Practice Trends

A new subspecialty certification in complex general surgical oncology aims to provide surgeons with training in the diagnosis, treatment, and rehabilitation of patients with complex cancers such as sarcoma, melanoma, and esophageal malignancies – and hopefully will attract surgeons who want to focus on research.

"The idea is to build leaders in cancer research," said Christine Shiffer, spokesperson for the American Board of Surgery (ABS). The certification program was created by the ABS and approved by the Accreditation Council for Graduate Medical Education (ACGME) in March.

Ms. Shiffer noted that the majority of oncology cases are – and will continue to be – treated by general surgeons trained in surgical oncology.

Some surgeons say the certification simply solidifies the training qualifications that surgical oncologists already have.

"Trained surgical oncologists are already available to provide care for complex general surgical oncology," said Dr. Stephen Edge, chair of the Commission on Cancer for the American College of Surgeons (ACS). "The SSO is taking it to the next level for the future. That’s good for surgeons. That’s good for the American College of Surgeons and, most importantly, that’s good for the American public."

Dr. Edge added that the public will benefit from the assurance that their doctor has the training and credentials to provide the best care possible.

The certification will have minimal impact on general surgeons currently treating the same conditions, said Dr. Fabrizio Michelassi, chair of the ABS Surgical Oncology Advisory Council.

"As current [Society for Surgical Oncology]–approved fellowships graduate only 50 surgical oncologists each year, the number of surgeons who will be eligible for this certificate is relatively small," Dr. Michelassi said in a statement.

The ABS decided against grandfathering surgeons who have already completed a fellowship in surgical oncology or general surgeons who perform oncologic surgery.

Newly trained surgeons should see the new certification program as an opportunity but not a necessity, said Dr. Patricia L. Turner, a general surgeon and director of member services at ACS. However, she added that the certification could eventually carry a greater marketing advantage for new surgical oncologists. When this process is rolled out, among trainees who finish the same fellowship 1 year apart (and have identical training), one would carry the certificate and the other wouldn’t, she explained.

While program development is underway, there is still work to be done. First, the ACGME will have to approve their training requirements, which the ABS expects to see by June. Once requirements are approved, the written and oral examinations can be finalized.

Existing surgical oncology training programs can become ACGME accredited to provide the training that will lead to ABS certification.* The first examinations are expected to start in the fall of 2012, at the earliest, according to the ABS.

*CLARIFICATION 1/23/12 Additional information was added to clarifiy the role of ACGME accredited training in ABS certification.

01/19/12