Transition to Discipline EPA’S
Surgical Foundations EPAs were updated in June 2021. The following information is for residents entering PGY-1 from 2021 onward:
1.1 Preoperative Preparation
Indirect observation by supervisor. Collect one observation of achievement.
1.2 Recognize Critically Ill
Direct observation by supervisor and review of clinic note. Collect two observations of achievement.
1.3 Documentation
Direct or indirect observation by supervisor with review of clinical documentation. Collect two observations of achievement, at least one inpatient and one outpatient.
1.4 Handover
Direct observation by supervisor. Collect two observations of achievement.
1.5 Operating Room
Supervisor or delegate does assessment based on direct observation. Collect one observation of achievement.
1.6 Wound Closure
Direct observation by supervisor. Collect one observation of achievement. Note: the wound must be at least five centimetres long.
1.7 Tubes | Drains | Lines
Indirect observation by supervisor. Collect one observation of achievement.
Foundations of Discipline EPA’S
2.1 Critically Ill Surgical
A. Patient Assessment: Direct or indirect observation by supervisor. Collect three observations of achievement, with at least two different presentations.
B. Procedure: Direct observation by supervisor. Collect four observations of achievement, with at least one tube thoracostomy, one surgical airway and one central venous line insertion.
2.2 Trauma
Two observations of achievement – one primary and one secondary.*Email Naomi Downer your advanced trauma life support (ATLS) certification.
2.3 Preoperative Optimization
Direct or indirect observation by supervisor. Collect four observations of achievement, with at least one elective, one emergent, one high risk and one critically ill and at least two assessors.
2.4 Consent
Direct observation by supervisor. Collect three observations of achievement, with at least two different assessors, at least one emergency procedure, at least one elective procedure and at least two in clinical setting.
2.5 Fundamental Surgical Procedure
A. Direct observation by supervisor. Collect four observations of achievement, with at least two by faculty, at least two different types of procedures and at least two different assessors.
B. Multiple observers provide feedback individually, which is then collated to one report for Competence Committee review. Collect feedback from at least six observers. Multisource Feedback Form 2.5B “Fundamental Aspects of Surgical Procedures” (PDF).
2.6 Surgical Procedures
Direct observation by supervisor in operating room (minor surgery or emergency). Collect four observations of achievement, with at least two by faculty, two different types of procedures and two different assessors.
2.7 Postoperative Uncomplicated
A. Direct or indirect observation by supervisor. Collect eight observations of achievement, with at least two from each stage of management, a range of hospital stays, a range of patient complexity and at least four different assessors.
B. Multiple observers from discharge planning team provide feedback individually, which is then collated to one report for Competence Committee review Collect feedback from at least six observers. Multisource Feedback Form 2.7B “Discharge Planning Team” (PDF).
2.8 Postoperative Complications
Indirect observation by supervisor with review of clinic note. Collect eight observations of achievement, with at least four different complications and at least three assessors.
2.9 Supervising Juniors
Direct observation by supervisor and junior learners. Collect six observations of achievement, with at least three different junior learners and at least three different senior residents or faculty.
Please note: Multi-source feedback guides and resources are available via Avenue to Learn.