Web Site:

THE AMERICAN COLLEGE OF

VETERINARY SURGEONS

INFORMATION BROCHURE

JUNE 1999

American College of Veterinary Surgeons

4401 East West Highway, Suite 205Bethesda, MD 20814-4523

Tel: (301) 913-9550Fax: (301) 913-2034

E-mail: [email protected] Site: www.acvs.org

TABLE OF CONTENTS

The College Seal 1

History 1

Organizational Structure 1

Membership 2

Objectives 2

Requirements for Admission 3

Veterinary Surgery Residency Program 3

Credentials Application Procedure 10

Examination 12

Appeal Procedure 13

Fees and Lock Box Address 14

Guidelines for Use of Diplomate Status 14

Humane Care and Use of Animals 15

Appendix 17

Approved Journal List 18

Residency Program Overview Checklist 19

List of Suggestions for Resident Logs and Credentials 20

Resident Forms: Program Initiated on or after July 1, 1996 21-43

Resident Forms: Program Initiated prior to July 1, 1996 44-53

ACVS Research Grant Application 54-62

Credentials Application Packet 63-72

Examination Reading List 73

Change of Address Form 74

Annual Veterinary Surgical Symposia Calendar 75

THE COLLEGE SEAL

Developed by Batvin Kramer, the seal symbolizes the ancient origin of surgery in animals and humans. Chiron is the name of the centaur. Xeipon in the upper left of the seal is the Greek word for Chiron. It is said that he taught surgery and medicine in his school to such famous pupils as Apollo, Jason, and Achilles. The Roman numerals in the lower right identify the year of incorporation of the College (1965). Modernized classic printing completes the periphery of the seal.

HISTORY

Between 1950 and 1965, veterinary specialty boards, under the jurisdiction of the American Veterinary Medical Association, began to emerge. It was during this period that the need for a veterinary specialty board became apparent to a number of leaders in the field of veterinary surgery. Foremost among this group was Dean Mark Allam of the University of Pennsylvania, who was the motivating force in forming an organizing committee.

This organizing committee consisted of Drs. J. Archibald of Ontario, W.O. Brinker of Michigan, E.A. Churchill of Maryland, R.L. Rudy of Ohio, and J. Jenny of Pennsylvania as Chairman. The objectives of this committee were to draft a constitution and bylaws and certify the credentials of charter members of the College.

The organizing committee examined the credentials of numerous veterinarians and accepted 36 as charter members. On December 16, 1965, the College was incorporated under the laws of the State of Illinois as a nonprofit educational organization.

The first annual meeting of the College was held in Chicago, Illinois on February 4, 1966. The Constitution was adopted and a slate of officers elected, with Dr. Jenny as President and Dean Mark Allam as Chairman of the Board of Regents.

The American Veterinary Medical Association granted probationary approval to the American College of Veterinary Surgeons on July 9, 1967, and the first examination of candidates for membership was given in Boston, July 21-22, 1968. The American College of Veterinary Surgeons received full approval from the American Veterinary Medical Association on June 22, 1970.

ORGANIZATIONAL STRUCTURE

Under the Constitution, management and control of the business and professional affairs of the College are vested in the Board of Regents. All elected and appointed officers of the College are members of the Board for their term of office. The officers are: Chair of the Board of Regents, President, President-Elect, Executive Secretary, and Treasurer. Six additional members are elected to the Board of Regents for terms of three years. In addition to the officers, the following standing committees assist in the administration of the College:

1. Annual Meeting Committee 2. Constitution, Bylaws, and Protocols Committee 3. Examination Committee 4. Nominating Committee 5. Publications Committee 6. Public Relations Committee 7. Research Committee

8. Resident Credentialing Committee9. Symposium Committee

The information contained in this brochure is a summary only and does not represent all of the rules and regulations that govern the College. Individuals are encouraged to contact the ACVS Office for further details.

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MEMBERSHIP

The members of the American College of Veterinary Surgeons (ACVS) are known as Diplomates.

Charter Diplomates: Recognized leaders in veterinary surgery were invited by the organizing committee to become charter members.

Active Diplomates: The Board of Regents approves these members after they have fulfilled the prescribed requirements and passed the certifying examination. Active Diplomates must be current with dues payment.

