Fellowship Requirements Pertaining to the United States and Canada
The American College of Surgeons admits to its Fellowship only those surgeons whose professional activity is devoted to surgical practice and who agree without compromise to practice by the professional and ethical standards of the College.
The standards of practice established and demanded by the American College of Surgeons are contained in the Fellowship Pledge and the Statements on Principles. All Fellows of the College and applicants for Fellowship are expected to adhere to these standards.
Surgeons request and voluntarily submit applications for Fellowship. In so doing, they are inviting an evaluation of their practice by their peers.
In evaluating the eligibility of applicants for Fellowship, the College investigates each applicant's entire surgical practice. Applicants for Fellowship are required to provide to the appointed committees of the College all information deemed necessary for the investigation and evaluation of their surgical practice.
Attainment of certification in the appropriate surgical specialty does not, of itself, entitle a surgeon to Fellowship.
FELLOWSHIP REQUIREMENTS
The College has designated the 15th of September of each year as the final date for acceptance of applications. All requirements must be met and the completed applications (new or continuing) must be on file in the Division of Member Services in Chicago by this date. Surgeons complying with this deadline will be considered for entry into Fellowship in October of the following year.
Applicants for Fellowship in the American College of Surgeons are required to have the following qualifications:
1. Graduation from a medical school acceptable to the American College of Surgeons.
2. Certification by an American Surgical Specialty Board which is a member of the American Board of Medical Specialties and which is appropriate to the applicant's specialty practice, or an appropriate specialty certification by the Royal College of Physicians and Surgeons of Canada.
3. A full and unrestricted license to practice medicine in their respective state or province.
4. One year of surgical practice after completion of all formal training. Additional practice time may be required if the practice situation and/or geographic location changes. Exceptions may be granted by the Member Services Liaison Committee.
5. A current appointment on the surgical staff of the applicant's primary hospital with no reportable action pending which could adversely affect staff privileges at that or any other health care facility.
6. A current practice that establishes the applicant as a specialist in surgery. The degree to which a practice must be restricted to the specialty is to be determined by a responsible College Credentials Committee. The limitation of an applicant's practice to the scope of the designated specialty is an important consideration.
7. Interest in pursuing professional excellence both as an individual surgeon and a member of the surgical community. Such interest may be evidenced by membership in local, regional, and national surgical specialty societies; participation in teaching programs and on hospital committees; continuing medical education through attendance at professional meetings, courses, and seminars.
8. Ethical fitness as well as professional proficiency as determined by an appropriate College Credentials Committee. This determination is based upon information obtained from Fellows who were consulted as references and from other sources.
The Member Services Liaison Committee determines whether the requirements for Fellowship are satisfied and may, at its discretion, defer any application until such requirements are met.
The Board of Regents makes the final decision regarding the applicant's eligibility for Fellowship.
The Board of Regents may, at any time, modify any portion of the requirements for Fellowship.
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PROCESS OF APPLYING FOR FELLOWSHIP
All properly submitted and accepted applications for Fellowship are developed and evaluated on a one-year cycle. The closing date for receiving completed applications is September 15 of each year.
1. Surgeons who fulfill all of the requirements may request an application for Fellowship.
2. Fellows of the College may request that the Fellowship application process be initiated for any surgeon who, in their opinion, qualifies for Fellowship.
3. A completed formal application is required from each applicant. In addition to providing information regarding their surgical training and practice, applicants are requested to:
a. Sign a statement agreeing to abide by the Bylaws, rules, and regulations of the College and the Fellowship Pledge.(See the Fellowship Pledge at the end of this document.)
b. Sign an authorization for hospitals, medical organizations, and others to release information deemed by the College to be material to its evaluation of the applicant.
c. Furnish as references the names of five Fellows of the College who are practicing surgery in the same geographic area as the applicant. The applicant is to obtain from these Fellows assurance of their willingness to serve as references.
4. Each Fellow named as a reference will be asked by the College to furnish a statement about the applicant's qualifications as a surgeon, as well as the applicant's professional and ethical standing in the community. The chief of surgery at each applicant's designated primary hospital(s) will be requested to provide a letter of reference. The College may also consult others.
5. Applicants are expected to compile and submit the most recent twelve-month summary listing of all surgical procedures they have performed after completion of all formal training. The appropriate forms and instructions will be provided. This surgical list is intended to serve as an index to the volume, variety, and character of an applicant's surgical experience.
6. Applicants may be requested to present detailed case reports and related information as additional evidence of their professional proficiency.
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EVALUATION OF APPLICATIONS FOR FELLOWSHIP
The evaluation of an applicant for Fellowship is based on comprehensive information relating to the applicant's surgical judgment and experience, professional competence, ethical conduct, professional standing in the local community, and attitude toward the basic tenets of the College. Such information is obtained from appointed College committees, references named by the applicant, and others.
1. The College Credentials Division reviews each application for completeness and prepares a summary of the biographical information and other pertinent information for review by the appointed committees of the College in evaluating the application. If the applicant's practice situation changes and it is determined that additional practice time is required, further processing of the application is deferred until the applicant has met all the requirements.
2. In many areas a Committee on Applicants interviews each applicant and reports to the Division of Member Services its findings regarding the applicant's eligibility for Fellowship.
3. The Credentials Committees of the College appraise information and recommendations from all sources relating to Fellowship applications and make recommendations to the Board of Regents. The Member Services Liaison Committee evaluates unusual practice situations to determine if the requirements for Fellowship have been met and recommends an action to the Board of Regents.
