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      <option value="1" selected="">Advanced GI MIS, Bariatrics, Complex Gastrointestinal Surgery, Comprehensive Flexible Endoscopy, Foregut, Hernia and Abdominal Wall, and HPB</option>
      <option value="2">Non-ACGME Advanced Colorectal and Advanced Thoracic</option>
      <option value="-1">HPB-Surgical Oncology Surgery and HPB-Transplant</option>
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The Fellowship Council

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DIRECTORY OF FELLOWSHIPS

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ADVANCED GI MIS, BARIATRICS, COMPLEX GASTROINTESTINAL SURGERY, COMPREHENSIVE
FLEXIBLE ENDOSCOPY, FOREGUT, HERNIA AND ABDOMINAL WALL, AND HPB





CURRENT DIRECTORY LISTING

Advanced GI MIS, Bariatrics, Complex Gastrointestinal Surgery, Comprehensive
Flexible Endoscopy, Foregut, Hernia and Abdominal Wall, and HPBNon-ACGME
Advanced Colorectal and Advanced ThoracicHPB-Surgical Oncology Surgery and
HPB-TransplantInternational

See Matching Process Schedules

FILTERS

Filter Mode: Inclusive (OR) Exclusive (AND)

 * Program Types
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Advanced GI MIS
Bariatrics
Complex Gastrointestinal Surgery
Comprehensive Flexible Endoscopy
Foregut
Hernia and Abdominal Wall
HPB

Alabama
Alberta
Arizona
British Columbia
California
Colorado
Connecticut
Florida
Georgia
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisana
Maryland
Massachusetts
Michigan
Manitoba
Minnesota
Missouri
Nebraska
New Hampshire
New Jersey
New York
North Carolina
Nova Scotia
Ohio
Ontario
Oregon
Pennsylvania
Quebec
Rhode Island
South Carolina
Tennessee
Texas
Virginia
West Virginia
Washington
Washington DC
Wisconsin


FELLOWSHIP DESIGNATION DESCRIPTIONS AND CRITERIA

The following outlines the comprehensive requirements and expectations for
advanced surgical fellowships offered by the Fellowship Council. This resource
is designed to provide valuable insights into the specific objectives and
standards for each fellowship designation. Our descriptions and criteria are
tailored to guide aspiring surgeons and institutions towards achieving
excellence in specialized surgical training. Explore the detailed requirements
and expectations within each fellowship designation as you embark on your
journey towards becoming a highly skilled and proficient surgical specialist.

Advanced Colorectal

An advanced fellowship in colorectal surgery will not substitute for an ACGME
accredited colorectal residency and will not allow the fellow to apply for entry
to the examination process provided by the American Board of Colon and Rectal
Surgery. Fellowships can provide broad based colorectal training intended for
international candidates who are not certified or eligible for certification by
the American Board of Surgery. These fellowships should include all aspects of
colorectal diseases including endoscopy, surgical resection, anorectal disease
and should provide MIS exposure.

Alternatively, fellowships can be developed for candidates who have completed an
ACGME-accredited general surgery and possibly an ACGME-accredited colorectal
surgery residency, who desire focused further training in a specific area such
as: pelvic floor disorders, MIS techniques, inflammatory bowel disease or
oncologic surgery.

A minimum of 100 complex colorectal operative cases should be performed during
the fellowship. All fellowships must have an educational program that includes
teaching conferences. Preoperative and postoperative care of the complex
colorectal patient must be included in the program. 

Advanced GI MIS
https://vimeo.com/873537995
Advanced GI MIS Fellowship Overview

An advanced GI fellowship consists of broad-based training in complex
gastrointestinal and abdominal operations. The intent of such fellowships should
be to train the general surgeon to do advanced and complex cases in various
areas of the gastrointestinal tract and abdominal wall. The fellow should be
exposed to and participate in at least 150 advanced cases in the areas of
bariatrics, advanced minimally invasive surgery, HPB, flexible endoscopy,
complex laparoscopic ventral hernia repair*, and/or advanced colorectal surgery.
For the purpose of this designation, "advanced" or "complex" GI operations
refers to those procedures not generally performed in sufficient numbers to
achieve competency within the context of General Surgery residency.

