Promoting a diverse and intense clinical experience is a central priority of the Fellowship Program. Acute Care surgical rotations will take place in Saskatoon at the Royal University Hospital, as well as St. Paul’s Hospital. There are two Acute Care surgical services in Saskatoon, one at each facility. These surgical units function as the major referral center for the northern half of the Province, and therefore, provide a large volume of diverse surgical urgent and emergent cases. The Royal University Hospital facility also provides Trauma services for the northern half of the Province which will provide the Fellow with the opportunity to enhance their trauma management and operative skills.

The exposure to Community Surgical experiences may take place in one of our affiliated Regional Teaching Centers. Our Regional centers will expose the Fellows to the breadth of surgical skills and the challenges of practice in a  rural surgical location. There will be opportunities to learn procedures not typically associated with traditional General Surgical training. The opportunity to enhance skills in areas such as endoscopy will also be available.

The rotation schedule will include elective time which can be utilized for focused training in specialized surgical skills. Opportunities for trauma exposure in high acuity centers can be accommodated. Elective time can also be used for rotations such as Urology, Plastics, or Critical Care which would lead to enhanced skill development for practice in Regional Centers. Examples of this could include cystoscopy, carpal tunnel release, c-sections etc.

ACS Fellows will serve as clinical and administrative chiefs on dedicated ACS services, and are responsible for directing patient management, teaching, and initiation and completion of surveillance and quality improvement initiatives. Opportunities will also be available for training of Graduates and Undergraduate students in both clinical and simulation settings.

The fellowship has an educational curriculum that includes: reading for Journal Club, and formal rounds presentation. All Fellows are encouraged to consider research opportunities, based on their personal interest and career ambitions. Clinical research endeavors are supported, and fellows will be encouraged to present their work at major National/International meetings.

A fellowship candidate must meet the following criteria:

1. has completed training and holds an M.D. or equivalent degree and
2. has completed an accredited General Surgery residency with certification upon starting the fellowship.

The Fellowship is advertised in the Fall for a yearly start date of July 1^st.

Clinical Fellowship Objectives:  CanMEDS Roles

1. Medical Expert

As Medical Experts, physicians integrate all of the CanMEDS Roles, applying medical knowledge, clinical skills, and professional attitudes in their provision of patient-centered care.  Medical Expert is the central physician Role in the CanMEDS framework.

• Investigation and diagnosis of all urgent and emergent general surgical conditions.
• Indications for operative management of all urgent and emergent general surgical conditions.
• Indications for management via interventional techniques.
• Indications for conservative management.
• Establishment of management priorities in acutely ill surgical patients.
• Organization of appropriate discharge planning and follow up.
• Technical expertise and independent performance of the following surgical skills:
  • Laparotomy for perforated or bleeding gastric pathology
  • Laparotomy for small bowel obstruction
  • Laparotomy for perforated or obstructed large bowel disease
  • Repair of incarcerated abdominal hernias
  • Laparoscopic or Open Cholecystectomy
  • Laparoscopic or Open Appendectomy
  • Pancreatic Debridement
  • Debridement of severe soft tissue infection
  • Endoscopic management of acute GI pathology including bleeding
  • Endoscopic management of feeding tubes

2. Communicator

As Communicators, physicians effectively facilitate the doctor-patient relationship and the dynamic exchanges that occur before, during, and after the medical encounter.

• Demonstrate effective communication with patients and families characterized by understanding, trust, empathy, and confidentiality.
• Demonstrate effective communication with team members, including nursing and support staff characterized by understanding, respect and collegiality.
• Efficient management of all written documentation including, progress notes, discharge summaries, operative notes.
• Ability to constructively deal with conflict within the team or with patients and families.

3. Collaborator

As Collaborators, physicians effectively work within a healthcare team to achieve optimal patient care.

• Demonstrate effective interaction with health care professionals with recognition of their roles in patient care.
• Effective use of Consultative services.
• Develop patient care plans which utilize all aspects of the patient care team.

4. Manager

As Managers, physicians are integral participants in healthcare organizations, organizing sustainable practices, making decisions about allocating resources, and contributing to the effectiveness of the healthcare system.

• Understand the concepts of resource utilization in a Canadian health care environment.
• Allocate resources appropriate for all patients.
• Demonstrate effective leadership with appropriate delegation of responsibilities to other medical and non-medical team members.
• Participate in the selection of appropriate cases for quality improvement and case presentation academic rounds.

5. Health Advocate

As Health Advocates, physicians responsibly use their expertise and influence to advance the health and well-being of individual patients, communities, and populations.

• Identify the important determinants of health which are common to Acute Care surgical diseases.
• Prioritize resources to address the needs of patients presenting with urgent and emergent surgical issues.
• Understand the relationship between disease prevention and identification of risk factors which may be modified through lifestyle changes as well as community resources.

6. Scholar

As Scholars, physicians demonstrate a lifelong commitment to reflective learning, as well as the creation, dissemination, application and translation of medical knowledge.

• Commitment as a specialist to engage in lifelong learning and pursuit of mastery
• Recognize gaps in one’s own knowledge base and seek out learning opportunities to remedy any deficiencies.
• Utilize an evidence-based approach to resolve acute surgical issues.
• Participate in the dissemination of evidence-based practice in General Surgery via presentations at academic rounds.

7. Professional

As Professionals, physicians are committed to the health and well-being of individuals and society through ethical practice, profession-led regulation, and high personal standards of behavior.

• Deliver the highest quality of care with integrity, understanding, and compassion.
• Have knowledge and understanding of the professional, legal, and ethical obligations to which a surgeon is bound.
• Demonstrate appropriate personal and inter-personal behavior.

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