4. After review and evaluation of all information, the Board of Regents makes one of three decisions:
a. Approved for Fellowship--In order to attain Fellowship, each applicant must receive the approval of three-fourths of the Board of Regents.
b. Postponed (for one or two years)--An applicant's postponement is not considered as a denial of application. It is designed to give the applicant an opportunity to acquire further knowledge or additional experience or to develop professionally. It also provides the College with an additional period for observation, investigation, and further evaluation of the applicant's eligibility for Fellowship.
c. Denial of Application.
1. Following a denial of application, the applicant may submit a new application after a waiting period of three years.
2. Applicants who have received a denial of application may request an appeal. To initiate an appeal, the applicant must submit a written request to the Executive Director. Appeals are heard under the direction of the Board of Regents. (As indicated in 4b, the College does not consider a postponement to be a denial of an application.)
3. The Board of Regents may reverse a denial of application at its discretion. However, the final decision of the Board of Regents, following an appeal, is binding.
5. No Action—No action is taken when an application is determined by the College's Division of Member Services to be incomplete. Incomplete applications are deferred for consideration to the following year.
6. Successful applicants (Initiates) are admitted into Fellowship during the Convocation at the College's Clinical Congress in October of each year. Fellowship is conferred by the President of the College.
a. Applicants are notified by letter of their acceptance for Fellowship and are admitted to Fellowship only after formal action of the Regents at the Convocation Ceremony held during the College's Clinical Congress.
b. Between the date of the acceptance notification letter and the Convocation Ceremony, successful applicants are known as Initiates. Initiates are requested to notify the Division of Member Services of any changes in their location, practice association, type of practice or hospital privileges since such changes may affect their admission into Fellowship.
7. The College declines to furnish to anyone other than the applicant or those individuals concerned with the College's evaluation of the application information concerning the status of an application for Fellowship.
The regulations for admission into Fellowship have been formulated by the Board of Regents and apply uniformly to all applicants. No other means of admission is available.
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FEES
1. Application Fee—This fee must accompany every application for Fellowship. The fee is intended to cover a portion of the cost of reviewing and processing the application and is not refundable.
2. Initiate Fee—A statement for the Initiate fee is sent to the applicants who are notified of their Initiate status. If this fee is not received at the College by September 1 of the appropriate year, the Initiate will not be awarded Fellowship in the College.
3. Annual Dues—Upon the recommendation of the Board of Governors, the Board of Regents determines the amount of annual dues.
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FELLOWSHIP PLEDGE
Recognizing that the American College of Surgeons seeks to exemplify and develop the highest traditions of our ancient profession, I hereby pledge myself, as a condition of Fellowship in the College, to live in strict accordance with the College's principles and regulations.
I pledge to pursue the practice of surgery with honesty and to place the welfare and the rights of my patient above all else. I promise to deal with each patient as I would wish to be dealt with if I was in the patient's position, and I will respect the patient's autonomy and individuality.
I further pledge to affirm and support the social contact of the surgical profession with my community and society.
I will take no part in any arrangement or improper financial dealings that induce referral, treatment, or withholding of treatment for reason other than the patient's welfare.
Upon my honor, I declare that I will advance my knowledge and skills, will respect my colleagues, and will seek their counsel when in doubt about my own abilities. In turn, I will willingly help my colleagues when requested.
I recognize the interdependency of all health care professionals and will treat each with respect and consideration.
Finally, by my Fellowship in the American College of Surgeons, I solemnly pledge to abide by the Code of Professional Conduct and to cooperate in advancing the art and science of surgery.
Code of Professional Conduct
(Approved by Board of Regents June 2003)
As Fellows of the American College of Surgeons, we treasure the trust that our patients have placed in us, because trust is integral to the practice of surgery. During the continuum of pre-, intra-, and postoperative care, we accept responsibilities to:
- Serve as effective advocates of our patients' needs.
- Disclose therapeutic options, including their risks and benefits.
- Disclose and resolve any conflict of interest that might influence decisions regarding care.
- Be sensitive and respectful of patients, understanding their vulnerability during the perioperative period.
- Fully disclose adverse events and medical errors.
- Acknowledge patients' psychological, social, cultural, and spiritual needs.
- Encompass within our surgical care the special needs of terminally ill patients.
- Acknowledge and support the needs of patients' families.
- Respect the knowledge, dignity, and perspective of other health care professionals.
Our profession is also accountable to our communities and to society. In return for their trust, as Fellows of the American College of Surgeons, we accept responsibilities to:
- Provide the highest quality surgical care.
- Abide by the values of honesty, confidentiality, and altruism.
- Participate in lifelong learning.
- Maintain competence throughout our surgical careers.
- Participate in self-regulation by setting, maintaining, and enforcing practice standards.
- Improve care by evaluating its processes and outcomes.
- Inform the public about subjects within our expertise.
- Advocate strategies to improve individual and public health by communicating with government, health care organizations, and industry.
- Work with society to establish just, effective, and efficient distribution of health care resources.
- Provide necessary surgical care without regard to gender, race, disability, religion, social status, or ability to pay.
- Participate in educational programs addressing professionalism.
As surgeons, we acknowledge that we relate to our patients when they are most vulnerable. Their trust and the privileges we enjoy depend on our individual and collective participation in efforts that promote the good of both our patients and society. As Fellows of the American College of Surgeons, we commit ourselves and the College to the ideals of professionalism.
Revised November 21, 2005
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by the American College of Surgeons, Chicago, IL 60611-3211
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