Cardiothoracic Surgery
General Surgery
Neurosurgery
Paediatric Surgery
Plastic Surgery
Urology

Cardiothoracic Surgery

Accreditation of Training Posts for Higher Surgical Training in Cardiothoracic Surgery

Department/unit applying for accreditation of Higher Surgical Training posts in Cardiothoracic Surgery must have been recognized by the College for Basic Surgical Training.

The number of training posts to be accredited will depend on the following factors:

  1. Manpower for supervision of training

    The recommended trainer to trainee ratio is 1 to 1. Hence, the maximum number of training posts allocated will not be larger than the number of trainers in the unit.

  2. Trainee undergoing Higher Surgical Training in Cardiothoracic Surgery must fill in a log book detailing the training he/she has received. Higher Surgical Trainees should be assessed every three months by trainers on:

    1. Clinical Skills
    2. Technical Skills
    3. Academic Performance
    4. Attitudes

    If serious deficiencies are evident, the trainees should be advised what measures are required to reverse these deficiencies. The log books have to be presented to designated supervisors for inspection every six months. The supervisor, upon satisfied that the trainee has in the six-months period

    1. Taken part in at least 75 major Cardiothoracic Surgical procedures;
    2. Shown good clinical acumen in the management of patients and
    3. Taken an active part in presentations and discussions at meetings for quality assurance, should sign in the log book.

    3. Below average assessment in any six month period will result in disqualification of that six-month training period. Any trainee who does not satisfy the standards set by or under training assessments consecutively twice or non-consecutively three times will be disqualified from the higher training programme. This log book will be inspected by the College from time to time and it has to be presented for inspection when the trainee comes up for the exit examination at the end of the Higher Surgical Training. The Surgical Training is not completed until the trainee has completed the minimum years of higher training and has passed the exit examination.

     

Guidelines on Major Operation

Higher Surgical Trainees in Cardiothoracic Surgery are required to fulfill the following operation requirements required by the Cardiothoracic Surgery Board within their higher surgical training before they can apply for the Fellowship of the College.

Definition of Major Operation

Recommended minimum number of major operations per six months per higher surgical trainee
Lung resection and above
75

 

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General Surgery

Accreditation of Training Posts for Higher Surgical Training in General Surgery

Department/unit applying for accreditation of Higher Surgical Training posts in General Surgery must have been recognized by the College for Basic Surgical Training.

The number of training posts to be accredited will depend on the following factors:

  1. Manpower for supervision of training

    The recommended trainer to trainee ratio is 1 to 1. Hence, the maximum number of training posts allocated will not be larger than the number of trainers in the unit.

     

  2. Trainee undergoing Higher Surgical Training in General Surgery must fill in a log book detailing the training he/she has received. Higher Surgical Trainees should be assessed every three months by trainers on:

    1. Clinical Skills
    2. Technical Skills
    3. Academic Performance
    4. Attitudes

    If serious deficiencies are evident, the trainees should be advised what measures are required to reverse these deficiencies.  The log books have to be presented to designated supervisors for inspection every six months.  The supervisor, upon satisfied that the trainee has in the six-months period

    1. Taken part in at least 100 major General Surgical procedures;
    2. Shown good clinical acumen in the management of patients and
    3. Taken an active part in presentations and discussions at meetings for quality assurance, should sign in the log book.

    3. Below average assessment in any six month period will result in disqualification of that six-month training period. Any trainee who does not satisfy the standards set by or under training assessments consecutively twice or non-consecutively three times will be disqualified from the higher training programme. This log book will be inspected by the College from time to time and it has to be presented for inspection when the trainee comes up for the exit examination at the end of the Higher Surgical Training. The Surgical Training is not completed until the trainee has completed the minimum years of Higher Surgical Training and has passed the exit examination.

     

Guidelines on Major Operation

Higher Surgical Trainees in General Surgery are required to fulfill the following operation requirements required by the General Surgery Board within their higher surgical training before they can apply for the Fellowship of the College.

