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زمالة جامعة الملك سعود 

 

POST GRADUATE

 

Combined KSU Fellowship and Saudi Board Training Program inOtorhinolaryngology and Head and Neck

Surgery

Section 1. -  Information  

King Abdulaziz University Hospital is one of the Teaching Institutions under King Saud University Hospital where it offers a Continuing Medical Education through its Fellowship over the years. 

One of its Fellowship Programs offers is in the field of Otorhinolaryngology and Head and Neck Surgery where, the Fellowship then is tied up and/or combined with that of the Training Program of the Saudi Council for Health Specialties.  King Abdulaziz University Hospital’s ORL Department then plays an important role and considered as the Center Hospital

While, five (5) other hospitals are affiliated and as well participating, where the Candidates are rotating during their entire training period (King Abdulaziz Medical City, Riyadh Al-Kharj Hospital, Riyadh Medical City, Security Forces Hospital and King Faisal Specialist and Research Centre)

Section 2. -  Post Graduate Unit

While ORL Department of King Abdulaziz University Hospital plays the major role, its Post Graduates’ Unit then is under its Department’s umbrella that shared the responsibilities concerning the affairs and handling the Candidates’ affairs and its program preparations. 

Post Graduate Coordinator has been delegated to handle the above responsibilities and has a direct supervision on this task.  He is coordinating with the members of the affiliated hospitals to attain the smooth flow of the training program.  He is as well responsible in furnishing the information to all its approving body particularly the ORL Department’s Board Members.

In coordination with the Department, in coming Residents will be given the necessary and important information as a sort of orientation which include:

 

a)     Securing bleep - Candidates may secure their bleep to the Post Graduate Unit’s Secretary at the beginning of each rotation and advising to return those bleeps at the end of their rotation.

b)     Bleeping system – Post Graduate Unit’s Secretary can assist the Candidates on how to use the bleep system in the hospital

c)     Their respective duties and obligations as per Department’s requirement e.g. on-call, workload-where it implies all the Residents activities for the whole rotation

period.  (these can be explained by the Post Graduate’s Secretary, Department’s Secretary and/or Clinic Coordination Secretary)

d)     Parking space and Candidates’ Badge– Candidates can coordinate with the PG Unit’s Secretary.

       For the arrangement of these things, a letter will  be sent to the Executive

      Director to request for the parking space for the rotating  Candidates and

      their respective Badges for identification purposes.

e)     Advising them  to go to Medical Records Department in securing their password to access to the Dictaphone system and/or contact the Secretaries at extension # 1051-1056 (note: usually, prior to the beginning of the new rotation, leaflet has been distributed to each of the Candidate for their information and the specified password numbers were indicated) 

f)      At the end of each rotation, Department’s clearance form should be secured and completed and this should be submitted to the Department (see attachment)

g)      Other instruction in relation to the Training Program and in relation to their rotation in the Department can be assisted by the Post Graduate and the Department’s   Secretary. 

Section 3. -  Residency’s Affairs

With pertains to the Residency’s affairs, originally it has a program of 4-year duration structured training period  in Otorhinolaryngology. But, it was rectified by the Executive Board / Scientific Board of the Training Program to a 5-year duration period to attain the maximum year of training exposures and expertise needed by the Candidates effective 1 October 2000.

Level of Residency is determined through category

R1 – 1st  Level (Rotation in General Surgery – ICU, Plastic and

         Neurosurgery)

R2 – 2nd  Level (rotation in ENT proper

         down to R5)

R3 – 3rd Level

R4 – 4th Level

R5 – 5th Level  (Graduating batch)

 

R1 Candidates will be rotating in the field of General Surgery as mentioned above for a period of 1 year.  While, for the R2 to R5, their rotation interval is within 3 months time.  Hence forth, 4-rotation period in each academic year.

Distribution of Candidates’ rotation will be determined during the Residency Training Committee Meeting prior to the beginning of its academic year in October.

Section 4Rotation

There are four quarters in each academic year.  Since, October is the beginning of the academic year, the first quarter will commence in October until December,  2nd is January to March, 3rd is April to June and the last quarter is July to September.

