Discipline of Surgery


Programs - Postgraduate - General Surgery Residency Program


AN OVERVIEW OF THE PROGRAM

 
The overall philosophy of the General Surgery Residency Program at Memorial University is to provide exceptional training in clinical surgery for potential community surgeons while having enough flexibility to allow the development of a surgical scientist. This is a five-year CBD program fully accredited for training by the Royal College of Physicians and Surgeons of Canada. The current enrolment is 20 residents. Residents are supervised by a total of 22 full-time and part-time faculty members during their adult and pediatric general surgical tertiary care and community center core rotations, generally with one resident per surgical service (2-3 faculty members).

The goal of the program is to produce broadly-trained surgeons prepared to go to the community to practice. The rotations are designed to cover many different areas, and allow for extensive community training. Upon completion of training, a resident is expected to be a competent specialist in General Surgery capable of assuming a consultants role in General Surgery. The resident must acquire a thorough knowledge of the theoretical basis of General Surgery, including its foundations in the basic medical sciences and research.

All residents should be able to achieve the following by the end of their program:
  1. Knowledge and expertise in clinical and operative management of diseases of the alimentary tract, breast and endocrine systems, trauma and critical care, General Surgical Oncology and ambulatory patient care for General Surgery.
  2. Mastery of surgical skills of open cavitary surgery, endoscopy, minimal access surgery, endocrine surgery, breast surgery, trauma surgery and soft tissue surgery including abdominal wall surgery.
  3. Effective clinical judgement and decision making in dealing with general surgical problems based on sound surgical fundamentals.
  4. The requisite knowledge, skills, and attitudes for effective patient-centered care and service to a diverse population. In all aspects of specialist practice, the graduate must be able to address issues of gender, sexual orientation, age, culture, ethnicity and ethics in a professional manner.

All General Surgery residents are automatically enrolled in Surgical Foundations, which is a Royal College Competence By Design (CBD) program completed in the first 18-24 months of general surgery residency. You will complete this program along with first-year residents in orthopedics and obstetrics and gynecology.

All of the compulsory rotations except trauma and community surgery are in one of the two adult hospitals and the pediatric hospital in St. John's. Community rotations can be arranged in Carbonear, Clarenville, and Grand Falls-Windsor, NL, and Charlottetown, PEI. Other sites, including out-of-province sites, may be used if requested and approved. The trauma rotation is in the PGY 2 year at Sunnybrook Hospital in Toronto, Ont. and there are senior resident rotations in a community hospital in both the PGY 4 and PGY 5 years. 


CLINICAL ROTATIONS


YEAR ROTATIONS DURATION (4-week blocks) Location (Notes)
PGY1 Emergency 1 HSC or SCMH
General Surgery 3 HSC (ACS)
General Surgery 3 SCMH (Team A)
ICU 1 SCMH
Medicine 1 SCMH
Pediatric Surgery 1 JCHC
Thoracic Surgery 1 SCMH
Vascular Surgery 2 SCMH
PGY2 Clinics/Oncology 1 St. John’s
General Surgery 3 HSC (Team B)
ICU 2 HSC or SCMH
Plastic Surgery 2 HSC
Research 1 St. John’s
Trauma 1 Sunnybrook (TO)
General Surgery 3 HSC
PGY3 Endoscopy 3 SCMH
Pediatric Surgery 3 JCHC
General Surgery 3 HSC*
General Surgery 3 SCMH (Team A)
Elective 1 Resident’s choice
PGY4 Community Surgery ** 3 Rural NL or PEI
Elective 3 HSC (Team B)
Endoscopy 1 HSC or SCMH
General Surgery 3 HSC
Head and Neck 2 St. John’s
Research 1 Sunnybrook (TO)
PGY5 Community Surgery ** 3 Rural NL, or PEI
General Surgery 10 HSC or SCMH
 
NOTE:
Some rotations may take place at the Saint John Regional Hospital, Saint John, New Brunswick.

LEGEND:
HSC - General Hospital, Health Sciences Centre, St. John's, NL
JCHC - Janeway Children's Health and Rehabilitation Centre, Health Sciences Centre, St. John's, NL
SCMH - St. Clare's Mercy Hospital, St. John's, NL
TO - Toronto, Ontario (Sunnybrook Hospital)

* Elective Surgery

** Carbonear, NL; Clarenville, NL; Grand Falls – Windsor, NL; Charlottetown, PEI; other sites may be arranged, if requested.

The fifth and final year offers Chief Resident rotations in St. John’s and at community hospitals. As part of these, all Chief Residents should complete 50 scopes in their chief year and should attend one half day clinic per week; ideally, but not necessarily, seeing new patients.
 

GENERAL SURGERY RESIDENCY PROGRAM in CBD

(Adapted from: https://www.royalcollege.ca/rcsite/cbd/what-is-cbd-e)

Competence by Design (CBD) is the Royal College of Physicians and Surgeons of Canada’s major change initiative to reform the training of medical specialists in Canada. It is based on a global movement known as Competency-based medical education (CBME), and is led by the medical education community. The objective of CBD is to ensure physicians graduate with the competencies required to meet local health needs. It aims to enhance patient care by improving learning and assessment in residency.

CBD can be explained as:
  • Stages of training
  • Clear learning objectives
  • Residents observed
  • Observations documented
  • Committee Reviewed
  • Progress to the next stage
CBD is a hybrid CBME model designed to work within the Canadian context, and combines a time-based and an outcomes-based approach to learning. It reviews the design, implementation, assessment and evaluation of each specialty program across Canada’s 17 medical universities, using CanMEDS 2015 as an organizing framework of competencies.

In CBD, progression of competence occurs within a structured but flexible curriculum consisting of five core components. More specifically, in a competency-based approach, competencies required for practice form a framework and are accordingly organized into a progressive sequence. Promoting resident progression forms the basis for the design of all curricular elements: learning experiences that are tailored to the acquisition of competencies, instruction that is competency-focused and assessment that is programmatic in approach.

GENERAL SURGERY COMPETENCIES
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GENERAL SURGERY TRAINING EXPERIENCES
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OBJECTIVES OF TRAINING IN THE SPECIALTY OF GENERAL SURGERY
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