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Training > HST / EEC > Introduction to Higher Surgical Training |
Admission to Ordinary Membership
Entry for Higher Surgical Training
Training Requirments
Supervision of Higher Surgical Training
Hospitals with Approved Programmes for Higher Surgical Training Clinical Attachment Programme(CAP)for Examination Eligible Candidate(EEC)
Admission to Fellowship
Admission to Ordinary Membership
ELIGIBILIY FOR APPLYING FOR THE ORDINARY MEMBERSHIP
To be eligible for applying for the Ordinary Membership of the College of Surgeons of Hong Kong(MCSHK), applicants must fulfill the following requirements:
- One must be fully registered with the Medical Council of Hong Kong
- One must complete two years of Basic Surgical Training of the Hong Kong Intercollegiate Board of Surgical Colleges(HKICBSC) with satisfactory training performance and proper rotations as prescribed in the Basic Surgical Training Curriculum
- One must have passed the Membership Examination of HKICBSC(MHKICBSC Examination) held in Hong Kong
- One must have completed satisfactorily all mandatory courses prescribed in the basic training programme
- One’s application must be proposed and seconded by two paid-up College Fellows
Please refer to the “Eligibility for Ordinary Membership” for further details.
APPLICATION
Upon completion of Basic Surgical Training and passing all parts of the Membership Examination of the Hong Kong Intercollegiate Board of Surgical Colleges (MHKICBSC Examination), trainees must apply for Ordinary Membership of the College of Surgeons of Hong Kong(CSHK) before they can enter into Higher Surgical Training.
ANNUAL SUBSCRIPTION FEE
Ordinary Members are required to make payment of their subscription fee annually. A surcharge of 5% will be levied for any late payment after 30th June of the subscription year. By the end of January of the current year, if any ordinary member fails to pay his/her annual subscription fee of the preceding year as well as the overdue surcharge(5% of the subscription fee), his/her name shall be removed from the College Register.
Please refer to the “Policy on Annual Subscription” for further details.
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Entry for Higher Surgical Training
Higher Surgical Training in the six surgical specialties (namely General Surgery, Urology, Neurosurgery, Paediatric Surgery, Cardiothoracic Surgery and Plastic Surgery) is under the auspices of the respective Specialty Boards of CSHK.
ELIGIBILIY FOR ADMISSION TO HIGHER SURGICAL TRAINING
To enter Higher Surgical Training Programme of CSHK, trainees must fulfill the following requirements:
- One must be fully registered with the Medical Council of Hong Kong
- One must obtain the Ordinary Membership of CSHK
- One must have passed the Conjoint Selection Exercise of Higher Surgical Trainees held by the Hospital Authority(HA) of Hong Kong and CSHK(Please refer to the website of HA: http://www.ha.org.hk/visitor/ha_visitor_index.asp?Content_ID=1237&Dimension=100&Lang=ENG)
- One must obtain a Higher Surgical Training post from an approved training units/institutions in Hong Kong
REGISTRATION DEADLINE
A register of Higher Surgical Trainees is maintained at CSHK Secretariat. Higher Surgical Trainees must register with CSHK within the first month of their higher surgical training. Failure to register in time will render the respective training period NOT recognized.
ANNUAL REGISTRATION FEE
Registration, which includes an annual registration fee, is applicable to all higher surgical trainees until they completed their higher surgical training.
Effective from 1 January 2012, trainees are required to make payment of their annual registration fee within the first month of the year, i.e. before 31st January. A surcharge of 100% will be levied for any late payment after the first month of the year. Those who still fail to settle the outstanding fee within the first three months of the year, i.e. before 31st March, will be removed from the College Register.
Only paid-up Higher Surgical Trainees are allowed to take the Fellowship Examination conducted by CSHK.
Please refer to the “Policy on Annual Subscription” for further details.
