Supervision of Higher Surgical Training

In-training Assessment

Assessment

· Mid-term Assessment

· Half-yearly Assessment

· Workplace Based Assessment (WBA)

· Unsatisfactory Training Performance

· Appeal Procedures

Mandatory Course

Operational Requirements

Research Requirements

Oral Presentation / Publication Other Requirements

Continuing Medical Education (CME) Programme

Others Requirement

The Education & Examination Committee and the Specialty Boards jointly undertake the responsibility of accreditation and recommendation for approval by the College Council. All trainees embarking on Higher Surgical Training must obtain a Logbook which can be purchased from CSHK Secretariat:

The Logbook provides information on:

1. Operation Statistics

o    Range

o    Emergency Content

o    Supervised Experience

o    Unsupervised Experience

o    Minor Surgery

o    Endoscopy

o    Record of Complication and Death

o    Summary

2. Academic Activities

o    Research

o    Publications

o    Presentation at Meetings

o    Attendance at Courses, e.g. Workshops and Seminar

IN-TRAINING ASSESSMENT

On-going in-training assessment is required throughout the Higher Surgical Training period. Training assessment is conducted half-yearly (every January and July) for recognition of the respective training period. Trainees must maintain a logbook for their operative experience until the completion of their higher training. They must keep a logbook prospectively recording all their training experience. During the training period, trainees must obtain satisfactory assessments from their supervisors and copies of these assessments must be filed in the trainees’ logbooks and recorded by the respective Specialty Board & CSHK. The logbook is required to be presented for inspection during the Joint Specialty Fellowship Examination.

Individual trainee’s Logbook should be reviewed regularly

·         3 monthly (Mid-term assessment) by mentor

·         6 monthly (Half-yearly assessment) by (i) Supervisors / (ii) The respective Specialty Board

ASSESSMENT

Mid-term Assessment

On completion of every 3-month training period, an interim face to face assessment between the mentor and the trainee should be carried out to thrash out any problems. During this interim debriefing assessment process, if serious deficiencies are evident, the mentor has to report in writing to the Chairman of the respective Specialty Board. The trainee should be advised what measures are required to reverse these deficiencies.

Half-yearly Assessment

On completion of each 6-month training period, each trainee in all specialties (except General Surgery) must submit the assessment documentation on or before 21st January or 21st July. The deadline will be automatically extended to the next working day if that day falls on a Saturday or public holiday. For those in General Surgery, they are required to submit the documentation to the Training Subcommittee of CSHK via their supervisor regularly in January and July every year for recognition of the respective period. Deadline for submission of half-yearly assessment documentation falls on the date of Training Subcommittee meeting. Late submission of the half-yearly assessment documentation will render the respective training period NOT recognized.

The assessment documentation should include the following:

·    Logbook Summary Report

·    Logbook Summary

·    CME Report

·   Two Mentors Assessment Forms for assessing trainee's performance in the past 6-month training period. Two mentors, who must be delegated or designated by the supervisor of the training hospital should complete these forms.

·    Research Reports (if any)

It is the obligation of Higher Surgical Trainees to submit the above requisite documentation through their supervisors/trainers for vetting regularly semi-annually by

·    Training Subcommittee (for Higher Trainees in General Surgery)

·    The respective Specialty Board

Programme Directors of respective Specialty Boards will conduct random check of the trainee’s Logbook Summary and Logbook Summary Report against the operation data from the Hospital Authority.

Workplace Based Assessment (WBA)

During the training period, trainees are required to fulfil the requirements on Workplace Based Assessment (WBA) of their respective specialty before they are eligible for examination enrolment.

Please refer to the “Workplace Based Assessment for Higher Surgical Trainees” for further details.

Unsatisfactory Training Performance

Trainees who fail to meet the above requirements will be required to undertake further training. The Training Subcommittee & the respective Specialty Boards of CSHK will endorse the respective training period on condition that satisfactory assessment must be achieved. In the event that individual trainee who has been warned of the deficiencies during the 3-month mid-term assessment still performs unsatisfactorily at the end of the 6-month period, the respective Specialty Board may interview this trainee as well as the mentors whom the trainee has worked for in the unsatisfactory period. Below average assessment of performance in any 6-month period will constitute grounds for disqualification of that 6-month training period. The respective training period could only be recognized and registered on condition that satisfactory assessment must be achieved. Any trainees who do not satisfy the standards or have unsatisfactory assessments consecutively twice or non-consecutively three times will be disqualified from the training programme.

