1. Report on the Division of General Surgery (May ’18)
Arthur Felice

2. Notable dates
26th and 27th September 2017: Part 1 and Part 2 of the UEMS EBSQ General Surgery Examination in Krakow.
27th September 2017: Meeting of the UEMS Division of General Surgery in Krakow
UEMS CESMA Workshop and Meeting on the 8th and 9th December in Brussels
UEMS EBSQ General Surgery Examination in Malta on the 12th and 13th September 2018
Division of General Surgery Meeting in Malta on the 13th September 2018

3. Financial situation
Healthy balance, but it will only take one or two exams with poor participation to render it precarious.

4. Structural alterations
Inclusion in the Examination Committee of a Head of Medical Assessment of the Division of General Surgery (Dr Marie Morris from Ireland). This is an honorary post created in 2017 to further professionalise and develop the examination.

5. Intended alterations to the EBSQ General Surgery Examination
The Eligibility Process to be recognised as an integral part of General Surgery Assessment and named as Part 1 of the Exam. The process will be formalised even more than it is at present.
The terminology associated with the 3 parts of the Examination will evolve at the 2018 Division of General Surgery Meeting.
The MCQ Part of the Examination has a Standard Setting at 65% of the 95th percentile. Those who do not reach this pass mark are excluded from sitting the Oral OSCE Examination.
The Standard Setting for the cumulative marks obtained at the Written (MCQs) and Oral (OSCE) is 75% of the 95th percentile (Modified Cohen Standard Setting)

6. The UEMS EBSQ General Surgery Examination
The examination is not only a priority for the Division, but the essential funding stream.
It constitutes our contribution for the improvement of professional standards and consequently patient safety.

7. Number of candidates per Exam session

8. Problems
Intrusion into the EBSQ General Surgery Examination webpage by outsize pink banners with links leading to the MIS Exam registration.
Difficulty experienced by potential applicants for the EBSQ General Surgery Examination to access the electronic application process.

9. If one accesses the UEMS Surgery Website and clicks on General Surgery Examination, this is what pops up:

10. If one goes to EBSQ Examinations in General Surgery and clicks on EBSQ Malta 2018, this is where one is led:

11. This situation goes on and on throughout the Website, whichever avenue one takes.

12. All the roads lead to Rome (MIS Exam) and the alleyways to the General Surgery Exam are blocked.

13. The Division of General Surgery, the Jeronimo Project and CCST (CCT)
CCST (CCT) stands for Certificate of Completion of Specialist Training. It would be senseless to award it after passing the online new General Surgery MCQ Exam (which would be equivalent to an MRCS) earlier on in training – ref. to Slide 16 and 17 in the Lisbon presentation).
If CCST is expected prior to sitting the EBSQ ,trainees from all countries where CCST is formally in place, will not be eligible to sit it.
Similarly, applicants from countries where CCST (CCT) does not exist, would also be barred from applying for the EBSQ General Surgery.

14. Suggested solutions:
The EBSQ General Surgery MCQs, in the electronic format, could be organised at an earlier level of training (e.g. at the end of BST level) and possibly in multiple centres. This would include a reasonable chunk of Basic Sciences in the Blueprint. This is not the level to award CCST (CCT).
A possible two-rail system is proposed where countries can choose to adopt EBSQ exam as an exit exam to get CCT (CCST) leading to Specialist registration, or to award CCT (CCST) at the end of training and then trainees will be able to sit the EBSQ and subsequently apply for Specialist registration.

15. The Division of General Surgery and an Examination in Basic Surgical Sciences
The Division of General Surgery does not have any conceptual objection to an Examination in Basic Surgical Sciences.
The Division of General Surgery would have an objection if the Examination in Basic Surgical Sciences becomes a compulsory pathway before sitting the EBSQ General Surgery. This would mean that the Eligibility Criteria of the Examination in Basic Surgical Sciences, with which the Division of General Surgery may have differences (e.g. the reference to CCST as indicated in the Jeronimo Project), would govern application for the EBSQ General Surgery Examination.

16. One needs real dialogue
…….but proper dialogue is reciprocal, not…

17. Any questions?

18. Thank you

19. Extract from e-mail from Prof. Feil sent 02/07/2017
In the last months I had not only to cope with the ongoing process of ISO certification in my hospital, I installed a second surgical dept. (Chairman: Georg Bischof) and took my responsibilty in the hospital quality management besides from everyday clinical workload. Last week I received the vocation to be the "Chief Medical Officer" in my hospital.
This means that I have now to reschedule my working time. I will stay in my post as President of the UEMS Board in any case with all responsibilities, but I have to reduce other time consuming works, that can be shifted away from my desk. This is why I have to draw back from the very time consuming work preparing the GenSurg Exam. I am happy and proud, that we relaunched GenSurg successfully and established our Exam as guiding line and basis for all other surgical examinations and went successfully through the CESMA validation process and started with the electronic online exam.
For me it is from now on not possible to enter questions into the databasis, structure the conduction of the exam, esp. the OSCEs. In any case I will support you with the questions from my database and all the MCQ and OSCE scenarios that already exist and also give you all macros and necessary layouts.