Although it will be presumed that such fellowships will not meet the criteria
for any of the specifically categorized areas of GI Surgery within the
Fellowship Council, it is encouraged that the fellowship concentrate in two or
three focused areas (e.g. HPB and foregut surgery, or bariatric and flexible
endoscopy). This focus should allow for clarity of purpose and intent in the
description of the training program, as well as the requisite exposure to the
technical, cognitive and practice/systems issues to confer a level of competence
in such disciplines.

The programs must provide a minimum of one year, in-depth experience in the pre-
and postoperative management of patients who have complex gastrointestinal
abdominal pathology as well as acquisition of technical skills within these
areas. Exposure to techniques in those domains with both open and minimally
invasive approaches is highly encouraged and expected. *Hernia cases can be
included in the cases as defined in Advanced GI MIS.

Case Log Minimums

   
 * 65 Defined Category MIS Cases
     
   * 20 Foregut
     
     
   * 25 Bariatric
     
     
   * 10 Inguinal Hernia
     
     
   * 10 Ventral Hernia
     
     
   * Only complex (not basic) MIS Cases will count for credit.  A “Complex MIS
     Case” is defined as any laparoscopic or thoracoscopic operation with the
     exception of a cholecystectomy, appendectomy, or diagnostic laparoscopy as
     these are considered “basic MIS cases.” Complex MIS cases done robotically
     or with a SILS technique will count for credit; however, basic MIS cases
     done robotically or via a SILS approach will still be treated as basic MIS
     cases. MIS inguinal and ventral hernias are considered complex MIS cases
     and there is no limit regarding how many hernia cases may be counted for
     credit in addition to the defined hernia category minimums.
     
     
   * All Defined Category MIS Cases must be performed using an MIS approach and
     the fellow must serve as either the Primary Surgeon (PS) or Teaching
     Assistant (TA) for all of these cases.
     
   
   
 * 85 Additional Complex MIS Cases
     
   * Up to 15 complex foregut, bariatric, or hernia cases may be performed using
     an open approach and will count for credit towards these 85 cases.
     
     
   * The fellow must serve as either PS or TA in at least 60 of these 85 cases.
     The fellow may serve as First Assistant (FA) in up to 25 of these 85 cases.
     
     
   * These 85 cases may consist of any complex MIS case type, including either
     the defined category case types (foregut, bariatric, or hernia) or other
     case types (colorectal, hepatobiliary, solid organ, thoracic, etc.).
     
   
   
 * 150 Total Complex MIS Cases
   

Flexible Endoscopy

   
 * 50 Upper or Lower Endoscopies
     
   * Can be diagnostic or therapeutic
     
     
   * Endoscopies performed as part of a logged MIS case (e.g. EGD performed
     during fundoplication) will count for endoscopy credit
     
   

Advanced Thoracic

An Advance Thoracic fellowship is an additional year of training for surgeons
already completing or intending to complete an ACGME-approved cardiothoracic
fellowship or equivalent. Completion of this fellowship does not fulfill
eligibility for board certification. It is also intended for international
trainees and surgeons seeking specialized focused training in thoracic surgery
before returning to their institution. The emphasis is on minimally invasive
techniques including robotic surgery. Principles of thoracic oncology, patient
selection and perioperative management should all be strongly emphasized.

Case Log Minimums

   
 * 100 total cases (not including bronchoscopies and endoscopies)
     
   * 20 pulmonary anatomic resections (Lobes, segmentectomies etc.)
     
     
   * 10 esophageal resections
     
     
   * 10 benign esophageal (paraesophageal hernia, diverticulum resection, heller
     myotomy etc.)
     
     
   * 10 chest/pleural (decortications, pleurectomy, blebs, chest wall etc.)
     
     
   * 5 mediastinal
     
   
   
 * 45 additional Thoracic Cases
   
   
 * 25 Bronchoscopies required (Do not count towards 100 minimum requirements)
   
   
 * 25 Endoscopies (Do not count towards 100 minimum requirement)
   
   
 * 5 Advanced fiberoptic procedures (Endoscopic) (EMR, POEM, Stent,
   Robotic/Navigational bronchoscopy, EBUS, Mediastinoscopy, laser, ridged
   endoscopy etc.)
   
