Specialty program: General Surgery residency

Objectives:
General Objectives
To train general surgeons capable of practicing surgery independently, safely, and competently with a strong ethical foundation at the specialist level, able to teach and undertake clinical research with life-long learning spirit.
Specific Objectives
At the end of four years of surgical training the resident will have:

good command of Ethiopia’s health policies as well as the community health needs.
the ability to conduct clinical research.
excellent leadership, teaching, and communication skills.
a strong foundation in the biomedical and clinical sciences that underlies surgical conditions.
the attitude, values, and ethics of medical professionalism and a commitment to service.

Entry Requirements:

Academic requirements:

The candidate should be a holder of a degree of Doctor of Medicine from a recognized university/college.
The candidate must be a registered general practitioner by the Federal Ministry of Health of Ethiopia.
The candidate must pass the national entrance written examination and interview.
Foreign applicants must hold a degree of Doctor of Medicine, must produce their professional license, and a letter of good standing from their local accreditation body.
Admission of foreign applicants shall be governed by the legislation of the University/College.

Non-academic requirements:

Applicants must be in acceptable physical and mental health, without any serious health conditions that would limit their ability to cope with the requirements of the training program and service. The department reserves the right to deny admission to unfit candidates (after medical checkup) as determined by the department council.
Applicants should not be older than 40 years of age.
Female candidates are strongly encouraged and given special consideration.
Applicants should bring two confidential letters of recommendation.

Personal attitudes and skills:

Caring attitude and ability to work in team
Honesty, reliability, and readiness to undertake responsibility
Potential to cope with stressful situations
Commitment to learning and punctuality
Good communication skills

Other requirements:

Prepared to rotate among different units or training hospitals

Criteria for selection (In case the current admission by the FMOH is terminated)

Entrance written examination – 60%

Entrance interview – 40%

Documents (5%)
Service year (5%)
Cumulative GPA (5%)
Internship evaluation in Surgery (10%)
Research (5%)
Interview (10%)

N.B: Candidates must score 60% or above to be considered for admission.
Duration of Study: 4 years
Graduate Profile: _
At the end of the program, the trainee will achieve adequate knowledge, skill, and value in the following profiles of a physician:according to the canmeds
A.Medical Expert

As Medical Experts, physicians integrate all of these roles: medical knowledge, clinical skills, and professional attitudes in order to ensure high-quality and safe, patient-centered care.
As Medical Experts who provide high-quality, safe, patient- centered care, physicians draw upon an evolving body of knowledge, their clinical skills, and their professional attitudes. They collect and interpret information, make clinical decisions, and carryout diagnostic and therapeutic interventions. They do so within their scope of practice and with an understanding of the limits of their expertise. Their decision-making is informed by best practices and research evidence and takes into account the patient’s circumstances and preferences as well as the availability of resources. Their clinical practice is up-to-date, ethical, and resource-efficient. Their clinical practice is conducted in collaboration with the patients and their families as well as other health care professionals and the community. The Medical Expert serves the function of the physician but also draws on the competencies included in their intrinsic roles (Communicator, Collaborator, Leader, Health Advocate, Scholar, Manager, and Professional).

B.Communicator

Communication skills refer to interpersonal communication skills that result in effective information exchange and collaboration with patients, patients’ families, professional associates, and the community at large.
Physicians enable patient-centered, therapeutic communication by exploring the patient’s symptoms, which may be suggestive of disease, and by actively listening to the patient’s experiences with his or her illness. Physicians explore the patient’s perspective, including his or her fears, ideas about the illness, feelings about the impact of the illness, and expectations of their health care. The physician integrates the following to understand the patient’s context: their socio-economic status, medical history, family history, stage of life, living situation, work or school setting, and other relevant psychological and social issues. Central to a patient- centered approach is shared decision-making: finding common ground with the patient in developing a plan to address his or her medical problems and health goals in a manner that reflects the patient’s needs, values, and preferences. This plan should be informed by evidence and guidelines.
Because illness affects not only patients but also their families, physicians must be able to communicate effectively with everyone involved in the patient’s care.