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Trainees in Higher Surgical Training will follow a structured programme of training and assessment laid down by CSHK. There are six specialties in Surgery, which CSHK recognizes to be so distinct and independent of each other in terms of training that independent training programmes are recommended. These specialties are:
- Cardiothoracic Surgery
- General Surgery
- Neurosurgery
- Paediatric Surgery
- Plastic Surgery
- Urology
All six specialties in Surgery have the same basic surgical training in Surgery and its related specialties for at least 2 years. At the end of the basic training, trainees have to pass the MHKICBSC Examination in Hong Kong before entry into Higher Surgical Training which can be one of the following
- Cardiothoracic Surgery
Training Duration : 5 years
Candidates can take the Joint Specialty Fellowship Examination with the Royal College of Surgeons of Edinburgh after the completion of 4 years of accredited higher training, but they must complete 5 years of training.
- General Surgery
Training Duration : 4 years
Trainees can take the Joint Specialty Fellowship Examination with the Royal College of Surgeons of Edinburgh after the completion of 3.5 years of accredited higher training, but they must complete 4 years of training.
- Neurosurgery
Training Duration : 5 years
Trainees can take the Joint Specialty Fellowship Examination with the Royal College of Surgeons of Edinburgh after the completion of 4 years of accredited higher training, but they must complete 5 years of training.
- Paediatric Surgery
Training Duration : 4 years
Trainees can take the Joint Specialty Fellowship Examination with the Royal College of Surgeons of Edinburgh after the completion of 3.5 years of accredited higher training, but they must complete 4 years of training.
- Plastic Surgery
Training Duration : 4 years
Trainees can take the Fellowship Examination conducted by the College of Surgeons of Hong Kong after the completion of 3.5 years of accredited higher training, but they must complete 4 years of training.
- Urology
Training Duration : 4 years
Trainees can take the Joint Specialty Fellowship Examination with the Royal College of Surgeons of Edinburgh after the completion of 3.5 years of accredited higher training, but they must complete 4 years of training.
Rotational Requirements
Trainees are required to meet the following rotational requirements prescribed by the respective Specialty during their higher surgical training:
Cardiothoracic Surgery
(1) All trainees should be rotated out of their parent training centre for a minimum of one year out of the required training period.
(2) Unless otherwise specified, the minimum period of each rotation out of the parent centre should be 6 months.
(3) All trainees working in their parent training centre should be rotated between different trainers every 6 monthly.
(4) Each trainee should be exposed to at least 4 different trainers in the higher surgical training.
General Surgery
(1) All trainees should be rotated out of their parent training centre for a minimum of one year out of the required training period.
(2) Unless otherwise specified, the minimum period of each rotation out of the parent centre should be 6 months.
(3) All trainees working in their parent training centre should be rotated between different trainers every 6 monthly.
(4) Each trainee should be exposed to at least 4 different trainers in the higher surgical training.
Neurosurgery
(1) All trainees should be rotated out of their parent training centre for a minimum of one year out of the required training period.
(2) Unless otherwise specified, the minimum period of each rotation out of the parent centre should be 6 months.
(3) All trainees working in their parent training centre should be rotated between different trainers every 6 monthly.
(4) Each trainee should be exposed to at least 4 different trainers in the higher surgical training.
Paediatric Surgery
(1) All trainees should be rotated out of their parent training centre for a minimum of one year out of the required training period.
(2) Unless otherwise specified, the minimum period of each rotation out of the parent centre should be 6 months.
(3) All trainees working in their parent training centre should be rotated between different trainers every 6 monthly.
(4) Each trainee should be exposed to at least 4 different trainers in the higher surgical training.
Plastic Surgery
(1) All trainees should be rotated out of their parent training centre for a minimum of one year out of the required training period.
(2) Unless otherwise specified, the minimum period of each rotation out of the parent centre should be 6 months.
(3) All trainees working in their parent training centre should be rotated between different trainers every 6 monthly.
(4) Each trainee should be exposed to at least 4 different trainers in the higher surgical training.
(5) Each trainee should be exposed to a mandatory 3 months hand surgery rotation.
(6) Each trainee should be exposed to a 12-session attachment on cosmetic surgery in the fourth year of higher surgical training.
Urology
(1) All trainees should be rotated out of their parent training centre for a minimum of one year out of the required training period.
