Nontraditional Pathway to ABS Certification
Surgeons who have completed an equivalently structured and accredited training program in surgery, in comparison to an ACGME-accredited general surgery or vascular surgery residency program, may be eligible to enter the ABS initial certification process.
Overview
Bridging the gap between non-ACGME trained surgeons and ABS board certification
An alternate pathway into the American Board of Surgery (ABS) initial certification process is available for qualified surgeons who completed their surgical training at a non-Accreditation Council for Graduate Medical Education (ACGME) accredited program.
The pathway is intended for surgeons who are in active practice in the United States and who are not currently admissible for ABS certification. Surgeons who practice in other countries and aspire to practice in the United States are not eligible for this pathway.
Sponsorship from the applicant’s current hospital or institution is required in order for a surgeon to pursue this pathway. Applicants must meet all pathway requirements as defined below. Application to the Nontraditional Pathway to ABS Certification is a multi-phase process requiring specific information and/or documentation at each stage.
Surgeons who previously applied for ABS certification through the now defunct Academic Pathway to ABS Certification may re-enter the certification process through the Nontraditional Pathway to ABS Certification provided that they meet the necessary requirements as outlined below.
Note About Program Accreditation
Surgeons who trained in the U.S. are eligible for ABS certification only if they successfully completed a surgical training program accredited by the ACGME or by the American Osteopathic Board of Surgery (AOBS). These surgeons are not eligible to apply for ABS certification through this pathway if they have been unsuccessful through our standard process. Please see our Osteopathic Trainees Policy for information regarding the single GME accreditation system and the requirements for osteopathic residents who complete their residency training in an ACGME-accredited training program.
Requesting an ABS Account
Applicants must request an ABS account by Oct. 1
Interested applicants must upload a copy of their current Curriculum Vitae (CV) when they submit the account request form. All remaining documentation and related application materials must be submitted via the ABS surgeon portal.
Interested applicants to this pathway must request an ABS surgeon portal user account by Oct. 1 of a given year in order to apply for the next scheduled Admissibility Examination, the first exam required in this pathway.
Note that all new account requests will be processed after the Oct. 1 deadline – no new user accounts will be set up before this date. Following access to their new user account, applicants may then submit the required information and materials to apply for the Admissibility Exam.
The account request form to enter this pathway and apply for the 2027 Admissibility Examination will be available by Aug. 1.
Phase I: Admissibility Examination
Successful completion of the Admissibility Exam is the first step towards achieving ABS certification
The Admissibility Exam is a screening tool to help both the candidate and the ABS determine if the candidate has a core body of knowledge that makes it possible for them to pass the more difficult and demanding Qualifying Examination (QE) and Certifying Examination (CE). Although passing the Admissibility Exam does not guarantee passage of the QE or CE, experience has shown us that poor performance on the Admissibility Exam is highly predictive of failure on the ABS QE and CE, and those candidates will not be permitted to proceed.
Once the applicant has received their ABS surgeon portal account, they must submit via the portal the necessary information and/or documentation to meet the following requirements by Dec. 1:
Possession of a current, full, and unrestricted medical license in the U.S. for a minimum of three years without any adverse licensure or credentialing actions is required.
Required documentation:
- Copy of medical license
- Copies of United States Medical Licensing Examination (USMLE) or Comprehensive Osteopathic Medical Licensing Examinations (COMLEX) Steps 1-3 Score Reports
Applicant must provide the names and contact information of two individuals from their current hospital leadership team and two ABMS-certified physicians, also from their current place of employment, who are familiar with their practice. The hospital leadership contacts must serve as the applicant’s sponsors and should include the chief quality officer in addition to another senior member of the hospital’s leadership team.
NOTE: Should the applicant pass the Admissibility Exam and move on to Qualifying Exam application, the listed hospital contacts must serve as their sponsors for this pathway.
Applicant must indicate whether the surgical training that they completed was international (including Canadian), osteopathic, or other.
Completion of medical school at an institution listed in the World Directory of Medical Schools (WDMS) and completion of an equivalently structured and accredited training program in surgery (international or not), in comparison to the current ACGME general surgery or vascular surgery residency program, is required. Evidence of this training will be required upon application to the QE.
Applicant must also have completed a minimum of one year of clinical postgraduate training in the U.S. or Canada at a program accredited by the ACGME, the Fellowship Council, and/or a sponsoring specialty society.
Required documentation:
- Copy of ECFMG certificate
Applicant must attest to their ethical and professional standing, which should adhere to the ABS Code of Ethics and Professionalism.
A minimum of three continuous years in clinical practice at a single institution is required. Applicant must currently be in practice at said institution.