C.Collaborators

As Collaborators, physicians work effectively with other health care professionals and support staff to provide safe, high-quality, and compassionate patient-centered care.
Collaboration is essential for safe, high-quality, patient-centered care, and involves patients and their families, physicians and other colleagues in the health care professions, community partners, and health system stakeholders. Collaboration requires relationships based on trust, respect, and shared decision-making among a variety of individuals with complementary skills in multiple settings across the continuum of care. It involves sharing knowledge, perspectives, and responsibilities, and a willingness to learn together. This requires understanding the roles of others, pursuing common goals and outcomes, and managing differences. Collaboration skills are broadly applicable to activities beyond clinical care, such as administration, education, advocacy, and scholarship.

D.Leader

As Leaders, physicians develop a vision of a high-quality health care system and, in collaboration with other health care leaders, take responsibility for effecting change to move the system toward the achievement of that vision.
Leadership and management ability are core requirements for the practice of medicine. Physicians and others exercise collaborative leadership within the complex health care systems that form their specific work environments. At a system level, physicians contribute to the development and delivery of continuously improving health care and engage others to work with them toward this vision. Physicians must balance their personal lives with their responsibilities as leaders and managers in their everyday clinical, administrative, research, and teaching activities. They function as individual care providers, as members of teams or groups, and as participants and leaders in the health care system locally, regionally, nationally, and globally. The Leader Role describes the active engagement of all physicians as leaders and managers in decision making in the operation and ongoing evolution of the health care system.

E.Health Advocate

As Health Advocates, physicians contribute their expertise and influence as they work to be role models for communities or patient populations to improve health. They work with those they serve to determine and understand needs, speak on behalf of others when needed, and support the mobilization of resources to effect change. Physicians consider the cultural context of the community whenever they engage in health advocacy and promotion.
Physicians recognize their duty to participate in efforts to improve the health and well-being of their patients, their communities, and the broader populations they serve.* Physicians possess medical knowledge and abilities that provide unique perspectives on health. Physicians also have privileged access to patients’ accounts of their experience with illness and the health care system. Improving health is not limited to mitigating illness or trauma, but also involves disease prevention, screening, health promotion, surveillance, and health protection. Improving health also includes promoting health equity, whereby individuals and populations reach their full health potential without being disadvantaged by, for example, race, ethnicity, religion, gender, age, social class, economic status, or level of education.
Physicians leverage their position to support patients in navigating the health care system and to advocate with them to access appropriate resources in a timely manner. Physicians seek to improve the quality of both their clinical practice and associated organizations by addressing the health needs of the patients, communities, or populations they serve. Physicians promote healthy communities and populations by influencing the system (or by supporting others who influence the system), both within and outside of their work environments. Advocacy requires action. Physicians contribute their knowledge of the determinants of health to positively influence the health of the patients, communities, or populations they serve. They take steps to maintain their own physical and mental health, using coping strategies and seeking appropriate assistance as needed; in this way, they serve as role models by advocating for and promoting healthy life style. Physicians gather information and perceptions about issues, working with patients and their families to develop an understanding of needs and potential mechanisms to address these needs. Physicians support patients, communities, and populations to call for change and they speak on behalf of others when needed. Physicians increase awareness about important health issues at the patient, community, and population level. They support or lead the mobilization of resources (e.g., financial, material, or human resources) on small and large scales.

F.Scholar

As Scholars, physicians demonstrate a lifelong commitment to excellence in practice through continuous learning, the teaching of others, the evaluation of evidence, and contributions to scholarship.
Physicians acquire scholarly abilities to enhance practice and advance health care. Physicians pursue excellence by continually evaluating the processes and outcomes of their daily work, sharing, and comparing their work with that of others while actively seeking feedback in the interest of quality and patient safety. Using multiple ways of learning, they strive to meet the needs of individual patients and their families and for the health care system at large. Physicians strive to master their domains of expertise and to share their knowledge. As lifelong learners, they implement a planned approach to learning in order to improve in each role. They recognize the need to continually learn and to model the practice of lifelong learning for others. As teachers, they facilitate, individually and through teams, the education of students and residents, colleagues, co-workers, the public, and others. Physicians are able to identify pertinent evidence, evaluate it using specific criteria, and apply it in their scholarly activities and practice. Through their engagement in evidence-informed and shared decision-making, they recognize uncertainty in practice and formulate questions to address knowledge gaps. Using skills in navigating information resources, they identify evidence syntheses that are relevant to these questions and arrive at clinical decisions that are informed by evidence, while taking patient values and preferences into account. Finally, physicians scholarly abilities allow them to contribute to the application, dissemination, translation, and creation of knowledge and practices applicable to health and health care.

