Re-entry Policy

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: Voluntary withdrawal from practice, Involuntary withdrawal from practice due to medical issues, or Involuntary withdrawal from practice for performance or professionalism issues.


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:

A re-entry pathway is warranted if you have been away from surgical practice after two or more years and should address the following elements.

Re-entry Elements

Assessment of status of practice at departure

You should provide reference letters from the chief of surgery and chair of credentials committee who were at the primary practice location, during the time of your 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.

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 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 will also usually require assessment of physical and/or mental health status by a specialist.


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.

Outcomes assessment

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

Continuing Certification Requirements

You will be required to come into compliance with the ABCRS Continuing Certification Program, and must meet requirements as needed based on your individual situation.  If you seek to re-enter practice, consult with the ABCRS regarding your situation prior to developing a re-entry plan based on the guidelines above. The ABCRS will review and may request additional plan elements prior to approval and implementation, as well as track the outcome of all re-entry plans. To initiate this process, contact the ABCRS office at

Compliance and Re-entry to Continuing Certification

All diplomates certified in 1990 or after enrolled in MOC/Continuing Certification must report to the ABCRS at five-year intervals to maintain your status, including a $500 annual MOC fee which began in 2018. If you fail to report to the ABCRS at five-year intervals by December 31, you are considered out of compliance and will be reported as “Not Meeting MOC/Continuing Certification Requirements.”

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

In order to reverse the revocation and re-enter Continuing Certification:  All past due fees and Continuing Certification requirements must be fulfilled up to that point; 2) A reinstatement fee of $500 must be paid. You cannot recertify until re-entry requirements are met.

See also:
1. Clinically Inactive
2. Revocation of MOC Certificate

Quick links for Special Cases

Ethics and Professionalism Policy

Unethical and unprofessional behavior is denoted by any dishonest behavior, including: cheating; lying; falsifying information; misrepresenting one’s educational background, certification status and/or professional experience; and failure to report misconduct. The American Board of Colon and Rectal Surgery has adopted a “zero tolerance” policy toward these behaviors, and individuals caught exhibiting such behaviors risk being permanently barred from certification, reported to state medical boards, and/or legally prosecuted for copyright or other violations.

Unethical behavior is specifically defined by the ABCRS to include the disclosure, publication, reproduction or transmission of ABCRS examinations, in whole or in part, in any form or by any means, verbal or written, electronic or mechanical, for any purposes. This also extends to sharing examination information or discussing an examination while still in progress. Unethical behavior also includes the possession, reproduction or disclosure of materials or information, including examination questions or answers or specific information regarding the content of the examination, before, during or after the examination. This definition specifically includes the recall and reconstruction of examination questions by any means and such efforts may violate federal copyright law. All ABCRS examinations are copyrighted and protected by law; the ABCRS will prosecute violations to the full extent provided by law and seek monetary damages for any loss of examination materials.

Continuing Certification

What does it mean when a physician is required?

Continuing Certification or Maintenance of Certification (MOC) is a process adopted by all 24 ABMS boards that assesses six core physician competencies approved by the ABMS and the ACGME throughout a physician’s career. The six competencies that have been identified as important to deliver quality care are communication skills, professionalism, medical knowledge, patient care, practice-based learning and improvement, which includes the ability to measure, and improve quality of care and system-based practice. All physicians certified after 1990 are required to participate in Continuing Certification.

What does it mean when a physician is required?

Prior to 1990, certification by the American Board of Colon and Rectal Surgery was granted for life. These certified colon and rectal surgeons are not required to recertify or to meet the requirements of Maintenance of Continuing Certification in this area but are strongly encouraged to do so.