Prior to the beginning of each academic year, distribution of Candidates will be arranged and they will be deployed and distributed accordingly to the affiliated hospitals with respect to their levels of Residency and with respect to the general rules stipulated in the Residency Training Committee’s By-Laws and Policies.

    a) Resident’s workload

            There are 4 ORL Department’s Groups of King Abdulaziz University Hospital

            which consist of Consultants in their distinct and respective fields   of

            specialties.

            Candidates will be distributed among these groups, ensuring that on the

            whole training periods, chances to rotate in each group will be there for their

            appropriate exposures in different fields of specialty and under the

            supervision of each Group’s Head. 

            Proposal then, on the allocation and/or distribution of the Residents will be

            made by the Coordinator and will be forwarded to the Department Board for

            its approval.   When the allocation of Group of the specific Candidate

            has been determined, whole week activities are there which was made by the

            Clinic Coordinator and consequently approved by the Head of the 

            Department  as a guidance for the Candidates as well as for the Department

            as a whole. 

 

DAY

 

CLINIC

 

 ADMISSION/

  CLERKING

 

PRE-OP

 

OR

 

POST OP

OTHER

DIRECTIVE

DUTY

SAT

Group III

Group II

Group II

Group I

---

 

SUN

Group IV

Group III

Group III

Group II

Group I

 

MON

Group I

Group IV

Group IV

Group III

Group II

 

TUE

--

-

 

ER CASES

 Any group

Group III

 

WED

Group II

Group I

Group I

Group IV

----

 

THURS

 

 

 

 

Group IV

 

Other Directive Duty: the concern of this aspect is for the Residents and Registrars on their free time slot to cover          whatever Group that has a Staff  shortage that comply to the department’s protocol.  This is also a means of exposure especially to the Candidates to ENT related works whether in Clinic and OR with variety of ENT cases.

The Department is encouraging its Candidates to stay in  the hospital as much as they could to enable them to gin the much needed exposures in enhancing their individual crafts whether to deploy them in OR, Clinic and other hospital activity and related works.

Other Department’s guidelines (as per affiliated hospitals) General Policies and Procedures are expected to be adhered to by all the Candidates.

      b) Residents’ On-call Duty

        As part of the Candidates’ duties and obligations, they will be given an on-call

            duties.  This on call schedule will be on a monthly basis.  As a rule, a

            maximum of 10 on calls are allocated to eacH Candidates and in

compliance to the Department’s protocol (see attachment).

            Junior Candidates (R2 & R3) will be on the first  on call  slot, while, the 

            Seniors (R4 / R5) will be on the  second on-call slot the same as the

            registrars of the Hospital. 

      

            Note that, Senior Candidates will be having a double  number of duties as

            compared to that of  the Registrars as per  Department’s policies

            In addition, Junior Candidates (R2 & R3)  are expected to inform all the

attended cases during his/her on call days and subsequently, Senior will   inform the respective Consultant on call on those  cases for their proper

management of each cases.

       c)  Group Activity

                As part of the Department’s continuing medical education, group activities are

            esigned other than  that of the usual activities for the Candidates  which will

            be mentioned on the later part. 

            With Department’s 4 groups, this will be divided into 2 subgroups, Group I –

            Group III and Group II - Group IV.  Each Candidate of the 2 subgroups  will be

            presenting a case presentation.  This case then will be discussed and related

            literatures are reviewed by the Teaching Staff of the concern group in support

            and give a more detailed explanations.  The  venue is usually in the lecture

            hall of Building  2.

      d)  Rounds 

            Pre and Post operation rounds (5A, 5B, 6A, 6B) arethere for n specific group

            as mentioned above as part of the whole week activity for the Candidates.

            During these rounds, discussions and teaching sessions are being

            administered in order to have a good and concrete knowledge of each

            patient’s cases. 

     e) Clinic

            Specific clinic day is assigned to each Candidate depending on their group

            allocation.  (see above schedule).

            Candidate has an assigned clinic room adjacent to his/her Consultant-in-

            Charge. Different cases are there, consultation and referrals are made by the

            Resident to the Staff  for discussion and further management.

