Page Contents
LMCC II
The Medical Council of Canada no longer administers the LMCC Part II exam. Prior to the COVID-19 pandemic it was a prerequisite to obtaining a medical license for most provincial colleges. It is now sufficient to write the LMCC Part I, which you write prior to starting residency, to obtain your Licentiate of the Medical Council of Canada.
Surgical Foundations
Surgical Foundations is a program that provides a common curriculum in the fundamental skills of surgery for residents in all surgical specialties, concurrent with training in their surgical specialty. At most schools this takes the form of a weekly academic half day throughout PGY1 and into PGY2 leading up to the Surgical Foundations exam. This exam, which is administered by the Royal College, is typically written in the Fall of your PGY2 year. Surgical residents must successfully complete this exam during their training.
Exam information and content: The is administered by the Royal College and is in written-only format. The content of the exam is based on a blueprint that reflects the competencies in surgical foundation. A score of 70% is required to pass, The format of the exam consists of 2 multiple choice papers with 125-150 questions each, written in 3 hours for each paper. Surgical residents must successfully complete this exam in order to sit for the surgical specialty exam.
Exam timing: Typically written in the Fall of your PGY2 year (approximately 12-15 months after starting residency). To sit this exam in your PGY2 year you must apply to the Royal College more than 12 months in advance you will be sent instructions on how to apply. You first apply to confirm your eligibility (Deadline: August 31 for the following Fall exam; Fee: $730). You will then receive an email in March of your exam year confirming your eligibility with the Royal College and with instructions on registering for the exam (Deadline: April 15 2024 for the Fall exam; Fee: $825). There are significant late fees to be sure not to miss the deadlines (timings are subject to change, follow instructions sent to you by email).
Area of knowledge assessed by the exam:
| Medical problems in the surgical patient, and pre-OP preparation | 10-15% |
| Conduct of a surgical procedure | 10-15% |
| Postoperative care | 5-10% |
| Wound healing and management | 5-10% |
| Hemostasis and use of blood products | 5-10% |
| Fluid management and acid-base problems | 5-10% |
| Hemodynamics, oxygen transport, shock | 5-10% |
| Metabolic and nutritional care | 0-5% |
| Legal and ethical responsibilities | 0-5% |
| Biostatistics, epidemiology and critical appraisal | 5-10% |
| Trauma and burns | 5-10% |
| Sepsis and surgical infections | 5-10% |
| Transplantation and implantation | 0-5% |
| Cancer | 0-5% |
| Safety principles – patients and practitioners | 0-10% |
| Patient evaluations, imaging and lab tests | 0-5% |
Officially recommended study resources:
- Sabiston textbook of surgery
- Schwarts text book of surgery
- ATLS = student course manual (10th edition or later)
- Canadian blood services professional guided
Most residents chose between Sabiston’s and Schwart’s. “The absite Review: Fiser” is another favorite for relevant topics due to its concise nature.
It is recommended to Form a study group and review practice questions together. Many upper year residents will have practice questions available for you to use. CanadaQBank is another option for practice questions for a fee.
Additional information about the format of the exam can be found on the Royal College website.
CAGS Practice Exam
The CAGS practice exam is an annual national practice exam taken by all General Surgery residents. It is a multiple-choice exam to help prepare for the written portion of the Royal College exam in PGY5. The exam also acts as a tool to measure resident progress throughout training. Your own marks may be compared to your cohort within your program and nationally or compared year to year as you progress.
https://cags-accg.ca/education/cags-exam-preparation/
Every year CAGS arranges a webinar series to go over the previous exam with a panel of experts to discuss answers. This is good way to prepare and learn from the exam, can be found in learning and resource centre, under CAGS resident corner.
Royal College Exam
This is the final examination prior to becoming a fully qualified general surgeon in Canada. This exam includes two parts: a written exam and an applied (oral) exam. Follow updates on the Royal College website as scheduling is set to change in upcoming years.
The written exam is a multiple-choice test. There are two three-hour sections with 100-110 questions in each. The applied exam is an oral exam. A total of eight fifteen-minute stations will be set up in which you will be given a clinical scenario and examiners will ask questions related to this scenario. They will not provide feedback as you go and may interrupt you to move the scenario along or gain a better understanding of your answer. You must pass the written exam in order to sit the oral exam (pass mark 70%).
To apply for continued training assessment: https://www.royalcollege.ca/rcsite/credentials-exams-e
To register for the exam: Details on registration will be sent out via email in the Fall prior to the exam.
Preparation: This exam covers all knowledge that is expected of a general surgeon practicing in Canada. A Competencies document (previously called Objectives of Training) and Training Experiences document can be found on the Royal College website