1) Major Operation

The following requirement is only applicable to Higher Surgical Trainees in General Surgery admitted before 1 July 2011

Definition of Major Operation

Recommended minimum number of major operations per six months per higher surgical trainee
Cholecystectomy and above
*100

The following requirement is only applicable to Higher Surgical Trainees in General Surgery admitted from 1 July 2011 onwards

Definition of Major Operation Recommended minimum number of Major Operations per six months per Higher Surgical Trainee

Diagnostic laparoscopy and above

Cholecystectomy and above
*100

* It is a recommended number. Trainees are allowed to perform a minimum of 80 major operations in a 6-month rotation but are required to make up a total of 800 major operations within 5 years of training. Completion of the above is one of the requirements for applying Fellowship of the College of Surgeons of Hong Kong.

Revised the Definition of Major operation by GS Board on 11 July 2011
Endorsed by E&EC on 20 July 2011
Council endorsed on 28 July 2011

2) Flagging Criteria

Higher Surgical Trainees in General Surgery are also required to fulfill the following criteria for HST in General Surgery within their higher surgical training before they can apply for the Fellowship of the College.

Year of Training

Last 6 monthS Major Cases*

Last 6 monthS % Major as Surgeons

1

<100

<  25

2

<100

<  40

3

<100

<  50

4

<100

<  60

* Primary operator is defined as where a trainee completes a major part of the surgery.
e.g.: Thyroidectomy, or completes a significant portion of a major complex operation
       Cholecystectomy during a hepatic resection.

IMPORTANT NOTES:
The recommended minimum number of operations per a 6-month rotation is 100. However, trainees are allowed to perform a minimum of 80 major operations in a 6-month rotation but are required to make up a total of 800 major operations within 5 years of training.

Endorsed by E&EC on 9 May 2006
Endorsed by Council on 25 May 2006
Revised by General Surgery Board on 19 May 2011(Deleted the requirement on minor operations)
Endorsed by E&EC on 20 July 2011(Deleted the requirement on C. Endoscopy & C. Colonoscopy)
Endorsed by Council on 28 July 2011
Revised by E&EC on 10 August 2011(with immediate effect)
Endorsed by Council on 26 August 2011
Revised by General Surgery Board on 12 September 2011(Added Important Notes

3) Index Operation

The following additional requirement applies to Higher Surgical Trainees in General Surgery admitted from July 2010 onwards. They are also required to fulfill the prescribed number of index operations (listed below) before they apply for the Fellowship of the College. Trainees are required to complete the Index Operation Fulfillment Form and submit together with the Application Form for Fellowship of the College.

Definition of Index Operation

Recommended minimum number within 4 years of training per higher surgical trainee

Hernia repair

20

Varicose veins operation

20

Appendicectomy

20

Cholecystectomy

20

Patch repair of peptic ulcer

10

Thyroidectomy

20

Hemorroidectomy

20

Bowel resection and anastomosis

20

Colonoscopy

100

Oesophagogastroduodenoscopy(OGD)

200

Mastectomy

10

Added the Index Operation by General Surgery Board in 9 February 2010
Endorsed by E&EC on 10 February 2010
Endorsed the number by Council on 26 February 2010
Revised the half year minimum requirement by GS Board on 20 October 2011

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Neurosurgery

Accreditation of Training Posts for Higher Surgical Training in Neurosurgery

Department/unit applying for accreditation of Higher Surgical Training posts in Neurosurgery must have been recognized by the College for Basic Surgical Training.

The number of training posts to be accredited will depend on the following factors:

  1. Manpower for supervision of training

    The recommended trainer to trainee ratio is 1 to 1. Hence, the maximum number of training posts allocated will not be larger than the number of trainers in the unit.

