Specific Standards of Accreditation for Residency Programs in Pediatric Surgery INTRODUCTION 2012 A university wishing to have an accredited program in Pediatric Surgery must also sponsor an accredited program in General Surgery. The purpose of this document is to provide program directors and surveyors with an interpretation of the general standards of accreditation as they relate to the accreditation of programs in Pediatric Surgery. This document should be read in conjunction with the General Standards of Accreditation, the Objectives of Training and the Specialty Training Requirements in Pediatric Surgery. STANDARD B1: ADMINISTRATIVE STRUCTURE There must be an appropriate administrative structure for each residency program. Please refer to Standard B1 in the General Standards of Accreditation for the interpretation of this standard. The program director should have Royal College certification in Pediatric Surgery or equivalent acceptable to the Royal College. STANDARD B2: GOALS AND OBJECTIVES There must be a clearly worded statement outlining the goals of the residency program and the educational objectives of the residents. The general goals and objectives for Pediatric Surgery are outlined in the Objectives of Training and the Specialty Training Requirements in Pediatric Surgery. Based upon these general objectives each program must develop rotation specific objectives suitable for that particular program, as noted in Standard B2 of the General Standards of Accreditation. STANDARD B3: STRUCTURE AND ORGANIZATION OF THE PROGRAM There must be an organized program of rotations and other educational experiences, both mandatory and elective, designed to provide each resident with the opportunity to fulfil the educational requirements and achieve competence in the specialty or subspecialty The structure and organization of each accredited program in Pediatric Surgery must be consistent with the specialty training requirements as outlined in the Objectives of Training and the Specialty Training Requirements in Pediatric Surgery. This document may be reproduced for educational purposes only provided that the following phrase is included in all related materials: Copyright 2012 The Royal College of Physicians and Surgeons of Canada. Referenced and produced with permission. Please forward a copy of the final product to the Office of Education, attn: Associate Director. Written permission from the Royal College is required for all other uses. For further information regarding intellectual property, please contact: documents@royalcollege.ca. For questions regarding the use of this document, please contact: accred@royalcollege.ca. Page 1 of 5
Residents must be provided with increasing individual and professional responsibility, under appropriate supervision, according to their level of training, ability and experience. STANDARD B4: RESOURCES There must be sufficient resources including teaching faculty, the number and variety of patients, physical and technical resources, as well as the supporting facilities and services necessary to provide the opportunity for all residents in the program to achieve the educational objectives and receive full training as defined by the Royal College specialty training requirements. In those cases where a university has sufficient resources to provide most of the training in Pediatric Surgery but lacks one or more essential elements, the program may still be accredited provided that formal arrangements have been made to send residents to another accredited residency program for periods of appropriate prescribed training. Learning environments must include experiences that facilitate the acquisition of knowledge, skills, and attitudes relating to aspects of age, gender, culture, and ethnicity appropriate to Pediatric Surgery. 1. Teaching Faculty There must be a sufficient number of qualified teaching staff to supervise residents and provide teaching in the basic and clinical sciences related to the subspecialty. The teaching staff should have a nucleus of full time teachers. 2. Number and Variety of Patients The number and variety of patients available for teaching must be appropriate to provide an adequate knowledge of: 1.1. Neonatal cases 1.2. Oncology cases 1.3. Those other important cases that characterize Pediatric Surgery, including minimally invasive surgery 1.4. Trauma cases (non-operative and operative) 3. Clinical Services Specific to Pediatric Surgery a. Inpatient Pediatric surgical services participating in the Pediatric Surgery program must be organized into one or more formal clinical services, each with an adequate number of patients available for teaching and administered by a chief-of-service to whom the senior resident is directly responsible. b. Ambulatory Inpatient and outpatient facilities should be integrated as far as possible, in order to provide longitudinal experience in patient care. There must be an outpatient department or alternative facilities for the provision of experience in the pre-admission and preoperative work-up of surgical patients and for follow-up care on an ambulatory basis. Page 2 of 5
c. Consultation The program must provide residents with the opportunity to obtain experience in the provision of a consultant service in Pediatric Surgery to primary care physicians and other specialists. d. Emergency The program must provide emergency experience in Pediatric Surgery and this should be incorporated into the daily experience of the residents on a Pediatric Surgery rotation as opposed to a separate emergency rotation. e. Intensive Care Unit The program must provide rotations in pediatric and/or neonatal intensive care units. 4. Supporting Services - Clinical, Diagnostic, Technical Liaison with Other Specialties and Subspecialties There must be appropriate liaison with teaching services in the following: general pediatrics, the pediatric subspecialties (hematology, medical oncology, gastroenterology, respirology, neonatology, endocrinology, cardiology, nephrology), pediatric anesthesiology, pediatric pathology, pediatric radiology, and other surgical disciplines with a pediatric focus such as urology, plastic surgery, cardiac surgery, orthopedic surgery, neurosurgery, gynecologic oncology, otolaryngology head and neck surgery and ophthalmology. STANDARD B5: CLINICAL, ACADEMIC AND SCHOLARLY CONTENT OF THE PROGRAM The clinical, academic and scholarly content of the program must be appropriate for university postgraduate education and adequately prepare residents to fulfill all of the CanMEDS Roles of the specialist. The quality of scholarship in the program will, in part, be demonstrated by a spirit of enquiry during clinical discussions, at the bedside, in clinics or in the community, and in seminars, rounds, and conferences. A scholarly approach implies an in-depth understanding of basic mechanisms of normal and abnormal states and the application of current knowledge to practice. Please refer to Standard B5 in the General Standards of Accreditation, the Objectives of Training, the Subspecialty Training Requirements in Pediatric Surgery and the CanMEDS Framework for the interpretation of this standard. Each program must develop a curriculum for each of the CanMEDS Roles, which reflects the uniqueness of the program and its particular environment. Specific additional requirements are listed below. Page 3 of 5
1. Medical Expert In addition to the General Standards of Accreditation, the following requirements apply: The program must provide residents with an opportunity to: a. Demonstrate a proficiency to perform independently the full spectrum of operative interventions in relation to the conditions outlined under Medical Expert Cognitive in the Objectives of Training document; b. Minimize risks and discomforts to the patient; c. Display abilities to provide team leadership and direct care of the multiple injured child; d. Demonstrate knowledge and proficiency in the safe and appropriate application of endoscopy and minimally invasive surgical techniques (including laparoscopy and thoracoscopy) as they pertain to the practice of Pediatric Surgery. 2. Communicator 3. Collaborator 4. Manager 5. Health Advocate 6. Scholar In addition to the General Standards of Accreditation, the following requirements apply: The program must provide residents with appropriate time, resources and supervision to complete a scholarly project suitable for presentations at a national/international meeting and/or suitable for submission to a peer-reviewed journal. 7. Professional Page 4 of 5
STANDARD B6: ASSESSMENT OF RESIDENT PERFORMANCE There must be mechanisms in place to ensure the systematic collection and interpretation of assessment data on each resident enrolled in the program. Residents must maintain and have submitted to their program director, prior to their FITER composition, operative case logs to confirm the variety, depth and breadth of cases performed by the resident that indicates a readiness for independent practice as a Pediatric Surgeon. Please refer to Standard B6 in the General Standards of Accreditation for the interpretation of this standard. Approved by Council 1998 Revised Education Ctee 2005 Name change - 2011 Revised SSRC - 2012 Page 5 of 5