into other markets. This alliance further supports our mission to give options to patients, who, otherwise, have no alternative treatments available.”

Synergy Disc is a registered trademark of SDRI. Joimax is a registered trademark of Joimax GmbH.

About Joimax GmbH.

Joimax GmbH, based in Karlsruhe, Germany, focuses on the development, production and marketing of technologies and methods of endoscopic spinal surgery. The complete Joimax systems provide the best possible visualization, tissue removal, stabilization and documentation in one, so the surgeon can work flexibly, independently and cost-effectively. The Joimax CM3, which includes surgery visitations, cadaver workshops and surgery support by experienced medical trainers and application specialists, employs a three-stage education program to train surgeons on the safe application of each specific surgery technique.

About SDRI, Inc.

Synergy Disc Replacement, Inc. (SDRI), headquartered in Toronto, Ontario, delivers alternative spinal technology solutions to solve complex surgical problems. The SDRI family of products include the SYNERGY® Cervical Disc. SYNERGY is the first and only artificial cervical disc to unite the needs for sagittal balance and motion, making it the only viable alternative to fusion in patients with pre-operative spine alignment issues.

A photo accompanying this release are available at: http://www.globenewswire.com/newsroom/prs/?pkgid=29639

Suzie Robinson, APR
Media and Investor Relations
| 214-577-9329

– See more at: http://globenewswire.com/news-release/2014/12/12/690985/10112195/en/SDRI-Appoints-JOIMAX-as-Exclusive-Distributor-for-SYNERGY-Cervical-Disc-in-Germany-Austria-and-Switzerland.html#sthash.Qxd2qOZ3.dpuf

joimax® Enters the Vietnamese Market, Partners with Trang Thi Medical Company Limited

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Karlsruhe (GER) – joimax® and Trang Thi are pleased to announce their partnership in bringing the joimax® full-endoscopic and minimally invasive spinal surgery technology to the Southern Provinces of Vietnam including Da Nang market.  joimax® a German-based company is a recognised market leader in these technologies and training methods with a history of innovation in endoscopic spine surgery since 2001.

Endoscopic Spine Surgery has been growing steadily in popularity since the late 1990’s and there has been exponential growth in the technique in the past 10 years. The distributor Trang Thi and joimax® are pursuing a long term corporation to provide a broader surgical choice for patients considering spinal surgery. “joimax® is looking forward to working with a partner as strong as Trang Thi, says joimax® Founder and CEO Wolfgang Ries and adds, “a company that has the necessary personnel, expertise, as well as the corresponding specialization and penetration of the market”.

“We’re very pleased to collaborate with joimax®,” comments Trang Thi Medical Co., Ltd Director Dieu Linh Nguyen. “Endoscopic spine surgery is a technique that enables patients to have access to truly minimally invasive surgical procedures of the spine.” Thus, joimax® strengthens its sales activities in Southern Provinces of Vietnam including Da Nang and enters into another important partnership across APAC.

About Trang Thi Medical Co. Ltd
Trang Thi Medical Co., Ltd (TRANG THI) is one among key players in Vietnam market, providing complete solutions for neuro and spine surgery. During the nine years of operation, TRANG THI has cooperated with many well-known manufacturers, transfering advanced and innovative technology to hospitals and healthcare centers. With the mission of community health, Trang Thi always strive to make a real difference to people’s lives.

joimax Partnership with Trangthimedical, 2021

joimax® presents EndoLIF® as a world premiere at the Annual Meeting of DGNC

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Not yet FDA cleared

joimax® presents EndoLIF® as a world premiere at the Annual Meeting of DGNC

Karlsruhe, 24 May 2013. It has become a good tradition – but this time it will include a world premiere: As in previous years, joimax® will present a lunch symposium during the 64th Annual Meeting of the German Society of Neurosurgery DGNC to be held in Düsseldorf, Germany, on 27 May 2013. As a world premiere joimax® will introduce its novel EndoLIF® system for endoscopic stabilization of the lumbar spine. The joimax® Faculty Team had the chance to see this technology during its yearly User Meeting held at the Institute of Anatomy of the University of Mainz, Germany, in April. It will now be displayed to the broad expert audience of DGNC’s Annual Meeting.

Besides the endoscopic technology for the access to the disc compartment based on the well proven TESSYS® or iLESSYS® access method, the EndoLIF® system comprises an O-cage (oblique cage) and a screw and rod system for posterior percutaneous stabilization. The advantages of this procedure are obvious:
– Smooth, atraumatic access due to dilation of tissue
– Dura and nerves are protected by the working tubes
– Dorsal bone structures are generally not affected
– O-Cage with osteo-conductive surface providing the optimum substrate for cell growth
– Stabilization via screw and rod system for percutaneous i.e. minimally invasive positioning
Indications for this procedure are the degenerative disease of intervertebral discs, mechanical instabilities and spondylolisthesis grade I and II. CE approval is expected by summer 2013.