(2) Unless otherwise specified, the minimum period of each rotation out of the parent centre should be 6 months.
(3) All trainees working in their parent training centre should be rotated between different trainers every 6 monthly.
(4) Each trainee should be exposed to at least 4 different trainers in the higher surgical training.
(5) Each trainee should not exceed 2 years of training in succession in any one centre.
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Supervision of Higher Surgical Training
The responsibility for accreditation and recommendation for approval by the Council of CSHK is vested jointly by the Education & Examination Committee and the Specialty Boards. All trainees embarking on Higher Surgical Training must obtain a Logbook which could be purchased from CSHK Secretariat:
The Logbook provides information on:
- Operation Statistics
- Range
- Emergency Content
- Supervised Experience
- Unsupervised Experience
- Minor Surgery
- Endoscopy
- Record of Complication and Death
- Summary
- Academic Activities
- Research
- Publications
- Presentation at Meetings
- Attendance at Courses, e.g. Workshops and Seminar
In-training Assessment
On-going in-training assessment is required throughout the Higher Surgical Training period. Trainees must maintain a logbook for their operative experience until the completion of their higher training. They must keep a logbook prospectively recording all their training experience. During the training period, trainees must obtain satisfactory assessments from their supervisors and copies of these assessments must be filed in the trainees’ logbooks and recorded by the respective Specialty Board & CSHK. The logbook is required to be provided for inspection during the Joint Specialty Fellowship Examination.
Individual trainee’s Logbook should be reviewed regularly
- 3 monthly (Mid-term assessment) by mentor
- 6 monthly (Half-yearly assessment) by (i) Supervisors / (ii) The respective Specialty Board
ASSESSMENT
Mid-term Assessment
On completion of every 3-month training period, an interim face to face assessment between the mentor and the trainee should be carried out to thrash out any problems. During this interim debriefing assessment process, if serious deficiencies are evident, the mentor has to report in writing to the Chairman of the respective Specialty Board. The trainee should be advised what measures are required to reverse these deficiencies.
Half-yearly Assessment
On completion of every 6-month training period, every trainee in all specialties (except General Surgery) must submit the assessment documentation on or before 21st January or 21st July. The deadline will be automatically extended to the next working day if that day falls on Saturday or public holiday. For those in General Surgery, they are required to submit the documentation to the Training Subcommittee of CSHK via their supervisor regularly in January and July every year for recognition of the respective period. Deadline for submission of half-yearly assessment documentation falls on the date of Training Subcommittee meeting. Late submission of the half-yearly assessment documentation will render the respective training period NOT recognized.
The assessment documentation should include the following:
- Logbook Summary Report
- Logbook Summary
- CME Report
- Two Mentors Assessment Forms for assessing his/her performance in the past 6-month training period. Two mentors who must be delegated or designated by the supervisor of the training hospital should complete these forms.
- Research Reports(if any)
It is the obligation of Higher Surgical Trainees to submit the above requisite documentation through their supervisors/trainers for vetting regularly semi-annually by
- Training Subcommittee (for Higher Trainees in General Surgery)
- The respective Specialty Board
Unsatisfactory Training Performance
Trainees who fail to meet the above requirements will be required to undertake further training. The Training Subcommittee & the respective Specialty Boards of CSHK will endorse the respective training period on condition that satisfactory assessment must be achieved. In the event that individual trainee who has been warned of the deficiencies during the 3-month mid-term assessment still performs unsatisfactory at the end of the 6-month period, the respective Specialty Board may interview this trainee as well as the mentors whom the trainee has worked for in the unsatisfactory period. Below average assessment of performance in any 6-month period will constitute grounds for disqualification of that 6-month training period. The respective training period could only be recognized and registered on condition that satisfactory assessment must be achieved. Any trainees who do not satisfy the standards set by or have unsatisfactory assessments consecutively twice or non-consecutively three times will be disqualified from the training programme.
Appeal Procedures
Trainees can appeal to the Appeal Board of CSHK concerning disqualification. However, the notice of such appeal must be lodged with CSHK Secretariat within 21 days from the date of notice in writing of such disqualification to the trainee.
