• For general information on the process for certification by the American Board of Surgery, see About ABS Certification.
• The American Board of Surgery does not offer reciprocity with certification in other countries. Surgeons who have completed some or all of their surgical training outside the U.S. and wish to become certified by the ABS must first enroll and complete training in an accredited U.S. or Canadian residency program.

• The ABS does not grant credit directly to residents for surgical education completed outside the U.S. or Canada. The ABS will consider granting partial credit for foreign graduate medical education to a resident enrolled in a U.S. ACGME-accredited general surgery or integrated vascular surgery residency program, but only upon request of the program director. Preliminary evaluations will not be provided before enrollment in a residency program, either to the resident or program director.
• The program director is the primary judge of the resident's proficiency. If a program director believes a resident to be a candidate for credit, the resident should be assigned to the PGY-2 or PGY-3 level when entering the program so the appropriate level of clinical skills can be assessed. Program directors should make the request for credit only after having observed the individual for at least six months.
• ABSITE Scores: For general surgery, residents must take the ABSITE before any credit may be requested. For integrated vascular surgery, both the ABSITE and VSITE must be taken before credit may be requested. The resident's scores should be consonant with the level of credit requested by the program director.
• See the respective Credit for Foreign Graduate Medical Education Policy for general surgery or integrated vascular surgery for complete details, including all required documentation. The ABS only grants credit toward general surgery or integrated vascular surgery training.
• All requests for credit and related inquiries must be sent by mail (no e-mails or faxes) on official letterhead from the program director.

• Surgeons who have completed all their training in Canada may apply for ABS certification upon completion of a residency program accredited by the Royal College of Physicians and Surgeons of Canada (RCSPC). Applicants must have completed all of the requirements in a program accredited by the RCSPC or in combination with a U.S. program accredited by the ACGME. No credit for postgraduate surgical education outside the U.S. and Canada will be granted to applicants who complete a Canadian program. Applicants from Canadian programs must comply with ABS requirements for certification.

• The ABS will accept in certain circumstances residency rotations outside the U.S. or Canada toward its general surgery or integrated vascular surgery residency training requirements. If program directors wish to credit training abroad toward ABS requirements, they must fully justify the reasons for it and receive ABS approval for such training in advance. No such rotations will be permitted in the first (PGY-1) or last (PGY-5) year of residency training.
• All training for which credit is requested must be completed under the direct supervision of a surgeon certified in general surgery or vascular surgery respectively by the ABS (or other qualifications deemed acceptable in advance) from either the parent institution or the institution where the training is occurring. The rotation will be considered an elective. For the cases to count toward the resident's operative experience, the rotation must also have been approved by the Residency Review Committee for Surgery of the ACGME.
• Requests for international rotation approval must include:

• Name and PGY level of resident
• Dates of rotation
• Name and location of international site
• Educational rationale of the rotation
• Competency-based goals and objectives of the rotation
• Specific names of the surgeons who will be supervising the resident and their ABS certification status or equivalent qualifications
• Complete description of the clinical experience: type of center (governmental, non-governmental, private); center's scope of practice, operative volume and type; adequacy of anesthetic, radiologic, laboratory and critical care infrastructure; opportunity for outpatient experience
• Verification that there will be an evaluation of the resident's performance based on the stated goals and objectives

• Requests must be sent by mail (no e-mails or faxes) on official letterhead from the program director.

• A certificate issued by the Educational Commission for Foreign Medical Graduates (ECFMG) is required for ABS certification for all international medical graduates. The certificate must be valid indefinitely for all international medical graduates who complete an ACGME-accredited residency program. International medical graduates who complete a Canadian residency accredited by the RCSPC will have an ECFMG certificate with a "valid until" date. The valid until date must be after the date of application to the ABS.

• The U.S. Department of State has designated the ECFMG as the visa sponsor for all J-1 exchange visitor physicians who participate in clinical training programs. Applicants who are currently enrolled in a non-standard fellowship that is preapproved by the ECFMG do not need a letter of support from the ABS for a visa extension. (See www.ecfmg.org for a list of preapproved programs.) Applicants who have completed their training programs and require a visa extension to take an ABS examination may write the ABS with the specifics of their situation to obtain a letter of support.
• J-1 Visas for Research Fellowships
  To obtain ABS support for a J-1 visa applicant who wishes to complete a research fellowship, a formal written request must be submitted by the program director. Requests must be sent by mail (no e-mails or faxes) on official letterhead and cover the information outlined in the document below. Program directors will be notified of the decision by letter from the ABS executive director.
Guidelines for Approval of Research Fellowships for J-1 Visa Applicants (pdf)

Updated: August 2013