Time as a trainee (ACGME accredited or otherwise) does not count for this requirement.
Required documentation:
- Current CV signed by the applicant (previously submitted with account request form; submit updated documentation if necessary)
NOTE: CV should be no more than 10 pages and should not include any publications - Summary of current practice
Review, sign, and date the attestation online.
Submit the nonrefundable credit card payment (Visa, Mastercard, American Express, Discover) where indicated.
Applicants must allow at least one month (30 days) from the date of submission for all information and materials to be reviewed and processed by ABS staff. All materials must be submitted electronically via the ABS surgeon portal; the ABS will not accept emailed documents nor physical documents mailed to the ABS office.
All applicants will be notified no later than mid-February whether they have been admitted to the examination and will be able to schedule their exam center following receipt of the exam authorization letter.
Phase II: Qualifying Examination
After successful completion of the Admissibility Exam, applicants may submit additional required documentation to apply for the following year's Qualifying Exam
Once the applicant has successfully completed the Admissibility Exam, they will be permitted to apply to the following year’s QE provided that they meet the minimum time-based requirements for application at that time.
Application information for the QE will be provided in the summer following the Admissibility Exam. At the time of application to the QE, the applicant must meet the following requirements and submit the necessary documentation via the ABS surgeon portal:
Sponsor and reference attestations must be received before the applicant will be permitted to submit any additional information or materials for application to the QE.
The attestation submitted by the applicant’s institutional chief quality officer must include information about the applicant’s outcomes in relation to other providers and national benchmarks.
The attestation submitted by the applicant’s additional hospital leadership must include information regarding the applicant’s good standing at each institution in which the applicant has had clinical privileges in the United States.
The attestations submitted by the two ABMS-certified peers must include information regarding the applicant’s performance, ethics, and professionalism.
Required documentation:
- Online forms submitted by the four individuals who were listed as sponsors and references at the time of application to the admissibility examination
Possession of a current, full, and unrestricted medical license in the U.S. for a minimum of five years without any adverse licensure or credentialing actions is required.
Required documentation:
- Copy of medical license (previously submitted for Admissibility Exam; submit updated documentation if necessary)
- Copies of United States Medical Licensing Examination (USMLE) or Comprehensive Osteopathic Medical Licensing Examinations (COMLEX) Steps 1-3 Score Reports (previously submitted for Admissibility Exam)
Applicant must have completed:
- Medical school at an institution listed in the WDMS
- An equivalently structured and accredited training program in surgery (international or not), in comparison to the current ACGME general surgery or vascular surgery residency program
- A minimum of one year of clinical postgraduate training in the U.S. or Canada at a program accredited by the ACGME, the Fellowship Council, and/or a sponsoring specialty society
Required documentation:
- Copy of ECFMG certificate (previously submitted for Admissibility Exam)
- Documentation with information regarding the one year of clinical postgraduate training completed in the U.S. or Canada
Completion of an international (including Canadian), osteopathic, or other equivalently structured and accredited training program in general surgery or vascular surgery, in comparison to the current related ACGME-accredited residency program, is required.
Required documentation:
- Signed attestation by the program director
Applicant must currently hold unrestricted clinical privileges at a licensed medical center certified by the Centers for Medicare and Medicaid Services (CMS).
A minimum of five continuous years of clinical practice at a single institution (or three continuous years at two separate institutions). Applicant must currently be in practice at said institution.
Time as a trainee (ACGME accredited or otherwise) does not count towards this requirement.
Required documentation:
- Current CV signed by the applicant (previously submitted for Admissibility Exam; submit updated documentation if necessary)
NOTE: CV should be no more than 10 pages and should not include any publications - Summary of current practice (previously submitted for Admissibility Exam; submit updated documentation if necessary)
Submit the nonrefundable credit card payment (Visa, Mastercard, American Express, Discover) where indicated; a completed application form must be submitted first. A separate exam fee will also be required once the application is approved.
If original documents are in a language other than English, a notarized English translation must accompany them. All materials must be submitted electronically via the ABS surgeon portal; the ABS will not accept emailed documents nor physical documents mailed to the ABS office.
The ABS will review all documents and letters of recommendation on a case-by-case basis; if acceptable, the candidate will be approved to register for the related QE.
Certifying Examination
The final step towards ABS initial certification
Successful completion of the General Surgery Qualifying Exam (GSQE) or Vascular Surgery Qualifying Exam (VSQE) is required before a candidate is able to register for the related CE.
To learn more about each specialty-specific CE, please use the links below.
Exam Admissibility
Three opportunities to pass the Admissibility Exam, seven-year limit to certification following successful completion
Applicants meeting the criteria for the first stage will then be eligible to enter the Nontraditional Pathway to ABS Certification and must remain in practice at the same institution/location while completing the three-step examination process.