MANDATORY COURSES
During the training period, trainees admitted from 1 July 2010 onwards are required to successfully complete mandatory courses stipulated in the training curriculum required by the respective specialty. Please refer to the "Mandatory Courses for Higher Surgical Trainee" for further details. Attendance at the courses must be recorded in the trainees’ logbooks. Trainees are also required to submit the Certificates of Attendance of the mandatory courses as evidence for completion when they enroll to Joint Specialty Fellowship Examination of the respective specialty.
OPERATIONAL REQUIREMENTS
All higher trainees are required to fulfill certain number of major operations within their 4/5 years of higher training period before they can apply for the Fellowship of the respective specialty. A Flagging Criteria for monitoring Higher Training in General Surgery is being enforced. Higher Surgical Trainees should have the ability to achieve the number/percentage of caseloads stipulated in the criteria which is available from CSHK website.
For HSTs in General Surgery admitted from 1 July 2010 onwards, they are required to fulfill the abovementioned & the Index Operation Requirements during their higher training period and complete the form below before they can apply for Fellowship of CSHK:
Index Operation Fulfillment Form
Please refer to the “Guidelines on Major Operation for HSTs” for further details.
RESEARCH REQUIREMENTS
Trainees are required to complete two research reports before they can sit for the Joint Specialty Fellowship Examination. Those who submitted their progress report are not regarded as a completed one even though their report is approved by the Research Committee. Its meeting is only held twice a year. The Research Committee strongly advised trainees to complete the research requirements within their first two years of Higher Surgical Training.
Deadline for research reports submission is normally at the end of March or September every year. Announcement for submission deadline will be sent to higher surgical trainees via email. CSHK will not take any responsibility of the consequence if any message delivering to the email address which was provided by trainees cannot reach them or they fail to check their email regularly.
Please refer to the “Guidance Notes for Research Requirements” for further details.
Continuing Medical Education (CME) Programme
CSHK undertakes CME administration for their trainees and reports their compliance to the Hong Kong Academy of Medicine.
Guidelines for Higher Surgical Trainees
- Each CME cycle is one year.
- The Cycle starts on 1 January or 1 July of every year.
- A new cycle commences at the conclusion of the previous cycle.
- Trainees do not fulfill the CME requirements will constitute grounds for disqualification of the previous 6-month training period.
CME Points Allocation
1. The CME system shall be based on the accrual of CME points.
2. A minimum of 30 points per year is required and composes of the followings:
-
Category 1
In-hospital Meetings
One CME point is awarded for each hour of in-hospital meeting and no more than 20 points can be awarded per year. -
Category 2
National/International Scientific Meetings
A minimum of 10 points per year should be accrued from these conferences held outside the parent hospital. (e.g. CSHK’s Annual Scientific Meetings, local and overseas scientific meetings) - Participation as Speaker/ Presenter
- 6 CME points per presentation and up to 12 points for any one meeting.
- Participation as Speaker/ Presenter
- 6 CME points per presentation and up to 12 points for any one meeting.
- Participation as attendees
- 1 CME point is awarded for each hour and up to a maximum of 6 points per day up to three day per meeting.
Documentation Proof
Each trainee is responsible to record his/her CME activities during the current training period. A CME Report Form can be obtained from CSHK to record the required information. Trainees must submit the completed form together with the Half-yearly Assessment Form every January and July to the respective Specialty Board through their Supervisor.
Please refer to the “CME Programme for Surgical Trainees” for further details.
Interrupted Training
Higher Surgical Training may be interrupted for rotating to a non-recognized training center or other reasons for a maximum of 6 months. Trainees may apply for interruption from the continuous training programmes for a maximum of 6 months provided that pre-approval from the respective Specialty Board & the Education & Examination Committee of CSHK was obtained beforehand.
Interruption of training longer than 1 month out of 6-month rotation can be granted only if trainees can provide good reasons such as sick leave, etc. Under such circumstances, the actual period of satisfactory training within that 6-month assessment can be counted provided the interruption is pre-approved and the performance of training is up to the satisfaction of mentors.