The joimax® lunch symposium will be chaired by Prof. Dr. Jürgen Kiwit (Berlin). Dr. Guntram Krzok (Friedrichroda) will present „TESSYS® and iLESSYS® for multiple decompression therapies“. Dr. Bernd Illerhaus (Recklinghausen) will then draw the line to the EndoLIF® technology with an outlook on future therapeutic options. „The EndoLIF® system is the next logical step in the evolution of endoscopic access technologies to the spinal canal for gentle and safe minimally invasive implantation of cages with subsequent percutaneous stabilization“, states Dr. Illerhaus with conviction.

joimax® STUDIES PUBLISHED IN WORLD NEUROSURGERY TESSYS® system proves to be surgical rescue solution for kyphoplasty complication and thoracic disc herniation.

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Irvine, Germany, September 14th, 2016 – joimax®, the expert in endoscopic minimally invasive spine surgery, is pleased to announce another publication on its technologies to be released in World Neurosurgery (2016). In the paper called “Transpedicular Lumbar Endoscopic Surgery for Highly Migrated Disc Extrusions, a preliminary series and surgical technique,” published by Krzok G et al, 21 patients underwent this procedure with the TESSYS® system. The paper follows two technical notes by Wagner R et al in which he shows joimax® techniques as surgical rescue solutions in a kyphoplasty complication and another one for the treatment of a thoracic disc herniation, all published in World Neurosurgery.

The first technical note mentioned above describes the case of a 72-year-old woman with a leakage of the kyphoplasty cement into the spinal canal (a described and known complication), where the joimax® technology was successfully used as a rescue solution to remove the cement and decompress the nerval structures preventing major surgery. The second technical note describes the transforaminal endoscopic foraminoplasty and discectomy for the treatment of a thoracic disc herniation. A 31-year-old woman with severe thoracic back pain over one year was successfully treated by using the transforaminal endoscopic approach so that open surgery was not needed.

Over the years a growing number of studies show the outstanding advantages of endoscopic minimally invasive spinal surgery, such as the prospective Randomized Controlled Trial (RCT) of Ruetten et al in 178 patients and by Hoogland et al in a study of 262 consecutive cases of transforaminal endoscopic spinal surgery. Both were published in Spine 2008, Vol. 33, Issue 9. Another retrospective evaluation with 195 patients of Jasper et al (Clinical Neurology & Neurosurgery 2013, Vol. 115, Issue 10) and a multi-centric MIS prospective registry published by Sclafani et al (IJSS 2015, Vol. 9, Art. 69) with 86 patients, also showed very encouraging results. Beyond that, a special edition in the Journal of Neurosurgery called Neurosurgical Focus, published by Gokaslan Z, Telfeian A and Wang M focused on Endoscopic Spine Surgery was released in February 2016 (JNS 2016, Vol. 40, No. 2).

“Working with Endoscopic Spine Surgery for more than 12 years (her performed already 2,400 Tessys® procedures in daysurgery in analgo-sedation) and seeing its evolution is just amazing and I wonder where we will be in five or ten years from now”, says Menno Iprenburg, MD from Veenhuizen, NL, who continues to be involved in many of these studies.

Albert Telfeian, MD, PhD from Brown University, RI is very happy about the actual hit rate on PubMed when searching for endoscopic spinal surgery, “To date we’ve received a rate of 2,730 papers on http://www.ncbi.nlm.nih.gov/pubmed/?term=endoscopic+spinal+surgery and I am really excited how many indications are treatable with endoscopy already today,” said Telfeian.

“Shortly another RCT study will be published by Gibson et al demonstrating the quality and great success rate of endoscopic spine treatments with a high adoption rate, especially in Asian countries, and in some countries where there is more than 50% growth per annum”, says Wolfgang Ries, founder and CEO of joimax®.

joimax® inspires Thai-German Neurosurgery Congress participants for TESSYS®

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Karlsruhe, 6th of October 2011. joimax® opened doors for the Thai-German Neurosurgery congress participants, under the patronage of the German Academy for Neurosurgery (GANS) and the presidency of the Director of the Clinic for Neurosurgery at the “Städtisches Klinikum” in Karlsruhe, Prof. Dr. med. Dr. h.c. Uwe Spetzger – this year taking place in Karlsruhe, South Germany.

joimax® organised a lunch symposium in line with the congress, beginning with a company conducted tour through the facility where the participants visited amongst others the departments of the technical staff, research, development and construction – the core competencies and heart of the company. Also interesting were the explanations of the company founder and managing director Wolfgang Ries speaking about the exhibits in the so called internal “museum”, documenting the development of the 10 years company history,
showing prototypes of instruments, endoscopes and devices from the founding years.