Honorary Diplomates: Honorary members are nominated by the members and elected by the Board of Regents and the membership. The nominees must have unusual eminence in veterinary surgery or the allied professions.

Emeritus Diplomates: A charter or active member who meets either criterion (a) or criterion (b) is granted Emeritus status and is not required to pay dues: Criterion (a) Reaches the age of sixty-five (65) years; or (b) Reaches at least sixty (60) years of age, has paid dues for twenty-five (25) consecutive years, and has retired from the active practice of surgery.

OBJECTIVES

The Constitution of the American College of Veterinary Surgeons states:

The objectives of the American College of Veterinary Surgeons shall be the advancement of the art and science of surgery and the protection of the public against incompetence by:

(1) The development of methods of graduate teaching in veterinary surgery with particular reference to the resident system.

(2) The establishment of a certifying agency to qualify members of the veterinary profession as specialists in surgery.

(3) The encouragement of its members to pursue original investigations and to contribute to the veterinary literature.

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REQUIREMENTS FOR ADMISSION

The Constitution of the American College of Veterinary Surgeons (ACVS) has established the following requirements for active membership status:

(a) Have a satisfactory moral and ethical standing in the profession.(b) Be either a graduate of a veterinary college accredited by the American Veterinary Medical

Association, or meet all requirements for licensure of foreign veterinary graduates as defined by the American Veterinary Medical Association, unless relieved of this obligation by the Board of Regents.

(c) Have devoted a minimum of four years after graduation from veterinary school to special training and experience in veterinary surgery in a training program acceptable to the College. (See VETERINARY SURGERY RESIDENCY PROGRAM below)

(d) Have successfully passed the qualifying examination of the College and certification by the Board of Regents. (See CREDENTIALS APPLICATION PROCEDURE, pg. 10 and EXAMINATION, pg. 12.)

VETERINARY SURGERY RESIDENCY PROGRAM(Adopted 2/9/89 - Amended 11/2/96)

To meet one of the criteria for admission regarding having devoted a minimum of four years after graduation from veterinary school to special training and experience in veterinary surgery, the following sequence of training is to be used:

a. A rotating veterinary internship, or its equivalent as defined by the ACVS.b. A three-year Veterinary Surgery Residency, as defined below.

I. Definition: A Veterinary Surgery Residency Program is a training program allowing a graduate veterinarian ("Resident") to acquire in-depth knowledge of veterinary surgery and its supporting disciplines under the supervision and guidance of a Diplomate of the American College of Veterinary Surgeons ("Diplomate").

II. Objectives of a Veterinary Surgery Residency Program:

A. To promote aptitude and clinical proficiency in the diagnosis, operative treatment, and postoperative management of animals with surgical disease(s).

B. To instruct the Resident in the science and practice of veterinary surgery and its supporting disciplines.

C. To provide the Resident with the opportunity to pursue career goals in teaching, research, clinical service, and/or specialty practice.

III. General program description: A Veterinary Surgery Residency Program ("Program") shall consist of a minimum of three (3) years (156 weeks) of supervised training, postgraduate education, and clinical experience in the science and practice of veterinary surgery and its supporting disciplines under the supervision of at least one (1) Diplomate who participates actively in that program. The following requirements can be met without regard to location or duration provided that the minimum standards are fulfilled. The only time limitation on prospective candidates is the 5-year limit on the date of publication described under Criteria for Acceptance of a Publication (See pg. 11). A Residency Program Overview Checklist (See APPENDIX - pg. 17) briefly outlines what needs to be completed during the residency program.

A. Prerequisite: Prospective Residents will be required to have broad training and experience in clinical veterinary medicine and surgery and their supporting disciplines, which must be attained by participation in an internship of 12 months duration or its equivalent.

B. Graduate degree studies: Graduate degree studies may be included in the Program; however, at least 60% of the time in that combined graduate degree-residency program must be allocated to clinical case responsibility.

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C. Continuing education programs: Continuing education programs, as the sole method of training, will not meet the requirements for certification as a Diplomate.

