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FAQs - Hardship Modifications to Pediatric Surgery Training Requirements

While trainees are encouraged to strive to meet 100% of current training expectations with respect to length of training time, the Pediatric Surgery Board (PSB) 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 by the program.

In addition, the PSB 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.

In total, graduating fellows must have completed 92 weeks of training throughout the two years of fellowship (48 weeks for the first year of fellowship + 44 weeks for the second year of fellowship).

The Pediatric Surgery Board (PSB) will consider special requests for excused absences on a case-by-case basis from trainees who contract COVID-19 and miss training for an extended period due to severe coronavirus-related illness. Similarly, special requests for trainees who are excused from clinical care due to pregnancies and/or immunocompromised states will also be evaluated on a case-by-case basis.

These requests should be accompanied by an attestation of competence from the program director and the local Clinical Competency Committee. In some cases where competency is not clear, the trainee will not be eligible for graduation or registration for the PQE and will be required to extend their training.

For 2020, the graduating pediatric surgery fellow is required to have 720 cases in order to apply for the Pediatric Surgery Qualifying Exam (PQE). Graduating fellows who fall short of this minimum threshold for procedures may petition the PSB to grant credit for their final 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 PSB. Those whose requests are granted will receive credit for their accrued cases and be advanced to graduation and registration for the PQE. Those whose requests are not granted for any reason will not receive credit and must extend their training.

Note: Other possible evidence of competency may include higher than average Milestones ratings (4 or greater), documentation of clinic time, and SimPL scores, among others.

Minimum case requirements are not applicable in the 2019-20 academic year. However, minimum case requirements will be applicable to the 2021 graduating fellow to apply to the 2021 Pediatric Surgery Qualifying Exam (PQE).

These hardship modifications apply to pediatric surgery fellows 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 fellows currently in training.

Graduating fellows should promptly assess their educational and clinical experience critically. This assessment should utilize metrics available including milestone evaluations, case numbers, number of weeks in "clinical activity" (with the broader definitions), quality improvement projects, and clinic attendance, among others. Fellows should promptly approach their program directors and together, with Clinical Competency Committee input, honestly and critically evaluate the trainee’s knowledge, skills and abilities. The results of this systematic assessment should be used to create a focused plan to be enacted for the rest of the academic year.

At this time, the September 14, 2020 PQE will continue as planned. Candidates who choose to wait have the option to postpone and take it in 2021, as there are multiple opportunities to take and pass the PQE. If you choose to wait, please note that 2020 will be counted as a missed opportunity.

Likewise, the Spring 2021 PCE will continue as scheduled. If necessary, the PSB will reassess and make a determination at that time.


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