   
 * At least 50 of the total cases and 25 of the defined category cases should be
   minimally invasive
   
   
 * For the 45 additional thoracic cases, requirements can be filled by either by
   major cases from define categories, non-anatomic lung resections or advance
   endoscopic procedures.
   
   
 * Bronchoscopies and endoscopies performed during major lung and esophageal
   cases can be counted towards the 25 required diagnostic bronchoscopies and
   endoscopies.
   

Bariatrics
https://vimeo.com/873538005
Bariatrics Fellowship Overview

A Bariatric fellowship provides exclusively or predominantly bariatric surgical
training. The institution sponsoring the fellowship must be certified by the
Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program
(MBSAQIP) or be actively engaged in the application process. Fellows finishing
bariatric fellowships should have completed the minimum number of cases required
to allow them to be "certified" as a bariatric surgeon at the completion of
their training.

The 35 undesignated cases can include internal hernias, band removals, band
repositioning, etc. A simple port change is not acceptable towards the 100- case
count. 80% of the primary bariatric surgeries must be performed using minimally
invasive techniques. As an additional point of clarification, the ASMBS
currently does not make any distinction between laparoscopic and robotic
procedures. Fellows must have demonstrable experience in the preoperative
evaluation and assessment as well as postoperative follow-up and assessment of
patients.

Current ASMBS guidelines require a minimum of 100 cases with 51 as Primary
Surgeon and must include a combination of restrictive procedures (bands and
sleeves) and malabsorptive procedures. 50 of the 100 cases must be bariatric
operations that include an anastomosis (eg: RNY Gastric Bypass or Duodenal
Switch with BPD), 10 restrictive cases (e.g. sleeve gastrectomy operations
and/or adjustable gastric banding procedures), and at least 5 revisional
procedures.

Complex GI
https://vimeo.com/873538013
Complex GI Fellowship Overview

A complex GI fellowship consists of broad-based training in complex
gastrointestinal and abdominal operations. The intent of such fellowships should
be to train the general surgeon to do advanced and complex cases in various
areas of the gastrointestinal tract and abdominal wall. The fellow should be
exposed to and participate in at least 150 advanced cases in the areas of
bariatrics, advanced minimally invasive surgery, HPB, flexible endoscopy,
complex laparoscopic ventral hernia repair*, and/or advanced colorectal surgery.
For the purpose of this designation, "advanced" or "complex" GI operations
refers to those procedures not generally performed in sufficient numbers to
achieve competency within the context of General Surgery residency.

Although it will be presumed that such fellowships will not meet the criteria
for any of the specifically categorized areas of GI Surgery within the
Fellowship Council, it is encouraged that the fellowship concentrate in two or
three focused areas (e.g. HPB and foregut surgery, or bariatric and flexible
endoscopy). This focus should allow for clarity of purpose and intent in the
description of the training program, as well as the requisite exposure to the
technical, cognitive and practice/systems issues to confer a level of competence
in such disciplines.

The programs must provide a minimum of one year, in-depth experience in the pre-
and postoperative management of patients who have complex gastrointestinal
abdominal pathology as well as acquisition of technical skills within these
areas. Exposure to techniques in those domains with both open and minimally
invasive approaches is highly encouraged and expected. *Hernia cases can be
included in the cases as defined in Advanced GI MIS.

Comprehensive Flexible Endoscopy

A flexible endoscopic fellowship is a fellowship that should focus on the
treatment of patients and diseases that require advanced endoscopic techniques.
The fellowship should provide experience in advanced upper and lower endoscopic
procedures. The training should include a broad-based comprehensive experience
in diagnostic and therapeutic upper and lower endoscopy. The fellowship should
satisfy the SAGES guidelines for training and credentialing in flexible
endoscopy
(http://www.sages.org/publications/guidelines/granting-of-privileges-for-gastrointestinal-endoscopy/).

