American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

Statement on Scope of Practice

The following statement was developed by the College's Committee on Ethics and was approved by the Board of Regents at its February 2002 meeting.

The American College of Surgeons maintains that high-quality surgical care for the sick and injured patient can be carried out only by qualified surgeons. Qualified surgeons are those physicians who have completed a surgical residency/fellowship approved by the Accreditation Council for Graduate Medical Education (ACGME) or the Royal College of Physicians and Surgeons of Canada (RCPSC); are certified, recertified, or qualified for examination by a surgical Board recognized by the American Board of Medical Specialties (ABMS) or the Royal College of Physicians of Surgeons of Canada (RCPSC); and who maintain continuing education and proficiency in their specialty. These qualifications are required for Fellowship in the American College of Surgeons.

A surgeon's scope of practice is determined by the appropriate surgical specialty board recognized by the ABMS or the RCPSC. Procedures performed are dictated by the guidelines set by a specialty board. Performing procedures outside of the field defined by a specialty board mandates additional education and experience, as well as certification where appropriate.

Surgeons are expected to study and evaluate new procedures and to become knowledgeable and proficient with advances that are appropriate. Technical skill alone is not sufficient to qualify a surgeon to perform new procedures. Procedural skills must be acquired within the context of in-depth knowledge about the natural course of a disease. It is mandatory when acquiring new skills that additional training by an accredited educational organization be obtained.

The College maintains that public education is vital. Specifically, patients must be informed about the qualifications of their surgeons. Any claims regarding expertise or any advertising done by a surgeon must be factual, documented with adequate data, and within the limits of his or her training and experience.

The College may take disciplinary action against Fellows who engage in surgical procedures outside their scope of practice as previously described or who falsely advertise their training, certification or experience.

Reprinted from Bulletin of the American College of Surgeons
Vol.87, No. 11, November 2002