Curriculum

Transition to Discipline EPA's

​Surgical Foundations EPAs were updated in June 2021. The following information is for residents entering PGY1 from 2021 onward:

1.1 Pre-Op Preparation

Indirect observation by supervisor Collect 1 observation of achievement

1.2 Recognize Critically Ill

Direct observation by supervisor and review of clinic note Collect 2 observations of achievement

1.3 Documentation

Direct or indirect observation by supervisor with review of clinical documentation Collect 2 observations of achievement - At least 1 inpatient - At least 1 outpatient

1.4 Handover

Direct observation by supervisor Collect 2 observations of achievement

1.5 OR

Supervisor or delegate does assessment based on direct observation Collect 1 observation of achievement

1.6 Wound Closure

Direct observation by supervisor Collect 1 observation of achievement - Wound must be at least 5 cm long

1.7 Tubes | Drains | Lines

Indirect observation by supervisor Collect 1 observation of achievement

Foundations of Discipline EPA's 

2.1 Critically ill surgical

A – Patient Assessment – direct or indirect observation by supervisor. Collect 3 observations of achievement – at least 2 different presentations. 

B – Procedure – Direct observation by supervisor. Collect 4 observations of achievement. At least one tube thoracostomy, one surgical airway, at least one central venous line insertion.

2.2 Trauma

2 observations of achievement, 1 primary 1 secondary 

*Provide Naomi with your ATLS certification at downernk@mcmaster.ca 

2.3 Pre-Op Optimization

Direct or indirect observation by supervisor Collect 4 observations of achievement - At least one elective, one emergent - At least one high risk - At least one critically ill - At least 2 assessors. 

2.4 Consent

Direct observation by supervisor Collect 3 observations of achievement - At least 2 different assessors - At least one emergency procedure - At least one elective procedure - At least two in clinical setting. 

2.5 Fundamental Surgical Procedure 

A - Direct observation by supervisor Collect 4 observations of achievement - At least 2 by faculty - At least 2 different types of procedures - At least 2 different assessors. 

*B - Multiple observers provide feedback individually, which is then collated to one report for Competence Committee review Collect feedback from at least 6 observers. MSF - 2-5-B Guide

2.6 Surgical Procedures

Direct observation by supervisor in OR (minor surgery or emergency) Collect 4 observations of achievement - At least 2 by faculty - At least 2 different types of procedures - At least 2 different assessors

2.7 Post-op uncomplicated

A - Direct or indirect observation by supervisor Collect 8 observations of achievement - At least 2 from each stage of management - A range of hospital stays - A range of patient complexity - At least 4 different assessors. 

*B - Multiple observers from discharge planning team provide feedback individually, which is then collated to one report for Competence Committee review Collect feedback from at least 6 observers. MSF - 2-7-B-1 Guide

2.8 Post-Op Complications

Indirect observation by supervisor with review of clinic note Collect 8 observations of achievement - At least 4 different complications - At least 3 assessors. 

2.9 Supervising Juniors

Direct observation by supervisor and junior learners Collect 6 observations of achievement - At least 3 different junior learners - At least 3 different senior residents or faculty.