Specific Standards of Accreditation for Residency Programs in Gynecologic Reproductive Endocrinology & Infertility 2011 INTRODUCTION A university wishing to have an accredited program in Gynecologic Reproductive Endocrinology & Infertility must also sponsor an accredited program in Obstetrics and Gynecology. The purpose of this document is to provide program directors, surveyors and residents with an interpretation of the general standards of accreditation as they relate to the accreditation of programs in Gynecologic Reproductive Endocrinology & Infertility. This document should be read in conjunction with the General Standards of Accreditation, the Objectives of Training and the Subspecialty Training Requirements in Gynecologic Reproductive Endocrinology & Infertility. STANDARD B1: ADMINISTRATIVE STRUCTURE There must be an appropriate administrative structure for each residency program. Please refer to Standard B1 in the General Standards of Accreditation for the interpretation of this standard. The program director must be Royal College certified in Gynecologic Reproductive Endocrinology & Infertility or possess the equivalent qualifications. STANDARD B2: GOALS AND OBJECTIVES There must be a clearly worded statement outlining the goals of the residency program and the educational objectives of the residents. The general goals and objectives for Gynecologic Reproductive Endocrinology & Infertility are outlined in the Objectives of Training and the Subspecialty Training Requirements in Gynecologic Reproductive Endocrinology & Infertility. Based upon these general objectives each program must develop rotation specific objectives suitable for that particular program, as noted in Standard B2 of the General Standards of Accreditation. STANDARD B3: STRUCTURE AND ORGANIZATION OF THE RESIDENCY PROGRAM There must be an organized program of rotations and other educational experiences, designed to provide each resident with the opportunity to fulfill the educational requirements and achieve competence in the subspecialty. The structure and organization of each accredited program in Gynecologic Reproductive Endocrinology & Infertility must be consistent with the specialty training requirements as outlined in the Objectives of Training and the Subspecialty Training Requirements in Gynecologic Reproductive Endocrinology & Infertility. This document may be reproduced for educational purposes only provided that the following phrase is included in all related materials: Copyright 2011 The Royal College of Physicians and Surgeons of Canada. Referenced and produced with permission. Please forward a copy of the final product to the Office of Education, attn: Associate Director. Written permission from the Royal College is required for all other uses. For further information regarding intellectual property, please contact: documents@royalcollege.ca. For questions regarding the use of this document, please contact: accred@royalcollege.ca. Page 1 of 5
The program must be organized such that residents are given individual professional responsibility, under appropriate supervision, according to their level of training, ability, and experience. STANDARD B4: RESOURCES There must be sufficient resources including teaching faculty, the number and variety of patients, physical and technical resources, as well as the supporting facilities and services necessary to provide the opportunity for all residents in the program to achieve the educational objectives and receive full training as defined by the Royal College specialty training requirements in Gynecologic Reproductive Endocrinology & Infertility. In those cases where a university has sufficient resources to provide most of the training in Gynecologic Reproductive Endocrinology & Infertility but lacks one or more essential elements, the program may still be accredited provided that formal arrangements have been made to send residents to another accredited residency program for periods of appropriate prescribed training. Learning environments must include experiences that facilitate the acquisition of knowledge, skills, and attitudes relating to aspects of age, gender, culture, and ethnicity appropriate to Gynecologic Reproductive Endocrinology & Infertility. 1. Teaching Faculty There must be a sufficient number of teaching staff/faculty with qualifications acceptable to the Royal College to provide appropriate teaching and supervision of residents. There must be a sufficient number of teaching staff/faculty who have appropriate research expertise to oversee the resident. There must be an adequate academic infrastructure to support the teaching. 2. Number and Variety of Patients There must be a sufficient number and variety of patients in all age groups experiencing disorders of the reproductive and endocrine system that interfere with reproductive health and the human procreative process. 3. Clinical Services Specific to Gynecologic Reproductive Endocrinology & Infertility a) Surgical Procedures Gynecologic reproductive endocrinology & infertility services participating in the program must have access to adequate surgical teaching volumes including minimally invasive surgery. b) Ambulatory Services Organized clinics or other ambulatory care facilities must be available to provide opportunities for follow-up of patients. Such assignments to these clinics must constitute a learning experience supervised by the teaching staff. Page 2 of 5