G.Professional

As Professionals, physicians are committed to the health and well-being of individual patients and society through ethical practice, high personal standards of behavior, dedication to the profession, profession-led regulation, and maintenance of personal health.
Physicians serve an essential role as professionals dedicated to the health and care of others. Their work requires mastery of the art, science, and practice of medicine. The professional identity of physicians has developed over millennia, and the Professional Role reflects contemporary society’s expectations of physicians. This role includes clinical competence, a commitment to ongoing professional development, a promotion of the public good, and an adherence to ethical standards and values, such as integrity, honesty, altruism, respect for diversity, and transparency with respect to potential conflicts of interest. It is also recognized that to provide optimal patient care, physicians must take responsibility for their own health and well-being and that of their colleagues. The professionalism of physicians is the basis of the implicit contract between society and the medical profession; physicians are granted the privilege of profession-led regulation with the understanding that they are accountable to those served, to society, to their profession, and to themselves.

Graduation Requirements:
The following are mandatory requirements for completion and elgibility for certification:
A.Program requirements:
⇨Completion of four years (48 months) of residency training with one month leave each year assigned by the department
⇨Successful exam qualification with a minimum aggregate score of 70% each year
⇨Submission of a well-kept counter signed and approved log book
⇨A progressive assessment report from the four years of training
⇨Submission of a mandatory research paper completed at the fourth year, six months prior to the qualification exam
B.Courses and workshop requirements:
⇨Basic Surgical Skills course (During Year I)
⇨Research Methodology course
⇨Ethics and medico-legal courses
⇨“Resident as a teacher” course
Optional courses
⇨A certified trauma course (once during the four years)
⇨Basic laparoscopy course
⇨Basic endoscopy course
⇨Basic endo-urology course
C.Operative Experience and skill requirements:
⇨To sit for the final qualification examination, the resident should perform a minimum of 500 operative procedures in four years, including at least 100 operative procedures in the final year of residency. The procedures must include operative experience in each of the content areas listed in Annex 1. The list of procedures must be clearly documented in the individual log books of the residents. Residents must also indicate their level of responsibility for the procedures listed.
D.Research Projects
The postgraduate education committee assigns one original research project for each resident during the second year of training. The resident develops project, collects data, and under the supervision of assigned preceptor/advisor, prepares the manuscript for presentation on a specific defense day. Publications and presentations at one or several surgical meeting including the department, school or college of medicine or other local, regional, or international scientific conferences is strongly recommended. The student and the advisor should spend a minimum of 20 consultation hours together, which should be monitored by the postgraduate coordinator.
Degree nomenclature:
After successful completion of the training and fulfilling the graduation requirement, the University Senate, upon recommendation by the Academic Commission, shall award the Specialty Certificate to the graduate titled as:
“Certificate of Specialty in General Surgery”
“የስፔሻሊቲ ሰርተፊኬት በጠቅላላ ቀዶ ህክምና”
List and semester breakdown of courses

Year	Course Selection	Duration
One	General Surgery I Orthopedic I Urology Trauma and Emergency Surgical Skill Lab Research Methodology Medical Ethics and Hospital Management Resident as a teacher Vacation	6 months 1 month 1 month 1 month 2 weeks 2 weeks 2 weeks 2 weeks 1 month
Two	General Surgery II Urology Orthopedic II Radiology Anesthesia – Operating Room (OR) Anesthesia – ICU Oncology Vacation	4 months 1 month 2 months 1 month 1 month 1 month 1 month 1 month
Three	General Surgery III Orthopedics III Obstetrics & Gynecology Plastic and Reconstructive Surgery Neurosurgery Pediatrics Surgery Vacation	5 months 1 month 1 month 1 month 1 month 2 months 1 month
Four	General Surgery IV Cardiothoracic Urology Study leave Exam month Vacation	7 months 1 month 1 month 1 month 1 month 1 month