Pre-approval from the Education & Examination Committee of CSHK is required if higher training is interrupted for more than 1 month. Trainees will be required to compensate the stipulated training requirements if there is more than 1 month discontinuity of Higher Surgical Training. Only under exceptional conditions (e.g. health, family or personal reasons), the interruption period can be longer than 6 months.
For any reasons of interruption of training, pre-approval is required. Trainees with pre-approved interruption of training longer than 1 year are not only required to make up the deficit but also do remedial training in additional to their normal period of training programme. However, for those who fail to obtain pre-approval from the Committee will constitute grounds for disqualification from the training programme. Trainees are required to start over their higher surgical training and re-apply for the Conjoint Selection Exercise, which is jointly organized by CSHK & Hospital Authority.
Trainees are allowed to have their training interrupted for the purpose of doing research study only when such application is pre-approved by the Education & Examination Committee and the length of interruption is up to 1 year.
Trainees are not allowed to have their training interrupted within 6 months prior to examination.
Such application is reviewed by the Education & Examination Committee of CSHK on case by case basis. The final decision is subject to the discretion of the Education & Examination Committee of CSHK.
Retrospective Recognition Of Local Training & Overseas Qualification
CSHK will NOT accept application for retrospective recognition of local or overseas qualification. All applicants are required to enter the training programme in Hong Kong from Basic Surgical Training.
Withdrawal From Higher Surgical Training
Trainees are required to write to the Censor-in-Chief of CSHK if they wish to withdraw from Higher Surgical Training.
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Hospitals with Approved Programmes for Higher Surgical Training
The followings are the recognized training centers in various specialties for Higher Surgical Training:
Specialty |
Hospitals |
| Cardiothoracic Surgery |
Queen Mary Hospital |
| Paediatric Surgery |
Prince of Wales Hospital / Princess Margaret Hospital / Pok Oi Hospital / Tuen Mun Hospital / North District Hospital / Alice Ho Miu Ling Nethersole Hospital |
| Neurosurgery |
Kwong Wah Hospital |
| General Surgery |
Caritas Medical Centre |
| Plastic Surgery |
Kwong Wah Hospital / Queen Elizabeth Hospital |
| Urology |
Pamela Youde Nethersole Eastern Hospital |
In collaboration with the RCSEd for the accreditation of mainland training centres, the following mainland centres’ Higher Surgical Training Programmes were accredited by CSHK and RCSEd:
Specialty |
Hospitals |
| General Surgery |
Peking Union Medical College Hospital 北京协和医院 |
| Urology |
West China Hospital of Sichuan University四川大學華西醫院 |
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Clinical Attachment Programme (CAP) for Examination Eligible Candidate (EEC)
Those who have fulfilled all the training requirements including the duration of training, operational requirements and mandatory course requirements but not yet passed the required examination will fall into the category of Examination Eligible Candidate (EEC). Clinical Attachment Programme(CAP) is a programme to which an EEC will be attached for the purpose of maintaining surgical skills until passing the Fellowship Examination. Every EEC must actively involve in surgical practice. CAP must be monitored by at least one trainer. Trainer to EEC ratio should be 1:1. (This is independent of the Trainer to HST or BST ratio.)
The maximum period allowed for clinical attachment:
| 5 years - | Cardiothoracic Surgery |
Neurosurgery |
|
Paediatric Surgery |
|
Plastic Surgery |
|
Urology |
|
| 3 years - | General Surgery |
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Any registered EECs failing to complete the Fellowship Examination of their respective Specialty within the stipulated time frame, they are required to withdraw from CAP and are no longer eligible to restart either from Basic Surgical Training which will not be recognized by CSHK or Higher Surgical Training in any specialties under the College of Surgeons of Hong Kong.
Registration
Trainees who cannot complete the Fellowship Examination within the stipulated Higher Surgical Training will be required for admission to the CAP for sitting the Fellowship Examination. These trainees are required to submit the EEC Registration Form to CSHK within the first month of the CAP. Failure to do so will render disqualification of sitting for the Fellowship Examination of their respective specialties.
