Pathway into the ABS certification process for IMGs

Academic Pathway to ABS Certification for International Medical Graduates

    Please be advised that we will not be accepting applications for this pathway in 2023.
  • An alternate pathway into the American Board of Surgery (ABS) certification process is available for truly exceptional academic surgeons who are International Medical Graduates (IMGs). Surgeons who trained internationally in non-Accreditation Council for Graduate Medical Education (ACGME) or Royal College of Physicians and Surgeons of Canada (RCPSC) programs may be eligible. This pathway is intended for candidates who have and will contribute to the field of surgery through scholarship, education and research. ABS considers this situation extraordinary, and will approve or disallow entrance into this alternate pathway on a case-by-case basis. The chair of the Department of Surgery, the general surgery residency program director and, if applicable, the subspecialty surgery program director at the institution where the candidate holds a current full-time faculty appointment must propose the candidate.

Requirements for Application

Eligibility Requirements
  • At the time of application, you must provide evidence of the following:
    1. Possession of a current, full and unrestricted medical license in the United States for a minimum of seven (7) years.
    2. Completed medical training at an Educational Commission for Foreign Medical Graduates (ECFMG) recognized medical school and possession of an ECFMG certificate.
    3. Unrestricted clinical privileges at a licensed medical center certified by the Centers for Medicare and Medicaid Services (CMS).
    4. A minimum of one (1) year of clinical postgraduate training in the USA/Canada at a program accredited by the ACGME and/or sponsoring specialty society.
    5. A minimum of five (5) continuous years at the current institution. Must be employed as a full-time teaching faculty member at a Liaison Committee on Medical Education (LCME) accredited medical school and at an institution with an ACGME-accredited general surgery residency training program. The accreditation of both the medical school and training program must span the five (5) continuous years of employment.
    6. Completion of an international, equivalently structured and accredited training program in surgery, in comparison to the current ACGME general surgery residency program, including a signed attestation by the Program Director and institution.
Required Documents
    1. Copies of United States Medical Licensing Examination (USMLE) Steps 1-3 Score Reports.
    2. Sponsorship letters from the chief of the medical staff, the chair of the Department of Surgery and the general surgery residency program director at that institution. Letters must document participation in local quality, patient safety, and outcomes programs.
    3. Documentation of board certification in surgery, by a national ABS-equivalent organization that is responsible for setting training and practice standards, in the country where general surgery training was completed. This will be reviewed and approved on a case-by-case basis.
    4. Documentation of extraordinary scholarship and evidence for continued contributions, as well as recognition, in one or more of the following areas: (1) Research; (2) Education; (3) Clinical Care; (4) Program Development; or (5) Service.
    5. Three reference letters from peers at the nominating institution and three reference letters from referring physicians that attest to the applicant’s performance, ethics and professionalism.
    6. Current Curriculum Vitae signed by the applicant and chair of surgery of the nominating institution.

  • If original documents are in a language other than English, a notarized English translation must accompany them.
  • ABS will review all documents and letters of endorsement; if acceptable, the candidate will be approved to take the entrance examination to the certification process.

How to Apply

    Please be advised that we will not be accepting applications for this pathway in 2023.


  • Applicants meeting these criteria will then be eligible to enter the ABS certification process and must remain in practice at the same institution/location while completing the certification examination process.
  • Upon application approval, the individual will be granted three opportunities within three years to pass an admissibility secure examination of approximately 175-200 multiple-choice questions relevant to general surgery practice.
  • Upon successful completion of the admissibility exam, the applicant will be admissible to the ABS Qualifying Examination (QE). Successful completion of the QE allows registration for the Certifying Exam (CE). Upon passing the CE, the individual will be deemed certified in surgery and will receive their official certificate within 6 months. They must thereafter participate in the ABS Continuous Certification Program to maintain their certificate.


  • ABS retains the privilege of review and consideration of eligibility on a case by case basis, and allows appeals in the event of non-favorable decisions.
  • Please note that not all policies related to general surgery certification apply to this special pathway. For any questions related to the process or requirements for this pathway, please contact the ABS office.