Training Requirements

Below is a general overview of the training requirements for general surgery certification. It is expected that trainees will meet all of the requirements listed. For complete details, please refer to the ABS Booklet of Information - Surgery (pdf).
For applicants who will not complete their residency training by June 30 of their chief year, the program must have obtained prior ABS approval for the extension of training. Applicants will be required to provide documentation of this approval at the time of application to the General Surgery Qualifying Examination (GSQE). All training must be completed by the end of August to be eligible for that year's exam.

Program and Time Requirements

A minimum of 5 years of progressive residency education satisfactorily completed in a general surgery program accredited by the ACGME or RCPSC. (See also Osteopathic Trainees Policy)
The 60 months of training at no more than 3 residency programs. If credit is granted for prior foreign training, it will count as one program. See also Limit on Number of Programs and Credit for Foreign Medical Education.
At least 48 weeks of full-time clinical activity in each residency year, regardless of the amount of operative experience obtained.
The 48 weeks may be averaged over the first 3 years of residency, for a total of 144 weeks required, and over the last 2 years, for a total of 96 weeks required. See our Leave Policy for further details; all time away from training must be accounted for on application form.
A categorical PGY-3 year completed in an accredited general surgery residency program. Note that completing three years at PGY-1 and -2 levels does not permit promotion to PGY-4; a categorical PGY-3 year must be completed and verified by the ABS' resident roster. The only exception is in cases where 3 years' credit has been granted for prior foreign graduate training.
At least 54 months of clinical surgical experience with increasing levels of responsibility over the 5 years, with no fewer than 42 months devoted to the content areas of general surgery.
No more than 6 months assigned to non-clinical or non-surgical disciplines during all junior years (PGY 1-3).
No more than 12 months allocated to any one surgical specialty other than general surgery during all junior years (PGY 1-3).
The final two residency years (PGY 4-5) in the same program.

Specific Requirements

Completion of the following programs: Advanced Cardiovascular Life Support (ACLS), Advanced Trauma Life Support® (ATLS®) and Fundamentals of Laparoscopic Surgery™ (FLS). Applicants are not required to be currently certified in these programs; they must only provide documentation of past certification.
Completion of the ABS Flexible Endoscopy Curriculum, effective with applicants graduating residency in the 2017-2018 academic year. The curriculum contains several levels; the final level includes successful completion of the Fundamentals of Endoscopic Surgery™ (FES) program. Documentation of current or past FES certification will be required for application approval.
At least 6 operative and 6 clinical performance assessments conducted by the program director or other faculty members while in residency. The ABS will not collect these forms, but will ask the program director to attest they have been completed.

Chief Resident Year

Acting in the capacity of chief resident in general surgery for a minimum of 48 weeks over the PGY-5 and PGY-4 years, per the definition below. Note: The program must obtain prior ACGME approval of chief rotations to be completed in the PGY-4 year. Documentation of ACGME approval of chief rotations in the PGY-4 year will be required at the time of application to the GSQE.
The term "chief resident" indicates that a resident has assumed ultimate clinical responsibility for patient care under the supervision of the teaching staff and is the most senior resident involved with the direct care of the patient.
The entire chief resident experience in either the content areas of general surgery or (noncardiac) thoracic surgery, with no more than 4 months devoted to any one area. All rotations at the PGY-4 and -5 levels should involve substantive major operative experience and independent decision making.

Operative Experience

The following operative requirements are in effect for applicants who graduated residency in the 2017-2018 academic year or later.

At least 850 operative procedures as surgeon over 5 years, with at least 200 in the chief resident year. Teaching assistant cases may count toward the 850 total; however these cases may not count toward the 200 chief year cases.
At least 40 cases in surgical critical care, with at least one in each of the seven categories: ventilatory management; bleeding (non-trauma); hemodynamic instability; organ dysfunction/failure; dysrhythmias; invasive line management and monitoring; and parenteral/enteral nutrition.
At least 25 cases as teaching assistant by the completion of residency.
At least 250 operations by the beginning of PGY-3 year. The 250 cases can include procedures performed as operating surgeon or first assistant. Of the 250, at least 200 must be either in the defined categories, endoscopies, or e-codes (see below for info on e-codes). Up to 50 non-defined cases may be applied to this requirement.

E-Codes: General surgery residents can use e-codes to receive ACGME case log credit for vascular surgical procedures. E-codes allow more than one resident to take credit for an arterial exposure and repair. The resident who accomplishes the exposure should add an "E" to the case ID for the system to allow credit for a second procedure on the same patient. The relevant CPT codes to use are: 35201 (Repair blood vessel, direct; neck); 35206 (upper extremity); 35216 (intra-thoracic without bypass); 35221 (intra-abdominal), and 35226 (lower extremity). Four categories are available under Trauma for residents to enter arterial exposures.

For specific inquiries regarding ABS training requirements, please send an email to the ABS coordinator.