Assessment documentation
EECs must keep logbook on recording the experiences gained during the period of clinical attachment. On completion of every 6-month period of CAP, EECs in all specialties (except General Surgery) must submit the assessment documentation on or before 21st January or 21st July. The deadline will be automatically extended to the next working day if that day falls on Saturday or public holiday. For those in General Surgery, they are required to submit the documentation to the Training Subcommittee of CSHK via their supervisor regularly in January and July every year for recognition of the respective period. Deadline for submission of half-yearly assessment documentation falls on the date of Training Subcommittee meeting. Late submission of the half-yearly assessment documentation will render disqualification of sitting for the Fellowship Examination of their respective specialties.
The assessment documentation should include the followings:
- 1 Assessment Form
- CME Report Form
EECs who receive unsatisfactory assessment from their trainers will render disqualification of sitting for the Fellowship Examination of their respective specialties. EEC status will be reviewed half-yearly by the respective Specialty Board until they pass the Fellowship Examination. The eligibility of EEC will be expired if their performance is unsatisfactory for two consecutive 6-month periods.
CME Requirements
EECs must have adequate CME score (Minimum 10 points in each category / 30 points per year)
- In-hospital meetings (Category 1)
- National/international scientific meetings (Category 2)
Annual REGISTRATION FEE
All EECs are required to pay an annual registration fee until they leave the CAP. Effective from 1 January 2012, EECs are required to make payment of their annual registration fee within the first month of the year, i.e. on or before 31st January. A surcharge of 100% will be levied for any late payment after the first month of the year. Those who still fail to settle the outstanding fee within the first three months of the year, i.e. before 31st March, will be removed from the College Register.
Please refer to “Clinical Attachment Programme for Examination Eligible Candidate” for further details.
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REGISTRATION
Upon completion of Higher Surgical Training and passing the Joint Specialty Fellowship Examination, Higher Surgical Trainees are eligible to apply for Fellowship of the College of Surgeons of Hong Kong (FCSHK) and Hong Kong Academy of Medicine (HKAM). It is a pre-requisite for trainees to register with CSHK as a fellow before they can register with the HKAM.
ELIGIBILIY FOR APPLYING FOR THE FELLOWSHIP OF CSHK
To be eligible for applying for the FCSHK, applicants must fulfill the following requirements:
- One must be fully registered with the Medical Council of Hong Kong
- One must complete 4/5 years of Higher Surgical Training of CSHK stipulated by the respective Specialty Boards with satisfactory training performance and fulfillment of training requirements as prescribed in the Higher Surgical Training Curriculum
- One must have passed the Joint Specialty Fellowship Examination/ Specialty Fellowship Examination(for Plastic Surgery only) held in Hong Kong or Singapore
ANNUAL SUBSCRIPTION FEE
Fellows are required to make payment of their subscription fee annually. A surcharge of 5% will be levied for any late payment after 30 June of the subscription year. By the end of January of the current year, if any fellow fails to pay his/her annual subscription fee of the preceding year as well as the overdue surcharge(5% of the subscription), his/her name shall be removed from CSHK Register. Please refer to the “Policy on Annual Subscription” for further details.
Continuing Medical Education (CME) Programme
All FCSHK who are also the Fellows of HKAM (Surgery) must satisfy the full requirements of the CME/CPD programme by the end of each Cycle. A cycle of CME/CPD assessment shall be three years. Fellows will commence their first cycle on the first day of the month immediately after their admission to Academy Fellowship; and the required CME/CPD points for the first cycle will be counted on a pro-rata basis.
Over a 3 years period, each fellow must collect a total of 90 points. A minimum of 15 CME/CPD points per year is recommended. Each fellow is responsible for collecting documentary proof of his CME/CPD points to be forwarded to CSHK at the appropriate time for CME/CPD point accrual. Please refer to the “Principles and Guidelines on Continuing Medical Education (CME) and Continuing Professional Development (CPD)” for further details.
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