Appeal Procedures

Trainees can appeal to the Appeal Board of CSHK concerning disqualification. However, the notice of such appeal must be lodged with CSHK Secretariat within 21 days from the date of notice in writing of such disqualification to the trainee.

MANDATORY COURSES

During the training period, trainees are required to successfully complete mandatory courses stipulated in the training curriculum required by the respective specialty. Attendance at the courses must be recorded in the trainees’ logbooks. Trainees are also required to submit the Official Certificates of the mandatory courses as evidence for completion when they enrol to Joint Specialty Fellowship Examination of the respective specialty.

• For HST admitted before 1 July 2021, please refer to the “Mandatory Courses for Higher Surgical Trainees admitted before 1 July 2021” for further details.
• For HST admitted from 1 July 2021 onwards, please refer to the “Mandatory Courses for Higher Surgical Trainees admitted from 1 July 2021 onwards” for further details.

OPERATIONAL REQUIREMENTS

All higher trainees are required to fulfil certain number of major operations within their 4/5 years of higher training period before they can apply for the Fellowship of the respective specialty. A Flagging Criteria for monitoring Higher Training in General Surgery is being enforced. Higher Surgical Trainees should achieve the number of caseloads stipulated in the criteria posted in CSHK website.

For HSTs in General Surgery admitted from 1 July 2010 onwards, they are required to fulfil the abovementioned & the Index Operation Requirements during their higher training period and complete the form below before they can apply for Fellowship of CSHK:

· Index Operation Fulfilment Form

Please refer to the “Guidelines on Major Operation for HSTs” for further details.

RESEARCH REQUIREMENTS

Trainees are required to have at least two completed research projects approved by the Research Committee before they are eligible for examination enrolment. It is the responsibility of the trainee to submit the report early in order to allow enough time for review, revision and endorsement. Meeting of the Committee is only held twice a year. The Research Committee strongly advised trainees to complete the research requirements within their first two years of Higher Surgical Training.

Deadline for research reports submission is normally at the end of March or September each year. Announcement for submission deadline will be sent to higher surgical trainees via email. CSHK will not take any responsibility if any message delivered to the email address provided by a trainee cannot reach the trainee or the trainee fails to check email regularly.

Please refer to the “Guidance Notes for Research Requirements” for further details.

ORAL PRESENTATION / PUBLICATION REQUIREMENT

(For HST admitted between January 2018 - 30 June 2020)

Trainees are required to have at least one oral or poster presentation in the Annual Scientific Congress of the College before they are eligible for examination enrolment.

(For HST admitted from July 2020 onwards)

Trainees are required to fulfil one of the following oral presentation/publication requirements before they are eligible for examination enrolment:

a.     at least 1 oral presentation (case report is not acceptable) as the first author in the Annual Scientific Congress of the College, OR

b.     at least 2 poster presentations in the Annual Scientific Congress of the College, OR

c.     at least 1 full paper (not a case report) publication as the first author in Surgical Practice / other peer-reviewed indexed journals

CONTINUING MEDICAL EDUCATION (CME) PROGRAMME

CSHK undertakes CME administration for their trainees and reports their compliance to the Hong Kong Academy of Medicine.

Guidelines for Higher Surgical Trainees

·  Each CME cycle is one year.

·  The Cycle starts on 1 January or 1 July of every year.

·  A new cycle commences at the conclusion of the previous cycle.

· Trainees do not fulfil the CME requirements will constitute grounds for disqualification of the previous 6-month training period.

CME Points Allocation

1.    The CME system shall be based on the accrual of CME points.

2.    A minimum of 30 points per year is required and composes of the followings (i & ii):

i. A maximum accrued CME points for Category 1 per year is 20 points.

ii. A minimum accrued CME points for National/International Scientific Meetings of Category 2 per year is 10 points.

3.    Allocation of CME points from Category 1 and 2 are as below:

i.  Category 1

In-hospital Meetings

One CME point is awarded for each hour of in-hospital meeting.

Publication

For the purpose of CME/CPD points, only publications in fields related to surgery shall count.

·     A publication shall accrue CME/CPD points at the time the material is accepted for publication (letter of acceptance should be submitted for proof) or is published (reprints should be submitted).