            Overall, ENT Clinic has 8 rooms and situated in Ground  floor of the main

            Building (Building 1).  The clinic will start at 8:00 a.m. to 12:00 noon,

             while, in  the afternoon, from  1:00 p.m. to 4:30 p.m..

    f)   Operation

            One of the objectives of the Training Program for  the Candidates is to give a

            more exposure and active participation in different variety of ENT procedures.      

            Candidates are expected to acquire a good surgical skills through the

            supervision of the Consultant in charge of the ENT Group.  Candidate will be

            exposed to variety of cases and they will be allowed to participate either as 

            Surgeon, 1st or 2nd Assistant .

            As a requirement of the Training Program, at  the end of        each rotation,

            Residents are obliged to  submit their logbook summary and to be submitted

            to Post Graduate Unit.  In turn, these will be discussed and assessed by the         

            Residency Training Committee on their meeting.          

            It has been advised as well to the Candidates to show their logbook to their

            respective Supervising Staff on a weekly basis and ask their signature(s)

            attesting to the listed procedures.

            The operation theater is located in level 2 of Building 1.

            The OR schedule will start at 7:30 a.m. until 4:30 p.m.

     g) Internal Affairs

            Any problems arising within the Group that concern with the Residents,

            this should be tackled  and solved within the Group itself.  However, if

            interference will be needed, this can be forwarded to the Coordinator, if not

            and/or depends on the weight of the incident, this can be addressed to the

            Head of the Department for Department Board resolution.

 Section 5 -  Hospital Feed Back Information

Prior to the end of each rotation period and each academic year, Candidates are requested to evaluate as well, the Teaching Staff of the affiliated hospitals. 

These evaluations will be discussed in the Residency Training Committee. 

Appropriate communication will be prepared by the Committee basing on the evaluations and to be sent to the concern Teaching Staff / Department Head for  their information. 

Section 6 -  Program/ Scientific Activities 

   a) Basic Science Course

            This is a one (1)-month compulsory Course to all the R2 Candidates of the

            Combined Residency training Program and held each year on the first

            Saturday after the Ramadan Holiday.  

Residents concerned will be released from their clinical training and commitments, and other hospital obligations on the inclusive period

            For the past two years, the Course was administered in other Region and on

            the coming year, it will be decided by the Committee.

    b)  Clinical Meeting Activity            

The activity will start at 1:00 p.m. to 2:00 p.m. in the main auditorium, 4th floor of Building 1 of King Abdulaziz University Hospital which is under the supervision of the Head of the ORL Department.           

The program is arranged by the Clinical Meeting Coordinator which includes

Clinico-Radiological Presentation, Clinico-Pathological Presentation, Case

Pesentation, Mortality and             Morbidity, Statistics and Epidemoly, Speech and

            Audiology Case Presentation and the Journal Presentation of the Candidates.                     

Occasionally there are presentations from the Companies, for their machine

            demonstration  which acquired by the Hospital, presentation of the invited

            Speakers from outside the Hospital and Country.   

            Participation of all the Teaching Staff in the University is compulsory to ensure

            a live and active discussions that will be beneficial to all Candidates.            

Above activity is announced to all the affiliated hospitals as a sort of information and  an invitation as well. 

      c) Tutorial Program

            This programme is arranged by the Coordinator and in coordination with the

            Chairman of the Residency Training Committee prior to the commencement

of  the academic year which was also discussed and approved in the Residency Training Committee. 

Since, this activity is maintaining its valuation to the Speakers, at the end of

each academic year, these Speakers’ evaluation will be discussed in the RTC

meeting.  Appreciation letter will be sent to those who garnered the best

marks.   

This is being held as well in King Abdulaziz  University Hospita’s main

auditorium from 2:00  p.m. to 4:00 p.m. after the Clinical Meeting activity.

          d) Journal Club Meeting / ENT Club Meeting

         This is one of the ORL Society’s activities for all the ENT Specialty Doctors. 

            This intent for their continuing Medica education and a sort of social

            gathering.   

            Lectures are being conducted here and hosted by the affiliated hospitals. 

            Residents of the Training Program are obliged to attend this activity.

