INTERNAL REGULATIONS FOR THE THORACIC SURGERY SPECIALTY QUALIFICATION
Last updated: April 26, 2019
Prepared in accordance with the General Assembly

I – DEFINITION
The Turkish Thoracic Surgery Qualification Board is an autonomous, subsidiary body of the Turkish Society of Thoracic Surgery (TSTS). The Qualification Board is organized as an independent, non-profit civil body. Its operating principles are aligned with the Medical Specialization Regulation and the Turkish Medical Association Specialty Societies Coordination Board (TTB–UDKK) directive.
In these regulations:
– Society refers to the Turkish Society of Thoracic Surgery (TSTS)
– Qualification refers to the Turkish Thoracic Surgery Qualification
– Qualification General Assembly refers to the body formed by thoracic surgeons who have obtained the qualification certificate
– Ministry refers to the Ministry of Health of the Republic of Türkiye

GENERAL MATTERS

II – OBJECTIVES

1. To establish, maintain, and enhance the standard of thoracic surgery specialty training
2. To ensure quality control in both training and practice
3. To encourage, promote, and monitor participation in Continuing Medical Education activities after specialization

III – METHOD
The Qualification Board carries out its functions through the boards and commissions specified in Article V, and awards Qualification Certificates to individuals and institutions that meet the established standards. For this purpose, it sets up standard examination conditions and conducts exams for volunteer candidates at the national level.

IV – ADDRESS
The address of the Turkish Thoracic Surgery Qualification Board is the same as the headquarters of the Turkish Society of Thoracic Surgery. (Currently, the Society headquarters is located at Ankara University Faculty of Medicine, İbn-i Sina Hospital, Department of Thoracic Surgery.)

V – STRUCTURE OF THE QUALIFICATION BOARD
The structure of the Turkish Thoracic Surgery Qualification Board consists of the following bodies:

1. Qualification General Assembly
2. Executive Board
3. Audit and Advisory Board
4. Accreditation Commission (Evaluation of Educational Institutions and Programs)
5. Examination Commission

V-1. General Assembly
Every thoracic surgeon who has obtained a Qualification Certificate in the field of Thoracic Surgery is a natural member of the Qualification General Assembly. Members of the General Assembly are elected to various boards and commissions. A member cannot serve on more than one board.

V-1.1 Duties of the General Assembly:
The Turkish Thoracic Surgery Qualification General Assembly convenes at least once every two years and is the main decision-making body of the Qualification Board. To participate in the General Assembly, members must not have any outstanding membership fees, must not be deprived of public rights, and must not have received any professional bans.

The primary duties of the General Assembly are:
a. To establish the budget of the Qualification Board
b. To elect the Executive Board and the Audit and Advisory Board
c. To review and decide on the approval of activity reports of previous term boards

V-2. Executive Board
Members of the Executive Board are elected by the Qualification General Assembly from among actively working educators (professors, associate professors, clinical chiefs, and assistant chiefs) for a term of two years. (Note: The titles “clinical chief” and “assistant chief” were replaced with “educational staff” by the General Assembly on December 6, 2012.)

The Executive Board consists of 5 full members (4 elected by the General Assembly, 1 appointed by the Society’s Board of Directors) and 3 substitute members. It convenes at least twice a year, makes decisions by majority vote, and in the event of a tie, the vote of the Chair counts as two. If a member resigns, passes away, misses 3 meetings without excuse, or no longer qualifies as an active educator, they are replaced by the next available substitute. If the vacant seat belongs to the society’s quota, the Society’s Board of Directors appoints a new member.

The Executive Board elects a Chair and a Secretary from among its members. Members cannot serve more than two consecutive terms.

V-2.1 Duties of the Executive Board:
a. To implement the decisions of the Qualification General Assembly
b. To appoint the Accreditation and Examination Commissions, evaluate their reports, make decisions, and implement them
c. To determine and announce exam dates and application fees at the beginning of each year
d. To issue Qualification Certificates to eligible candidates
e. To convene the General Assembly and present an activity report

V-3. Audit and Advisory Board
The Audit and Advisory Board is elected by the Qualification General Assembly for a two-year term and consists of 3 full and 2 substitute members selected from among educators with at least 10 years of experience in educational institutions. The election of this board is held concurrently with that of the Executive Board. A member may be elected for no more than two terms. The board convenes at least twice a year and makes decisions by majority vote. In the event of a tie, the Chair’s vote counts as two.

