Re-entry to Surgical Practice


  • The American Board of Thoracic Surgery (ABTS) supports the re-entry of surgeons to active surgical practice and endorses the following guidelines for surgeons seeking to re-establish their clinical careers. 
  • Most surgeons who have stopped practicing fit into one of three categories, which may impact how a specific re-entry pathway is constructed: 

1. Voluntary withdrawal from practice

2. Involuntary withdrawal from practice due to medical issues

3. Involuntary withdrawal from practice for performance or professionalism issues 

  • The re-entry pathway must recognize that ABTS certification requires competence in all aspects of the discipline of Thoracic Surgery, as is true for the primary certification and for Maintenance of Certification (MOC). 
  • For those Diplomates in whom their time away from clinical practice is less than two years, please contact the Board office. 
  • The following re-entry pathway is warranted after two or more years away from surgical practice and should address the following elements: 

Re-entry Elements 

  1. Assessment of status of practice at departure 
  • The surgeon should provide reference letters from the: 

1) chief of surgery; and 2) chair of credentials committee at the primary practice location of the individual at the time of his or her departure from practice. The letters will specifically address any issues relevant to surgical practice such as malpractice history, professionalism or patient care issues. 

2. Re-entry pathway constructed by the local physician champion:

  • Specifics of the re-entry pathway should be constructed by the local physician champion and approved by the ABTS. This plan will include assessment of the six competencies: medical knowledge; patient care; professionalism; communication; practice-based learning; and systems-based practice. Medical knowledge will have individualized assessment based on factors such as certificate/MOC status and duration of clinical inactivity. Patient care will be assessed by the proctor. Individualized pathways may warrant additional assessment of patient care (e.g., oral examination) depending on circumstances. Individuals who withdrew involuntarily from practice (groups 2 and 3 above) will also usually require assessment of physical and/or mental health status by a specialist.

3. Proctoring plan:

  • All pathways should include a proctoring plan. The duration of proctoring will be individualized based on factors such as complexity of anticipated clinical practice. A local proctor who is a Diplomate of the ABTS must be identified and agree to serve in this role for the duration of the trial period. The proctor will provide a final assessment based on the six competencies.  The plan will include an individualized operative case log.

4. Examination Requirements

  • The individual will be required to come into compliance with the ABTS examination requirements as needed based on his or her individual situation.
  • Individuals seeking to re-enter practice should consult with the ABTS regarding their situation prior to developing a re-entry plan based on the guidelines above. The ABTS must review and approve the re-entry plan prior to implementation. The ABTS will also track the outcome of all re-entry plans.

5.  Outcomes assessment:

  • The hospital should complete a Focused Professional Practice Evaluation (FPPE) in accordance with The Joint Commission guidelines within six months of beginning independent practice.


American Board of Thoracic Surgery
633 North St. Clair Street, Suite 2320
Chicago, IL 60611
Tel: 312-202-5900
Fax: 312-202-5960

Copyright © 1998 - 2011 by The American Board of Thoracic Surgery.