c) Emergency Facilities Facilities suitable for emergency and urgent care must be available for residents to develop expertise in the initial diagnosis and management of GREI types of emergencies. d) Other Clinical Resources Residents must be familiar with diagnostic procedures (listed in the FITER), their indications, contra-indications, techniques, limitations, sources of error, and interpretation. Clinical facilities must be organized for teaching the investigation and treatment of the disorders defined under reproductive endocrinology and infertility. These disorders include reproductive endocrinopathy in the female and male, the infertile couple, recurrent pregnancy loss, relevant endocrine abnormalities of childhood and adolescence, menopause, dysfunctional uterine bleeding, premenstrual dysphoric disorder (PMDD) and sexual dysfunction. 4. Supporting Services - Clinical, Diagnostic, Technical The following special facilities and services must be available for the training of residents and closely coordinated with the overall program: i. Core diagnostic biochemical and immunoassay facilities for steroid and peptide hormones. ii. Clinical and diagnostic investigation units for both in-patient and/or outpatient assessment of patients with gynecologic reproductive endocrinology and infertility disorders. iii. A teaching service in internal medicine with a program in Endocrinology and Metabolism. iv. A clinical service in pathology with provision for the study of endometrial biopsies and other material obtained surgically. v. A clinical service in nuclear medicine and/or radiology, including specialized staff and facilities in the following areas - CT scanning, ultrasonography and MRI. vi. A clinical service in urology providing consultation services in male infertility and andrology. vii. A consultation service in medical genetics. viii. Consultation in clinical epidemiology and biostatistics Page 3 of 5
STANDARD B5: CLINICAL, ACADEMIC AND SCHOLARLY CONTENT OF THE PROGRAM The clinical, academic and scholarly content of the program must be appropriate for university postgraduate education and adequately prepare residents to fulfill all of the CanMEDS Roles of the specialist. The quality of scholarship in the program will, in part, be demonstrated by a spirit of enquiry during clinical discussions, at the bedside, in clinics or in the community, and in seminars, rounds, and conferences. Scholarship implies an in-depth understanding of basic mechanisms of normal and abnormal states and the application of current knowledge to practice. Please refer to Standard B5 in the General Standards of Accreditation, the Objectives of Training, the Subspecialty Training Requirements in Gynecologic Reproductive Endocrinology & Infertility, and the CanMEDS Framework for the interpretation of this standard. Each program is expected to develop a curriculum for each of the CanMEDS roles, which reflects the uniqueness of the program and its particular environment. Specific additional requirements are listed below. 1. Medical Expert In addition to the General Standards of Accreditation, the following requirements apply - Where certain clinical conditions occur so infrequently that clinical material is not always available, then the teaching program must ensure that by formal means adequate exposure to these areas is achieved. - The program should include teaching in the basic science related to the specialty, including the physiology, pathophysiology and pathology of the hypothalamus and pituitary-gonadal axis. 2. Communicator 3. Collaborator 4. Manager 5. Health Advocate 6. Scholar In addition to the General Standards of Accreditation, the following requirements apply. Page 4 of 5
- The program must provide opportunities for each resident to present to an audience during their residency training a topic pertinent to their educational objectives. - There must be opportunities for residents to participate in at least one research project during the course of their residency program. Resources must be provided to facilitate the resident s preparation of a report suitable for submission to a peer reviewed journal. 7. Professional In addition to the General Standards of Accreditation, the following requirements apply - There must be opportunities for residents to become familiar with and monitor the impact of the new reproductive technologies on bioethics and health economics. STANDARD B6: EVALUATION OF RESIDENT PERFORMANCE There must be mechanisms in place to ensure the systematic collection and interpretation of evaluation data on each resident enrolled in the program. In addition to Standard B6 in the General Standards of Accreditation the following requirements apply. The residents must keep track (written or electronic list) of the number and types of procedures relevant to GREI, including assisted reproduction procedures and surgical procedures, performed during their training. Evaluation will also include the investigative manuscript(s) summarizing the research project(s) carried out by the resident as a prerequisite for successful completion of the residency program. Adopted/Council 97 04 11 Revised 99 03 26 Revised 05 06 29 Revised 06 03 Education Committee Revised April 2011 - SSRC Page 5 of 5