Colorectal Surgery (PDF)

as published in: The American Journal of Surgery (2007) 193, 125-6.

Elisa Birnbaum, MD
Associate Professor of Surgery
Director of Fellowship Program
Section of Colon and Rectal Surgery
Washington University School of Medicine
St. Louis, Missouri

The spectrum of disease treated by colon and rectal surgeons is broad, including, but not limited to, inflammatory bowel disease, colorectal cancer and benign anorectal diseases.

The American Society of Colon and Rectal Surgeons (ASCRS) was founded in 1899. Initially known as the American Proctologic Society, the name was changed to the American Society of Colon and Rectal Surgeons in 1973 to indicate the scope of its members' interest. Currently, of the 1281 Board Certified Colorectal Surgeons in the United States and Canada, 102 are women. The spectrum of disease treated by colon and rectal surgeons is broad, including, but not limited to, inflammatory bowel disease, colorectal cancer, and benign anorectal diseases. Colorectal surgical practices vary from institution and practice, with a large percentage of Board Certified Colorectal Surgeons limiting their practice to only colon and rectal surgery. 

Residency Requirements

Currently, 36 accredited programs exist in colon and rectal surgery. To apply for an accredited program, the individual needs to be in (or have completed) a five-year ACGME-approved general surgery training program. The application process typically begins in the fourth clinical year of residency. A formal match process is conducted. For a listing of programs, and to enter the match, the National Resident Matching Program should be contacted.1

Although research experience is not required, many applicants have had some formal experience during their residency. Almost all others have at least written a clinical paper or case report that demonstrates some objective interest in colon and rectal surgery.

Residency

The colon and rectal residency is for one year, although numerous programs with research year opportunities are available. The minimum case requirements are published annually. Residents are required to have experience in endoscopy techniques and some programs may have research requirements. The surgical cases are broken down into major abdominal cases, anorectal procedures, endoscopy, anal physiology, and endorectal ultrasound. The mix varies from institution-to-institution, and it is worthwhile to review the prior residents' case logs to gain a better understanding of what a program has to offer. 

Board Certification

To qualify, an individual must pass the American Board of Surgery Certifying Examination and complete an approved colorectal training program. The surgeon will be eligible to take the qualifying examination in colorectal surgery (written examination) in the Fall after completing their training. A certifying examination (oral examination) also is taken after passing the qualifying examination. Re-certification in general surgery is required to re-certify in colon and rectal surgery (every ten years). Requirements for certification can be obtained by writing the American Board of Colon and Rectal Surgeons.2

Grant Funding in Research Fellowships

Medical Students

A student interested in colon and rectal surgery should attempt to identify with a mentor early. For students interested in formal research experience, there may be institutional or departmental funds to support the project.

Residents

Often there is a good opportunity for colon and rectal research at your institution or through local or regional societies. All 20 regional societies with current continuing medical education have full representation at the national level through the Regional Society Committee of the American Society of Colon and Rectal Surgeons (ASCRS).3  

Faculty

The ASCRS sponsors a Young Surgeons Committee. The American Society of Colon and Rectal Surgeons Research Foundation has raised over $5,000,000 toward research in the field of colorectal surgery. These funds are available through grants to members of ASCRS. Applications for research grants are available by calling (847) 956-1846, writing to the ASCRS.3
 

Membership in ASCRS

The ASCRS is dedicated to advancing and promoting the science and practice of treatment of patients with diseases and disorders that affect the colon and rectum. This is an active society, which sponsors an Annual Meeting in the Spring or early Summer. The society also sponsors a full-day course at the American College of Surgeons in the Fall. Several classes of membership are available within the society: Fellow, Honorary Fellow, Candidate, Allied Health Professional, and Affiliated Scientific Investigator. Specific requirements for each category are listed on the application form and can be obtained by writing to the ASCRS.3

The official journal of ASCRS is Diseases of the Colon and Rectum, founded in 1958. All dues-paying members of ASCRS receive a paid subscription. The ASCRS also publishes patient-education brochures, available on the ASCRS Website.

References

1.      National Residency Matching Program
 

2.      American Board of Colon and Rectal Surgeons
         20600 Eureka Rd., Ste. 600, Taylor, MI 48180
         734-282-9400 
         www.abcrs.org 

3.      American Society of Colon and Rectal Surgeons
            85 West Algonquin, Ste. 550, Arlington Heights, IL 60005
           
847-290-9184
         www.fascrs.org