American College of Surgeons

Mary C. McCarthy, MD, FACS

The American College of Surgeons (ACS) is a scientific and educational association of general and specialty surgeons that was founded in 1913 to improve the quality of care for the surgical patient by setting high standards for surgical education and practice.

Role of the ACS

The ACS has expanded its original focus on surgical education and patient care to encompass all areas of surgical practice. Major activities include continuing medical education, advocacy and health policy, sponsorship of the Residency Review Committees, provision of public information, and publication of printed and web-based updates for surgeons. The Cancer and Trauma Committees are especially active, providing consultation/verification programs for hospitals seeking to provide optimal care to these groups of surgical patients.

Importance of Becoming a Fellow in the ACS

The benefits of ACS membership include scholarships and traveling fellowships, continuing education (required for licensure, board certification, and updated practice), contact with surgeons in other surgical specialties, representation for surgeons in political and economic realms at all governmental levels (through the Office for Advocacy and Health Policy in Washington and through local Chapter advocacy in state government) and input into the requirements for surgical training and practice. The ACS also publishes the Journal of the American College of Surgeons, and the weekly ACScope, an e-mail newsletter with frequent updates of interest to all surgeons.

Membership Application

There are more than 64,000 members of the American College of Surgeons with several categories of membership. Membership in the ACS Candidate group is open to any surgical resident in an approved residency program. Information regarding the process of application and a membership form is available here.

Associate fellow membership is open to young surgeons who are within five years of graduation from surgical residency, and may be pursuing postgraduate specialty training or establishing a practice. Information regarding the process of application and a membership form is available here.

The American College of Surgeons admits to Fellowship (FACS) only those surgeons whose professional activity is devoted to surgical practice and who agree to practice by the professional and ethical standards of the College. Information regarding the standards and the process of application is available here.

How to Become Active in the Organization

The ACS is supportive of an increase in the diversity of its membership and its leadership at the local, regional, and national levels. To increase the number of women participating, the ACS has recommended (at my proposal, and with the affirmation of the Governors’ Committee on Chapter Activities and the Board of Governors) that each ACS chapter appoint an Association of Women Surgeons (AWS) member to its Council. However, not every chapter has implemented this recommendation. If your chapter has not yet implemented this recommendation, approach your Chapter Council with your interest. These positions offer an introduction to involvement in chapter activities. For these AWS representatives, some ideas to increase the participation of women in their chapters follow:

  • Serve on your chapter’s nominating committee.
  • Consider hosting or asking your chapter to host a networking breakfast or reception at their annual meeting.
  • Contact the ACS and request a list of female ACS members who do not belong to your chapter. Invite them to join and ask them what activities would interest them.
  • Be aware of leadership roles in your chapter and identify and recommend to chapter leaders appropriate women and minorities to serve in senior roles.

The ACS benefits from participation by all surgeons. Diversity makes more members feel welcome and provides different views of practice as well as the inclusion of multiple value systems. Diversity comes from race and gender as well as family background, religion, geographical location, surgical training and value system, among other factors.

The first level of College involvement is the local chapter, which conducts state and local activities to meet the ACS goals. Each chapter has its own committees, which include the Program, Nominating, Membership, Legislative, and Socioeconomic Committees. The chapter is also expected to relate to the Committees on Cancer and Trauma of the College, both of which have representation in each state. To become involved in a chapter committee, contact the chapter president and inform him/her of your interest and expertise.

National College involvement, open to all ACS members, stems from local and regional participation and needed areas of expertise. The nominating committees of the Regents, the Board of Governors and the Fellows make nominations for leadership positions. Nominations for committees are made by current committee members or by the chair. Independent nominations may be submitted through the committee chair and the ACS staff member responsible for that committee. Submission should include the nominee’s name, interest and qualifications. Nomination deadlines generally occur within the first quarter of the year. Nominations then go to the committee’s Executive Committee, then on the committee membership, and finally to the Board of Regents in October. Generally speaking, terms for committee members are 3 years. Members can be re-elected once and can subsequently serve as a senior member for 4 years.

Structure of the American College of Surgeons

There are 97 chapters of the college, 67 in the United States, 2 in Canada, and 28 in other countries. Occasionally chapters overlap due to the historical peculiarities of new chapter development. Each chapter has its own governing structure, committees and activities – meetings, newsletters, advocacy and website.

Three committees nominate the leadership of the College: the Nominating Committee of the Board of Regents, the Nominating Committee of the Fellows, and the Nominating Committee of the Board of Governors. The 19-member Board of Regents governs the ACS. When new members are selected, an attempt is made to maintain a balance of geographic and surgical specialty representation.

The Nominating Committee of the Board of Regents nominates the Board’s chair and vice chair (1 year terms), the secretary and the treasurer. This committee also nominates the additional members of the Board’s Executive Committee (the Board chair and vice chair, College President, and 3 regents) and the Finance Committee (Board Chair, College president, treasurer and three fellows).

The Nominating Committee of the Fellows, whose five members are appointed by the College President and chairs of the Board of Governors and Regents, nominates the President-elect, the first and second vice presidents-elect (1 year terms) as well as Governors for open positions from primary and alternate names submitted by chapters, specialty societies, and countries outside the U.S. and Canada.

The Nominating Committee of the Board of Governors, whose five members are nominated by the Executive Committee and elected by the Board of Governors, nominates new members for the Board of Regents (3-year terms, 3-term limit) and nominates the Board of Governors’ Executive Committee–chair, vice chair, and secretary (each 1 year terms), and four members (2 year terms). The Advisory Committee on Nominations for the Board of Regents, which consists of the past three College Presidents, provides consultation to the Nominating Committees of the Board of Governors’ and of the Fellows.

Nominating Committee members are given seven guidelines for consideration in any nomination: the individual’s (1) integrity in practice; (2) representation of all surgeons; (3) leadership qualities demonstrated in previous College service and participation; (4) geographical location and practice type–private or academic; (5) not being a member of the nominating committee; and (6) specialty as it relates to the diversity of the committee; and (7) the College encourages the consideration of women and other under-represented minorities. The last criterion is one I asked the ACS to add during my tenure on the nominating committees.

Committees of the American College of Surgeons

ACS committees are divided into standing committees with specific charges and Regental Committees, which are appointed on an as needed basis as the college tries to address its members’ new interests. Regental Committees may evolve into a standing committee or dissolve when their function is complete. Current committees include:

Program Committee
Allied Health Personnel
Central Judiciary Committee
Commission on Cancer
Continuing Education
Diversity Issues
Emerging Surgical Technology and Education
Board of Regents Committee on Ethics
Forum on Fundamental Surgical Problems
General Surgery Coding and Reimbursement Committee
Graduate Medical Education
Committee on Informatics
International Relations Committee
Video-Based Education
Member Services
Committee on Patient Safety and Professional Liability
Perioperative Care
Surgical Education in Medical Schools
Surgical Research and Education
Young Surgeons
Committee on Women’s Issues
Candidate and Associate Society


In the past there has been some ambiguity regarding Committee appointments, functions, structure and governance, but these “Longmire rules” have been recently revised, for implementation in October 2002 (Rules and Guidelines Governing College Committees). Of particular note for our members is “Principle 2.” Each committee shall seek diversity in its membership by recommending surgeons from all practice venues, research and administration; all surgical specialties; a variety of geographical locations; all age groups while being mindful of the need for young surgeons; as well as women and other minorities which may be under-represented populations of the Fellowship.