Program Description
The Surgical Foundations Program provides surgical residents from the 9 primary surgical specialties with the knowledge and skills needed to allow residents to excel as a senior surgical resident and as a practicing surgeon. It is part of the Royal College Competence by Design framework and runs along with residents completing their Transition to Discipline and Foundations of Discipline stages of training. This is typically within the first 2 years of surgical training. The UBC Surgical Foundations Program runs in parallel with a resident’s primary specialty. The program is delivered through a combination of didactic teaching sessions (monthly academic half days), the mini-CRASH course (OSCE and technical skill based training), and the month-long CRASH course described in detail below.
Application & Eligibility
All residents in the 9 primary surgical specialties (Cardiac Surgery, General Surgery, Neurosurgery, Orthopedics, Otolaryngology, Obstetrics and Gynecology, Plastic Surgery, Urology and Vascular Surgery) are automatically enrolled in Surgical Foundations.
Program & Curriculum Information
The Surgical Foundations program is composed of a seminar based instructional component, mini-CRASH, CRASH, and examination preparation. Attendance and completion of these segments is mandatory to the successful completion of the Surgical Foundations Program.
Seminars
Academic seminars are hosted during the first Wednesday of every month taking place over the course of a morning (08:15 – 12:15). Attendance at these academic half-days is mandatory and forms the primary component of the didactic educational program. All pertinent Surgical Foundations content as outlined by the Royal College will be covered during academic seminars for year 1 Foundations residents. Year 2 Foundations residents will cover content review and examination prior to the Surgical Foundations Examination in the Fall.
Mini-CRASH
Mini CRASH comprises OSCEs, simulation and technical skills learning days on 3 Wednesdays in July. The OSCEs involve common clinical situations involving the spectrum of CanMEDS competencies and are designed to provide a framework and approach to frequently encountered clinical problems for surgical residents. There are 24 OSCEs in total (8 each day). The simulation and skills labs involve hands on training in suturing, foley catheter insertion, airway management, and vascular access (arterial lines and central lines). At the end of mini-CRASH residents will be expected to have the foundational tools necessary to thrive in a clinical setting.
CRASH Course – Block 4
All surgical foundations PGY1 residents are enrolled in the CRASH (Surgical Competencies in Resuscitation and Stabilization of Hospital Patients) Course which takes place in Block 4. Included in this block is the ATLS (Advanced Trauma Life Support) course and the FCCS (Fundamentals of Critical Care Support) course designed to supplement and enhance your clinical encounters with patients.
Objective:
The Surgical CRASH Course is a modular 1-month curriculum that emphasizes key cognitive and technical competencies in caring for unstable surgical patients. Residents are relieved from clinical duties during CRASH.
Overview:
The CRASH Course will include in-depth comprehension of essential scientific literature, critical appraisal skills, fluency in resuscitation, algorithms on trauma and critical care, familiarity with technical aspects of resuscitation, and effective communication and management skills in high intensity situations. All aspects of the CRASH Course including quality and value of the curriculum and resident performance are rigorously evaluated, and the curriculum is continuously improved to meet educational needs. By the end of this course residents will have obtained formal certification in the ATLS program and the FCCS program.
The CRASH course will involve multiple didactic and hands on sessions, including technical skills training in trauma with live animal labs, a teambuilding workshop at UBC (ropes course), suturing sessions, communications skills training, and a wellness retreat.
Residents will be excused from regular service activities but will still have nominal call responsibilities (which will allow immediate application and reinforcement of acquired competencies). Call will preferably be taken on Friday nights or Saturdays.
Assessment:
Residents will be assessed by both EPAs as part of the Competence by Design Framework and also by an OSCE examination at the end of the program. Successful completion of ATLS will require completion of both a written and oral examination during training.
Exams
Royal College Surgical Foundations Exam
The Royal College Surgical Foundations examination is the cornerstone of the Surgical Foundations training program and is mandated for completion of both the Surgical Foundations program as well as to be eligible to write the final Royal College examinations for each of the respective surgical specialties. Much of the UBC Surgical Foundations academic program is designed to help prepare residents for successful completion of this examination.
The Royal College Surgical Foundations examination is written in the fall of the resident’s second year of training. It is a 2-day written examination involving approximately 125 – 150 multiple choice questions each day. A combined score of at least 70% is required to pass the Surgical Foundations examination. The written examination is based completely on the Royal College objectives for training.
Competence by Design
The UBC Surgical Foundations program is a special program within Competence by Design through the Royal College of Physicians and Surgeons of Canada. Successful completion of Surgical Foundations also mandates completion of Entrustable Professional Activities (EPAs) which are separate from those of the home surgical program for the resident. The UBC Surgical Foundations Program is designed to facilitate residents achieving these EPAs from within the delivered curriculum during mini-CRASH and CRASH, though some may be required in a resident’s home program during clinical rotations. Residents must successfully complete the Competence by Design component and the required EPAs to progress to the Core of Discipline stage of their training. Progress and Promotions are overseen by an independent Surgical Foundations Competence Committee and Residency Education Committee.