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FAQs - Hardship Modifications to Surgical Critical Care Training Requirements

While trainees are encouraged to strive to meet 100% of current training expectations with respect to length of training time, the Trauma, Burns and Surgical Critical Care Board (TBSCCB) 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 TBSCCB 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.

Graduating fellows who fall short of this minimum threshold for training time may petition the TBSCCB to grant credit for the 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 TBSCCB. Those whose requests are granted will receive credit for their accrued cases and be advanced to graduation and registration for the SCC CE. Those whose requests are not granted for any reason will not receive credit and must extend their training.

The Trauma, Burns and Surgical Critical Care Board (TBSCCB) 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 Surgical Critical Care Certifying Exam (SCC CE) and will be required to extend their training.

The Trauma, Burns and Surgical Critical Care Board (TBSCCB) has made the assumptions that; (1) some volume of trauma and surgical emergencies needing critical care will continue to occur; and (2) SCC fellows may be asked to help care for critically ill COVID patients or care for non-COVID “medical” ICU patients to off-load the COVID team.

We believe that most SCC fellows should be able to meet the case volume minimums despite these limitations, so case volume allowances will not be made for the 2019-20 academic year.

Graduating fellows who fall short of this minimum threshold for procedures may petition the TBSCCB to grant credit for the 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 TBSCCB. Those whose requests are granted will receive credit for their accrued cases and be advanced to graduation and registration for the SCC CE. 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.

These hardship modifications apply to surgical critical care 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.

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 SCC CE 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 SCC CE. If you choose to wait, please note that 2020 will be counted as a missed opportunity.


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