The Ideal Candidate

Statement by the Association of Pediatric Surgery Training Program Directors
on Flexibility in General Surgery Residency Specialty – Specific Guidelines

Background:  In 2011 the American Board of Surgery approved a new policy to permit greater flexibility in the structure of general surgery residency training. The policy allows up to 12 months of flexible rotations so program directors may tailor training to a resident’s future career interest. The board offered the following guidelines for such rotations in Pediatric Surgery.

A senior rotation in Pediatric Surgery is recommended for residents to gain exposure to advanced pediatric surgery and to demonstrate capabilities critical for selection to pediatric surgery programs. 

The following surgical rotations are also felt to be of benefit:

  • Thoracic/esophageal
  • Surgical oncology
  • Head and neck/endocrine surgery
  • Hepatobiliary
  • Advanced minimally invasive surgery
  • Colorectal surgery
  • Surgical critical care

 

The purpose of this document is to provide general surgery residents interested in pediatric surgery and their program directors a consensus of the Association of Pediatric Surgery Training Program Directors as to the characteristics of an ideal candidate for pediatric surgery training.  These recommendations may help inform the decisions made by these potential applicants as to the use, if any, of the flexibility allowed by the ABS in General Surgery training.

Characteristics of the ideal applicant include the following:

  • Expected completion of an ACGME approved General Surgery Residency. Most successful candidates for Pediatric Surgery obtain their General Surgery education in university-based General Surgery Programs. 
  • Readiness of the applicant to enter into independent practice of general surgery at the time he/she begins training in Pediatric Surgery to include:
    • Eligibility for certification by the American Board of Surgery
    • Demonstration of a broad fund of medical knowledge as documented by objective measures to include assessment by the applicants program director, performance on the ABSITE, USMLE examinations and satisfactory completion of SCORE, FLS, PALS and ATLS.
    • Documented mastery of preoperative and postoperative patient care for general surgery patients undergoing a broad range of surgical procedures. This documentation should include a statement from the program director that the candidate has had semiautonomous responsibility for patient care and a composite of the resident’s evaluations focused on this domain of patient care.
    • Competence in performing a broad range of basic and intermediate general surgical procedures including advanced laparoscopic and open surgical procedures. The scope of experience should include thoracic/esophageal, head and neck, endocrine, liver and pancreas resection, biliary reconstructive surgery, colorectal surgery including the surgical management of inflammatory bowel disease and the surgical management  of benign and malignant tumors of the abdomen and chest  A statement by the program director giving specific data on typical senior-level experiences at their institution which could reasonably be expected for the applicant at the time of completion of his/her residency is desirable.
    • Mastery of professionalism, system based care, etc., as documented by a composite of evaluations provided by the program director.
    • Active involvement in the addition of new knowledge or advanced pediatric surgical care (example ECMO or MIS  fellowships). This may be documented through participation in basic or clinical research, involvement in surgical quality/safety programs such as the National Surgical Quality Improvement Project, demonstrated interest in education through participation in institutional GME organizations or organizations such as the Association of Program Directors in Surgery, or Society of Surgical Education.  Objective evidence of success through publication of peer reviewed work in any of these areas is desired.  This domain may be satisfied with or without doing additional nonclinical time during the five-year General Surgery Residency.
  • Interest in the care of infants and children as demonstrated by a personal statement, letters of recommendations and elective clinical or research experiences. Objective demonstration of commitment to and passion for the care of children is advantageous.
  • Objective demonstration of excellence through institutional, regional (i.e. local chapters of the ACS) or national awards/recognitions.
  • Competence in administrative duties including the leading of a surgical team, maintenance of schedules, successful compliance with institutional rules including the 80-hour work week, timely documentation of medical records, etc. This should be documented by a specific evaluation by the Program Director.

 

The APSTPD recognizes that both candidates and program directors in general surgery face considerable challenges in providing these outcomes. We do not feel that proscriptive requirements for specific rotations are necessary or desirable given the variety of training programs in the United States. Our desire is to provide access to Pediatric Surgery training for the men and women from all types of general surgery training programs who are best suited for advanced training in pediatric surgery by dint of their personal accomplishments and demonstrated ability.


