Duration of Residency Training in Singapore

The duration of residency training accredited by ACGME-I and that required for exit certification by the Specialists Accreditation Board is listed in the following table. Where the duration for accreditation exceeds that of ACGME-I, the remaining time will be accredited by the Joint Committee on Specialist Training (JCST).

Specialty

Duration of training accredited by ACGME-I for residency programme (mths)

Total duration of training in Singapore (mths)

Orthopaedic Surgery

60 (60) + 12


Training Requirements Document

Specialty

Training Requirements

Orthopaedic Surgery

Orthopaedic Surgery Residency Training Requirements (amended as @ 4 June 19)

 
Singapore Country Addendum to the ACGME-I Advanced Specialty Requirements

The Singapore Country Addendum to the ACGME-I Advanced Specialty Requirements prescribes specialty-specific programme requirements applicable to residency programmes in Singapore as discussed with the ACGME-I and the Singapore Residency Advisory Committees (RAC).

Read together with the ACGME-I Advanced Specialty Requirements, they represent the requirements of graduate medical education in the specialties listed.


Section

ACGME-I Specialty-Specific Program Requirements for Graduate Medical Education

Addition/Change

Clarification

B.

The education in orthopaedic surgery must be 48 months in length.

 

The total duration of training for exit certification in Singapore must be 72 months in length.

The 1st year of Orthopaedic Surgery residency will be termed R1, followed by R2 to R6.

ACGME-I accredited years are R2 - R5.

R1 Postings

· Anaesthesia (3 months, including 2 weeks of Intensive Care)

· Emergency Medicine (3 months)

· General Surgery (6 months)

 

II.A.3

Clinical problems of sufficient variety and volume to afford the residents adequate experience in the diagnosis and management of adult and paediatric orthopaedic disorders must be available.

a. Each resident should be the surgeon or 1st assistant for at least 200 cases per year and see at least 750 outpatients per year.

For Singapore, the Resident must perform at least 25 cases as 1st Surgeon supervised per year out of the 200 cases per year. The complexity and number of the cases as surgeon should be increasing as the resident advances in training. E.g. amputation and drainage in R2, simple ankle, elbow and patella fractures, external fixation in R3, tendon repair, nailing, simple arthroscopy in R4, TKR, ACL recon in R5 and decompression /discectomy in R6.

Singapore RAC specification for curriculum content.

II.A.3.b

NEW ENTRY

For resident to be logged as first surgeon, he/she should perform 75% of the surgery either independently or supervised depending on the level and skill of the resident. 1st assistant must be involved in planning, positioning and review of the patient pre and post-operation.

Singapore RAC specification for curriculum content.

II.B

Entering residents must have successfully completed an accredited ACGME-I Transitional Year residency.

Eventually, entering residents should have successfully completed a customized Transitional Year residency that includes:

a) at least two months of structured education and clinical experience in General Surgery that may include multi-system trauma, plastic surgery, intensive care, vascular surgery neurology, neurological surgery, paediatrics, paediatric surgery, anaesthesiology, musculoskeletal imaging, or rehabilitation.

b) at least four months of experience in internal medicine

c) at least four months (with an optional additional two months) of orthopaedic surgery

d) at least two months of paediatrics or paediatric surgery

 

II.C.5

Residents must have instruction in:

a. basic motor skills, including proper use of surgical instruments and operative techniques must occur;

b. anatomy that includes study and dissection of anatomic specimens by the residents and lectures or other formal sessions;

c. pathology that includes correlative pathology in which gross and microscopic pathology are related to clinical and roentgenographic findings;

d. biomechanics presented in seminars or conferences emphasizing principles, terminology, and application to orthopaedics;

e. the appropriate use and interpretation of radiographic and other imaging techniques; and,

f. orthopaedic oncology, rehabilitation of neurologic injury and disease, spinal cord injury rehabilitation, orthotics and prosthetics, and the ethics of medical practice

For the Singapore programme, a large majority of these are covered by the compulsory courses e.g. the surgical approaches course, biomechanics course, x-ray reading course, SMA ethics course e.t.c.

 

II.D.1

The four accredited years must include at least three years of rotations on orthopaedic services.

The R2 through R6 years must include at least five years of rotations in orthopaedic services.

Singapore RAC specification for curriculum content.

II.D.8

NEW ENTRY

The educational programme must ensure candidates complete courses in x-ray, basic communication, evidence based medicine, Advanced Trauma Life Support (ATLS), basic fracture fixation, Biomechanics course, SMA Ethics course and Postgrad course in Orthopaedics.

Singapore RAC specification for curriculum content.

II.D.9

NEW ENTRY

Research is compulsory and must be presented as a thesis in R4.

Singapore RAC specification for curriculum content.

Annex 1

 

Please refer to Annex 1 for compulsory requirements for Orthopaedic Surgery Residency

Singapore RAC specification for curriculum content.

Annex 1: Compulsory Requirements for Orthopaedic Surgery Residency

i)   Postings

  • At least 6 months of general orthopaedics and trauma
  • At least 3 months of hand surgery
  • At least 3 months orthopaedics of sports related surgery including arthroscopy and arthroscopic reconstruction
  • At least 3 months of paediatric surgery
  • At least 3 months of adult reconstructive surgery including arthroplasty and foot and ankle
  • At least 3 months of musculoskeletal oncology
  • At least 3 months of spinal surgery
  • R6 is for research and elective year

ii)   Examinations

  • R1/R2 - MRCS
  • R3 - M.Med II [For exams conducted before February 2014]
          - M.Med (Orthopaedic Surgery) Part 1 (Viva) Exam [For exams conducted after February 2014]
  • R4 - M.Med III [For exams conducted before February 2014]
       - M.Med (Orthopaedic Surgery) Part 2 (Thesis Presentation & Oral Defence) exam [For exams conducted after February 2014]
  • R6 - FRCS(Ortho)

iii)   Others

  • Presentation of paper at SOA ASM (at least 2)
  • Minimum attendance at SOA teaching sessions
    • Prior to 2016 intake - at least 75% from R2 to R6
    • With effect from July 2016 are required to meet the following minimum attendance at the SOA:
      • R1: attendance will be optional
      • R2 to R4: minimum 50% attendance
      • R5 to R6: minimum 75% attendance
  • Attendance at training events
  • Compulsory Courses (to be completed within a year before or after the recommended year)
  • R1: Suturing, plaster application, traction, X-Ray reading, Basic Communication Skills, Evidence Based Medicine, ATLS
  • R2: Basic fracture fixation course, biomechanics course
  • R3: Nil
  • R4: Nil
  • R5: SMA ethics
  • R6: Postgraduate course in Orthopaedics
  •  Compulsory courses to be completed between R1 and R6 (with effect from 2019 intake batch onwards)
    • Knee Arthroscopy course

    • Hip & Knee (AR) course

    • Shoulder Arthroscopy course

    • Spine course

Requirements for Progression to Senior Resident

Specialty

Requirements

Orthopaedic Surgery

  • Pass MRCS and M.Med (Orthopaedic Surgery) Part 1 (Viva) exam
  • PD certification of successful completion of R3 


Exit Criteria

Specialty

Current Exit Examinations / Assessments

Orthopaedic Surgery

  • Conjoint exam (FRCS (Orth))
    • Written assessment
    • Clinical assessment
    • Oral assessment

Co-Payment of Training Fee

Residents in Orthopaedic Surgery will co-pay a monthly training fee for the entire duration of their training. The training fee is subject to revision.