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

Statement for the Advisory Council for General Surgery to the Board of Regents of the American College of Surgeons

The Advisory Council for General Surgery unanimously recognizes and reaffirms that General Surgery is the basic core specialty within the discipline of surgery. The general surgeon is a surgical specialist engaged in the comprehensive care of surgical patients. The future of General Surgery is dependent upon the maintenance of comprehensive training standards and scope of practice.

The Advisory Council for General Surgery accepts and endorses the definition of General Surgery as a specialty as articulated by the American Board of Surgery and as described in the special requirements for residency training in General Surgery by the Residency Review Committee for Surgery.*

It is essential that the full scope of this definition be retained in the actual clinical experience of the general surgery trainee. An adequate number of general surgical procedures must be maintained for comprehensive education and training programs of general surgery residents.

  1. General Surgery, as defined by the American Board of Surgery and the Residency Review Committee for Surgery, emphasizes the acquisition of knowledge in the basic sciences underlying surgical practice and the development of clinical skills in the diagnosis, preoperative, operative, and postoperative care of patients with disease as outlined on the next page.
  2. The Advisory Council for General Surgery supports the previous action of the Board of Regents of the American College of Surgeons in opposing the further fragmentation of Surgery, and the Council opposes the issuing of additional certificates of special or added qualifications.
  3. Technologic advances continue to characterize the modern practice of scientific medicine. Surgeons should continue to direct the development of and the definition of the true merit of technical innovations in many aspects of general surgical care. Some current examples include percutaneous angioplasty, fiberoptic endoscopy, intensive care technologies, and biliary lithotripsy.

Surgeons should be involved in decisions to use limited interventions, which should be performed only by individuals fully trained in the procedure with continuing outcome-related quality control. Patients are best cared for when the procedure is done by or with the full and previously established cooperation of a surgical specialist capable of definitive correction of the patient's illness or likely complications.

Definition of General Surgery

American Board of Surgery

General Surgery includes:

  1. A central core of knowledge embracing anatomy, physiology, metabolism, immunology, nutrition, pathology, wound healing, shock and resuscitation, intensive care, and neoplasia.
  2. Specialized knowledge and skill relating to the diagnosis, preoperative, operative, and postoperative management in the following areas of primary responsibility:
    • Alimentary tract.
    • Abdomen and its contents.
    • Breast, skin, and soft tissue.
    • Head and neck.
    • Vascular system, excluding the intracranial vessels, the heart, and those vessels intrinsic and immediately adjacent thereto.
    • Comprehensive management of trauma. The responsibility of all phases of care of the injured patient is an essential component of general surgery.
    • Complete care of critically ill patients with underlying surgical conditions, in the emergency room, intensive care unit, and trauma/burn units.

*As published in Humphreys JW Jr: General surgery redefined in the era of specialization. Bull Am Coll Surg,69:4-6, 1984.

Reprinted from Bulletin of the American College of Surgeons
Vol. 74, Vol 6, Pages 6-7, June 1989