D. Participation of the Diplomate, American College of Veterinary Surgeons, in the Veterinary Surgery Residency Program:

1. Director of the Veterinary Surgery Residency Program ("Program Director"): The Program Director shall be responsible for the administration and continuity of the Program.

a) The Program Director must be a Diplomate. b) One Program Director may administer small and large animal programs.c) The Program Director is responsible for verification of pre-residency training, and

presence of suitable surgical facilities, equipment, and supplies. This must be completed within 30 days of program initiation by sending a Program Director's Statement to the ACVS Office. The Program Director should give a copy of this completed form to the resident and should be retained by the resident. A copy of the Program Director's form may be obtained from the ACVS Office and is found in the Appendix. (See APPENDIX - ACVS FORM 1, pg. 25)i. The Resident is not considered to be in an officially sanctioned ACVS Residency

Program until this form is filed. Requests for retroactive approval of programs lacking such sanction may be denied.

ii. Program Directors must file a form for each Resident under their supervision, including transfers from other programs.

iii. A Program Director's Statement must be filed for each resident when a Program Director changes. It is the responsibility of the new Program Director to refile the Program Director’s Statement to signify the change in responsibilities.

d) The Program Director is responsible for annual distribution of the documentation forms and Resident Credentialing Committee log evaluation comments to each Resident.

2. Resident Advisor: The Resident Advisor shall be responsible for the administration and evaluation of the general and specific program requirements for a Resident.

a) The Resident Advisor must be a Diplomate. b) Each Resident must be assigned a Resident Advisor by the Program Director within the

first calendar quarter of his/her Program. c) The Resident Advisor must possess appropriate species expertise germane to the

training of the resident.d) The Resident Advisor is responsible for:

i. Verification of semiannual progress and performance evaluations.ii. Verification of the Surgery Case Log.iii. Verification of the Resident Activity Log.iv. Verification of the Resident Oral Seminar Log.v. Submission of a Resident Advisor's Statement at the completion of the residency (or

partial completion, in the event that a Resident transfers to a new program). (See APPENDIX - ACVS FORM 11, pg. 43)

3. Diplomate Supervisor: Diplomate supervisors are responsible for the day-to-day training of the Resident.

a) The Diplomate Supervisor must possess appropriate expertise for species germane to the training of the resident and procedure.

b) Diplomate supervisors must provide appropriate in-house supervision to train the Resident. When a Resident is able to function independently, a Diplomate must at least provide the following supervision:i. appropriate case consultationii. be in-house while the Resident is performing non-emergency surgeryiii. be available for consultation when the Resident is performing emergency surgery

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4. The Program Director, Resident Advisor, and Diplomate Supervisor may be the same individual.

5. One Diplomate may supervise up to two (2) Residents concurrently while he or she is active on the clinic floor.

E. Evaluation of the Resident:

1. Residents must meet with their Resident Advisor or Program Director at least twice a year for evaluation of performance and progress.

2. The ACVS is responsible for:a) evaluation of each Resident's progress annually (each 52 week cycle) based on

documentation submitted by the Resident, andb) communication of deficiencies to the Program Director and Resident.

F. Documentation and verification of the Veterinary Surgery Residency Program: The Program Director, Resident Advisor, Resident and the ACVS have responsibilities for documentation and verification of satisfactory training for each Resident.

IV. Facilities, services, and equipment required in a Veterinary Surgery Residency Program:

A. Medical library: A library containing recent textbooks and current journals relating to veterinary surgery and its supporting disciplines must be accessible.

B. Medical records: A complete medical record must be maintained for each individual case and those records must be retrievable.

C. Radiographic services: Separate rooms and appropriate equipment for comprehensive diagnostic imaging and darkroom processing must be available.

D. Pathology services:

1. Clinical pathology: A clinical pathology laboratory for hematologic, clinical chemistry, microbiologic, and cytologic diagnosis must be available. Clinical pathology reports must be retained and retrievable.

2. Anatomic pathology: A separate room for gross pathologic examination must be available. Facilities for histopathologic examination of surgical and necropsy tissues must be available. Anatomic pathology reports must be retained and retrievable.

E. Surgical facilities:

1. Operating suite: The operative suite must be consistent with current concepts of aseptic surgery. The sterile surgery room(s) must be sized adequately for the patient, staff, and associated equipment. The sterile surgery room(s) must be ventilated according to the current concepts of aseptic surgery. Emergency lighting must be available. Adjacent room(s) shall be provided for induction and postoperative recovery. It is recommended that dentistry and surgery of infected wounds should not be performed in the sterile surgery room.