- Upon approval of the Phase I application, the individual will be granted three opportunities within three consecutive years to pass the relevant Admissibility Exam.
- Following successful completion of the Admissibility Exam, pathway applicants will have no more than seven academic years to complete the certification process, including passing both the relevant QE and CE. The seven-year period begins with the following year's Phase II application window for the QE.
- Up to four opportunities in four consecutive years will be given to pass the QE, providing the individual applies for the exam immediately following successful completion of the Admissibility Exam. If a candidate decides not to take the exam in a given year, it is a lost opportunity as the four-year limit is absolute. After four years, if the QE is not passed, the individual is no longer admissible to the certification process.
- Up to three opportunities in three consecutive years will be given to pass the CE, immediately following successful completion of the QE. Candidates will only be permitted one exam opportunity per year. If a candidate decides not to take the exam in a given year, it is a lost opportunity as the three-year limit is absolute. After three years, if the CE is not passed, the individual is no longer admissible to the certification process.
- Candidates who successfully complete the QE in fewer than four opportunities may not apply unused opportunities toward the CE.
- If a candidate does not take the QE or CE when offered, they will lose an exam opportunity.
Applicants to the Nontraditional Pathway to ABS Certification may not re-enter the pathway if they fail to complete it, nor may they appeal any decisions or determinations made by the ABS with regards to their application materials or examination performance.
The applicant will have no status with the ABS while they complete the Admissibility Exam. During the time that the applicant is applying for and taking the QE and CE, they will be considered “in the examination process.” Upon passing the CE, the individual will be deemed certified in the specialty for which they completed the examination process and will receive their official certificate within six months. They must thereafter participate in the ABS Continuous Certification Program to maintain their certificate.
Continuous Certification
Following certification, diplomates must participate in the ABS Continuous Certification Program to maintain their certificate. The ABS will waive 60 credits of CME with self-assessment toward Continuous Certification for this certification; the waiver will appear automatically in diplomates’ CME Repository.
Surgeons who achieve ABS certification may also apply to the American Medical Association (AMA) to receive 60 AMA PRA Category 1 Credits™. Please see the AMA website and the direct CME application for details.
Frequently Asked Questions
Pathway FAQs
Frequently asked questions about the Nontraditional Pathway to ABS Certification.
Successful completion of the Admissibility Exam is the first step towards achieving ABS certification. Following successful completion of the Admissibility Exam, the candidate must complete and pass first the Qualifying Exam, and then the Certifying Exam.
The Admissibility Exam covers topics from residency training, such as applied science and management of clinical problems, not from current practice. A list of “Keyword Descriptors” of topics covered on the Admissibility Exam will be posted to the Documents section of your portal in early March.
The Admissibility Exam is administered annually between March 15 and May 15 at PearsonVUE testing centers.
A results letter will be posted in the Documents section of your ABS portal in two to three weeks following your exam date. Your “Report of Performance with Keyword Descriptors of Incorrect Answers” will be posted to the Documents section of your portal in early summer.
No, the application for Phase II for the Qualifying Examination will become available the following February.
If you move to a new institution between Phase I and Phase II, you must be in practice at the new institution for three years of continuous practice and must be in practice at that same institution when applying to Phase II of the pathway. The new institution will now serve as sponsors for this pathway.
No, you must remain in practice at the same institution/location while completing the Certifying Examination process.
No, you do not meet the requirements of Phase I to apply. You must have three years of practice in your current institution at the time of application. Your previous institution may not serve as your sponsor.
You have four opportunities in four consecutive years to pass the QE. If you decide to not take an exam in a given year, it is a lost opportunity as the four-year limit is absolute. After four years, if you do not pass the QE, you are no longer admissible to the certification process. Applicants to the Nontraditional Pathway to ABS Certification may not re-enter the pathway if they fail to complete it, nor may they appeal any decisions or determinations made by the ABS with regards to their application materials or examination performance.
You have three opportunities in three consecutive years to pass the CE. If you decide to not take an exam in a given year, it is a lost opportunity as the three-year limit is absolute. After three years, if you do not pass the CE, you are no longer admissible to the certification process. Applicants to the Nontraditional Pathway to ABS Certification may not re-enter the pathway if they fail to complete it, nor may they appeal any decisions or determinations made by the ABS with regards to their application materials or examination performance.
Yes. Upon passing the CE, you will be deemed certified in the specialty for which you completed the examination process and will receive your official certificate within six months. You must thereafter participate in the ABS Continuous Certification Program to maintain your certificate.
Most questions can be answered with the information available on our website. For specific inquiries, please contact our team.