Resident Participation in the American College of Surgeons: A Cross-Specialty Analysis of Membership.

Abstract

Increasing use of integrated subspecialty training pathways may reduce residents' exposure to the broader surgical professional community. We evaluated resident representation in the American College of Surgeons (ACS) and specialty-specific societies across 13 surgical specialties and examined its association with training pathway structure. This cross-sectional analysis used 2024-2025 Accreditation Council for Graduate Medical Education active resident counts, 2025 ACS Fellowship Statistics, and available specialty-society membership data. Membership representation was calculated as resident members divided by ACGME-reported active residents. Specialty-society and ACS membership proportions and ACS representation in dual-pathway (integrated and independent) versus integrated-only specialties were compared using chi-squared tests. Among 34,610 ACGME-reported active residents, 13,975 (40.4%) were represented among ACS Resident Members. Specialties offering dual pathways had greater ACS membership representation than integrated-only specialties (19.1% vs 4.2%, p<0.001). Among subspecialties, ACS representation was highest in vascular surgery (26.5%), otolaryngology (18.7%), and plastic and reconstructive surgery (16.8%), and lowest in ophthalmology (0.9%), obstetrics and gynecology (1.3%), orthopaedic surgery (1.6%), and neurosurgery (4.0%). Specialty-society membership ranged from 65.8% to 100% among specialties with available data. ACS resident membership representation varies substantially across surgical specialties and is higher among specialties retaining integrated and independent training pathways. As surgical training increasingly adopts integrated models, targeted strategies to strengthen cross-specialty professional engagement may complement strong specialty-specific society participation.