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FAQs - Hardship Modifications to General Surgery Training Requirements

While residents are encouraged to strive to meet 100% of current training expectations with respect to length of training time, the General Surgery Board (GSB) understands the nature of the impact that the COVID-19 pandemic has had on surgical training. To this effect, any non-voluntary offsite time that is used for clinical or educational purposes can be counted as clinical time. The types of activities done in this time should be documented.

In addition, the GSB will accept 44 weeks of clinical time (including the non-voluntary time) for the 2019-20 academic year, without the need for pre-approval, permission or explanation. This represents approximately a 10% decrease in time requirements.

Residents in extremely extenuating circumstances who do not complete 44 weeks of training, but complete at least 40 weeks of training in the affected academic year, may petition the GSB to grant credit for the academic year, provided that they have letters of support from their program director and chair of their clinical competency committee citing an achievement of sufficient milestones and other hallmarks of adequate preparedness despite these limitations. Those whose requests are granted will receive credit for the affected academic year. Those whose requests are not granted for any reason will not receive credit and may not advance in training or complete training without extending their training.

Residents who do not complete at least 40 weeks of training in the affected academic year will not be eligible for promotion or graduation and will be required to extend their training no matter the circumstance.

While graduating residents are encouraged to make their best attempt to meet 100% of case volume requirements, the General Surgery Board (GSB) understands the nature of the impact that the COVID-19 pandemic has had on surgical training. To this effect, the GSB will accept a 10% decrease in total cases, or 765 cases, without the need for further documentation.

This means that, while all chief residents are encouraged to complete the requisite 850 cases during their training, the GSB will make an allowance for chief residents who complete 90%, (765 cases) as a minimum threshold. Residents who have completed at least 765 procedures in total will not need approval from the GSB to complete training and register for the General Surgery Qualifying Exam (GQE), provided that they are compliant with other existing criteria.

Further, the GSB is making the allowance that chief residents will be assessed on their total case volume at this time, not on the separate requirement of having logged 200 cases specifically as chief. Chief residents are encouraged to pursue chief-level cases whenever possible, but at this time, there will be no minimum threshold for chief year cases.

The GSB is making the additional allowances that there will be no required minimum number of surgical critical care or teaching assistant cases at this time.

This means that chief residents who report at least 765 cases in the aggregate of their training experience who have the support of their program director and Clinical Competency Committee, and meet the other standard criteria or published allowances, will be considered to have met their training requirements and will be allowed to complete their training on time and register for the GQE.

Chief residents who fall short of this minimum threshold for procedures but who have at least 80% of the traditionally required cases, 680 procedures, may petition the GSB to grant credit for their chief year, provided that they have letters of support from their program director and chair of their Clinical Competency Committee, and their overall application is acceptable to the GSB. Those whose requests are granted will receive credit for their accrued cases and be advanced to graduation and registration for the GQE. Those whose requests are not granted for any reason will not receive credit and must extend their training.

Chief residents who do not log at least 680 procedures in total throughout their residency training period will not be eligible for graduation or registration for the GQE and will be required to extend their training no matter the circumstance.

Applicants are still required to have had at least 6 operative performance assessments and 6 clinical performance assessments conducted by their program director or other faculty members, as outlined in our Training Requirements. As a reminder, these assessments will not be collected; when approving an individual's application, the program director will be asked to attest that these 12 assessments have been completed.

The General Surgery Board (GSB) encourages residents to collect the required 250 case experience before beginning the PGY-3 level of training whenever possible. However, understanding the nature of the impact that the COVID-19 pandemic is having on surgical training, the GSB will allow residents who fall short of that case volume to progress into their PGY-3 experience with the expectation that they will have logged a minimum of 250 procedures within 6 months of starting the PGY-3 program. Residents affected by this circumstance must review the trajectory of their operative experience with the program director and propose a plan to reach the intended case volume target of 250 procedures. Those who do not meet this flexible allowance in the required number of cases by this time will be required to complete an additional year of training.
With the exception of the 250-case requirement for residents beginning PGY-3 as outlined in FAQ #3 above, these hardship modifications apply to general surgery residents graduating in 2020 only. As we begin to understand the impact of COVID-19 and the tools, options, and situational changes employed during this time, we will be better positioned to make recommendations for the future trainees. We fully expect to recognize the impact of the pandemic for all residents currently in training.
Provided that Pearson VUE testing centers will be open by July 16, 2020, the General Surgery Board (GSB) will offer the 2020 GQE as planned, and those who feel prepared can sit for the exam. Candidates who feel that they will be unprepared and want to wait have the option to postpone and take it in 2021, as there are 4 opportunities in 4 years to take and pass the GQE. If you choose to wait, please note that 2020 will be counted as a missed opportunity.

The General Surgery Board (GSB) will permit those who have been affected by the cancellation of FLS and FES exams to apply for and take the GQE without these certifications by the posted deadlines. However, if successful on the GQE, candidates will be required to provide documentation of both FLS and FES certification in order to register for the General Surgery Certifying Exam.

Current ATLS certification is not required in order to register for the GQE; residents must only provide documentation of past certification.

For residents who have not yet taken ATLS and are unable to find a course prior to the GQE application deadline, ABS will work with ATLS staff to develop a list of residents who are unable to attend an ATLS course during the necessary time period.

ATLS staff will grant access to the Learning Management System online ATLS modules, which represent the didactic portion of the current ATLS course. Residents will be required to complete these modules prior to application for the GQE.

However, if successful on the GQE, candidates will be required to attend an ATLS course to complete the Skills Training and testing portions of the course and provide documentation of ATLS certification in order to register for the General Surgery Certifying Exam.


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