North American Board Certification
The American Board of Colon and Rectal Surgery is an independent member board of the American Board of Medical Specialties. Certification is a two-stage process — a written Part 1 followed by an oral Part 2 — and it sits on top of, not instead of, certification by the American Board of Surgery. This guide covers the structure, the eligibility sequence, the topics tested and how to prepare for each part.
The American Board of Colon and Rectal Surgery certifies surgeons who have completed a twelve-month ACGME-accredited colon and rectal surgery fellowship after general surgery residency. It is an independent board, not a subspecialty certificate issued by the American Board of Surgery.
The certification sequence is strict and catches candidates out. You must have passed the American Board of Surgery qualifying examination before you can sit ABCRS Part 1, and you must hold full American Board of Surgery certification before you can sit ABCRS Part 2. A delay in the general surgery pathway therefore delays the colorectal one.
Part 1 assesses knowledge of the theory and practice of coloproctology, including the relevant basic science, radiology and pathology. Part 2 assesses something different: clinical experience, problem-solving and surgical judgement, examined by conversation rather than by recognition.
Part 1 — Written Examination
Part 2 — Oral Examination
Part 1 eligibility runs for a defined period, so passing the written does not leave you indefinite time to sit the oral. Confirm the current window with the board before planning your attempt.
Colon Cancer
Staging, oncologic resection and lymphadenectomy, complete mesocolic excision, adjuvant decision-making and surveillance.
Rectal Cancer
Magnetic resonance staging and the circumferential resection margin, total mesorectal excision, total neoadjuvant therapy, organ preservation and watch and wait.
Inflammatory Bowel Disease
Dysplasia surveillance and its interpretation, ileal pouch surgery and pouch complications, Crohn strictureplasty and reoperative strategy.
Benign Anorectal and Pelvic Floor Disease
Fistula-in-ano and sphincter preservation, haemorrhoidal disease, fissure, incontinence and obstructed defaecation.
Anal Neoplasia
Anal squamous carcinoma and its non-operative management, anal intraepithelial neoplasia, and the role of salvage surgery.
Advanced and Recurrent Disease
Locally advanced and locally recurrent rectal cancer, pelvic exenteration, and peritoneal disease of colorectal origin.
Basic Science, Radiology and Pathology
Colorectal physiology, anorectal manometry and imaging, and the pathological reporting that drives management.
Part 1 is held annually in the spring at Pearson VUE centres; Part 2 is held annually in the autumn. Application deadlines fall several months before each, and the oral examination fee has its own earlier deadline.
Dates, fees and eligibility windows change each cycle — confirm the current requirements with the American Board of Colon and Rectal Surgery (abcrs.org) before applying.
Colorectal surgery has moved decisively towards specialist practice: rectal cancer accreditation programmes, pelvic exenteration networks and complex pouch surgery all concentrate in certified hands. ABCRS certification is the credential that identifies a surgeon as having been assessed against that specialist standard rather than a general one.
The Part 2 oral is what distinguishes this certification. It examines judgement under questioning — the decision to divert, the decision to reoperate, the decision to stop — and those are exactly the decisions that separate good colorectal practice from adequate colorectal practice.
It has two parts. Part 1 is a written multiple-choice examination of about six hours at a Pearson VUE centre, covering the spectrum of colon and rectal surgery together with the relevant basic science, radiology and pathology. Part 2 is an oral examination consisting of at least three thirty-minute sessions, each conducted by a team of two examiners, assessing clinical experience, problem-solving and surgical judgement.
You must have passed the American Board of Surgery qualifying examination before being admitted to ABCRS Part 1, and hold full American Board of Surgery certification before being admitted to Part 2. Completion of an ACGME-accredited colon and rectal surgery fellowship is required, along with a current, valid, full and unrestricted licence to practise maintained throughout the process.
The oral tests judgement rather than recall, so rehearsal matters more than volume. Work through colorectal cases out loud until you can state the staging, the multidisciplinary decision, the operative plan and the supporting evidence without hesitating. The SurgBoardsQ&A Exam Simulator runs this format: it presents a case step by step and follows up whenever your reasoning is incomplete.
SurgBoardsQ&A provides 1,055 colorectal and peritoneal practice questions mapped to the coloproctology syllabus, each with a full explanation referenced to the ASCRS clinical practice guidelines or the relevant NCCN guideline.
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SurgBoardsQ&A provides 1,000+ practice questions mapped to the exam syllabus, each with a detailed explanation and guideline citation.
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50 questions free, no credit card required. Filter by board, topic, or difficulty. Explanations cite ESMO and NCCN.