The application of TESSYS® was presented by Prof. Dr. med. Ju?rgen Kiwit, Chief Physician of the Helios Hospital for Neurosurgery in Berlin Buch, in his demonstrative lecture with many pictures and videos. “In my opinion the minimally invasive TESSYS® method is the future of spine surgery, especially when treating herniated discs and stenosis. The advantages of this gentle method are more than obvious,” he stated.

The full potential of the endoscopic spinal surgery was impressively shown by Wolfgang Ries in his overview presentation: with special instruments it is also suitable for treating e.g. spinal canal stenosis and so makes – besides the transforaminal – the interlaminar access possible also, so that the spinal canal is now accessible from all sides, meaning 360°. The instruments of the next generation with flexible forceps, reamers and endoscopes are already very advanced in the joimax® development pipeline. An endoscopic assisted spine stabilisation system will open further wide ranges of applications.

A concluding hands-on with the latest joimax® endoscopic devices on models fully convinced the 45 Thai-German guests of the company’s innovative performance.

Thai-German_Meeting2011

joimax® – The experts in minimally invasive endoscopic spinal surgery show flag at the EUROSPINE in Lyon

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Karlsruhe – joimax® is participating with an industrial exhibition at the annual meeting of the european spine society „EUROSPINE“ from October 1st to October 3rd at the Congress Center in Lyon. In Forum N° A43 the company, located in Karlsruhe, exhibits its now highly diversified product portfolio for 360° surgery in nearly all areas of the spine including endoscopic or percutaneous stabilization. In various lunch symposia, numerous european experts will show their experiences and results. During a 2 hours lunch symposium on the first day of the Congress in Hall Rhône 1 internationally recognized spine specialists under the leadership of Dr. Menno Iprenburg (Veenhuizen / Netherlands) and Dr. Alastair Gibson (Edinburgh / United Kingdom) will provide insights of their experience and into their scientific results.

Lectures on the latest product developments are expected with great interest, hereby:

  • The EndoLIF® system for endoscopic lumbar column stabilization. This system includes not only the fully endoscopic access technology to the disc space with the proven TESSYS® or iLESSYS® method, but also an implant, the so-called O-Cage (O = oblique).
  • Percusys®, an innovative screw and rod system for the posterior percutaneous stabilization.

The advantages of this methods are obvious:

  • Tissue sparing access by dilation
  • Protection of dura and nerves through a proven access corridor
  • Preservation of the posterior bony structures due to the special lateral access
  • EndoLIF® O-Cage made of Ti6Al4V for optimized bone ingrowth
  • Percutaneous stabilization by Percusys® and therefore minimally invasive

Both new systems are CE approved and the FDA approval is in progress.

Since 2004, more than 100,000 patients in 30 countries were successfully operated using the TESSYS® method and their further developments. Studies show the shorter reconvalescence time, faster recovery and thereby speed up the return of the patients to work and enhance quality of life.

Visit joimax® at EUROSPINE, Cité Internationale, Lyon Convention Centre, Forum N° A 43 and see for yourself the benefits of the new systems.

Virtual Global Symposium on Minimally Invasive Spinal Surgery Highlights Livestream Training Benefits

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Karlsruhe, Germany — The Global Symposium of the ESPINEA® Academy in Karlsruhe, sponsored by joimax®, showcased how modern, advanced training for surgeons works. Earlier this month, over four days, more than 300 participants from around the world learned about the latest endoscopic surgical methods for spinal diseases. Via live demonstrations, twelve world-renowned spinal surgeons presented case studies, gave tips and tricks, and allowed people to look over their shoulders at endoscopic videos while operating on cadavers. The livestream made it possible for participating surgeons to understand exactly how endoscopic operations are carried out.

“You can only get closer if you do it yourself,” said one participant.

Endoscopic spinal surgery is developing into the gold standard for back problems that need surgery,” said Wolfgang Ries, the academy’s founder and chairman. “A large number of studies show it is superior to conventional methods of open spine surgery. Unfortunately, this technique is still not taught in most training centers around the world”.

ESPINEA® fills this gap with an extensive training program. Webinar formats are unavoidable in the Coronavirus period. With today’s livestream technologies, ESPINEA® was able to provide real-time, interactive surgical training, zooming in on how its surgical instruments can be used successfully.

