Update on the American Board of Surgery subspecialty certificate in Complex General Surgical Oncology.

At the conclusion of my presidential address describing the events that led to a subspecialty certificate in Advanced Surgical Oncology at the 63rd Annual Cancer Symposium of the Society of Surgical Oncology (SSO) in March 2010, I stated: ‘‘It is fair to say that the goal is in sight, yet it is prudent to remind ourselves that we have not crossed the finish line yet’’. 3 years later, I have realized how prophetic that statement was. The events that followed the submission of a formal request by the American Board of Surgery (ABS) to the American Board of Medical Specialties (ABMS) to establish a certificate for Advanced Surgical Oncology and the subsequent steps that led to its approval by the ABMS have been detailed in a previous editorial. This was an historical event for the discipline of surgical oncology, which was recognized as deserving of a formal training and a unique certificate. This was also a significant moment for the ABS in that this certificate is the first new certificate offered by the ABS in more than 20 years. The process then continued with the Accreditation Council on Graduate Medical Education (ACGME). The ACGME asked the Residency Review Committee in Surgery (RRC-S) to specify the training requirements for surgical oncology programs. A subcommittee of the RRCS was established with Drs. Peter Fabri, Mark Wallack, and Thomas Whalen (chair). The SSO was asked to name a representative, and Dr. Russell Berman joined the subcommittee. Once defined, the proposed program requirements were then sent to the GME constituency on February 6, 2012, for the statutory 45-day comment period. After the RRC-S collated and answered all comments received, it submitted the final document to the Requirement Development Committee of the ACGME Board of Directors for review. Finally, the full Board of Directors of the ACGME approved the program requirements at the June 10, 2012, meeting. By the first week in July, both the program requirements and the program information form (PIF) were available on the ACGME Web site. In recognition of the high quality of program supervision that the Training Committee of the SSO had provided to SSO-accredited programs, the RRC-S, which has oversight responsibility for the fellowships, agreed that current SSOapproved programs would not require a site visit as a part of the initial accreditation review. Non-SSO-approved programs would require a site visit to verify and confirm the information provided in the PIF. In accordance with ACGME policy, programs accredited in the 2012–2013 academic year could request a retroactive effective date of accreditation to July 1, 2012, making graduates of these ACGME-accredited fellowships eligible to participate in the ABS certification process upon graduation on June 30, 2013. In the meantime, changes also occurred at the ABS. The name of the Surgical Oncology Advisory Council (SOAC) was changed to Surgical Oncology Board. In addition, its composition was defined (Table 1). I was elected the first chair of the Surgical Oncology Board (2011–2012) and was then followed by Dr. Selwyn Vickers, who is currently serving a 2-year mandate. The newly established Surgical Oncology Board decided to award the certificate of Complex General Surgical Oncology to eligible candidates after successfully passing a qualifying examination (QE) and a certifying examination (CE), very much like the process leading to a certificate in surgery. The first order of business therefore became to establish a sizable multiplechoice question bank for the qualifying exam. In order to expeditiously attend to this task, the Surgical Oncology Board created a group of 12 consultants, two for Society of Surgical Oncology 2013