General Surgeon Education and Training in Canada

To get to the stage of General Surgery and become a practicing surgeon, you must have foundations and have completed your study at the undergraduate level in the medical field.

General Surgery is a specialty, and post-residency training is sub-specialty training. However, all General Surgeons are highly trained and highly skilled professionals.

General Surgeons’ responsibilities emphasize the whole patient; therefore, General Surgeons are leaders of modern multidisciplinary teams, that is; they oversee a team of other medical doctors who specialize in other parts of the medical practice in hospitals and in the health care systems.

They share a responsibility to coordinate complex operative care, whether in General Surgery, oncology, transplant, or trauma.

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Criteria For Becoming A General Surgeon

For you to become a General Surgeon, you must:

• Have completed an undergraduate and graduate education and obtained a baccalaureate degree and a medical degree.
• Have completed a 5-year residency program in general surgery.
  • This includes specialized knowledge of the abdomen; alimentary tract (digestive organs); breast, skin, and soft tissue;
  • Have a comprehensive trauma management acumen; critical care; endocrine system; head and neck;
  • Surgical oncology (management of screening, surveillance, surgical therapy, rehabilitation, and follow-up with cancer patients); and vascular (circulatory) system.
• Residency program requirements differ for each surgical specialty area; for example, thoracic surgery requires five years of general surgery training plus two years of training in cardiovascular and thoracic surgery.

Who Is A General Surgeon

A general surgeon is a physician or a medical doctor who has been educated and trained in human medicine and the diagnosis and pre-operative, operative, and postoperative patient care management.

Surgery practice requires knowledge of anatomy, emergency, and intensive care, immunology, metabolism, nutrition, pathology, physiology, shock, and resuscitation, and wound healing.

Scope Of A General Surgeon

The general surgeon is trained to provide surgical care for the whole patient, especially in internal medicine. This includes making a diagnosis; pre-operative, operative, and postoperative management of the patient; and the surgical treatment of the following:

• alimentary tract;
• abdomen and its contents, including the pelvis;
• breast, skin, and soft tissue; and
• endocrine system.

It also includes head and neck surgery, pediatric surgery, critical surgical care, surgical oncology, trauma and burns, transplants, and vascular surgery.

The nature, scope, and description of a general surgeon’s practice may be dependent on whether the practice is in an academic center, an urban community, or a more rural center.

In rural practice, the surgeon’s practice may be subjected to gynecology, urology, orthopedic and ENT surgeries.

In addition, a general surgeon’s activities and practice might be limited to one sub-specialty in academic centers. This is due to the demography of the area and the prevalent incidences and susceptibility of the area.

Areas And Scope Of General Surgery

General surgery encompasses a specialty in a wide array of medical disciplines; here, the activities of a general surgeon involve spending time in the operating room, office, emergency department, and intensive care unit.

Moreso, General surgical practice requires expertise in communication and collaboration, teaching and research, health care management, and continuing professional development.

After completing medical school, you will require five years of training and education in a Royal College-approved program in Canada to become a general surgeon.

Other schools also offer a 6-year program, while others offer an optional PGY6 year.

As a resident, you must acquire a thorough knowledge of the theoretical basis of general surgery, including its foundations in the basic medical sciences and research.

Your training must incorporate the principle of graded increasing responsibility.

Thus, this must include at least 36 months of general surgery rotations, of which at least one year must be spent as a senior or chief resident.

Path To General Surgery In Canada

The national professional association or body which oversees the medical education and training of specialists in Canada is the Royal College of Physicians and Surgeons of Canada.

This body accredits every university program that trains resident physicians to become specialized practitioners.

It also creates and conducts the demanding examinations that residents must pass in other to become certified as specialists.

The Royal College of Physicians and Surgeons also oversees postgraduate medical education in Canada.

The Royal College must assess a physician’s credentials before he or she is eligible to write any exam to be certified as a specialist.

Assessment Pathway

To become a physician and practice in Canada, you must go through the following training pathways to become a specialist.

The Royal College established several pathways for you to be certified as a specialist or a sub-specialist.

• As a prospective general surgeon, you must first complete your undergraduate degree in medicine.
• After your undergraduate training, commence and complete your residency training in an accredited program that is of your desire.
• To become qualified as a General Surgeon, you will have to undergo five years of additional training before you will be eligible to write the Royal College Exams to become certified as a specialist.
• Continuous Professional Training and Education
  • When you become qualified as a General Surgeon and a member of the Royal College, you must participate in The Maintenance of Certification (MOC) Program.
  • The MOC Program is the Royal College’s continuing professional development program for Fellows and health care, professionals. Participation in the MOC Program is a mandatory requirement for admission and renewal of fellowship as a member of the Royal College.

The MOC Program of the Royal College is designed to support the lifelong learning and training requirements of Fellows and health care professionals in Canada.

Thus, once you start to practice as a General Surgeon, ongoing training and assessment become a requirement in order for you to maintain your membership and fellowship in the Royal College.

Specialty Training Requirement In General Surgery

Below are the training requirements a prospective General Surgeon must fulfill as stipulated by the Royal College of Canada to be certified as a General Surgeon.