             This is a chance as well to meet all their colleagues (ENT Doctors) and

            occasionally, meet Speakers invited during the Seminars/ Courses and or a

            visiting Professor.      

      e) Other related scientific activities

 

            Candidates are encourage to attend other related scientific activities

            including Seminars, Courses and Conference to enable them to abreast

            to new information that can be gained on these activities  ll above-mentioned

            activities are maintaining an attendance sheets for the Candidates since these

            have a bearing in computing their promotion grades except on item  # 5.

Section 7 -  Evalution

 

At the end of each rotation period, a standard form of evaluation has been formed and Candidates will be evaluated basing on the following criteria / fields stated on this.

 

1.     Knowledge 

a)     Basic

b)    Clinical

 

2.     Clinical Skills

a)     History & Physical Examination

b)    Clinical Judgment and Decision Making

c)     Consultation skills

d)    Performance in emergencies

e)     Appropriate utilization of the investigation

f)     Records and reports

g)    Participation in scientific activities

                                                                                                  

3.     Operative and interventional skills

a)     Indication and judgment

b)    Technical

 

4.      Personality and Ethics

a)     Punctuality

b)    Discipline and reliability

c)     Attitude to patients

d)    Attitude to Staff

e)     Ability to supervise

 

At the end of the rotation period, evaluations of the Candidates will be asked by the Post Graduates’ Coordinator to submit to their Unit. Once all evaluations have been secured, in particular for the King Abdulaziz University Hospital, these will be forwarded to the Head of the Department for their discussion and for their approval on the Department Board Meeting.

 

Likewise, these will be discussed by the Residency Training Committee and once approved, these will be forwarded to King Saud University and to Saudi Council for its reference and filing purposes.

 

Section 8 -  Examination

 

  a)  Selection Examination

 

            Selection examination is administered on the 2nd Saturday of April each year

            for the in-takes on the next academic year. 

 

            The venue is in the lecture hall, level 2 of Building 2 of King Abdulaziz

            University Hospital.

 

            Appropriate preparations are being conducted in collaboration         with the

            Continuing Medical Education Centre including its announcement and with

regards to the direct communication with the applicants prior to its  commencement.

 

            Result of the above examination will be discussed by the Examination      Committee for its approval.  Consequently, this will be forwarded to the Head

            of the Department of King Abdulaziz University Hospital  for its Board’s

            approval.

    

            Upon securing its approval from the Board, a correspondence will be made

            addressed to the Dean of the University, King Saud Univiersity for its approval

            and the rest of the Communication will be made by the Continuing Medical

            Education, in the office of its Director in coordination with the Post Graduates’ Unit.

 

            Appropriate acceptance letter will be sent to the selected Candidates

particularly, the information when the deadline will be since most cases,  those accepted Candidates were not able to complete their requirements,

            hence, from the  stand by status its where we are pulling to include in the final

            selected candidates.  Please note that only 6 Candidates are allotted for this

            program.

      

   b) Promotion Examination

 

                Prior to a higher level, Candidates are expected to pass the yearly Promotion

Examination. For the Written, it is scheduled each year on  the 2nd Saturday of 

June followed  by the Oral examination on the  coming Tuesday  and  usually  

falls on the 2nd Tuesday of June of  each year as well.

 

            In Oral, there are TWO examiners in each Examination Committee.  Each

            Committee has a bearing of 10 marks  (10%) each.

 

            Committee I and II Examiners are assigned for the Senior Levels, while,

            Committee III and IV for the Junior Levels.

                                                                  

            Out of 100 %, 50% is allotted to its written examination.  The remaining 50%

            is computed from the  Candidates’ Oral Examination Result, Hospital Rotation

            Evaluation, Attendance of the Clinical Meeting and Tutorial, Evaluation from

            the  Candidates Journal Presentation during Clinical  Meeting, Log Book

            Summary.

           

          Passing mark is 60 %.

 

Note: Saudi Council’s yearly 1st Part Examination has an inter relation to promotion as well. Candidates will not be promoted to R4 level unless he/she pass  the 1st part Saudi Board Examination.  However, 3 chances are given to each Candidate.

 

Result of this promotion examination and a confirmation from the Residency Training Committee will be forwarded for approval to the Department Board of King Abdulaziz University Hospital and to the Saudi Council for Health Specialties’ Scientific Board and Central Supervision Committee.