The focus should be on advanced and therapeutic endoscopy. A minimum of 100
therapeutic endoscopic procedures, for which the fellow is the Primary Surgeon,
is required to be accredited as a Flexible Endoscopy fellowship. The Fellowship
must cover the educational content/curriculum for all 10 flexible endoscopy
entrustable professional activities (EPAs, see attached list) The Fellowship
must provide a minimum of 150 flexible endoscopy procedures and meet the
following case volume mandates: A. The cases must fall into the domain of at
least 5 different procedural based EPAs (this includes Flex Endo EPAs 3-10, as
well as the Bariatric EPA "Endoscopic Bariatric Interventions" B. There must be
minimum of 10 cases in each of these 5 EPAs C. There must be a minimum of 100
therapeutic endoscopy cases The fellow must successfully pass the Fundamentals
of Endoscopic Surgery (FES) and the Fundamental Use of Surgical Energy (FUSE)
programs prior to completion of the fellowship

   
 * The focus should be on advanced and therapeutic endoscopy. A minimum of 100
   therapeutic endoscopic procedures, for which the fellow is the Primary
   Surgeon, is required to be accredited as a Flexible Endoscopy fellowship.
   
   
 * The Fellowship must cover the educational content/curriculum for all 10
   flexible endoscopy entrustable professional activities (EPAs, see attached
   list) The Fellowship must provide a minimum of 150 flexible endoscopy
   procedures and meet the following case volume mandates:
     
   * The cases must fall into the domain of at least 5 different procedural
     based EPAs (this includes Flex Endo EPAs 3-10, as well as the Bariatric EPA
     "Endoscopic Bariatric Interventions"
     
     
   * There must be minimum of 10 cases in each of these 5 EPAs
     
     
   * There must be a minimum of 100 therapeutic endoscopy cases
     
   
   
 * The fellow must successfully pass the Fundamentals of Endoscopic Surgery
   (FES) and the Fundamental Use of Surgical Energy (FUSE) programs prior to
   completion of the fellowship.
   

Flexible Endoscopy EPAs

   
 * Sedation and Monitoring of Patients Undergoing Flexible Endoscopy
   
   
 * Endoscopy In The Patient With Surgically-Altered GI Tract Anatomy
   
   
 * Evaluation and Management of the Patient Requiring Advanced Tissue
   Resection/Transection/Ablation
   
   
 * Evaluation and Management of Obstructing GI Tract Processes
   
   
 * Evaluation and Management of GI Tract Bleeding
   
   
 * Evaluation and Management of Partial and Full Thickness GI Tract Defects
   
   
 * Evaluation and Management of the Patient Requiring Submucosal or Translumenal
   Endoscopy
   
   
 * Evaluation and Management of Patients with Pancreatico-Biliary Diseases
   
   
 * Evaluation and Management of a Patient Needing Complex Endoscopic Enteral
   Access
   
   
 * Evaluation and Endoscopic Management of the Patient with Gastroesophageal
   Reflux
   

Foregut

Programs can submit a request for a designation change via the accreditation or
member change process for: a) the addition of the Foregut designation to their
existing designation type, or b) the reclassification to the Foregut designation
type.

   
 * Completion of the Foregut Fellowship Curriculum
   

   
 * 150 Total Core Procedures
     
   * 75 Minimally Invasive Foregut Procedures, including:1
       
     * 10 Therapeutic Flexible Endoscopy2
       
       
     * 10 Revisional Foregut Procedures
       
     
     
   * 75 Additional Advanced Procedures3
     
   

Citations
    
 1. For the 75 Minimally Invasive Foregut Procedures:
      
    * These may include fundoplications of any type, hiatal hernia repairs
      (performed as the primary procedure), esophagogastric myotomy,
      pyloromyotomy, pyloroplasty, gastric electrical stimulation, gastrectomy
      (excluding bariatric sleeve gastrectomy), esophagectomy, esophageal
      diverticulectomy/diverticulotomy.
      
      
    * Up to 25 of these procedures may include anastomotic bariatric foregut
      procedures involving anastomosis of the small intestine to the stomach or
      duodenum, including RYGB, SADI, BPD/DS. Bariatric sleeve gastrectomy may
      not be included.
      
      
    * These procedures may be performed via a laparoscopic, thoracoscopic,
      flexible endoscopic, and/or robotic approach.
      
    
    
 2. For the 10 Therapeutic Flexible Endoscopic Procedures, these may include
    POEM, POP, EMR, ESD, stenting, suturing, Zenker’s diverticulotomy.
    Diagnostic endoscopies may not be included.
    
