Fellowship Requirements Pertaining to Surgeons from Countries Other Than The United States, Its Possessions, and Canada

FELLOWSHIP REQUIREMENTS

Surgeons practicing in countries other than the United States, its possessions, and Canada are eligible to apply for Fellowship in the American College of Surgeons.

The College has designated July 1 of each year as the final date for acceptance of these applications. The completed applications (new or continuing) must be on file in the Division of Member Services in Chicago by this date. Only completed applications from surgeons who fulfill the following requirements will be considered for entry into Fellowship in October of the following year.

1. Ability to speak and/or write in the English language. The application form must be completed and all correspondence conducted in English.
2. Graduation from a medical school acceptable to the American College of Surgeons
3. Certification by: (a) an American Surgical Specialty Board, which is a member of the American Board of Medical Specialties; (b) the College of Surgeons of South Africa, the Royal Australasian College of Surgeons, the Royal College of Physicians and Surgeons of Canada, the Royal College of Physicians and Surgeons of Glasgow, the Royal College of Surgeons of Edinburgh, the Royal College of Surgeons of England, the Royal College of Surgeons in Ireland; or (c) an appropriate national surgical board from the country where the applicant is currently practicing. If none of the above apply, documentation of the completion of the basic surgical training requirements determined by their country will be required.
4. One year in an approved surgical training program in the United States or Canada is considered desirable, but is not mandatory.
5. A full and unrestricted license to practice medicine in the country and in the state or province where they are in practice.
6. Three years of uninterrupted surgical practice in one location, intended as permanent, after the completion of all formal training, is required.
7. If a surgeon moves to another country, additional practice time may be required.
8. A current appointment on the surgical staff of the applicant's primary hospital with no reportable action pending that could adversely affect staff privileges at that or any other health care facility.
9. A current surgical practice that establishes the applicant as a specialist in surgery. All applicants are expected to be physicians who have primary independent responsibility for the surgical treatment of patients.
10. Ethical fitness as well as professional standing as determined by an appropriate College credentials committee. This determination is based upon information obtained from Fellows who were consulted as references and from other sources.
11. Professional proficiency as determined by certification by an appropriate national surgical board, fellowship in certain of the Royal Colleges of Surgeons, and certificates of completion of higher training in surgery. Depending upon the applicant's education, training, and practice location, this requirement may vary.

The Member Services Liaison Committee determines whether the requirements for Fellowship are satisfied and may, at its discretion, defer any application until such requirements are met.

The Board of Regents makes the final decision regarding the applicant's eligibility for Fellowship.

The Board of Regents may, at any time, modify the requirements for Fellowship.

PROCESS OF APPLYING FOR FELLOWSHIP

All properly submitted and accepted applications for Fellowship are evaluated on a one-year cycle. The closing date for receiving completed applications is July 1 of each year.

1. Surgeons who fulfill all of the requirements may submit an application for Fellowship.
2. Fellows of the College may request that the Fellowship application process be initiated for any surgeon who, in their opinion, qualifies for Fellowship.
3. A completed formal application is required from each applicant. In addition to providing information regarding their surgical training and practice, applicants are requested to:

1. Sign a statement agreeing to abide by the Bylaws, rules, and regulations of the College and the Fellowship Pledge.
2. Sign an authorization for hospitals, medical organizations, and others to release information deemed by the College to be material to its evaluation of the applicant.
3. Furnish as references the names of five Fellows of the College who know the applicant and who can provide an evaluation. Ideally, these references will practice surgery in the same geographic area as the applicant. The applicant is to obtain from these Fellows verbal assurance of their willingness to serve as references.

4. Each named reference will be asked by the College to complete and return a questionnaire relating to the applicant's qualifications as a surgeon, as well as the applicant's professional and ethical standing in the community.

EVALUATION OF APPLICANTS FOR FELLOWSHIP

The evaluation of an applicant for Fellowship is based on information relating to the applicant's surgical judgment and experience, professional competence, ethical conduct, and professional standing in the local community. Such information is obtained from appointed College committees, references named by the applicant, and others.

1. In some areas a Committee on Applicants interviews each applicant and reports to the Division of Member Services its findings regarding the applicant's eligibility for Fellowship.
2. The credentials committees of the College appraise information and recommendations from all sources relating to Fellowship applications and make recommendations to the Board of Regents. The Fellowship Liaison Committee evaluates unusual practice situations to determine if the requirements for Fellowship have been met and recommends an action to the Board of Regents.
3. After review and evaluation of all information, the Board of Regents makes one of three decisions:

1. Approved for Fellowship—In order to attain Fellowship, each applicant must receive the approval of three-fourths of the Board of Regents.
2. Postponed (for one or two years)—an applicant's postponement is not considered as a denial of application. It is designed to give the applicant an opportunity to acquire further knowledge or additional experience or to develop professionally. It also provides the College with an additional period for observation, investigation, and further evaluation of the applicant's eligibility for Fellowship.
3. Denial of Application

1. Following a denial of application, the applicant may submit a new application after a waiting period of three years.
2. Applicants who have received a denial of application may request an appeal. To initiate an appeal, the applicant must submit a written request to the Executive Director. Appeals are heard under the direction of the Board of Regents.
3. The Board of Regents may reverse a denial of application at its discretion. However, the final decision of the Board of Regents, following an appeal, is binding.