 

 

  c)  Final Examination

 

        KSU Fellowship

 

          Graduating Candidate(s) is/are eligible to sit on this examination only if they

          will pass all the necessary and incidental requirements including in particular,

          the hospital rotation evaluation and promotion examination.

 

 

          This examination consists of Written and Oral examination   and held in

          October each year.  The written will be on the  2nd Saturday and has 2 sets,

          first set in the morning and the second set in the afternoon. Candidate should

          score a minimum of 50% in final written             examination to be eligible to sit in the

          oral examination.

 

    While, on the Oral Examination (which usually inviting an External Examiner),

 

Four Examination Committees are there with a 10 marks/percentage each.  For each Committee, it comprises of 2 Members that deal in different field; Otology, Rhinology, Larynx/Pharynx and Head and Neck, Principles of Surgery with allotted time of 20  minutes per Candidate.

 

Out of 100 %, 60% is allotted for the Written Examination and 40% for its 

Oral. Close marking system is implemented by the KSU Fellowship’s

 

Examination Committee in determining the passing marks of the Candidates;

Passing mark (70), Border Line (69) and Failure (68 down).

 

The result will be forwarded to the KAUH’s ORL  Department Board Members

for its Approval before sending to King Saud University.

 

       For those who fail, three attempts are allowed to pass on this final.

 

 

 

Section 9 -  Footnote

 

Upon completion of the training program, the trainee should have gained sound and solid knowledge of otorhinolaryngology.  He/she should have gained enough clinical and technical experience to practice as a safe and competent otorhinolaryngology Head & Neck surgeon. He/she should be able to evaluate,

assess, diagnose all problems of otorhinolaryngology and safely manage them.

 

At the end of training, the candidate should have the following capabilities and skills:

 

 

 

 

Section 10 -  Candidate(s) in the other fields of  specialties and/other  Candidate/Trainee

 

 

Other Saudi Board Candidate(s) from other fields of specialties are also doing their ENT rotation to the Department for the period of 1-month and/or as specified by the Training Program/Department.

 

 

1)    Family Medicince

 

As part of the Candidate(s) trainig requirements, Candidate has to complete their 1-month rotation in the field of ENT.  Hence, Post Graduate Unit has the duty to distribute them in order to attain and gain knowledge and the necessary exposure  in the field of  ENT. 

 

Candidate(s) is(are) deployed in Speech Unit, Audiology Unit and ENT Clinic.

 

2)    Oral and Maxillofacial Surgery

 

The same provisions but the allocation is the same as the Rotation Candidates of the Combined KSU Fellowship and Saudi Board Training Program (see the aforementioned infromation) which includes Clinic, Pre-op Op round, Admission and Clerking and other scientific activity of the department.

 

3)    Interns

 

Though,  primarily, this is the job description of the Department’s Undergraduate Program’s Coordinator.

 

Related rotation and workload of the Interns will be as the same as the Candidates of the Combined Training Program as well.

 

 

 

Article XIII

KSU Fellowship Examination Committee

 

 

Section 1 General Information

 

King Saud University Fellowship Examination Committee is one of the Committees of the ORL Department that is directly involved and has the responsibility in the King Saud University Fellowship’s Final Examination for its Candidates.

 

It entails the examination preparations including the selection of its Examiners and the preparation of the examination materials to be used and all other aspects with regard to the Examinations. 

 

Over the years, External Examiners (from U.S.A.-NewYork, Germany ….) were invited to share their valuable contributions to the examination-exposure wise in different styles/forte of the concerned Examiners that test the ability of the Candidates and measures their competence.

 

The Final Examination of King Saud University Fellowship is conducted on the 2nd Saturday of October for the Written Examination and the coming Tuesday of the same week will be the Final Oral/Clinical Examination yearly and/or otherwise specified and rescheduled by the Committee itself and/or by the Department.

 

The venue will be in King Abdulaziz University Hospital’s premises – Lecture Room, Level 2 of Building 2.