“The participants’ enthusiasm is confirmation that we need to further develop online trainings,” said Ries. “While virtual events cannot replace face-to-face instruction — after all, it’s learning by doing — they provide an excellent alternative”.

ESPINEA® Academy was founded by joimax® in February 2019. A month later, joimax® CEO and Founder Wolfgang Ries held its first faculty and user meeting at the Paracelsus Medical University in Salzburg. Since then, ESPINEA® has been accredited by the oldest surgical college in the world, the Royal College of Surgeons Edinburgh. Participants at events such as the Global Symposium can earn medical training credits for Continuing Professional Development (CPD points). Points can be applied to medical license renewals.

Underscoring the importance of virtual learning, three ESPINEA® board members chaired the symposium: Menno Iprenburg from Iprenburg Spine Clinic in Veenhuizen, Netherlands; Sang-Ho Lee, president of Wooridul Spine Hospital, Korea; and J. N. Alistair Gibson, Royal College of Surgeons in Edinburgh. The participants concluded, “It was worth taking part just to hear these luminaries in person. But the best part was the opportunity to see the operation as if you were performing it yourself.”

Contact:
joimax® GmbH 
Nicole Read
info@espinea.org

joimax® starts into spring with a comprehensive education initiative

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Karlsruhe, 12th April 2013. April is the month of international workshops for joimax® – with its holistic Education Program and 4 cadaver workshops in total in the US and Germany the leading provider of instruments and techniques for minimally invasive endoscopic spine surgery starts into spring.

The starting signal sounded on 5th April in Irvine, California, where the subsidiary joimax®, Inc. is located. The two-day cadaver lab attended by 10 surgeons at the Advanced Med Institute let the spine physicians from around the United States experience the joimax® TESSYS® (Transforaminal Endoscopic Surgery System) surgery technique for the endoscopic access to the spinal column step-by-step. Reference surgeon Dr. Carl Spivak, neurosurgeon at Bassett Hospital Cooperstown in New York, talked about the anatomy of the lumbar spine, the transforaminal access to the vertebral canal and suitable indications. During the wet lab hands-on session on 3 workstations the surgeons were able to intensively try and train the minimally invasive operation technique for the treatment of disc herniations and spinal canal stenosis. „The technical performance of the joimax® procedure and the approach to the pathology have impressed me. After the workshop I feel very comfortable expanding my indications and applying endoscopy for the spine“– that’s what stated one of the attendees.

A real highlight of the spring education initiative is the first joimax® balloon-kyphoplasty workshop on 12th April at the Clinic for Accident, Hand and Restorative Surgery at the UKGM in Gießen, Germany. Besides interesting scientific presentations on balloon-kyphoplasty and osteoporosis therapy, the workshop’s main focus lies on the practical training of this minimally invasive surgical technique for the gentle treatment of vertebral fractures. Under the guidance of the instructors Professor Christian Heiß, Associate Professor Dr. Wolfgang Böcker and Dr. Markus Engelhardt their experiences and expert knowledge will be directly transferred to the 8 attendees.

The end of this training-intensive month forms an exclusively held workshop for a Chinese group of physicians at the University Medical Center of the Johannes-Gutenberg-University in Mainz, Germany. Under the guidance of Dr. Michael Schubert (Munich) und Dr. Guntram Krzok (Friedrichroda), the top delegation of 6 spine specialists from China will receive phase-on training on how to perform endoscopic spinal surgeries using the specific transforaminal and interlaminar joimax® access and decompression procedures.

Particularly exciting for the joimax® Faculty is 14th April when the already 5th international User Meeting will be hosted right after the Chinese Workshop. Here, the brand new joimax® products will be presented on the anatomical specimen – starting with CESSYS® (Cervical Endoscopic Surgical System) for the therapy of herniated discs on the cervical spine through to the next generation of TESSYS® with the quick FastTrack-access. Specifically designed for experienced users, the fine-tuned FastTrack surgical instruments allow for the transforaminal acces to the spinal canal in fewer steps. A very special highlight is, however, the EndoLIF® System (Endoscopic Lumbar Interbody Fusion) for spinal stabilisation, which is going to be presented for the first time. Various cage technologies and spinal implants have been designed specifically for the minimally invasive endoscopic lumbar spine fusion procedure; the access to the disc space is based on the well-proven TESSYS® and iLESSYS®-systems – thus this is the world’s first fusion procedure under endoscopic view.

You can find all workshop dates for 2013 at p478114.webspaceconfig.de/en/doctors/education