  2. Trainee undergoing Higher Surgical Training in Neurosurgery must fill in a log book detailing the training he/she has received. Higher Surgical Trainees should be assessed every three months by trainers on:

    1. Clinical Skills
    2. Technical Skills
    3. Academic Performance
    4. Attitudes

    If serious deficiencies are evident, the trainees should be advised what measures are required to reverse these deficiencies. The log books have to be presented to designated supervisors for inspection every six months. The supervisor, upon satisfied that the trainee has in the six- month period

    1. Taken part in at least 60 major Neurosurgical procedures;
    2. Shown good clinical acumen in the management of patients and
    3. Taken an active part in presentations and discussions at meetings for quality assurance, should sign in the log book.

    3. Below average assessment in any six month period will result in disqualification of that six-month training period. Any trainee who does not satisfy the standards set by or under training assessments consecutively twice or non-consecutively three times will be disqualified from the higher training programme. This log book will be inspected by the College from time to time and it has to be presented for inspection when the trainee comes up for the exit examination at the end of the Higher Surgical Training. The Surgical Training is not completed until the trainee has completed the minimum years of higher training and has passed the exit examination.

Guidelines on Major Operation

Higher Surgical Trainees in Neurosurgery are required to fulfill the following operation requirements required by the Neurosurgery Board within their higher surgical training before they can apply for the Fellowship of the College.

Definition of Major Operation Recommended minimum number of Major Operations per six months per Higher Surgical Trainee
Burr-hole and above 60

 

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Paediatric Surgery

Accreditation of Training Posts for Higher Surgical Training in Paediatric Surgery

Department/unit applying for accreditation of Higher Surgical Training posts in Paediatric Surgery must have been recognized by the College for Basic Surgical Training.

The number of training posts to be accredited will depend on the following factors:

  1. Manpower for supervision of training

    The recommended trainer to trainee ratio is 1 to 1. Hence, the maximum number of training posts allocated will not be larger than the number of trainers in the unit.

  2. Trainee undergoing Higher Surgical Training in Paediatric Surgery must fill in a log book detailing the training he/she has received. Higher Surgical Trainees should be assessed every three months by trainers on:

    1. Clinical Skills
    2. Technical Skills
    3. Academic Performance
    4. Attitudes

    If serious deficiencies are evident, the trainees should be advised what measures are required to reverse these deficiencies. The log books have to be presented to designated supervisors for inspection every six months. The supervisor, upon satisfied that the trainee has in the six-month period

    1. Taken part in at least 100 major Paediatric Surgical procedures, of which at least 15 should be major neonatal operations;
    2. Shown good clinical acumen in the management of patients and
    3. Taken an active part in presentations and discussions at meetings for quality assurance, should sign in the log book.

    3. Below average assessment in any six month period will result in disqualification of that six-month training period. Any trainee who does not satisfy the standards set by or under training assessments consecutively twice or non-consecutively three times will be disqualified from the higher training programme. This log book will be inspected by the College from time to time and it has to be presented for inspection when the trainee comes up for the exit examination at the end of the Higher Surgical Training. The Surgical Training is not completed until the trainee has completed the minimum years of Higher Surgical Training and has passed the exit examination.

Guidelines on Major Operation

Higher Surgical Trainees in Paediatric Surgery are required to fulfill the following operation requirements required by the Paediatric Surgery Board within their higher surgical training before they can apply for the Fellowship of the College.

Definition of Major Operation Recommended minimum number of Major Operations per six months per Higher Surgical Trainee
Orchidopexy and above 100 (of which at least 15 should be major neonatal operations)

 

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Plastic Surgery

Accreditation of Training Posts for Higher Surgical Training in Plastic Surgery

Department/unit applying for accreditation of Higher Surgical Training posts in Plastic Surgery must have been recognized by the College for Basic Surgical Training.

The number of training posts to be accredited will depend on the following factors:

  1. Manpower for supervision of training

    The recommended trainer to trainee ratio is 1 to 1. Hence, the maximum number of training posts allocated will not be larger than the number of trainers in the unit.