 

Section 2 Committee’s Affairs and Responsibilities

 

The major responsibilities of the Committee include the examination material preparations, invitation of Examiner(s) including External Examiner(s), preparation of examination results.  While, other related task in relation to the Committee’s scope of responsibilities includes, allocation of the Examiner(s) to each Examination Committee, preparation of the communication to be sent particularly the communication to the Head of the Department for any approval to its  Board Members and in all the affairs concerning the Fellowship.

 

All these concerns are being discussed in their meeting particularly the selection of Examiners that is discuss 10 months earlier prior to the examination date and its material preparations.

 

In connection to the preparation, as per the Department’s resolution, each year, all Teaching Staff of the Department are obliged to furnish the Committee the required MCQ and OSCE for the Unit’s Question Bank so as to have an essential number of questions.    It is likewise approved that a total of 150 questions will be supplied by all the Teaching Staff of the Department per academic year.

 

Though, this does not necessarily mean that all of these solicited questions will be the official material to be used. The Committee has the responsibility as well to sort and consequently approve these questions in relation to the Committee’s setted rules with its Resolution # 5-3 that questions are classified as follows.

          

50 %  - Intermediate

                        30 %  - Easy

                        20 %  - Difficult

 

Section 3 Types of Examination

 

       

   a)  Written

 

ý   There are 2 sets, 1st set will be administered in the morning at 9:00 a.m. until 12:00 noon and  the 2nd set will be in the afternoon from 1:00 p.m. to 3:00 p.m..

 

ý   Format is Multiple Choice Questions (MCQ) and Objective Structured Clinical Examination (OSCE), though, it is as well depends on the Examination      Committee’s discretion in the finalization    

       of materials.

 

  b) Oral         

 

ý   4 Committees are there for a respective field - Otology, Rhinology, Larynx and and Pharynx and Principles of Surgery-Head and Neck

 

ý   2 Members per Committee

 

ý   20 Minutes alloted alloted time per Committee (10 min.@ Examiner)

 

ý   10 marks are allocated per Committee

Section 4 -  Eligibility and Criteria

 

Candidate(s) should pass the Promotion Examination (Graduating Batch of the Combined KSUF and Saudi Board Training Program) to be able to sit in this Finals as well as to complete his logbook.

 

While, Candidate(s) who will be taking the KSUF Finals must pass the KSUF Written Examination (50%) to be eligible in taking the Oral, if Candidates garnered less than 50% as stipulated, he/she will be considered failed.

Section 5 -   Examination Rules & Computation of  Marks

 

     a)   As a general rule, to be elligibel for entry for this finals, the candidate(s) must

              1.  complete satisfactorily the training Program in ORLHNS

             2.  Pass successfully the annual (promotion)  Examination

             3.  Complete logbook

 

       b)  The passing mark is 70%, 69 % is the border mark, while the failure mark is

             68 % or less.

                

          For the past years, the Department is adopting the Close Marking system

which has been approved and ratified by the Department Board  and described as follows:

 

 

PASS MARK

70 %

BORDER LINE

69 %

FAILURE

68 % or less

 

 

OTOLOGY

RHINOLOGY

LARYNX /

PHARYNX

PRIN. Of

SURGERY-HN

WRITTEN

EXAM.

FULL

MARK

10

10

10

10

10

PASS

7

7

7

7

7

BORDER

LINE

6.9

6.9

6.9

6.9

6.9

FAILURE

6.8

6.8

6.8

6.8

6.8

 

CLOSE MARKING SYSTEM

(GUIDELINES)

 

PASS

PASS

PASS

PASS

PASS

PASS

+ PASS

PASS

PASS

PASS

PASS

PASS

+ PASS

 

FOR DISCUSSION

PASS

PASS

BORDER

LINE

BORDER

LINE

PASS

+ PASS

PASS

PASS

PASS

PASS

FAILURE

+ PASS

 

Section 6 Examination Result Fiinalization (Approval)

 

The computed result of the Candidates will be discussed by the Examination Committee itself and the KAUH Department’s Board Members for its approval which will be based on the close marking system (guidelines) as stated above.

 

Once the result is approved, a letter will be sent to the Dean of the University

for their information and approval.  A copy as well will be sent to the Medical Education Centre for thier information for the necessary preparation of the Candidates’ certificate (Note: they will also wait for the Dean’s approval prior to the preparation of the certificate)