Royal College of Physicians and Surgeons of Canada: Applying competency-based practices to residency education
To contribute to the success of Canadian physicians and the delivery of high-quality patient care, the Royal College of Physicians and Surgeons of Canada has embarked upon an initiative to introduce competency-based medical education (CBME) in Canadian postgraduate specialty training and in professional practice in Canada. This initiative, called Competence by Design (CBD), aims to enhance patient care by aligning medical education and lifelong learning with evolving patient needs and empowering learners to more fully engage in their education process.
CBD will use time as a framework rather than the basis for progression. It is not anticipated that the duration of training will change for the majority of trainees. Residency programs will be broken down into stages, and each stage will have a series of milestones based on required competencies. These milestones will create more targeted learning outcomes and involve more frequent, formative assessments within the clinical workplace to ensure residents are developing and receiving feedback on the skills they need.
The Royal College anticipates that all specialty and subspecialty programs in Canada will adopt CBD in gradual phases. All disciplines have been divided into seven cohort groups, each of which will adopt CBD at different times. It is anticipated that national implementation of CBD within certain, individual programs could begin as early as July 2017 - with more disciplines to following in subsequent years.
In Neurosurgery, residents entering residency as of July 2019 are scheduled to experience CBD.
All programs implementing CBD will continue to undergo the same rigorous accreditation processes as traditional programs. All CBD programs (and traditional programs) will continue to lead to Royal College approved certification. Certification for trainees in both CBD and traditional programs will include the completion of a Royal College examination; however, residents in CBD programs will also be assessed against program milestones throughout their training. Within a CBD program, all milestones (documented within an electronic portfolio) and the Royal College examination must be successfully completed to achieve certification.
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Program application language: English
Required documents for ALL applicants
The province of British Columbia will accept one of the following notarized/certified documents as proof of the citizenship/permanent residency and is required for all types of applicants. Photocopies are accepted but, citizenship documents other than what is listed below are not accepted. Proof of citizenship/permanent residency must be submitted to CaRMS by the File Review deadline. No allowances for late submission.
CMG / USMG
If you graduated from an English medical school in Canada (including McGill) or the US, you are exempt from providing proof of language proficiency.
Candidates who attended medical school in Quebec or the University of Ottawa where the language of instruction or the primary language of patient care was not English, must fulfill the English Language Proficiency requirements of the College of Physicians of Surgeons of BC as identified below. This requirement is the same for IMGs and is required by the start of the Ranking Period.
The College of Physicians and Surgeons of BC requires applicants to be proficient in the English language.
The Registration Committee may determine that an applicant has demonstrated English language proficiency if the following conditions are met:
Applications received by the College of Physicians and Surgeons of BC on or before June 30, 2023, who have not met the above requirements will require one of: IELTS Academic examination, OET Medicine Examination or CELPIP General Examination for licensing (see criteria below). As such, applicants must submit the proof of English language proficiency to CaRMS by the start of Ranking Period. Photocopies are acceptable.
Please note that results from these three examinations cannot be mixed. Candidates must meet all of the criteria in either the IELTS, OET or CELPIP examination.
Applicants are advised to review the College of Physicians and Surgeons English Language Proficiency Requirements here: https://www.cpsbc.ca/files/pdf/REG-ELP.pdf
Clinical references carry more weight if written by someone known to the Division of Neurosurgery in UBC, or by someone who has significant exposure to the applicant. Reference letters will not be accepted after the CaRMS reference letter deadline.
Your medical school transcript can be submitted through one of the methods below:
For current year Canadian medical graduates (CMGs), there is no action required from you. Your medical school will automatically submit your MSPR to CaRMS on your behalf for you to assign.
If your MSPR is in a language other than the program language of English or French, you are required to have the document translated.