·      A maximum of 10 CME/CPD points (active) may be awarded to thesis, books, chapters in books, original articles in Index Medicus listed journals or journals published by the HKAM or its constituent Colleges.

·      A maximum of 5 CME/CPD points (active) may be awarded to Short Communications (for example surgical technique, Letters to the Editor) in Index Medicus listed journals or journals published by the HKAM or its constituent Colleges.

· Publication of non-Index Medicus listed journals and those not published by the HKAM or its constituent Colleges might also be awarded with CME/CPD points, application and the points to be awarded would be subject to the approval of the CME/CPD committee and approval must be obtained from the CSHK prior to publication.

·      The same CME/CPD points (active) will be awarded to anyone of the individual authors in the publication as CME/CPD encourages involvement and it is by no means an academic assessment.

·       Abstracts that have been presented at a FCAPM will not be awarded with dual CME/CPD accreditation.

Research

·      A research activity/investigation studies shall accrue CME/CPD points at the time the project is completed with an output. Mandatory research project submitted by Higher Trainees within the four years of higher training will not be awarded with CME/CPD accreditation.

·      A maximum of 10 points (active) may be awarded per published paper with the submission of a copy of the paper.

·      A maximum of 5 points (active) may be awarded per poster with the submission of a copy of the output.

·      Studying in postgraduate degree could be considered accreditable on submission with the documentation proof. Points awarded will be determined from case to case.

ii. Category 2

National/International Scientific Meetings (Accrue a minimum of 10 points per year)

Conferences held outside the parent hospital. (e.g. the College’s Annual Scientific Meetings, local and overseas scientific meetings)

1.    Participation as Speaker/ Presenter: 6 CME points per presentation and up to 12 points for any one meeting.

2.    Participation as Moderator/ Chairman/ Panelist: 3 CME points per hour and up to 6 points for any one meeting.

3.    Participation as attendees: 1 CME point is awarded for each hour and up to a maximum of 6 points per day up to three day per meeting.

Documentation Proof

Each trainee is responsible to record his/her CME activities during the current training period. A CME Report Form can be obtained from CSHK to record the required information. Trainees must submit the completed form together with the Half-yearly Assessment Form every January and July to the respective Specialty Board through their Supervisor.

Please refer to the “CME Programme for Surgical Trainees” for further details.

OTHERS

Neurosurgery

For HSTs in Neurosurgery admitted from 1 July 2021 onwards, they are required to complete at least 15 Case Report Logbooks on the following themes before being eligible to enrol in the fellowship examination: Neuropathology, Neuroradiology, and Neurology (5/theme; 2 sides of A4)

Urology

1. Learning Points

For HSTs in Urology admitted from 1 January 2021 onwards, they are required to obtain 20 Learning Points per year from the online assessment (BJUI Knowledge) organised by the British Journal of Urology

International. Trainees who failed to achieve this requirement would not be able to proceed to next year’s training. Please refer to the link: https://bjuiknowledge.bjuinternational.com

2. Clinical Proctorship Records

For HSTs admitted before 1 January 2021

HSTs are required to submit a total of 6 Clinical Proctorship Records (one on each of the following procedure) to Urology Board for vetting:

• The minimum number of cases to be performed under proctoring are shown below:

The deadline for submission is on 1 April and 1 October every year. A reminder for the submission deadline will be sent to HSTs via email. CSHK will not take responsibility for the consequence if any message delivering to the email address which was provided by trainees cannot reach them or they fail to check their email regularly.

For HSTs admitted from 1 January 2021 onwards

HSTs are required to submit 6 Clinical Proctorship Records (one on each of the following procedure) with accurate records of patient identity (HN) and trainee’s role (assistant/chief with supervision/chief without direct supervision) to the College Secretariat per 6 months together with the half-yearly assessment:

• The minimum number of cases to be performed under proctoring are shown below:

^includes transperitoneal or retroperitoneoscopic laparoscopic radical prostatectomy, radical cystectomy, pelvic lymphadenectomy, total nephrectomy, partial

nephrectomy, nephroureterectomy, adrenalectomy, ureteral surgery but excludes robotic procedures

* including 1-2 cases performed for PBA

• Completion of the above is one of the requirements for the award of The Certificate of Competency in Endoscopic and Laparoscopic Skills in Urology, which is one of the eligibility criteria for application for Fellowship.