  2. Trainee undergoing Higher Surgical Training in Plastic Surgery must fill in a log book detailing the training he/she has received. Higher Surgical Trainees should be assessed every three months by trainers on:

    1. Clinical Skills
    2. Technical Skills
    3. Academic Performance
    4. Attitudes

    If serious deficiencies are evident, the trainees should be advised what measures are required to reverse these deficiencies. The log books have to be presented to designated supervisors for inspection every six months. The supervisor, upon satisfied that the trainee has in the six-month period

    1. Taken part in at least 50 major Plastic Surgical procedures;
    2. Shown good clinical acumen in the management of patients and
    3. Taken an active part in presentations and discussions at meetings for quality assurance, should sign in the log book.

    3. Below average assessment in any six month period will result in disqualification of that six-month training period. Any trainee who does not satisfy the standards set by or under training assessments consecutively twice or non-consecutively three times will be disqualified from the higher training programme. This log book will be inspected by the College from time to time and it has to be presented for inspection when the trainee comes up for the exit examination at the end of the Higher Surgical Training. The Surgical Training is not completed until the trainee has completed the minimum years of Higher Surgical Training and has passed the exit examination.

Guidelines on Major Operation

Higher Surgical Trainees in Plastic Surgery are required to fulfill the following operation requirements required by the Plastic Surgery Board within their higher surgical training before they can apply for the Fellowship of the College.

Definition of Major Operation Recommended minimum number of Major Operations per six months per Higher Surgical Trainee

Resection of Tumour or above

Any Therapeutic endoscopic/ interventional procedures		 50

 

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Urology

Accreditation of Training Posts for Higher Surgical Training in Urology

Department/unit applying for accreditation of Higher Surgical Training posts in Urology must have been recognized by the College for Basic Surgical Training.

The number of training posts to be accredited will depend on the following factors:

  1. Manpower for supervision of training

    The recommended trainer to trainee ratio is 1 to 1. Hence, the maximum number of training posts allocated will not be larger than the number of trainers in the unit.

  2. Trainee undergoing Higher Surgical Training in Urology must fill in a log book detailing the training he/she has received. Higher Surgical Trainees should be assessed every three months by trainers on:

    1. Clinical Skills
    2. Technical Skills
    3. Academic Performance
    4. Attitudes

    If serious deficiencies are evident, the trainees should be advised what measures are required to reverse these deficiencies. The log books have to be presented to designated supervisors for inspection every six months. The supervisor, upon satisfied that the trainee has in the six-month period

    1. Taken part in at least 75 major Urological procedures;
    2. Shown good clinical acumen in the management of patients and
    3. Taken an active part in presentations and discussions at meetings for quality assurance, should sign in the log book.

    3. Below average assessment in any six month period will result in disqualification of that six-month training period. Any trainee who does not satisfy the standards set by or under training assessments consecutively twice or non-consecutively three times will be disqualified from the higher training programme. This log book will be inspected by the College from time to time and it has to be presented for inspection when the trainee comes up for the exit examination at the end of the Higher Surgical Training. The Surgical Training is not completed until the trainee has completed the minimum years of Higher Surgical Training and has passed the exit examination.

Guidelines on Major Operation

Higher Surgical Trainees in Urology are required to fulfill the following operation requirements required by the Urology Board within their higher surgical training before they can apply for the Fellowship of the College.

Definition of Major Operation Recommended minimum number of Major Operations per six months per Higher Surgical Trainee

For Diagnostic procedures, Diagnostic endoscopy of upper urinary tract, and above. Any therapeutic endoscopy and Interventional procedures,

For Open procedures, Open Lihotomy and above

 100

Revised the number by Urology Board in Dec 2005
Endorsed the recommendation by Council in Jan 2006

IMPORTANT NOTES:
Individual Specialty Board should be the sole body for interpretation of the definition of major operation in the respective specialty.

For Further details, please refer to “Guidelines on Major Operation” for Higher Surgical Training.

 

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