Your autobiographical letter should answer the following questions: - Why are you interested in this specialty and in training at the University of British Columbia? - What are your objectives for a career? - What things indicate you have the technical aptitudes to be a surgeon? - What is your perception of the requirements of residency and the demands of neurosurgical practice? - What non-medical interests and hobbies do you have?Photo
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Applications submitted after file review has opened on January 10, 2023
Supporting documents (excluding letters of reference) that arrive after file review has opened on January 10, 2023
Letters of reference that arrive after the unmasking date on January 10, 2023
Academic record which demonstrates interest and proficiency in subjects related to the specialty.
Some references should be obtained from academic specialists in the specialty or allied areas. Reference should attest to interest and proficiency in knowledge and clinical skills related to the specialty, as well as comments on motivation, empathy, interpersonal skills, and technical aptitudes.
The Neurosurgery Residency training program at the University of British Columbia is dedicated to the comprehensive training and development of the next generation of leaders in all areas of neurosurgery. This encompasses emphasis on clinical excellence in both knowledge and technical skills as well as scholarship, leadership, advocacy and teaching. We strive to train clinically superior surgeons. We strive to equip our graduates with the academic, leadership andteaching skills to be positioned to advance all spheres of our field over the course of their careers. We believe that regardless of the future career path of our trainees, all trainees must be fully equipped to practice in all areas of clinical neurosurgery. Residents in our program are expected to demonstrate clinical and academic excellence, exceptional interpersonal and teamwork skills, contribute to the advancement of knowledge in the field, and have sense of responsibility and dedication to the profession. Residents are expected to be active community members and demonstrate balance in life as evidenced by engagement in volunteer, extracurricular or other types of activities.
A successful applicant to the neurosurgical program at the University of British Columbia will have demonstrated a keen interest in pursing a career in neurosurgery have the traits necessary to develop into an excellent neurosurgeon. They will have demonstrated the ability to work effectively and professionally as a member of the healthcare team and interact well with patients and their families. They will have demonstrated maturity and skill in all the intrinsic roles outlined in the CanMEDS 2015 project (Medical Expert, Communicator, Leader, Collaborator, Health Advocate, Scholar and Professional). They will have demonstrated the ability and enthusiasm to learn and to adapt to the various demands of residency training. They will have shown an interest in service their patient populations.
Review team composition : The review team consists of the program director, 5 other members of the faculty and 2 senior residents
Average number of applications received by our program in the last five years : 0 - 50
Actual average number of applications in the last 5 years: 26
Average percentage of applicants offered interviews : 76 - 100 %
|CV||Demonstration of well rounded individual and/or excellence in a given area|
|Electives||Sufficient neurosurgery electives demonstrating understanding of the speciality|
|Examinations||We do not evaluate this file component.|
|Extra-curricular||Demonstration of well rounded individual and/or excellence in a given area|
|MSPRs||Demonstration of aptitude to pursue career in neurosurgery - CanMEDS roles|
|Personal letters||Demonstration and explanation of path leading to commitment to neurosurgery and|
|Reference documents||Demonstration of aptitude to pursue career in neurosurgery - CanMEDS roles|
|Research/Publications||Demonstration of commitment to advancing science and some research in neurosurgery|
|Transcripts||Demonstration of academic excellence|
Demonstration of an understanding of the rigors of neurosurgery training and practice and a commitment to a career in neurosurgery through completion a reasonable number of neurosurgery electives is important
Interview format :
We do not re-schedule interviews for applicants after we have completed the scheduling process.
|Collaboration skills||Ability to work effectively with faculty, residents, rest of healthcare team and patients|
|Collegiality||Ability to get along well with colleagues and rest of healthcare team|
|Communication skills||Excellence in all forms of communication (verbal and non-verbal) in English|
|Health advocacy||Good understanding of underlying determinants of health in neurosurgical patients|
|Interest in the discipline||Good understanding of rigors of neurosurgery and commitment to pursuit of the career|
|Interest in the program||Knowledge of the program and its culture and ability to integrate within it|
|Leadership skills||Ability to initiate programs, lead organizations or groups, and make an impact|
|Professionalism||Maintaining a hight degree of professionalism throughout all interactions|
|Scholarly activities||Academic excellence, knowledge and commitment to advancement of knowledge in our field|
|Other interview component(s)||Technical abilities/manual dexterity may be assessed|
This residency program is for 6 years.