2. Anesthetic and critical care equipment: An anesthetic machine and medical gases, a positive-pressure ventilator, and a physiologic recorder, including blood pressure and electrocardiographic monitoring, are required.

3. Surgical instrumentation: A full complement of general and special instrumentation for diagnostic and operative surgery of all body systems must be available.

4. Photography: Photographic equipment for documentation of surgical disease is required.5. Sterilization: Steam and gas sterilization of surgical instrumentation and supplies must be

available, and the sterilization capacity must be commensurate with the surgical caseload.

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V. Specific program description:

A. Surgical service rotations facilitate development of knowledge, skill, and proficiency in veterinary surgery via exposure to a wide variety of surgical diseases with the guidance and collaboration of experienced veterinary medical specialists.

1. At least 94 weeks of the 156 week Program must be spent on a surgical service under the direction of a Diplomate.

2. Resident responsibilities: The degree of responsibility assumed by the Resident shall be appropriate to the nature of the surgical procedure and training experience. The Resident on a surgical service shall be responsible for:a) receiving clinic appointments and obtaining history and pertinent information from clientb) supervising daily management of hospitalized animalsc) participating in clinical teachingd) providing optimal clinical service and prompt professional communications

3. The Resident Credentialing Committee recommends that first-year residents perform at least 50% of their procedures with a Diplomate at the operating table.

4. The Resident Credentialing Committee recommends that at least 50% of Core Curriculum surgeries be supervised by a Diplomate of the ACVS.

B. Anesthesiology, radiology, internal medicine, and pathology service rotations:

1. Anesthesiology: The surgery resident anesthesiology training requirement includes a minimum of 80 hours, supervised directly or indirectly by an ACVA Diplomate, which might include routine and emergency patient care, journal clubs, literature reviews, case discussions, seminars and graduate courses. This requirement must be fulfilled under a program mutually agreeable to the ACVS and ACVA Diplomates at the institution(s) involved in the surgery resident program and the anesthesiology training requirement.

2. Radiology: The surgery resident radiology training requirement includes a minimum of 80 hours, supervised directly or indirectly by an ACVR Diplomate, which might include participation in patient care, special diagnostic procedures, radiology rounds, journal clubs, case discussions, seminars, various imaging modalities, therapeutic procedures, and graduate courses. This requirement must be fulfilled under a program mutually agreeable to the ACVS and ACVR Diplomates at the institution(s) involved in the surgery resident program and the radiology training requirement.

3. Internal Medicine: The surgery resident internal medicine training requirement includes a minimum of 80 hours, supervised directly or indirectly by an ACVIM Diplomate, which might include routine and emergency patient care, journal clubs, literature reviews, case discussions, seminars and graduate courses. This requirement must be fulfilled under a program mutually agreeable to the ACVS and ACVIM Diplomates at the institution(s) involved in the surgery resident program and the internal medicine training requirement.

4. Pathology: The surgery resident pathology training requirement includes a minimum of 80 hours, supervised directly or indirectly by an ACVP Diplomate, which might include microscopic and gross pathology, pathology rounds, journal clubs, case discussions, seminars, surgical biopsy service, clinical case data interpretation, and graduate courses. This requirement must be fulfilled under a program mutually agreeable to the ACVS and ACVP Diplomates at the institution(s) involved in the surgery resident program and the pathology training requirement.

C. Emergency duty: The Resident must perform emergency surgery and manage emergency surgical cases.

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D. Residents must spend at least 31 weeks of their Program in any or all of the following ways (recorded as S = Special rotation on Activity Log):

1. research or clinical investigation2. preparation of scientific manuscripts3. graduate degree studies4. national or international level continuing education courses5. special veterinary rotation with the approval of the Resident Advisor6. special rotation at a human medical hospital7. anesthesiology, radiology, internal medicine, and pathology ACVS requirements

E. The balance of the Resident's Program is left up to the discretion of the Program Director.

F. Neurosurgery: For residents training at institutions where neurosurgery is not performed by Diplomates of the ACVS, rotations on neurosurgical services headed by individuals who are not ACVIM Diplomates (Neurology) must be counted as Surgical Rotations Not Supervised By an ACVS Diplomate. Rotations on neurosurgical services headed by ACVIM Diplomates (Neurology) may be counted toward any of the Residency Program’s 156 weeks including supervised surgery rotations.