Minimum Training Requirement

The journey to becoming a General Surgeon begins with Five (5) years of approved residency training in General Surgery. This period must include:

• Two (2) years (26 blocks) of foundational training in surgery that meets the requirements of the Royal College Objectives of Surgical Foundations Training; this must include:
  • As a junior resident in General Surgery, you must have undergone six (6) – eighteen (18) blocks.
  • Undergone two (2) blocks of critical care
  • You must have attained two (2) blocks on a service that provides initial trauma management, inclusive of Emergency Medicine, General Surgery, trauma team, Orthopedic Surgery, or Plastic Surgery.
• You must have attained twenty-six (26) blocks of further approved residency training in General Surgery.
  • This is inclusive of a minimum of thirteen (13) blocks as a senior resident.
• A maximum of six (6) blocks, selected from one or more of the following:

1. 1. 1. Pediatric surgery
      2. Thoracic surgery
   2. Vascular surgery

• In addition, undergoing two (2) blocks of training in gastrointestinal endoscopy, including both upper and lower gastrointestinal tract.
• You must have attained eleven (11) blocks of elective rotations, which may include any combination of the following:
  • Further training in General Surgery
  • Clinical rotations in other surgical and non-surgical disciplines relevant to the resident’s career goals
  • Clinical or basic research.

Note: A block is defined as a four (4) weeks rotation

Senior residency is the thirteen-block period during which the resident is regularly entrusted with the responsibility for pre-operative, operative, and post-operative patient care, including the most difficult problems in General Surgery.

During this period, the senior resident is often put in charge of a General Surgery unit, under the supervision of the attending staff.

Note: No other resident or fellow will be permitted to impede or disrupt direct communication between the senior resident and the attending General Surgeon.

Requirement For Certification:

To be eligible for certification, you must meet and fulfill the Royal College requirements for General Surgery certification; all of the listed must be met:

• You must have completed the Royal College Surgical Foundations curriculum.
• Must have completed the Royal College Surgical Foundations Examination.
• You must have completed a 5-year Royal College accredited program in General Surgery.
• Must have completed a research investigation, including presentation of results related to General Surgery; this must be verified and attested to by the residency program director.
• Must have completed the Royal College certification examination in General Surgery.

Note: The five-year program outlined above should be regarded as the minimum training requirement.

Furthermore, additional training and education may be required by the program director to ensure clinical competence.

Assessment Fees

If you are a physician applying for Royal College certification, you must first apply for a training and/or practice assessment to ensure you have met specialty-specific training and/or practice standards to register for the examination.

This may take between six to eight months for you to receive your letter of eligibility. Please note that these costs are only for the training and/or practice assessment. Exam fees are paid separately.

Fees are to be paid in Canadian dollars; nevertheless, these are subject to change each year. Fees are paid in the process of application.

Effective from January 1 – December 31, 2021

Assessment Fees

Canadian and U.S. Medical Residents
Assessment of Canadian residency training — specialties and surgical foundations	$730
”             of Canadian residency training — sub-specialties	$380
”               of ACGME-accredited training in the United States — specialties	$1,130
”               of ACGME-accredited training in the United States — sub-specialties	$780
International Medical Graduates
Assessment of jurisdiction- approved training — specialties	$3,660
Assessment of jurisdiction-approved training — sub-specialties	$1,745
Practice Eligibility Route for sub-specialists (PER-sub)	$975
Practice Ready Assessment (PRA)	$1,030
Eligibility Route (PER) – For those who have completed 2 years of practice in Canada	$4,010
Practice Eligibility Route (PER) – For those who have not completed 2 years of practice in Canada	$7,000
Sub-specialty Examination Affiliate Program (SEAP)
Sub-specialty examination affiliate program (SEAP)	$1,705
Practice Eligibility Route for the sub-specialty examination affiliate program (PER-SEAP)	$4,010
Academic Certification
Academic certification	$5,260
AFC (Diploma)
AFC (Diploma) – Credentialing and Assessment Fee	$965
PER-AFC Diploma – Credentialing and Assessment Fee	$1,950

Examination Fees

EXAM FEES

Surgical Foundations exam	$825
Spring and fall comprehensive objective exam (includes both written and oral/Objective Structured Clinical Examination (OSCE) components)	$4,415
Spring and Fall wrote an exam	$2,200

Other Fees

OTHER FEES

Late fees — for applications received after the deadline
Less than 90 days after deadline:	$710
More than 90 days after deadline:	$1,410
The appeal of an eligibility ruling:	$1,195
Renewal of eligibility
Renewal – spring:	$730
Renewal – fall:	$380

Exams Fees – Online Payment Process

• Your exam registration fees are to be paid online by credit card.
• Once your registration form has been submitted, you must submit payment online to complete your exam registration.
• The online payment link will be included in your exam registration email, which is sent from the Credentials Unit.

Steps To Make Payments Online

• Access the online payment link sent to you in your registration email
• Log in using your Royal College ID
• Enter your credit card information
• Click to submit
• You will receive a confirmation email once your payment has been submitted successfully.

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For further information or inquisition on the application fees and exam fees for the Royal College General Surgery assessment and examination in Canada, visit the link below:

https://www.royalcollege.ca/rcsite/credentials-exams/exams-fees-e

Conclusion

In conclusion, Canada has a well-developed system of general surgeon education and training. This system is comprised of a variety of options, including university medical schools, residency programs, and subspecialty fellowship programs. These programs provide surgeons with the skills and knowledge needed to provide excellent care for their patients.