COVID-19 > 2021 Hardship Modifications to Surgical Critical Care Training Requirements
2021 Hardship Modifications to Surgical Critical Care Training Requirements
Please see below for a list of hardship modifications and accompanying FAQs for 2021 graduating surgical critical care 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.
- The Trauma, Burns and Surgical Critical Care Board of the ABS (TBSCCB) will accept 44 weeks of clinical time (including the non-voluntary time) for the 2020-21 academic year, without the need for pre-approval, permission or explanation.
- Due to the nature of the specialty, and the fact that some volume of trauma and surgical emergencies needing critical care continue to occur despite the pandemic, case volume allowances will not be made for the 2020-21 academic year.
- Program directors are entrusted, as they always are, to make a decision about the readiness of the fellow for independent practice. If a fellow falls below the 44-week mark for time in training, and the program director nevertheless endorses them as ready for independent practice, the TBSCCB will seek a more detailed supporting statement. This might include information from the CCC, milestones achievements, entrustment through EPAs, 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 program directors.
FAQs
While trainees are encouraged to strive to meet 100% of current training expectations with respect to length of training time, the Trauma, Burns and Surgical Critical Care Board (TBSCCB) 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 addition, the TBSCCB will accept 44 weeks of clinical time (including the non-voluntary time) for the 2020-21 academic year, without the need for pre-approval, permission or explanation.
Graduating fellows who fall short of this minimum threshold for training time may petition the TBSCCB to grant credit for the 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 TBSCCB. Those whose requests are granted will receive credit for their accrued cases and be advanced to graduation and registration for the SCC CE. Those whose requests are not granted for any reason will not receive credit and must extend their training.
The TBSCCB 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 Surgical Critical Care Certifying Exam (SCC CE) and will be required to extend their training.
The TBSCCB has made the assumptions that; (1) some volume of trauma and surgical emergencies needing critical care will continue to occur; and (2) SCC fellows may be asked to help care for critically ill COVID patients or care for non-COVID “medical” ICU patients to off-load the COVID team.
We believe that most SCC fellows should be able to meet the ACGME case volume minimums despite these limitations, so case volume allowances will not be made for the 2020-21 academic year.
Graduating fellows who fall short of this minimum threshold for procedures may petition the TBSCCB to grant credit for the 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 TBSCCB. Those whose requests are granted will receive credit for their accrued cases and be advanced to graduation and registration for the SCC CE. 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.
These hardship modifications apply to surgical critical care 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.