Program length of training does not exceed the Royal College or College of Family Physicians of Canada standard.
PGY-1 & 2 (surgical foundation)
The first two years of training fall under the Royal College Surgical Foundation guidelines. Rotations are tailored to the resident’s needs and goals, and generally include non-neurosurgery (off-service) rotations in other specialties with options such as ENT / Plastics / Orthopedics / Trauma surgery Vascular surgery, emergency medicine, ICU, and Neurology. The resident rotates multiple times with the Adult Intracranial Neurosurgery and Spinal Neurosurgery services during this period. There are weekly core surgery lecture series and a 4 week dedicated "CRASH" course to aid in the integration into surgical residency and also preparation for the Surgical Foundations Examination.
PGY-3 to 6
The total amount of clinical neurosurgical training required by the Royal College is a minimum of 42 blocks of approved resident training in neurosurgery with progressively increasing responsibility for patient care. Included in the 42 blocks of clinical neurosurgery are 6 blocks of pediatric neurosurgery, 9 blocks on the combined neurosurgery and orthopedic spine service and 6 blocks of community neurosurgery. Other rotations include 3 blocks of neuropathology, and 3 blocks of neuroradiology.
Further training may also include further approved residency training in neurosurgery (including pediatric neurosurgery, spine or community neurosurgery), clinical or basic research, other approved training or research relevant to the field of neurosurgery, desired by the resident and approved by the program director.
To allow broad experience, several specific rotations may be arranged where needed or requested, such as: additional adult neurosurgery may be done in a community /rural private practice; option of additional spine program experience; additional neuroradiology; 1 or more years of research in an approved neurosurgical or related laboratory; and an elective period of training approved by the program director and head of division. The resident is responsible for patient care activities under supervision, progress according to his/her increasing capabilities and is exposed to an extensive operating experience.
The teaching activities center around a weekly academic day with formal academic presentations, case presentations, correlative rounds (neurosurgery, neuroradiology, neuropathology), quality assurance ward audit, and topical seminar sessions. In addition there are research rounds and journal clubs. In addition to the clinical based training, the resident has opportunity to attend several courses which may include the University of Calgary Spine Course, the University of Toronto Microsurgical Course, ATLS training, and various courses associated with neurosurgical meetings depending on the resident's career goals and on approval by the program director. Residents are also expected to attend Resident Boot Camp, as well as cadaver dissection sessions at the VGH Simulation Centre at Vancouver General Hospital.
Basic science research is encouraged but not a requirement. A supervised annual clinical research project is expected in PGY2 and above residents. Residents are expected to present their projects at the annual resident research day and submit their papers to the annual BC Neuroscience day. Trips to present papers at major neurosurgical North American meetings are funded by the division. The division has a full-time reseach coordinator that residents have access to far helping research-ethics, submissions, interactive review, statistics, funding applications, etc.
Training occurs at the following institutions: Vancouver General Hospital and Health Sciences Centre, BC Children's Hospital, Victoria General Hospital, Lions Gate Hospital. There are no mandatory rural rotations.
Currently there are 7 residents enrolled in The University of British Columbia Division of Neurosurgery training program, and 37 faculty members all over the province. There are over 2,000 cranial cases, 2,000 spinal cases, and over 300 paediatric cases performed in the main training hospitals (1,200+ cranial and 1,000+ spinal cases at Vancouver General Hospital). 3,300+ admissions and 7,000+ clinic visits per year.
Vancouver Hospital Health Sciences Center is the largest hospital network (>1,900 beds) and the Vancouver General Hospital is the largest single acute care hospital in Canada (>955 beds).