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Become a member and receive career-enhancing benefits

Our top priority is providing value to members. Your Member Services team is here to ensure you maximize your ACS member benefits, participate in College activities, and engage with your ACS colleagues. It's all here.

Become a Member
Become a member and receive career-enhancing benefits

Our top priority is providing value to members. Your Member Services team is here to ensure you maximize your ACS member benefits, participate in College activities, and engage with your ACS colleagues. It's all here.

Membership Benefits

ACS Fundamentals of Surgery Curriculum® (ACS FSC)

ACS Fundamentals of Surgery Curriculum® (ACS FSC)

Give your residents the benefits of cognitive simulation

“This curriculum provides exposure to real-life situations, preparing residents to think on their feet with ease, handling challenging and common situations after having worked through similar conditions in the ACS FSC.”
-Participating Program Director

The ACS Fundamentals of Surgery Curriculum® (ACS FSC) is a highly interactive, case-based, online curriculum that addresses the essential content areas that all surgical residents need to master in the early years of training. Developed by the American College of Surgeons Division of Education, the curriculum includes more than 108 simulated case scenarios in which residents are asked to recognize and assess symptoms and signs, order appropriate tests and procedures, evaluate data, and initiate appropriate actions.

The ACS FSC virtual environment:

  • Builds learner confidence within the safety of a virtual environment
  • Provides the same learning opportunities for all residents
  • Emphasizes critical thinking skills
  • Supplements current educational programs
  • Is available 24/7 through any computer with Internet access
  • Provides tools for program directors to track resident progress

Virtual Lives, Real Decisions, Essential Content

Goals and Objectives

The goal of the ACS Fundamentals of Surgery Curriculum® is to ensure that first-year surgical residents have encountered simulations of the critical situations they will face in real life and have learned a safe way to approach each patient. The curriculum allows all residents to manage specific simulated case scenarios addressing essential content areas without the variability sometimes associated with clinical rotations. In addition, residents are able to learn, test various options, make errors, and engage in the self-assessment process without the concerns associated with real patients.

After successful completion of the ACS FSC, participants will be able to:

  • Manage surgical patients using a systematic approach—recognizing and assessing symptoms and signs, ordering appropriate tests and procedures, evaluating data, and initiating appropriate actions
  • Make appropriate decisions about involving other team members—notifying more senior residents, attending surgeons, or other health care professionals—or implementing independent decisions
Essential Content Areas

ACS FSC scenarios cover the following 14 essential content areas through 108 simulated case scenarios:

  • Patient and Workplace Safety
  • Preoperative Assessment
  • On-Call Issues
  • Pain Management
  • Unresponsive and Agitated Patients
  • Respiratory Management
  • Gastrointestinal Conditions
  • Wound Management
  • Nutritional Support
  • Fluid and Electrolyte Management
  • Cardiac Conditions
  • Vascular Conditions
  • Cardiothoracic Conditions
  • Oncology
Content Development Background

The content for the ACS FSC is based on Successfully Navigating the First Year of Surgical Residency: Essentials for Medical Students and PGY-1 Residents, developed by the ACS Division of Education. This document lists the critical cognitive, clinical, and technical skills needed as a foundation for education and training in all the surgical specialties. The ACS FSC Steering Committee identified the 11 modules* of essential content areas, core scenarios for the modules, and authors to develop the content. Under the guidance of Curriculum Director Patricia Numann, MD, FACS, and Associate Curriculum Director Richard Welling, MD, FACS, scenarios were written by small groups of surgeon authors using the best available evidence and expert consensus. Once complete, the scenarios were reviewed by a separate group of surgeon program directors who provided comments and feedback. The feedback was then collated and used to refine the scenarios as necessary. In addition, the electronic and interactive format of the scenarios was tested and critiqued with groups of residents from across the country.

*Three new modules have been added, two in 2014 and one in 2016, bringing the total to 14.

Benefits for Program Directors

The ACS FSC has many features designed specifically for program directors. The Instructors’ Manual provides an overview of each scenario including the topic, key learning points, core competencies addressed, answers, references, and images. Some program directors have used the scenarios as the basis for small group discussions and worked through the scenarios with groups of residents, in addition to using the scenarios as individual learning activities. Many programs find practice in the ACS FSC useful in view of duty hour restrictions. The ACS FSC is available on April 1, making it possible for programs to assign the curriculum to incoming residents prior to the start of the academic year.

The system allows program directors to make individual assignments to specific residents and to follow their progress. If desired, reports can be generated to show the progress of individual residents, small groups, or all residents, including which scenarios have been completed, which are in progress, which have not been started, and the amount of time spent on each scenario. Administrators have access to several guides with user-friendly, step-by-step instructions to easily administer the curriculum.


Since its launch in 2009, more than 19,300 residents have used this curriculum as part of their introduction to surgery residency.

Program Director Feedback

  • “Residents like it. The time commitment is reasonable. Residents perform better overall, understand certain basic concepts better, and are more professional and confident. The only change in our program was the addition of the ACS FSC.”
  • “Residents have improved confidence in specific areas of knowledge. The ACS FSC is particularly relevant, useful, and adaptable to the core surgery training paradigm in Canada.”
  • “The interactive requirement of the ACS FSC requires active participation by the resident, and it is easy to document completion of the scenarios.”
  • “Based on a review of ABSITE questions, the material in the scenarios was relevant.”
  • “I think that working through the case scenarios contributed to excellent ABSITE scores.”

Resident Feedback

  • “It’s really nice to be chastised by the case scenarios for wasting time doing things that aren’t the most efficient use of your time, since as a medical student, you are rarely told what NOT to order or examine, and are only told when you forget to order something. So the default approach, at least for me, is to order everything I can reasonably think of ordering. Clearly, this isn’t an optimal approach to medicine, as it’s nice to have a program that gives you realistic guidelines as to how to efficiently approach and manage common problems.”
  • “The ACS FSC is a great simulation and the interface is very involving. A few cases actually had my heart racing as if it was a true emergency! The resource links are priceless.”
  • “It is very useful and fun!”
  • “I really enjoy it, and think it’s very useful for day-to-day patient management knowledge, things that are usually left out of textbooks and other resource materials, and things that we usually have to learn on the fly, with no small amount of difficulty and struggle.”


ACS FSC is purchased by program directors for residents in their surgical residency programs. All PGY-1s within a program must be enrolled. Enrollment provides a subscription for each resident and a complimentary administrator account. Enrollment begins on Match Day each year. Programs are given access upon payment, but no earlier from April 1. Access ends on March 31 of the following year.

Fees per resident for academic year 2024-2025


Resident Member


Early Enrollment Discount
Before or on April 30



After April 30




To enroll, please access the online enrollment form below. A username and password for your program is required.

Begin your Enrollment Form

Sample Case Scenario

Experience an interactive scenario from the Safety Module. As you assume the role of a surgeon, this scenario puts you in the emergency room responding to a nurse’s call. You will examine the patient, interact with hospital personnel, and ensure that the patient is ready for a safe operation.

View Sample Scenario


Curriculum Directors

James C. Hebert, MD, FACS
Patricia J. Numann, MD, FACS

ACS Staff

Stephanie Hermes
Senior Administrator, ACS FSC

Tim Hotze
E-Learning Software Developer

Contact Us

For more information, email fundamentalsofsurgery@facs.org or call 312-202-5171