ABS Training Requirements

For comprehensive details, refer to the ABS Booklet of Information – Surgery.

The American Board of Surgery outlines the following training requirements for general surgery certification:

• Residency Duration: Complete a minimum of five years (60 months) of progressive residency education in a general surgery program accredited by the ACGME or RCPSC.

• Program Limit: Training must be completed at no more than three residency programs.

• Clinical Activity: Engage in at least 48 weeks of full-time clinical activity in each residency year, which may be averaged over the years.

  Chief Resident Experience: Serve as a chief resident in general surgery for a minimum of 48 weeks during the PGY-4 and PGY-5 years, with prior ACGME approval required for any chief rotations in the PGY-4 year

• Operative Experience: Accumulate at least 850 operative procedures as the surgeon over five years, including a minimum of 200 during the chief resident year. Additionally, complete at least 40 cases in surgical critical care and 25 cases as a teaching assistant by the end of residency.

• Curriculum Requirements: Successfully complete courses in Advanced Cardiovascular Life Support (ACLS), Advanced Trauma Life Support® (ATLS®), and Fundamentals of Laparoscopic Surgery™ (FLS).

• Resident Performance Assessments: Obtain at least six operative and six clinical performance assessments conducted by the program director or other faculty members during residency.

  
  

   

1. Residents must complete 4 EPAs per week
2. Completing your EPAs will help you meet the ABS 6 clinical and 6 operative assessment requirements. 
3. Ask an Attending to complete an EPA assessment on you
4. Use the SIMPL EPA app

Resident must initiate communication with an Attending physician and ask to complete an assessment on them.  The Residency Program will not do this for you.

• What is an Entrustable Professional Activities (EPAs)?

  • EPAs are a competency-based assessment tool introduced by the American Board of Surgery (ABS) for general surgery residency programs.
  • As of July 2023, 18 core EPAs are implemented in all ACGME-accredited general surgery residency programs.

• Core EPAs for General Surgery:

  • Include essential clinical tasks such as:
    • Managing appendicitis, breast disease, colon disease, gallbladder disease, hernias, and acute abdomen.
    • Treating anorectal disease, small bowel obstruction, thyroid and parathyroid disease, and dialysis access.
    • Addressing soft tissue infections, cutaneous and subcutaneous neoplasms, and severe pancreatitis.
    • Performing perioperative care of critically ill patients, flexible GI endoscopy, and trauma evaluations.
    • Providing general surgery consultations.

• Purpose of EPAs:

  • EPAs serve as practical, observable units of work that allow direct assessment of clinical skills.
  • Designed to ensure frequent, efficient, and feedback-driven evaluations within clinical workflows.
  • Help create a standardized and reliable assessment method for surgical trainees.

• Implementation Support:

  • ABS provides resources such as detailed EPA descriptions, ACGME Milestones alignment, training videos, webinars, and guides.
  • A mobile application is available to streamline and integrate EPA evaluations into clinical practice.

• Significance:

  • Represents a shift toward competency-based surgical education.
  • Ensures residents are adequately prepared for independent practice by mastering core surgical activities.

More Resources

CLICK HERE for  iPhone download

CLICK HERE for Android download 

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• Complete during Endoscopy rotation
• Complete the Endoscopy Rotation Intake Form
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• Requirement :
•  You need 1 Colonoscopy (1 required with a score of 18 or higher)
• You need 1 Upper GI Endoscopy (1 required with a score of 18 or higher)
• Ask an Attending to complete an upper or lower GAGES on you; they can log into their Medhub account and view from their list of evals in their dropdown or you can contact the Residency Office and ask them to deliver eval to the designated Attending 
• Medhub has the following GAGES forms available for faculty to use: GAGES - Colonoscopy Scoresheet  & GAGES - Upper GI Endoscopy Scoresheet 
• The ABS announced in 2014 a new requirement to ensure all ABS-certified general surgeons have completed a standard curriculum in the use of endoscopic techniques. This new requirement will apply to certification applicants who complete their residency training in the 2017-2018 academic year or thereafter.
• During their general surgery residency, applicants will be required to have completed the ABS Flexible Endoscopy Curriculum (pdf).
• Residents will be trained in basic upper and lower endoscopy, augmenting their endoscopy suite experience with cases in the ICU and operating room. Technical progress is assessed during this block using the Global Assessment of Gastrointestinal Endoscopic Skills (GAGES). GAGES scores should be recorded for residents at baseline and then at least intermittently through the course of their endoscopic experience. The goal is for residents to consistently achieve a GAGES score of ≥ 18 during their procedures. There should also be exposure to multidisciplinary GI meetings such as pathology conferences and GI conferences. 
• LEVEL IV (Typically completed in PGY-3 or -4) This initial senior experience encompasses improvements in both cognitive and technical skills with cases assessed using GAGES to achieve a minimum score of 18 for both upper and lower endoscopy — a score achieved by “experienced” endoscopists during the GAGES validation studies. Residents continue with more advanced cognitive modules for therapeutic endoscopic techniques. Clinical experience for residents, outside of their dedicated endoscopy experience, should take place in the operating room and ICU, and continued work in the endoscopy suite of the home institution or other affiliated or associated institutions is encouraged.