If a member resigns, passes away, misses three meetings without excuse, or no longer qualifies as an active educator, they are replaced in order by the substitute members.

V-3.1. Duties of the Audit and Advisory Board:
The Audit and Advisory Board meets at least twice a year to review and audit the decisions and actions of the Executive Board. When necessary, it provides reports on contentious issues referred by the Executive Board. The Board prepares an interim report each year and a final report at the end of each term. The final report is submitted to the Qualification General Assembly. In extraordinary situations, the Board may convene an extraordinary General Assembly meeting by giving at least 15 days’ notice. No additional items may be added to the agenda of such extraordinary meetings.

V-4. Evaluation Commission for Educational Institutions and Programs (Accreditation Commission)
This commission consists of 5 full and 3 substitute members who are active educators (professors, associate professors, clinical chiefs, and assistant chiefs) appointed by the Executive Board. (The titles “clinical chief” and “assistant chief” were redefined as “educational staff” by the General Assembly on December 6, 2012.) Members are elected for two-year terms and may serve for a maximum of two terms. The commission elects a chair, a vice-chair, and a secretary from among its members. It convenes at least twice a year to discuss its agenda and makes decisions by majority vote. In the event of a tie, the chair’s vote is counted as two. If a member resigns, passes away, misses three meetings without excuse, or no longer qualifies as an active educator, they are replaced in order by substitute members. The commission also meets at least twice a year, or more frequently upon request by the Executive Board, and submits its reports to the Executive Board.

V-4.1. Duties of the Evaluation Commission for Educational Institutions and Programs:
a. To evaluate educational institutions and programs upon their invitation and to submit their reports to the institution and the Executive Board.
b. To provide recommendations to the Executive Board regarding the standards of educational institutions.
c. To make recommendations to the Executive Board regarding the educational curriculum.
d. To publish annually a list of appropriate journals, publications, studies, and books for individuals and institutions to follow, and to determine the credit values of conferences, panels, articles, and publications appearing in these sources.

V-5. Examination Commission
The Examination Commission consists of five professors, associate professors, clinical chiefs, or assistant chiefs who have been actively serving as educators for at least five years. They are appointed by the Executive Board for a two-year term. (The titles “clinical chief” and “assistant chief” were redefined as “educational staff” by the General Assembly on December 6, 2012.) The commission elects a chair, a vice-chair, and a secretary from among its members. If a seat becomes vacant, a new member is appointed by the Executive Board within 15 days. The commission convenes at least four times a year and submits evaluation reports to the Executive Board.

V-5.1. Duties of the Examination Commission:
a. To evaluate applications for the Qualification Exam and ensure that eligible candidates are admitted.
b. To prepare the Qualification Exams.
c. To ensure the scientific oversight of the written Qualification Exams.
d. A single institution may not have more than one jury member in the same examination panel.
e. To evaluate examination results and report them to the Executive Board.
f. To organize and conduct internal training examinations.
g. To evaluate internal training exams and report the results to relevant boards and institutions.
h. To establish sub-commissions related to exam preparations.

VI – BUDGET AND FINANCING OF THE BOARD’S ACTIVITIES

VI-1. General Provisions
The financing of the activities of the Turkish Thoracic Surgery Qualification Board is provided by the Turkish Society of Thoracic Surgery (TSTS). The financial responsibility for accounting operations lies with the Society. The income provided by the Qualification Board to the Society and the expenditures made from the Society’s budget are recorded and processed by the accounting unit of the Society. Payments related to examination fees and issuance of Qualification Certificates are collected using official receipts on behalf of the Qualification Board. These fees are determined separately for each year. If a candidate who has made a payment withdraws from the examination, the payment will not be refunded.

VI-2. Conditions
Individuals who have obtained a Qualification Certificate must remain active members of the Turkish Society of Thoracic Surgery throughout their professional careers and regularly pay their annual membership fees.