4. No action is taken when an application is determined by the College's Division of Member Services to be incomplete. Incomplete applications are deferred for consideration to the following year.
5. Successful applicants (Initiates) are admitted into Fellowship during the Convocation Ceremony at the College's Clinical Congress in October of each year. Fellowship is conferred by the President of the College.

1. Initiates are notified by letter of their acceptance prior to August 1.
2. Between the date of the acceptance notification letter and the Convocation, Initiates must notify the Division of Member Services of any changes in their location, practice association, type of practice or hospital privileges since such changes may affect their admission into Fellowship.

6. The College provides information concerning the status of an application for Fellowship only to the applicant or those individuals involved in the College's evaluation of the application.

FEES

1. Application Fee
   
   This fee must accompany every application for Fellowship. The fee covers a portion of the cost of reviewing and processing the application and is not refundable. No application will be processed without the fee.
   
   
2. Initiate Fee
   
   A statement requesting payment of the Initiate fee is sent to the applicants who are notified of their Initiate status. Unless this fee is received at the College by September 1 of the appropriate year, Fellowship will not be conferred. This fee covers a portion of the costs incurred by the College in processing applications and the process of initiation.
3. Annual Dues
   
   Upon the recommendation of the Board of Governors, the Board of Regents determines the amount of annual dues.
   
   Fellowship Pledge
   
   

   Recognizing that the American College of Surgeons seeks to exemplify and develop the highest traditions of our ancient profession, I hereby pledge myself, as a condition of Fellowship in the College, to live in strict accordance with the College's principles and regulations.

   I pledge to pursue the practice of surgery with honesty and to place the welfare and the rights of my patient above all else. I promise to deal with each patient as I would wish to be dealt with if I was in the patient's position, and I will respect the patient's autonomy and individuality.

   I further pledge to affirm and support the social contact of the surgical profession with my community and society.

   I will take no part in any arrangement or improper financial dealings that induce referral, treatment, or withholding of treatment for reason other than the patient's welfare.

   Upon my honor, I declare that I will advance my knowledge and skills, will respect my colleagues, and will seek their counsel when in doubt about my own abilities. In turn, I will willingly help my colleagues when requested.

   I recognize the interdependency of all health care professionals and will treat each with respect and consideration.

   Finally, by my Fellowship in the American College of Surgeons, I solemnly pledge to abide by the Code of Professional Conduct and to cooperate in advancing the art and science of surgery.

   Code of Professional Conduct

   (Approved by Board of Regents June 2003)

   As Fellows of the American College of Surgeons, we treasure the trust that our patients have placed in us, because trust is integral to the practice of surgery. During the continuum of pre-, intra-, and postoperative care, we accept responsibilities to:

   • Serve as effective advocates of our patients' needs.
   • Disclose therapeutic options, including their risks and benefits.
   • Disclose and resolve any conflict of interest that might influence decisions regarding care.
   • Be sensitive and respectful of patients, understanding their vulnerability during the perioperative period.
   • Fully disclose adverse events and medical errors.
   • Acknowledge patients' psychological, social, cultural, and spiritual needs.
   • Encompass within our surgical care the special needs of terminally ill patients.
   • Acknowledge and support the needs of patients' families.
   • Respect the knowledge, dignity, and perspective of other health care professionals.

   Our profession is also accountable to our communities and to society. In return for their trust, as Fellows of the American College of Surgeons, we accept responsibilities to:

   • Provide the highest quality surgical care.
   • Abide by the values of honesty, confidentiality, and altruism.
   • Participate in lifelong learning.
   • Maintain competence throughout our surgical careers.
   • Participate in self-regulation by setting, maintaining, and enforcing practice standards.
   • Improve care by evaluating its processes and outcomes.
   • Inform the public about subjects within our expertise.
   • Advocate strategies to improve individual and public health by communicating with government, health care organizations, and industry.
   • Work with society to establish just, effective, and efficient distribution of health care resources.
   • Provide necessary surgical care without regard to gender, race, disability, religion, social status, or ability to pay.
   • Participate in educational programs addressing professionalism.

   As surgeons, we acknowledge that we relate to our patients when they are most vulnerable. Their trust and the privileges we enjoy depend on our individual and collective participation in efforts that promote the good of both our patients and society. As Fellows of the American College of Surgeons, we commit ourselves and the College to the ideals of professionalism.

Member Services