Obtaining credit for international training

Credit for Foreign Graduate Medical Education

The following policy outlines the terms under which the ABS will grant credit in general surgery for training completed outside the U.S. or Canada.


  • 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 in an U.S. ACGME-accredited general surgery residency program, but only upon request of the program director. Preliminary evaluations will not be provided prior to enrollment in a residency program, either to the resident or program director.
    All requests for credit and related inquiries must be sent by mail or fax on official letterhead from the program director—emails will not be accepted. Requests for more than one year of credit must be submitted by March 15 with all required documentation.

Requests for Credit

  • 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 to ascertain that clinical performance is consistent with the level of credit to be requested.
  • Requests for credit from the program director must be accompanied by the following:
  1. Documentation of satisfactory completion of foreign medical school
  2. Documentation of satisfactory completion of foreign residency training
  3. Documentation of specialty certification in the foreign venue, if achieved
  4. Chronological listing of former foreign and U.S. practice after specialty training
  5. Chronological listing of all U.S. training, with specific description of accreditation status of training program and whether or not resident occupied an accredited or supernumerary (above accredited limit) position in program
  6. An operative log of cases during U.S. training and role in each as operating surgeon or first assistant, if available
  7. Attestation by program director of satisfactory completion of all U.S. or Canadian surgical resident training years for which credit is sought
  8. All ABSITE scores
  • Residents must take the ABSITE before any credit may be requested. The resident's scores on the ABSITE should be consonant with the level of credit requested by the program director.
    Requests will not be approved without the documentation above. Requests for credit should be submitted only once all required documentation, as outlined above, is available. Requests for more than one year of credit must be submitted by March 15.

Requesting 3 Years' Credit: Special Considerations

  • Program directors who wish to advance residents to senior levels must obtain ABS approval prior to beginning the PGY-4 year; otherwise credit for these years will be denied.
  • When seeking three years of credit to enter training at the PGY-4 level, a candidate should complete at least six months of general surgery training at the PGY-3 level under the program director's supervision, or be participating in a surgical fellowship at the same institution (e.g., transplantation, advanced GI, etc.) for a similar period so the level of clinical functioning can be evaluated.
  • Requests for three years of credit should include, in addition to the documentation listed above, an operative log of cases completed by the candidate as operating surgeon during the PGY-3 or fellowship experience at the requesting institution. In addition, such candidates must take the ABSITE at least once prior to the request for credit and demonstrate the expected level of knowledge for their level of training.

Approval Process

  • Requests for credit for one year of residency training may be approved at any time by the executive director of the ABS; requests for more than one year of credit must be approved by the ABS Credentials Committee. The March 15 deadline for requests for more than one year of credit allows time for review by the ABS Credentials Committee in order to provide program directors with a decision by May 1. Program directors will be notified of credit decisions by letter from the ABS executive director.

Credit Granted

  • Credit for foreign training may be granted in lieu of the first or second clinical years of residency, and rarely the third. Credit is never given for the fourth or fifth clinical years, which must be completed satisfactorily in an accredited U.S. program.
  • Typically one year of credit will be granted for three or more years of foreign training, and two years of credit will be granted for full surgical training plus board certification or its equivalent in the foreign venue if the training is similar in length and in the breadth of experience obtained. The granting of credit is not guaranteed. If the resident moves to another program, the credit is not transferable and must be requested by the resident's new program director after a new period of evaluation.

Canadian Residents

  • No credit for postgraduate surgical education outside the U.S. and Canada will be granted to applicants who complete a Canadian program. Such applicants must have completed all of the requirements in a Canadian surgery program accredited by the RCPSC or in combination with a U.S. surgery program accredited by the ACGME. Applicants from Canadian programs must comply with ABS requirements for certification.

Prior U.S. Training

  • Prior residency training in ACGME-accredited surgical residencies as a preliminary (non-categorical) resident at the PGY-1 or PGY-2 level may be credited on a year-for-year basis if satisfactory completion of each year is documented in writing by the responsible program director. The training must have been completed within the five-year period preceding the request for credit. Credit will only be granted for the specific level of training completed; candidates who complete two years at the same level of training, e.g., a preliminary PGY-1 followed by a categorical PGY-1, will receive credit for only one year. Training at the PGY-3 level will only be accepted if accomplished as a categorical resident in an accredited program.

International Rotations

  • The ABS will accept in certain circumstances residency rotations outside the U.S. or Canada toward its general surgery 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 in advance. No such rotations will be permitted in the first (PGY-1) or last (PGY-5) year of residency training. Rotations must be at least four weeks in length to be considered for credit.
  • To request approval for an international rotation, a letter should be sent by mail or fax (no emails) to both the ABS and the RRC-Surgery. The letter must be co-signed by both the program director and the designated institutional official (DIO) and contain the information outlined in the International Rotation Policy (pdf).
  • The program will receive separate approval letters; both must be received prior to implementation of the international rotation.

Non-Residency Fellowships

  • It has become increasingly common for foreign medical graduates to complete non-ACGME accredited fellowships in specialty areas of general surgery (e.g., transplant, cardiac or pediatric surgery) prior to entering residency. It is not possible for the ABS to evaluate the quality of such training, and in general it will not be creditable toward the required residency training or will be creditable only on a limited basis.

See also Information Regarding International Training

For questions regarding this policy, please contact the ABS coordinator.

Updated: June 2015

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