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Chapter 1: Introduction

1.1 Background and Overview

The Surgical Foundations academic-half-day occurs from 9am to 12 noon on Wednesday mornings.  Sessions mainly all take place in the same lecture theater (4E20) at the McMaster University Medical Centre (MUMC), however various venues are used.  There are either two 1.5-hour sessions or one 3-hour session each morning.

Wednesdays 9am to noon is protected teaching time and residents are to turn their pagers off during these hours. 

Sessions take the form of large and small group sessions, workshops or hands-on sessions.  The SF curriculum is comprised of SF type topics, clinical topics, research methodology sessions, and technical skill events.  The schedules can be found in chapter 7 of this manual. Please see Events Calendar for most up to date information.

Lectures and sessions are delivered by Faculty of the Department of Surgery, other Faculty at McMaster University, invited lecturers, fellows (surgical & other), senior residents and the PGY2 residents themselves (Resident-Led Series). 

Presentations, where available, are on the McMaster SF website for subsequent review and stored on the same website year over year. SF Live provides video archives of selected presentations within the curriculum for further reference.

1.2 Surgical Foundations Committee (SFC)

The SF Committee (SFC) is comprised of:

  • The SF Director
  • The program directors of subspecialties participating in Surgical Foundations, viz. Cardiac Surgery, General Surgery, Neurosurgery, Orthopedic Surgery, Otolaryngology/Head & Neck Surgery, Plastic Surgery, Urology, Vascular Surgery and Ob/Gyn
  • The president of the Resident Respresentative Group (RRG)
  • The vice president of the RRG
  • The PGY1 Representative of the RRG.
  • The SF Coordinator

The SFC meets regularly - a minimum of 4-6 times per academic year, roughly bi-monthly - and is involved in determining the course for Surgical Foundations, schedule planning & session coordination, and responding to difficulties that may arise systematically or episodically. Other members of the RRG, besides the president and vice president, are welcome to attend SF Committee meetings.

The SF Resident Representative Group (RRG)

The SF Resident Representative Group (RRG) is comprised of:

  • A resident representative (PGY2) from each of the following subspecialties: Cardiac Surgery, General Surgery, Neurosurgery, Orthopedic Surgery, Otolaryngology/Head & Neck Surgery, Plastic Surgery, Urology, Vascular Surgery and Ob/Gyn
  • A PGY1 Representative.
  • The SF Coordinator

Residents of the RRG are involved with SF schedule planning and coordinating of the SF sessions ie. lession plans, planning of session objectives and liaising with the session presenters and SF Coordinator. The Resident Representatives provide input and liaise with committee members regarding the organizational structure, functionality, educational objectives and content of SF.  Resident Representatives act as liaison between the SF Committee and the residents of Surgical Foundations. Resident Representatives act as liaison between SF and the corresponding subspecialty program director. 

The president of the RRG sits on the Residency Education Committee of the Department of Surgery.

1.3 Curriculum

The scope of Surgical Foundations is broad and includes five separate themes:

  • Surgical Foundations (SF) topics, including the Resident-led Series
  • Clinical topics in the surgical subspecialties, including the Emergency / 101 Series
  • Research methodology, the Surgical Research Methodology (SRM) Program
  • Technical/surgical skills
  • CanMEDS

SF topics

SF topics make up approximately 25-30% of the Surgical Foundations curriculum.  The SF topics are chosen by the SF Committee and Resident Representative Group, the choice being guided by the Royal College’s Objectives of Surgical Foundations Training document.  The PGY2 residents themselves present 8-10 sessions per year, in the Resident-Led Series (RLS).

Clinical topics

Clinical topics make up approximately 10% of the Surgical Foundations curriculum, and include the Emergency/101 Series eg. Plastics 101General Surgery Emergencies etc.  SF’s goal is to include at least one session per surgical sub-speciality per year or at minimum once in a 2-year cycle.  The session content is determined by the coordinating resident and the presenter.

Research

Surgical Foundations has a comprehensive research methodology curriculum, the Surgical Research Methodology (SRM) Program.  This comprises some 20% of the Surgical Foundations curriculum.  The SRM program is coordinated by the Surgical Research Methodology Program Director, Dr. Forough Farrokhyar, a non-physician PhD Epidemiologist, and is a two-year program.  The first year consists of a series of 12 modules covering various research design and implementation topics.  In the second year PGY2 residents plan and present a research proposal or project.  Critical appraisal skills education occurs within the context of the SRM program.

Technical skills

Surgical Foundations has a comprehensive technical skills curriculum making up approximately 30% of the SF curriculum.  The following skills are covered: suturing, vascular anastomosis, central line placement, chest tube insertion, emergency airways including tracheostomy, splinting for the ER, cadaveric and prosected anatomy sessions.

CanMEDS competencies

Surgical Foundations provides some formal training of the CanMEDS competencies eg. ethics,  professionalism, managerial/leadership, education & teaching skills etc.  

1.4 Attendance

Attendance at Surgical Foundations is mandatory for all PGY1 and PGY2 residents. SF has an attendance policy and attendance forms part of the resident evaluation and passing criteria for Surgical Foundations. A minimum attendance rate of 70% required, which allows a 30% yearly absence for vacation, attendance at conferences etc. Please see attendance policy for more details.

SURGICAL FOUNDATIONS ATTENDANCE POLICY

Program directors and residents are provided with quarterly progress reports. Poor attendance is flagged and addressed. Residents who do not meet the minimum attendance rate are required to meet with their program directors to discuss reasons for absence. The resident and the program director will together identify and seek to resolve any issues that might be barriers to attendance. If attendance criteria are continually not reached the resident will receive an unsatisfactory evaluation from Surgical Foundations and a remediation program will be instituted.

1.5 Evaluation

Residents are formally evaluated in four areas of Surgical Foundations:

Attendance: SF attendance is mandatory.  An attendance policy exists mandating a minimum 70% attendance rate. 

Technical Skills: SF hosts 10-12 technical skills events per academic year, 5 of which are evaluated.

Research: Scores from 12 research modules in PGY1 are averaged to give a final quiz score.  A research project is presented in PGY2.  Final quiz score and presentation score combined make the final research score.

Resident-led Session: Residents present a resident-led session in PGY2.  The session is evaluated by their peers.  Collated feedback from the evaluation forms serves as the evaluation for this component of SF.   

Minimum requirements exist for each area of evaluation and falling below this requirement will result in remediation. In the event that remediation becomes necessary, this will be discussed between SF Director, PD, and resident.  A remediation contract will be signed.  Please see evaluation document for more details of evaluation criteria and minimum requirements.

SF EVALUATION PASSING CRITERIA 

In addition residents’ level of participation, contribution and attitude are also monitored as a form of resident evaluation.

The SF Evaluation Summary Form / SF Exit Summary captures all evaluation data for the two years of Surgical Foundations and it provided to divisional program directors and residents quarterly and on exit from Surgical Foundations.

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