Oversight Organizations in Complex General Surgical Oncology - Potential Impact on Competency Based Education

Area of Science:

• Medical Education
• Surgical Oncology Training
• Competency-Based Medical Education

Background:

• Surgical oncology training typically involves a general surgery residency and a Complex General Surgical Oncology (CGSO) Fellowship, totaling approximately 9 years.
• Current training models are time-dependent, with trainees progressing based on fixed durations rather than demonstrated competencies.
• Several oversight organizations are involved in surgical oncology training, but these systems largely remain time-based.

Purpose of the Study:

• To analyze the current oversight framework for surgical oncology training.
• To explore the potential for implementing a competency-based medical education (CBME) model in surgical oncology fellowship programs.
• To identify challenges and facilitate modifications towards a CBME approach.

Main Methods:

• A narrative review of existing literature and guidelines on Complex General Surgical Oncology (CGSO) fellowship training.
• Development of hypothetical models illustrating the interplay between various oversight organizations.
• Analysis of current training structures and emerging initiatives like Competency-Based Medical Education (CBME).

Main Results:

• Multiple organizations oversee surgical oncology training at residency, fellowship, match, and board certification levels.
• Existing training structures predominantly rely on time-in-training for progression.
• Competency-Based Medical Education (CBME) is being introduced through initiatives like the American Board of Surgery's Entrustable Professional Activities.

Conclusions:

• The current surgical oncology training environment faces challenges including duty hours, technological advancements, and evolving employment models.
• A thorough understanding of the existing oversight bodies is crucial for any proposed changes to the training framework.
• Adapting the Complex General Surgical Oncology (CGSO) Fellowship towards a Competency-Based Medical Education (CBME) model requires a clear grasp of the current regulatory machinery.