International Fellowship Requirements

The FACS credential exists to foster the professional growth and development of surgeons, promote high standards and best practices in surgical care, and establish and maintain patients’ confidence in the ability and integrity of their surgeon. Conferred on surgeons who meet specific academic and practice requirements, the FACS credential can only be used by Fellows in good standing with the American College of Surgeons (ACS). The FACS credential is not an honor that should be discarded lightly; members are expected to engage in ACS activities and remain financially current with their annual membership dues in order to continue to use the designation. Once membership lapses, a surgeon is no longer legally allowed to display FACS after their name and medical degree in any context. The designation is the exclusive intellectual property of the ACS. Misuse of the FACS designation by nonmembers is pursued by the ACS.

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

The American College of Surgeons admits to its Fellowship only those surgeons whose professional activity is devoted to surgical practice and who agree without compromise to practice by the professional and ethical standards of the College.

The standards of practice established and demanded by the American College of Surgeons are contained in the Fellowship Pledge, Statements on Principles, and the Code of Conduct. All Fellows of the College and applicants for Fellowship are expected to adhere to these standards.

Surgeons voluntarily submit applications for Fellowship. In so doing, they are inviting an evaluation of their practice by their peers.

In evaluating the eligibility of applicants for Fellowship, the College investigates each applicant's surgical practice. Applicants for Fellowship are required to provide to the appointed committees of the College all information deemed necessary for the review and evaluation of their surgical practice.

The College has designated December 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.

Applicants for Fellowship in the American College of Surgeons are required to have the following qualifications:

• Ability to speak and/or write in the English language. The application form must be completed online and all correspondence is to be conducted in English.
• Graduation from a medical school acceptable to the American College of Surgeons
• Documentation of the completion of basic surgical training requirements as determined by your country
• Certification by one of the following:
  • An American Surgical Specialty Board, which is a member of the American Board of Medical Specialties
  • 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, Consejo Mexicano, or the Philippine Board of Surgery
  • An appropriate national surgical board from the country where the applicant is currently practicing if applicable for the country.
• A full and unrestricted license to practice medicine in your country and in the state or province with no reportable action pending that could adversely affect the status of that licensure.
• Three years of surgical practice after the completion of all formal training is required (training appointments such as resident, registrar, fellow, etc., do not count as practice).
• Twelve (12) consecutive months of practice in the applicant’s current location is required before the application is submitted.
• 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.
• 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.
• Ethical fitness as well as professional proficiency. This determination is based upon information obtained from Fellows who were consulted as references and from other sources.
• Interest in pursuing professional excellence both as an individual surgeon and a member of the surgical community. Such interest may be evidenced by membership in local, regional, and national surgical societies; participation in teaching programs and on hospital committees; continuing medical education through attendance at professional meetings, courses, and seminars.

The Division of Member Services 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.

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

• Surgeons who fulfill all of the requirements must submit an online application for Fellowship.
• In addition to providing information regarding their surgical training and practice, applicants are requested to:
  • Abide by the Bylaws, rules and regulations of the College and the Fellowship Pledge
  • Accept an Authorization to Release Information for hospital, medical organization, and others to release information deemed by the College to be material to its evaluation of the applicant.
  • Furnish as references the names of at least three Fellows of the College who can provide an evaluation based on their actual knowledge of your surgical practice. The applicant is to obtain verbal assurance from these Fellows of their willingness to serve as references.
• Each Fellow named as a reference will be asked by the College to complete a form about the applicant's qualifications as a surgeon, as well as the applicant's professional and ethical standing in the community.
• Participate in an interview by teams composed of either officers from your local ACS Chapter, your local ACS Governor, or appointees of the ACS International Relations Committee.

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.

• The College Credentials Staff appraises information and recommendations from all sources relating to Fellowship applications and makes recommendations to the Board of Regents. The Applicant Review Committee (ARC) evaluates unusual practice situations to determine if the requirements for Fellowship have been met and recommends an action to the Board of Regents.
• The College Credentials Staff reviews each application for completeness and prepares a summary of the biographical information and other pertinent information for applicant review and evaluation by the appointed Committee on Applicants.
• The Committees on Applicants interviews each applicant and reports its findings regarding the applicant's eligibility for Fellowship to the Credentials Staff.
• After review and evaluation of all information, the Board of Regents makes one of three decisions:
  • Approved for Fellowship—In order to attain Fellowship, each applicant must receive the approval of three-fourths of the Board of Regents.
  • Postponed (for one or two years)—an applicant's postponement is not considered a denial of the 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.
  • Denial of Application
    • Following a denial of an application, the applicant may submit a new application after a waiting period of three years.
    • Applicants who have received a denial of their application may request an appeal. To initiate an appeal, the applicant must submit a written request to the Director of the Division of Member Services. Appeals are heard under the direction of the Board of Regents.
    • The Board of Regents may reverse a denial of an application at its discretion. However, the final decision of the Board of Regents, following an appeal, is binding.
• 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.
• 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.
  • Initiates are notified by email of their acceptance prior to August 1.
  • 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 situation, type of practice or hospital privileges since such changes may affect their admission into Fellowship.
• 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.

Application Fee

The fee must accompany every application for Fellowship and is paid at the time the application is submitted. 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.

Annual Dues

Upon the recommendation of the Board of Governors, the Board of Regents determines the amount of annual dues.

Initiate Fee

A statement for the Initiate Fee is sent to the applicants who are notified of their Initiate
status. If this Fee is not received at the College by September 1 of the appropriate year, the Initiate
will not be awarded Fellowship in the College.

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 contract 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.

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.