The annual promotion assessment consists of the following components: a. Written examination b. Continuous Assessment

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1 SAUDI FELLOWSHIP TRAINING PROGRAM ADULT MEDICAL ONCOLOGY Promotion Examination 2019 Objectives: The general objective of the annual promotion assessment is to evaluate that the trainee has satisfactorily acquired the theoretical knowledge and clinical competences that he/she should have acquired during the relevant year(s). The annual promotion assessment consists of the following components: a. Written examination b. Continuous Assessment Eligibility for Written Examination: Valid registration with the SCFHS. Completion of at least nine months of training in the concerned year of residency/fellowship training. Written Examination Format: A written examination shall consist of one paper with not less than 100 MCQs with a single best answer (one correct answer out of four options). The examination shall contain type K2 questions (interpretation, analysis, reasoning and decision making) and type K1 questions (recall and comprehension). The examination shall include basic concepts and clinical topics relevant to the specialty. Clinical presentation questions include history, clinical finding and patient approach. Diagnosis and investigation questions; include the possible diagnosis and diagnostic methods. Management questions; including treatment and clinical management, either therapeutic or nontherapeutic, and complications of management. Materials and Instruments questions; including material properties, usage, and selection of instruments and equipment used. Health maintenance questions; include health promotion, disease prevention, risk factors assessment, and prognosis, see examples below. Page 1

2 Continuous Assessment Formats: Continuous assessment formats consist of: a. In-training evaluation reports (ITERs). 20% o ITERs should be conducted at least three times that covers 9 training months per year. o ITERs are submitted to local supervisory committee for each trainee based on Case-based Discussion ratings considered relevant by the specialty. b. Academic assignments 25%. I. Regional treatment plan oral presentation (CBD): 10% o The resident will be evaluated based on an oral presentation as part of the his/her annual promotion assessment where he/she describes a case, including history-taking, diagnostic tools used, diagnosis in each discipline, and how he/she can formulate an integrated treatment plan and identify alternative plans. II. Quizzes: 15% o Three quizzes contacted through the year c. Log book 20% o Daily evaluation of resident his\her cases base on quality and quantity of treatment. If any other assessment format (not mentioned above) is used, the CAC must agree to its implementation. Page 2

3 Passing Score for Promotion Exam: The trainee's performance is assessed in each of the evaluation formulas according to the following scoring system: Score Less than 50% 50% 59.4% 60% % More than 70% Description Clear Fail Borderline Fail Borderline Pass Clear Pass 1. To upgrade the trainee from a training level to the next level, She/he must obtain at least a Borderline Pass in each evaluation form. 2. The program director may recommend to the local supervision committee to request the promotion of the trainee who did not meet the previous promotion requirement according to the following: A. In case that the trainee gets a borderline Fail result in one of the evaluation forms, the remaining evaluation forms must be passed with Clear Pass in at least one of them. B. In case that the trainee gets a borderline Fail result in two of the evaluation forms to a maximum, provided they do not fall under the same theme (Knowledge, Attitude, Skills). The remaining evaluation forms must be passed with Clear Pass in at least two of them. C. The promotion must be approved in this case by the Scientific Council for the specialization. Score Report: All written examination score reports shall go through a post-hoc item analysis before being approved by Executive Director of Assessment, within two weeks of the examination. Scientific Examination Committee is encouraged to provide the Scientific Council for the specialty with results feedback representing the performance of all residents based on each section of the exam according to the test blueprint, and based on their training center if possible. Page 3

4 General Rules: The written examination shall be held once a year within 4-6 weeks of completion of nine months of training in that particular year. There shall be no re-sit examination. There shall be no promotion written examination at the end of final year of training. Promotion written examination and continuous assessment results are valid for the specific year in which they were conducted. Blueprint Outlines No. F1 Section Proportion% 1 Hematologic Neoplasms 11 % 2 Thoracic Cancer 9% 3 Breast Cancer 15% 4 Genitourinary Cancer 8% 5 Gynecologic Cancer 5% 6 Gastrointestinal Cancer 15% 7 Other Solid Tumors 3% 8 Anticancer Therapeutics 10% 9 Supportive Care, Survivorship, and Radiotherapy 8% 10 Head, Neck, Thyroid, and Central Nervous System Malignancies 5% 11 Genetics and Tumor Biology and Epidemiology of Cancer in Saudi Arabia 3% 12 Ethics and Research 8% Total 100% Note: Blueprint distributions of the examination may differ up to +/-3% in each category. Page 4

5 Suggested References: The Basic science of oncology by Ian Tannock. Cancer principles and practice of oncology by Devita, Helman, and Rosenberg s. Professionalism and Ethics, Handbook for Residents, Practical guide, Prof. James Ware, Dr. Abdulaziz Fahad Alkaabba, Dr. Ghaiath MA Hussein, Prof. Omar Hasan Kasule, SCFHS, Latest Edition. Essentials of Patient Safety, SCHS, Latest Edition. Crash Courses: Outline of each course including suggested reading references given by the provider. Note: This list is intended for use as a study aid only. SCFHS does not intend the list to imply endorsement of these specific references, nor are the exam questions necessarily taken solely from these sources. Page 5

6 Example Questions EXAMPLE OF K1 QUESTIONS Question 1 Which of the following best describe the role of anti EGFR biological agents in non-small cell lung cancer? A. Erlotinib is best used with Exon 20 deletion B. Used in second line in All patient with adeno carcinoma C. Used in all patients with wild type EGFR genetic subtype D. Used as maintenance therapy for squamous cell subtype EXAMPLE OF K2 QUESTIONS Question 1 A 65-year old man presented with a progressive left breast mass over one year. He sought medical advice and was found to have a 4cm retroaerolar mass. Biopsy revealed Invasive ductal cancer. He had palpable nodes. Staging work was negative. He underwent left Modified Radical Mastectomy 4 weeks ago (see report). Pathology: A 3.5 cm Grade 2 Invasive cancer estrogen and progesterone receptor strongly positive and her 2 negative with negative margins, 2 out of 11 nodes were involved with metastatic cancer. Which of the following is the best adjuvant therapy? A. Chest wall radiation therapy and Adjuvant Tamoxifen B. Adjuvant anthracycline based therapy for 3 4 cycles followed by chest wall radiation therapy and Tamoxifen C. Adjuvant chemotherapy with anthracycline based therapy followed by taxanes based therapy, followed by chest wall Radiation therapy and Tamoxifen D. Adjuvant chemotherapy with anthracycline based therapy followed by taxanes based therapy, followed by chest wall Radiation therapy and aromatase inhibitors (Letrozole) Page 6