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ABCRS Guidelines on Re-entry to Surgical Practice

The ABCRS 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 affect 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

A re-entry pathway is warranted after two or more years removed 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 must specifically address any issues relevant to surgical practice such as malpractice history, professionalism or patient care issues. Proof of a full (unrestricted) valid medical license in the state in which the individual will practice must be provided.

2. Re-entry pathway constructed by the local physician champion
The local physician champion should construct specifics of a re-entry pathway and 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. The proctor will assess patient care. 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 and amount of technical activity during the period of inactivity. A local proctor who is a diplomate of the ABCRS 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 direct observation.

4. Outcomes assessment
The hospital should complete a Focused Professional Practice Evaluation (FPPE) per Joint Commission guidelines within six months of beginning independent practice.

5. Maintenance of Certification
The individual will be required to come into compliance with the ABCRS Maintenance of Certification (MOC) Program, and must meet MOC requirements as needed based on his or her individual situation.

Individuals seeking to re-enter practice should consult with the ABCRS regarding their situation prior to developing a re-entry plan based on the guidelines above. The ABCRS will review and approve the re-entry plan prior to implementation. The ABCRS will also track the outcome of all re-entry plans. To initiate this process, individuals should contact the ABCRS office via email at lhaag@abcrs.org

Compliance and Re-entry to MOC
All diplomates certified in 1990 or after enrolled in MOC must report to the ABCRS at three-year intervals to maintain their status, including a $500 annual MOC fee starting in 2018. Individuals that fail to report to the ABCRS at three-year intervals by December 31 are considered out of compliance with MOC and will be reported as “Not Meeting MOC Requirements.”

Noncompliance during a three-year cycle will result in revocation of ABCRS certification. During this time, any verification performed on the ABCRS website, will show a UN certified status and “Not Meeting MOC Requirements”.

In order to reverse the revocation and re-enter MOC; all past due fees and past due MOC requirements must be fulfilled up to that point. They cannot recertify until MOC re-entry requirements are met.

See also:

1. Clinically Inactive

2. Revocation of MOC Certificate