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2021 Hardship Modifications to Pediatric Surgery Training Requirements

Please see below for a list of hardship modifications and accompanying FAQs for 2021 graduating pediatric surgery fellows. Unless noted otherwise, these hardship modifications apply to individuals completing training in 2021 only.

Hardship Modifications

  • 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 total, graduating fellows must have completed 92 weeks of training throughout the two years of fellowship.
  • For 2021, the graduating pediatric surgery fellow is required to have 720 cases in order to apply for the Pediatric Surgery Qualifying Exam (PQE). Those who fall short of this minimum threshold may petition the Pediatric Surgery Board of the ABS (PSB) to grant credit for their final year.
  • Minimum case requirements are applicable to the 2021 graduating fellow applying to the 2021 PQE. If the fellow does not meet any of the case minimums, the fellow should petition the PSB as part of the application for the PQE. A letter of support from the program director should accompany the petition. The PSB will consider each petition on a case-by-case basis.

    PSB-ABS MINIMUM CASE REQUIREMENTS:
    - Abdominal - 120
    - Thoracic - 50
    - Trauma Critical Care - 20 operative, 90 non-operative
    - Oncology - 25
    - Head and Neck/Endocrine/GU/Anorectal - 50
    - Endoscopy - 30
    - TA - 50 minimum (common cases); maximum 100 cases

  • Program directors are entrusted, as they always are, to make a decision about the readiness of the trainee for independent practice. If a trainee falls below the minimum thresholds for cases or training time, and the program director nevertheless endorses them as ready for independent practice, the PSB will seek a more detailed supporting statement. This might include information from the CCC, milestones achievements, entrustment through EPAs, ITE scores, evidence of leadership during this crisis, or other information.
  • Trainees should assess their own progress towards the standard requirements in terms of rotations, cases, and specialty-specific requirements. Trainees should make a remediation proposal for gaps, and share with their PDs.

FAQs

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 total, graduating fellows must have completed 92 weeks of training throughout the two years 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 2021, 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 applicable to the 2021 graduating fellow to apply to the 2021 Pediatric Surgery Qualifying Exam (PQE). If the fellow does not meet any of the case minimums, the fellow should petition the PSB as part of the application for the PQE. A letter of support from the program director should accompany the petition. The PSB will consider each petition on a case-by-case basis.

PSB-ABS MINIMUM CASE REQUIREMENTS:

  • Abdominal - 120
  • Thoracic - 50
  • Trauma Critical Care - 20 operative, 90 non-operative
  • Oncology - 25
  • Head and Neck/Endocrine/GU/Anorectal - 50
  • Endoscopy - 30
  • TA - 50 minimum (common cases); maximum 100 cases
These hardship modifications apply to pediatric surgery fellows graduating in 2021 only.

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.


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