An Update from the Foundation for Surgical Fellowships: Growing Need Requires Broader Support

| March 1, 2016 | 0 Comments

This column aims to educate individuals and organizations about the importance of the work that the Foundation for Surgical Fellowships is doing to ensure the funding that leads to the innovative training for surgeons to apply the principles of advanced surgical techniques in patient care.

This month: An Update from the Foundation for Surgical Fellowships: Growing Need Requires Broader Support

by Linda Schultz
Linda Schultz is Executive Director for the Foundation for Surgical Fellowships, Los Angeles, California

This year, The Foundation for Surgical Fellowships will celebrate its fifth year of funding fellowship training in minimally invasive general surgery disciplines. In that time, the Foundation has awarded over $36 million to fund nearly 670 fellowship positions. This article is one in a series that focuses on the important work of the Foundation and on the value of fellowships in general.

Bariatric Times. 2016;13(3):22.

At the advent of Minimally Invasive Surgery (MIS), the majority of related fellowships were directly funded by industry without a bridge that connected them to the goals of the larger surgical community. The absence of this synergy caused industry leaders and the major minds in surgical education and training to come together to envision an innovative new entity.

Beginning in 2009, leaders from The Americas Hepato-Pancreato-Biliary Association (AHPBA), The American Society for Metabolic and Bariatric Surgery (ASMBS), The Fellowship Council, The Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), and The Society for Surgery of the Alimentary Tract (SSAT) conducted many planning meetings. One year later, the Foundation for Surgical Fellowships (FSF) was created as a self-governing 501(c)(3) non-profit, dedicated to “a world in which surgeons receive optimal education and training in advanced surgical techniques with the goal of improved patient care.”

Today, fellowships are as critical to a new surgeon’s training as ever. “The issues in residency are complex and well documented. In short, general surgery residents often receive relatively limited training in the management of patients who require complex surgical procedures,” said Dr. Dennis Fowler, President of the FSF. “For example, during five years of surgical residency, an average resident will do 90 Minimally Invasive Surgery cases, most of which are relatively less complex cases, such as cholecystectomy. In contrast, during one year of fellowship training, a surgeon will do, on average, over 275 complex cases in the chosen discipline.” Honing their skills for managing the patients who require more complex operations, including pre- and post-operative care, is the primary reason that 70 to 80 percent of surgical residents pursue fellowship training.[1,2]

The FSF provides a key source of independent funding for these fellowships. Bariatric and Bariatric/MIS Fellowships account for 45 percent of the positions funded, followed by MIS General Surgery (25%), Thoracic (11%), HPB (10%), Colorectal (6%), and Robotics (3%). SEE GRAPH

Programs from across the United States apply to the FSF’s grant program. In a blinded process, the programs are ranked based on the quality of training facilities; methodologies and technologies; the academic, scholarly, and innovative activities of faculty and fellows in a given program; and the volume and variety of cases to which fellows are exposed. Using an objective scoring process, each fellowship program is evaluated and scored in each of three domains: clinical experience, accreditation, and scholarly activity. To be eligible for FSF funding, programs must achieve a threshold score and be accredited by either the Fellowship Council or the Accreditation Council for Graduate Medical Education (ACGME). Both accrediting organizations conduct rigorous reviews to ensure the standards of training are met.

Currently, demand for surgical fellowships exceeds available positions, and the FSF perpetually seeks new funding sources to ensure continued access to training. In its early years, nearly 100 percent of the Foundation’s support came from just a few key industry donors. As those donors faced economic changes, the FSF has sought support from the larger surgical community, including corporations, societies, and foundations as well as individual donors eager to give back. “Fellowships are a requisite for the availability of complex surgical procedures that have a tangible benefit on the lives of patients,” explained Dr. Fowler. “Funding the fellowships now depends on a broader group of stakeholders. The Foundation is grateful to its supporters and proud to carry out its mission.”

To learn more about the FSF, visit

1.    Bell RH Jr, Banker MB, Rhodes RS, et. al. Graduate Medical Education in Surgery in the United States. Surg Clin North Am. 2007 Aug:87(4):811-23.
2.    Numann, PJ. Presidential Address, 97th Clinical Congress, American College of Surgeons, San Francisco Oct. 23, 2011.

Funding: No funding was provided for this article.

Financial disclosures: The authors report no conflicts of interest relevant to the content of this article.



Category: Past Articles, Spotlight on Surgical Fellowships

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