G. Vacation time is counted separately. (Residents beginning their programs before July 1, 1996 should count vacation time in the Director’s Choice Category.)

H. Conferences:

1. Required attendance: During surgical service rotations, the Resident is required to attend surgery resident’s conferences and surgery ward rounds.

2. Optional attendance: The following conferences are recommended for attendance:a. veterinary specialty oriented conferences (e.g., ophthalmology, neurology, internal

medicine)b. scientific journal clubsc. other scientific presentations, including human medical conferences

I. A Surgery Case Log listing the date of procedure, case number, species, diagnosis, surgical procedure, designation as elective or emergency, responsibility as assistant or primary surgeon, supervisor, and presence of an ACVS Diplomate in the surgery room must be maintained by the Resident. The Resident may be considered to be the primary surgeon when that individual can document a significant role in all of the following aspects of management: determination or confirmation of the diagnosis, provision of preoperative care, selection and performance of the appropriate operative procedure, direction of the postoperative care, and accomplishment of sufficient follow-up to be acquainted with both the course of the disease and the outcome of its treatment. For Residents starting their programs on or after July 1, 1996, a minimum of 380 surgical procedures will be required in the small animal curriculum (See APPENDIX - ACVS FORM 2-SA, pg. 30-31) and 250 procedures in the large animal curriculum (See APPENDIX - ACVS FORM 2-EQ, pg. 26-27 AND ACVS FORM 2-FA, pg. 28-29). Full size examples of the forms which are to be used by Residents for Program documentation are found in the Appendix of this book. Copies of these forms can also be obtained through the ACVS Office.

J. A Resident Activity Log listing major activities for each of the 156 weeks must be maintained by the Resident. The typical schedule of rounds, seminars, lectures attended and other professional activities should be summarized as part of the Activity Log.

K. Research and publications:

1. Research project: The Resident must complete an investigative project that uses the scientific method. It is recommended that this project be initiated in year 1 of the residency program.

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2. Publications: The Resident is required to prepare one (1) first-author manuscript for an approved journal. (See CRITERIA FOR ACCEPTANCE OF A PUBLICATION, pg. 11.)

L. Seminar and teaching responsibilities: A Resident Oral Seminar Log listing seminars and presentations made by the Resident must be maintained by the Resident.

1. Definition of seminar: An oral scientific presentation which is followed by a discussion period.a) Program Directors at smaller institutions or practices need to be sure that their residents do

in-depth presentations to peer audiences. b) Lecture, case rounds presentations or reviews of single journal articles will not count

towards this requirement.2. Seminar requirement: The Resident must present a minimum of 6 seminars during the

program.3. Surgery resident’s(s) rounds presentations: The Resident must regularly present cases at

surgery resident’s(s) rounds.4. Clinical teaching: The Resident is required to participate in the clinical education of graduate

veterinarians and/or veterinary medical students assigned to the surgical service rotations.

VI. Instructions to Residents:

The Resident is responsible for:

1. Maintenance of the Surgery Case Log (See APPENDIX- ACVS FORMS 6 AND 7, pg. 37-38).

a) On the surgery log, list only the people who were actually at the table or ACVS Diplomates in the operating theater.

b) The Resident is considered to be the primary surgeon when that individual can document a significant role in all of the following aspects of management: determination or confirmation of the diagnosis, provision of preoperative care, selection and performance of the appropriate operative procedure, direction of the postoperative care, and accomplishment of sufficient follow-up to be acquainted with both the course of the disease and the outcome of its treatment.

c) Only one procedure per patient per anesthetic episode may be used in fulfillment of the Core Curriculum. Multiple procedures on the same patient during the same anesthetic period may NOT be entered into multiple Core Curriculum categories.

d) Do not list elective ovariohysterectomy, castration, declaw, or dental prophylaxis on the small animal surgery log.

e) Do not list cases that are diagnostic workups, but never go to surgery, on either large or small animal surgery logs.

