The Fellowship Council (FC) has historically mandated quarterly evaluations to achieve and maintain accreditation. In 2012, FC members voted to approve both a mandatory quarterly fellow assessment and intraoperative/technical skills assessment that were developed by the FC Education/Curriculum Committee.
The FC Board of Directors is phasing in a new competency-based educational model that focuses on outcomes of fellowship training. The aim is to present a more unified approach to defining fellowship standards to:
- Provide a clear understanding of expected performance using Entrustable Professional Activities (EPAs) for training and assessment
- Assist Fellows and Program Directors in identifying gaps in training or learning that can be addressed and tracked over time.
- Facilitate uniform accreditation of fellowship programs.
- Better align with North American General Surgery Residency training programs as they shift towards competency-based assessment frameworks.
This new competency-based model including EPAs is available across the Fellowship Council fellowships for the 2022-2023 fellowship year. Fellows are able to access the EPA Assessment Tool on their fellow dashboard in order to initiate an EPA. As this is a new approach for many, these first few years will be a time of transition. Information about the development and use of the FC EPAs and resources for implementation and faculty development are available here: https://www.fellowshipcouncil.org/program/epa-assessment-tool/
Until EPAs become an accreditation requirement, the quarterly and intraoperative/technical skills assessments will remain mandatory. These assessment tools and an archive are available through FC member accounts. For the 2023-2024 fellowship year, quarterly technical assessment requirements have changed for programs that meet a minimum number of EPAs. Programs that complete 5 EPAs per quarter per fellow (a total of 20 per year per fellow), no longer need to complete the intraoperative/technical skills evaluations (GOALS/Intraoperative Performance Assessment Tool). Below is information regarding the guidelines for these quarterly and intraoperative/technical skills assessments.
Quarterly Fellow Assessment
- The Quarterly Fellow Assessment Tool is required to be completed once a quarter by the program and should be a composite evaluation of all contributing faculty members. The Program Director should collate the individual faculty evaluations and ideally, address any discrepancies or outlying positive or negative ratings or comments in advance of the required quarterly evaluation review with the Fellow so that they can be discussed at that meeting with the Fellow and constructive feedback and dialogue achieved.
- The Quarterly Fellow Assessment tool is independent of the type of fellowship and is based on the ACGME Core Competencies. This is specifically to allow Program Directors to substitute the Fellowship Council tool in the place of any individual institutional evaluation forms, and thus avoid filling out redundant evaluations. If any Program Directors encounter resistance to the use of the tool in place of the individual institution’s form based on one or more required elements not present, please communicate that to the Council so that the addition can be considered and the tool modified appropriately.
- To access the Quarterly Fellow Assessment Tool, log into your account on the Fellowship Council website, fellowshipcouncil.org, and go to the Evaluation Tools section. Click on the link for the Quarterly Fellow Assessment Tool. Print a copy of the tool to review with all contributing faculty members. Then the program should complete ONE composite form online per quarter.
Intraoperative / Technical Skills Assessment
Requirements
For the 2023-2024 Fellowship Year, each program must submit 1 (at the minimum) of each of the following Index Cases based on the program’s accreditation designation due each quarter, unless they complete a minimum number of EPAs as noted below.
However, the assessment can be used for any procedure and ideally will be used to provide ongoing feedback to the fellow throughout the year and not only on a quarterly basis.
As a reminder, effective immediately for the 2023-2024 fellowship year, if a program completes 5 EPAs per quarter per fellow, for a total of 20 per year per fellow, no technical skills evaluations would be required from the program.
Note:
- Advanced GI programs should select 2 of the most common index cases their program performs from any of the cases listed below. For example, if the program performs a majority of hernia and EGDs, they should submit 1 assessment for each of those cases each quarter.
- If a program does not perform a case from the list below, the program should select another case and submit 4 assessments for the year on the same type of case. For example, an Advanced GI MIS program that does not perform fundoplication should submit 1 Lap Inguinal Hernia Repair assessment every quarter and 1 additional case assessment every quarter.
Programs must submit at minimum 1 of each index case listed below per quarter, based on their accreditation designation. If a program has not yet been accredited, it must submit assessments based on its designation by the Membership Committee.
Advanced GI MIS (Intraoperative Performance Assessment Tool or GOALS):
- Minimally Invasive Fundoplication
- Minimally Invasive Inguinal Hernia Repair
Bariatric (Intraoperative Performance Assessment Tool or GOALS):
- Minimally Invasive Sleeve Gastrectomy
- Minimally Invasive Roux-en-Y Bypass
Hepato-Pancreato-Biliary (Intraoperative Performance Assessment Tool):
- Pancreatico-duodenectomy (open only)
- Liver Resection>2 segments with hilar dissection
Advanced Colorectal (Intraoperative Performance Assessment Tool):
- Minimally Invasive Right Hemi-Colectomy
- Minimally Invasive Sigmoid Resection
Flexible Endoscopy (GAGES)
- EGD
- Colonoscopy
Foregut (Intraoperative Performance Assessment Tool or GOALS):
- Minimally Invasive Fundoplication
- The second index case is at the discretion of the program. The program must communicate which procedure is selected to the fellow and the FC by August 31, 2024. Options include any procedure counted toward the mandatory MIS foregut cases (i.e. myotomy, gastrectomy, esophagectomy, anastomotic bariatric case).
Advanced Thoracic (Intraoperative Performance Assessment Tool):
***Thoracic programs may submit any 2 of the 4 Index Cases listed.
- Foregut / Esophageal- Gastric Fundoplication/ Complete (Nissen)
- Foregut/Esophagus-Resection/Location of Anastomosis not to be specified
- Thoracic/Lung/Anatomic segmentectomy or lobectomy
- Mediastinum/Mediastinum-Resection/Posterior or anterior mass
To access the Intraoperative/Technical Skills Assessment tool, log into your account on the Fellowship Council website, fellowshipcouncil.org, and go to the Evaluation Tools section. Click on the link for the appropriate Intraoperative/Technical Skills Assessment tool. The program should complete the online form.
Since accessing the Intraoperative/Technical Skills Assessment tools requires being able to log on to the Fellowship Council website, each faculty member who participates will need his/her own user account. The Program Director can manage those sub-accounts using the Manage Program Administrative Users link under the Actions section of the Program Director’s regular FC account.
Using this menu, Program Directors may control which users have access to which functions, so that you may control exactly which users may modify the program description or applicants page, all users will have access to the evaluation tools.
Fellowship Council members interested in research projects using the data generated from the Intraoperative/Technical Skills Assessment tool are directed to submit requests for data access to the Fellowship Council Research Committee.
Program Directors will receive quarterly reminder emails from the Fellowship Council office to complete the assessments.
Assessment deadline dates are as follows:
For the 2023-2024 Fellowship Year, 1 Quarterly and 1 Technical Skills assessment or 5 EPAs for each of the index cases listed above are due each quarter by
- October 31, 2023
- January 31, 2024
- April 30, 2024
- July 31, 2024
Scholarly Activity
It is a requirement that the fellowship take place in an environment of inquiry and scholarship in which trainees participate in the development of new knowledge, learn to evaluate research findings, develop habits of inquiry as a continuing professional responsibility and participate in teaching.
The Fellowship Council has developed a Scholarly Activity Form to enable fellows to track their scholarly activity. Each fellow should use the form to describe the types of educational/scholarly activity performed. Fellows are required to complete the form at a minimum each six months.
Please send any questions regarding these tools or the process to info@fellowshipcouncil.org.
Regards,
Education/Curriculum Committee
The Fellowship Council