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General Surgery
Training Requirements
Candidates for initial certification in general surgery must be meeting all posted requirements in place at the time of application.
Intro
All requirements must be met by the time of application to the Qualifying Exam
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.
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 GSQE.
Curriculum Requirements
Specific courses and related requirements
Where applicable, documentation must be provided at the time of application to the GSQE.
Residency Program Requirements
Must be completed during residency
The following program and time requirements are currently in place for candidates applying to the GSQE.
A minimum of five years (60 months) 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 must be completed at no more than three 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; see our leave policy for further details.
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’s resident roster. The only exception is in cases where three years’ credit has been granted for prior foreign graduate training. See also Credit for Foreign Medical Education.
At least 54 months of clinical surgical experience with increasing levels of responsibility over the five years, with no fewer than 42 months devoted to the content areas of general surgery.
No more than six months assigned to non-clinical or non-surgical disciplines during all junior years (PGY 1-3).
No more than twelve months allocated to any one surgical specialty other than general surgery during all junior years (PGY-1, -2, and -3).
The final two residency years (PGY-4 and -5) must be completed in the same program.
International Rotations
Receive approval in advance from the ABS and the ACGME
In certain circumstances, the ABS will accept rotations completed outside of the U.S. or Canada toward its general surgery training requirements.
Chief Resident Year Requirements
Specific requirements must be met in the chief year of residency
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.
Candidates for certification:
- Must have acted in the capacity of chief resident in general surgery for a minimum of 48 weeks over the PGY-4 and PGY-5 years, per the definition above. 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.
- Must complete the entire chief resident experience in either the content areas of general surgery or (noncardiac) thoracic surgery, with no more than four 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.
- Note: Applicants will be required to provide documentation of ACGME approval of chief rotations completed in the PGY-4 as part of the GSQE application.
Operative Experience Requirements
Required case numbers, completed during residency
The following operative requirements are in effect for applicants who graduated residency in the 2017-2018 academic year or later. Candidates must upload a PDF of the ACGME General Surgery Defined Category and Minimum Report via the ABS website.
- At least 850 operative procedures as surgeon over five 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. Up to 50 non-defined cases may be applied to this requirement.
Entrustable Professional Activities (EPAs)
Now being implemented at general surgery residency programs
Entrustable Professional Activities (EPAs) were developed to provide the opportunity for frequent, time-efficient, feedback-oriented and workplace-based assessment in the course of daily clinical workflow. They are an important clinical assessment component of competency-based resident education, offer the opportunity to operationalize competency evaluation and related entrustment decisions in the course of regular patient care, and address some of the challenges educators and trainees have faced in bridging core competency theory into clinical practice and performance assessment.
EPAs launched in July 2023 at all U.S.-based ACGME-accredited general surgery residency programs, with the other ABS specialties to follow in the coming years.
Examinations
Two exams are required for initial certification in general surgery
Successful completion of both the General Surgery Qualifying and Certifying Exams is required.
ABSITE
Offered annually to programs
The ABS offers annually to general surgery residency programs the ABS In-Training Examination (ABSITE®), a multiple-choice exam designed to measure the progress attained by residents in their knowledge of applied science and management of clinical problems related to surgery.
The ABSITE is furnished to program directors as a formative evaluation instrument to assess residents’ progress. The results are released only to program directors and should not be shared outside of the department GME division, although scores may be shared with the individual trainee. The exam is not available to individuals, may not be administered program faculty, and is not required as part of the board certification process.
Contact
Our exam managers are here to help.
Most questions can be answered with the information available on our website. For specific inquiries, please contact the general surgery exam manager.