The Blue Ribbon Committee II (BRC II), a joint initiative by the ACS, American Surgical Association, and American Board of Surgery, examined critical issues related to surgical education and published key recommendations in October 2024.*
One recommendation in particular was aimed at strengthening the pipeline of surgeon-scientists.† This recommendation was proposed by the BRC II Research Subcommittee, chaired by Jeffrey B. Matthews, MD, FACS (coauthor of this article), and Mary T. Hawn, MD, MPH, FACS.
Pilot Begins This Match Cycle
As a result, a pilot project to establish a formal surgeon-scientist training pathway (SSTP) within surgical residencies will launch in the 2026–2027 Match cycle; interested program administrators from all surgical subspecialties are encouraged to enlist in this effort.
The contributions of surgeon-scientists to the betterment of humanity are legion. However, despite significant evolution in the way scientific research is conducted, the process of developing surgeon-scientists has remained static for decades. Today, aspiring young physician-scientists may view the technical demands of surgical training to be incompatible with a research-oriented career. Indeed, many exceptional candidates are actively discouraged by medical school advisors from even considering surgery as a field.
Traditionally, surgical residents who are interested in basic, translational, and health services research careers take a 1- to 2-year hiatus in the middle of residency for a mentored laboratory experience, during which time clinical activity is minimal. Residents then rejoin the demanding final clinical years of training where little engagement in research is feasible.
It is generally agreed that a 2-year mentored laboratory experience is no longer adequate preparation given today’s complex research landscape and highly competitive funding environment. Moreover, this “start-stop” approach does not teach the trainee the key time management skill of integrating investigative work and clinical practice. With their first academic post still 4–6 years away (after fellowship), research-oriented trainees find themselves at a significant disadvantage amidst rapidly evolving scientific questions and methods.
Several research-intensive departments of surgery have sought innovative ways to better cultivate research-oriented residents in an effort to more formally integrate clinical and research experiences throughout the continuum of residency training. Some programs provide trainees blocks of time during the clinical residency to pursue mentored research and schedule time for them to remain engaged clinically during the academic development period.
The new SSTP pilot leverages the collective efforts for maximal impact: sharing best practices, creating common expectations for trainees and programs, and increasing awareness of the continued viability of a surgeon-scientist career.
This joint approach is analogous to existing physician-scientist training pathways in internal medicine and pediatrics. The process involves creating a separate, matchable “track” for aspiring surgeon-scientists to enter directly from medical school. This track leverages the National Resident Matching Program “reversion” mechanism where any unfilled slot in the surgeon-scientist track would automatically revert to the regular categorical track so that program positions are not at risk.
The envisioned SSTP track provides a more robust longitudinal “post-doc” fellowship experience, in addition to the traditional 2-year professional development options. The program is designed to better position surgeon-scientists to compete for subsequent independent funding such as National Institutes of Health K-type or R-type awards or extramural funding. Though yet unproven, the rationale behind this approach is to better prepare trainees for success as surgeon-scientists.
Programs are expected to provide a well-developed training infrastructure, mentors, institutional commitment, and a high-quality research environment. Mentors for trainees would include a multidisciplinary team, such as a scientific mentor, surgical mentor, programmatic leadership, and research advisory council.
5+2 Model
A categorical general surgery SSTP would follow a 5+2 structure, with 5 years of clinical training and 2 years of research time. Unlike current 5+2 models, the structure also would allow for continued research involvement during clinical training, especially during the final years so trainees remain engaged in research activities in tandem with their clinical education. This model also allows for individual paths based on the need for an additional research year, specialization, fellowship, and faculty role preparation.
A key innovation of the pilot project is the intention to better integrate these designated surgical residents into the broader community of physician-scientists and surgeon-scientists. Participants in the SSTP track will be expected to engage through institutional offices for physician-scientist development, as well as participate in focused sessions at national meetings such as the ACS Clinical Congress, Academic Surgical Congress, and American Society for Clinical Investigation/Alliance for Academic Internal Medicine/Burroughs Wellcome Fund Physician-Scientist Pathways Workshop.
Salary support will be provided through departmental or hospital funding with some limited clinical call obligations. Institutional training grants and individual career development awards are encouraged to provide additional sustainable funding avenues.
Participant data also will be collected to evaluate the success of the pilot. Key performance indicators will include published articles, career paths (including retention in the program), board pass rates, fellowship matches, types of jobs obtained, and ability to secure independent funding.
Join the Pilot
As noted, the formal launch of this SSTP track is planned for the 2026-2027 Match cycle. The BRC II invites all interested institutions to participate in the pilot. Profiles of participating programs will be made available online and promotion to medical schools will be part of the pilot. Learn more at facs.org/sstp. Contact SSTP@facs.org for additional information.
