General Requirements
In general, the ABS requires 48 weeks of full-time clinical activity in each of the five years of residency, regardless of the amount of operative experience obtained. The remaining four weeks of the year are considered non-clinical time that may be used for any purpose, such as vacation, conferences, interviews, etc.
All time away from clinical activity (i.e., non-clinical time), including vacation and time taken for interviews, visa issues, etc., must be accounted for on the application for certification.
ABS General Surgery Leave Policy
The ABS acknowledges the need to take time away from training for certain significant life events. Effective as of the 2021-2022 academic year and thereafter, as allowed by their programs, residents may take documented leave to care for a new child, whether for the birth, the adoption, or placement of a child in foster care; to care for a seriously ill family member (partner, child, or parent); to grieve the loss of a family member (partner, child, or parent); or to recover from the resident’s own serious illness. This policy is not retroactive and does not apply to leave taken prior to the 2021-2022 academic year.
Residents may take an additional four (4) weeks off during the first three (3) years of residency, for a total of 140 weeks required, and an additional four (4) weeks off during the last two (2) years of residency, for a total of 92 weeks required, all while maintaining admissibility to the ABS initial certification examination process. Residents are expected to complete a minimum of 48 weeks of Chief Resident rotations (e.g., a resident may accomplish this by logging chief cases as a PGY-4).
Programs will be required to obtain ACGME approval for chief rotations completed in the PGY-4 year. Residents will be required to provide documentation of ACGME approval of PGY-4 chief rotations at the time of application to the Qualifying Examination (QE).
See here for AGCME’s PGY-4 chief rotation guidelines.
Note: This is an ABS policy only and should not be confused with family leave as permitted by the Family and Medical Leave Act (FMLA). No approval is needed for this option if taken as outlined.
Additional Options
While the ABS considers the 48-week requirement to be a valuable standard in developing fully trained surgeons, options are available to provide programs and residents with some flexibility.
Averaging
The 48 weeks may be averaged over the first 3 years of residency, for a total of 144 weeks required in the first 3 years, and over the last 2 years, for a total of 96 weeks required in the last 2 years. Thus, non-clinical time may be reduced in one year to allow for additional non-clinical time in another year.
Extending Chief Year
The ABS will permit with advance approval applicants to extend their final year of training through the end of August and still take that year’s Qualifying Examination (QE). Program directors are required to submit a formal request for an extension of training to the ABS for consideration and approval. Applicants will be required to provide documentation of ABS approval of the training extension at the time of application to the QE.
Upon completion of training, the program is responsible for providing the ABS with a final attestation stating that the individual has met all ABS training requirements. Reminders will not be sent to the program. The attestation letter must be received by the ABS before registration access for the Certifying Examination (CE) is provided to the applicant. Note, prior approval from the RC-Surgery may be needed for the increase in complement.
Completing 5 Years in 6
The ABS also permits, with advance approval, the five clinical years of residency to be completed over a six-year period (“6-Year Option”). See farther below for more details.
Other Arrangements
The ABS will also consider other arrangements beyond what is noted above on a case-by-case basis. These will also require advance approval.
All requests for approval must be made by the program director (not the resident) and must be sent by mail or email on official letterhead to the ABS office.
6-Year Option
If permitted by the residency program, the five clinical years of residency training may be completed over six academic years. All training must be completed at a single program with advance approval from the ABS. In this option, an average of 48 weeks of full-time training is required in each clinical year as explained above. The first 12 months of clinical training would be counted as PGY-1, the second 12 months as PGY-2, and so forth. No block of clinical training may be shorter than one month (four weeks).
Under this option, a resident may take up to 12 months off during the six-year training period. The resident would first work with his or her program to determine an appropriate leave period or schedule. The program would then request approval for this plan from the ABS; requests must be sent by mail or email on official letterhead to the ABS office.
Use of the six-year option is solely at the program’s discretion, and contingent on advance approval from the ABS. The option may be used for any purpose approved by the residency program, including but not limited to, family issues, visa issues, medical problems, maternity leave, external commitments, volunteerism, pursuit of outside interests, educational opportunities, etc.
Considerations for Workplace Support of Pregnant Surgeons
The American Board of Surgery recommends personalized training scheduled and responsibilities based upon pregnancy-related conditions. Programs should consider, and where appropriate, employ modifications to protect the pregnant surgeon and fetus. Consideration should be given to eliminating overnight call, assigning rotations that do not require long periods of standing, either during cases or otherwise, and limiting duty hours, especially during the third trimester. The American Board of Surgery expects that these decisions be made in accordance with federal and state laws and with the involvement of the trainee.
For questions regarding this policy, please contact the ABS.
Previous ABS General Surgery Leave Policy
Prior to the 2021-2022 academic year, as allowed by their programs, residents could take documented leave to care for a new child, whether for the birth, the adoption, or placement of a child in foster care; to care for a seriously ill family member (spouse, son, daughter, or parent); to grieve the loss of a family member (spouse, son, daughter, or parent); or to recover from the resident’s own serious illness. This policy was not retroactive and did not apply to leave taken prior to the 2019-2020 academic year.
Residents could take an additional 2 weeks off during the first 3 years of residency, for a total of 142 weeks required, and an additional 2 weeks off during the last 2 years of residency, for a total of 94 weeks required. Note: This was an ABS policy only and should not be confused with family leave as permitted by the Family and Medical Leave Act (FMLA). No approval was needed for this option if taken as outlined.