 

Alberta Children's Hospital/University of Calgary
Alberta Children's Hospital/University of Calgary

Ann & Robert H. Lurie Children’s Hospital of Chicago
Ann & Robert H. Lurie Children’s Hospital of Chicago

Arkansas Children's Hospital (University of Arkansas for Medical Sciences)
Arkansas Children's Hospital (University of Arkansas for Medical Sciences)

Baylor College of Medicine
Baylor College of Medicine

BC Children’s Hospital Pediatric Surgery, University of British Columbia, Vancouver, Canada
BC Children’s Hospital Pediatric Surgery, University of British Columbia, Vancouver, Canada

Boston Children’s Hospital Pediatric Surgery Fellowship
Boston Children’s Hospital

Children’s Hospital Los Angeles
Children’s Hospital Los Angeles

Children’s Hospital of Michigan
Children’s Hospital of Michigan

Children’s Hospital of Philadelphia Pediatric General Surgery Fellowship
Children’s Hospital of Philadelphia

Children’s National Hospital
Children’s National Hospital

Children's Hospital, University of Oklahoma
Children's Hospital, University of Oklahoma

CHU Sainte-Justine Pediatric Surgery Fellowship (Université de Montréal)
CHU Sainte-Justine

Cincinnati Children's Hospital Pediatric Surgery Fellowship
Cincinnati Children's Hospital

Cohen Children's Medical Center- Northwell Health
Cohen Children's Medical Center- Northwell Health

Emory University/Children's Healthcare of Atlanta
Emory University/Children's Healthcare of Atlanta

Johns Hopkins All Children's Hospital
Johns Hopkins All Children's Hospital

Johns Hopkins University
Johns Hopkins University

Le Bonheur Children’s Hospital Pediatric Surgery Fellowship
University of Tennessee Health Science Center

Loma Linda University Children’s Hospital
Loma Linda University Children’s Hospital

Mayo Clinic Arizona/Phoenix Children’s Hospital Pediatric Surgery Fellowship
Mayo Clinic Arizona/Phoenix Children’s Hospital

McMaster Children’s Hospital Pediatric Surgery Fellowship
McMaster Children’s Hospital

Medical College of Wisconsin and Affiliated Hospitals
Medical College of Wisconsin and Affiliated Hospitals

Montreal Children’s Hospital (McGill University)
Montreal Children’s Hospital (McGill University)

Nationwide Children’s Hospital Pediatric Surgery Fellowship
Ohio State University/Nationwide Children's Hospital

NewYork-Presbyterian Pediatric Surgery Fellowship Program(Columbia Campus)
NewYork-Presbyterian/Columbia

Nicklaus Children's Hospital Pediatric Surgery Program
Nicklaus Children's Hospital

Oregon Health and Science University
Oregon Health and Science University

Rady/UCSD
The University of California, San Diego, Rady Children’s Hospital

Riley Hospital for Children at IU Health/Indiana University School of Medicine
Riley Hospital for Children at IU Health/Indiana University School of Medicine

Sidney Kimmel Medical College at Thomas Jefferson University/duPont Hospital for Children
Sidney Kimmel Medical College at Thomas Jefferson University/duPont Hospital for Children

St. Christopher's Hospital for Children
St. Christopher's Hospital for Children

Stanford University Pediatric General Surgery Fellowship
Stanford University

University at Buffalo
University at Buffalo

University of Alabama at Birmingham/Children’s of Alabama
University of Alabama at Birmingham/Children’s of Alabama

University of California San Francisco Pediatric Surgery Fellowship
UCSF Benioff Children's Hospitals

University of Chicago Medicine Comer Children's Hospital
University of Chicago Medicine Comer Children's Hospital

University of Colorado/Children’s Hospital Colorado Pediatric Surgery Fellowship
University of Colorado/Children’s Hospital Colorado

University of Connecticut Pediatric Surgery Fellowship At Connecticut Children’s
Connecticut Children's Medical Center

University of Florida
University of Florida

University of Iowa/ Stead Family Children's Hospital
University of Iowa/ Stead Family Children's Hospital

University of Louisville
University of Louisville

University of Michigan CS Mott Children's Hospital
University of Michigan CS Mott Children's Hospital

University of Mississippi Medical Center – Pediatric Surgery Fellowship Program
University of Mississippi Medical Center

University of Missouri – Kansas City/Children’s Mercy Kansas City
University of Missouri – Kansas City/Children’s Mercy Kansas City

University of Nebraska Medical Center Pediatric Surgery Fellowship
University of Nebraska Medical Center

University of Texas Health Science Center at Houston
University of Texas Health Science Center at Houston

University of Texas Southwestern Medical Center; Department of Surgery
University of Texas Southwestern Medical Center; Department of Surgery

University of Toronto/The Hospital for Sick Children
University of Toronto/The Hospital for Sick Children

University of Utah/Primary Children’s Hospital
University of Utah/Primary Children’s Hospital

University of Washington Pediatric General Surgery Fellowship
University of Washington

UPMC Children's Hospital of Pittsburgh
UPMC Children's Hospital of Pittsburgh

Vanderbilt University Medical Center/Monroe Carell Jr. Children's Hospital - Pediatric Surgery
Vanderbilt University Medical Center/Monroe Carell Jr. Children's Hospital

Washington University School of Medicine/St. Louis Children's Hospital Pediatric Surgery Fellowship
Washington University School of Medicine/St. Louis Children's Hospital

Yale University
Yale University