    
 3. For the 75 Additional Advanced Procedures:
      
    * These may include open or minimally invasive advanced alimentary tract or
      abdominal procedures. These additional procedures are not limited to the
      foregut.
      
      
    * These may include all bariatric procedures (including bariatric sleeve
      gastrectomy) that are above and beyond the 25 bariatric procedure limit
      from above.
      
      
    * Basic procedures such as laparoscopic cholecystectomy, diagnostic
      laparoscopy or laparoscopic appendectomy are not eligible.
      
      
    * 50 Flexible Endoscopy Procedures4
      
      
    * 10 Primary Interpretation of Foregut Physiology Studies5
      
    
    
 4. May be diagnostic or therapeutic (including intra-operative endoscopy)
    
    
 5. Primary Interpretation of Foregut Physiology Studies may include:
    high-resolution esophageal manometry, FLIP, 24-hour pH testing. The fellows’
    interpretation of these studies will be confirmed and signed off by the
    fellowship director.
    

Hernia and Abdominal Wall
https://vimeo.com/873538022
Hernia Fellowship Overview

Fellows must complete procedure requirements with the following category
minimum.

100 total core procedures minimum

   
 * 30 Inguinal Hernia Repairs
     
   * 15 of these must be done via an MIS approach (Laparoscopic or Robotic)
     
     
   * 10 of these must be recurrent hernias
     
   
   
 * 30 Ventral/Incisional Hernia Repairs (3-10 cm width or length)
     
   * These could be performed via a variety of techniques including onlays,
     retrorectus, IPOM.
     
     
   * 15 of these must be performed as MIS extraperitoneal
     
   

   
 * 25 Ventral/Incisional Hernia Repairs (>10cm width or length)
     
   * These can be either External Oblique releases or Transversus Abdominis
     releases or preperitoneal via any approach
     
   
   
 * 15 Atypical hernia cases
     
   * These include operations for groin pain, repair of parastomal hernias,
     surgery for infected mesh including potential management of hernia
     recurrence concomitantly, hernias in the setting of an enteric fistula,
     subxiphoid, flank, suprapubic hernias.
     
   
   
 * In addition to the 100 core cases, fellows must complete the following
   additional requirements:
     
   * 5 clinic evaluations for groin pain
     
     
   * Completion of the FC Hernia Curriculum which is currently under development
     
     
   * Documentation of competence in at least 5/8 FC Hernia EPAs.
     
   

Hepato-Pancreato-Biliary (HPB)
https://vimeo.com/873538039
HPB Fellowship Overview

An HPB fellowship program provides concentrated exposure to patients with both
benign and malignant pancreatic, biliary, and liver diseases. While absolute
numbers of operative cases have not yet been defined for a specific disease, a
minimum of 100 total major operative HPB cases are required (no variance
allowed), and the fellow must act in the Primary Surgeon role for at least 70 of
these major cases.

A minimum of 25 major liver, 15 complex biliary, and 25 major pancreas cases are
required. The remaining 35 major operative HPB cases may be within any of these
categories. Within the liver category, at least 20 cases (no variance allowed)
of these procedures must be either hemi-liver resection, trisectionectomy, right
posterior/anterior sectionectomy, central hepatectomy, and/or in situ donor
hemihepatectomy. Within the pancreas category, at least 20 cases (no variance
allowed) must be pancreaticoduodenectomies.

Principles of management of patients with malignant and benign conditions in a
multi-disciplinary fashion are required.

Basic HPB cases which do not count towards these minimum requirements include
cholecystectomy, liver, and pancreas biopsy (any technique). Liver transplant,
donor hepatectomy, and donor pancreatectomy are not required but may account for
up to 20% of one category (pancreas, biliary or liver), with a maximum of 20% of
total requirements. Experience in MIS pancreas (5 cases min), MIS liver (5cases
min), hepatic hilar dissection, intra-operative ultrasonography, and hepatic
tumor ablation are required. The programs must provide a minimum of one year of
in-depth experience in the pre and postoperative management of patients with
simple and complex HPB pathology as well as the acquisition of technical skills
for performing complex HPB operations.



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