VI-3. Sanctions
Those who fail to fulfill their membership obligations to the Turkish Society of Thoracic Surgery or do not comply with decisions regarding the Qualification Certificate may be subject to sanctions by the Qualification General Assembly, including the invalidation of their certificate.

VII – SPECIALTY AND TRAINING

VII-1. Specialty Field:
The relevant specialty field is Thoracic Surgery.

VII-2. Specialty Training:
The duration of training, required rotations, and rotation periods are determined by the Medical Specialization Regulation.

VIII – DOCUMENTATION OF TRAINING

VIII-1. Certification of Training:
To be eligible to take the exam, a candidate must:

1. Provide official documentation of being a certified Thoracic Surgeon (approved by the Ministry of Health of the Republic of Türkiye).
   b. Submit institution-approved documentation of surgical and scientific activities carried out during training and specialization.

These documents are reviewed by the Examination Commission. Candidates whose documentation is complete are granted the right to take the exam.

IX – EXAMINATION

IX-1. General Information
After the type of exam and eligible candidates are determined, the entrance requirements, stages, and exam schedule are set by the Examination Commission. The exam calendar is announced with the approval of the Executive Board. Exams are held at least once a year.

IX-2. In-Training Examinations
These are administered as nationwide exams during the residency period, if needed. All medical specialty trainees and residents from training institutions can voluntarily participate. The results are evaluated and reported comparatively to the training institutions.

IX-3. Qualification Examinations
The eligibility criteria outlined in Article 7.1 apply to those who wish to take the Qualification Exam. The exam consists of two stages:

1. Written Exam
   This knowledge-based exam is conducted at least once a year. A minimum score of 70% is required to pass. Candidates who pass the written exam are eligible to take the oral exam. The written exam results are valid for 5 years. The format and scope of the exam are determined by the Examination Commission. Results are communicated to the candidates individually.
2. Oral Exam
   This is a practice-based exam designed to assess the candidate’s clinical skills. It is held at least once a year. Only candidates who have passed the written exam may participate. The exam includes theoretical knowledge aimed at problem-solving and is conducted by an assigned jury. A score of at least 70% from the jury members is required to pass.

IX-4. Certification of Qualification
Candidates who successfully pass the exam are awarded a Qualification Certificate. This certificate is valid for 10 years.

IX-5. Recertification
At the end of the 10-year period, individuals who meet the criteria below will have their Qualification Certificate validity extended for another 10 years. For renewal, the candidate must have participated in thoracic surgery-related Continuing Medical Education (CME) activities accredited by the TTB–CME Accreditation Board and must have earned at least 100 CME credits. Of these credits, at least 50 must have been obtained within the last 5 years.
“Alternatively, participation in five national or international congresses related to their field within the last 10 years must be documented.” (Added at the General Assembly on December 6, 2012.)

X – TEMPORARY ARTICLES

X-1. These regulations shall come into force as of January 18, 2003.

X-2. Professors, associate professors, clinical chiefs, and assistant clinical chiefs who are currently working in educational institutions shall receive the Qualification Certificate upon approval by the Executive Board of the Turkish Society of Thoracic Surgery.

X-3. The Qualification Certificate shall be revoked if the certificate holder is banned from practicing the profession.

X-4. The first Qualification Exam shall be conducted within two (2) years following the enforcement of these regulations.

X-5. Thoracic surgeons who have worked as specialists in a thoracic surgery training institution for the last five years and who apply within six months of the enforcement of the regulations—provided they meet the criteria set by the Executive Board—shall be eligible to obtain the Qualification Certificate through an oral examination. The time and place of the exam are determined by the Examination Commission.

X-6. Specialists in general surgery or cardiovascular surgery who are serving as faculty members in thoracic surgery clinics and/or hold a European Board of Thoracic Surgery Certificate may apply within six months of the enforcement of the regulations. Upon documentation of their status, the General Assembly shall decide on the issuance of the Qualification Certificate based on the report of the Executive Board.

X-7. Members of the Society who have completed 10 years of professional practice as thoracic surgeons and continue to work as associate professors or professors in educational thoracic surgery clinics, but have not taken the Qualification Exam, may apply for the exam until December 31, 2020. They will be admitted to the oral exam only, and those who pass will be issued a certificate. (This article was added by the General Assembly decision dated April 26, 2019.)