f) If a resident is doing surgery on research animals, submit a separate research surgery log. Research or teaching surgeries may not be used in fulfillment of the Core Curriculum unless pre-existing (spontaneously occurring) disease is being treated.

g) The Resident’s and Resident Advisor’s signatures are REQUIRED on the Surgery Log Cover Sheet (See ACVS Form 6, pg. 37) each time the logs are submitted to the ACVS Office. The Resident Advisor needs to sign the Cover Sheet for the surgery log, but not each sheet. The Cover Sheet indicates that the resident's performance was satisfactory. Thus, if the resident leaves a residency program and goes to another program, he/she will be able to use the weeks spent in the first program towards fulfilling ACVS requirements.

2. Maintenance of the Resident Activity Log (See APPENDIX - ACVS FORM 8, pg. 39-40).

a) On the Activity Log, list each of the 52 weeks of the year individually, the primary activity for the week, which activity category the week counts towards and obtain a Diplomate’s signature for each separate week. The Diplomate's signature indicates compliance with supervision requirements.

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3. Maintenance of the Resident Oral Seminar Log (See APPENDIX - ACVS FORM 9, pg. 41).

a) On the Resident Oral Seminar Log, the Resident lists ONLY the seminars he/she wishes to count towards the 6-seminar requirement.

b) Oral seminars may not include multiple presentations of the same topic or lecture.c) Each seminar must be unique. Same topic seminars will not be counted more than once.

4. Summarize Resident Rounds (See APPENDIX - ACVS FORM 9, pg. 41)

a) The resident should summarize the typical daily or weekly formal scheduled interactions with Diplomates, residents and students. These activities may include morning rounds, evening rounds, and weekly discussion groups.

5. Documentation of training in veterinary anesthesiology, veterinary radiology, veterinary internal medicine, and veterinary pathology (See APPENDIX - ACVS FORM 10, pg. 42).

a) The resident should utilize the standard documentation form to present evidence of completion of the 80-hour training requirements in pathology, radiology, internal medicine, and anesthesiology.

b) This training must be verified by a Diplomate of the appropriate respective specialty college. Only the Diplomate specialist supervising the 80 hours of training in pathology, radiology, internal medicine, or anesthesiology should sign the verification form.

c) Under no circumstances should the verification form be modified to reflect some period of training less than the 80 hours required for completion of that requirement.

d) When submitting logs for annual evaluation, the resident should submit each of the 80-hour verification forms for anesthesiology, radiology, internal medicine, and pathology as they are completed throughout the residency program.

e) When submitting logs at the completion of the residency program, residents should include copies of all verification forms, certifying that each of the 80-hour training experiences in the related specialties has been completed.

f) NOTE: The 80 hour requirement of internal medicine training, adopted February 1, 1995, applies to all Residents beginning training programs on or after July 1, 1995.

6. Submitting 4 bound copies of the verified Surgery Case Log, Resident Activity Log, Resident Oral Seminar Log and copies of all correspondence from the ACVS Office on all previously submitted logs (this includes log evaluation sheets) for receipt at the ACVS Office on or before August 1st of each year. All residents must submit 4 bound copies no matter what year an individual resident began his/her program.

a) The logs must be arranged in the sequence listed on the "Residency Training Documentation" form (See APPENDIX - ACVS FORM 3, pg. 32) and bound in 4 packets. The preferred method for binding will allow the pages to lie flat as turned (e.g., plastic, spiral, 19- pin PVC binding). Heavy, three-ring notebooks, paper clips and binder clips are not acceptable.

b) The resident's name and year of residency must appear on the front cover of each packet. c) The logs must be typed to be evaluated. d) These logs document the program from July 1 to June 30 of the current year. Residents with

less than 6 months in training need not submit these until August 1st of the following year. e) When submitting logs to the ACVS Office, the resident should enclose a self-addressed,

stamped, blank postcard for providing confirmation of receipt of the logs by the ACVS. The postcard will be return mailed by the ACVS staff to the resident, acknowledging that the logs arrived at the ACVS Office. Return of the postcard neither implies nor certifies that the logs are complete, acceptable, or approved.

f) Copies of the regulation size forms are found in the APPENDIX. Residents may photocopy or generate an identical facsimile of these forms.

g) If a Diplomate other than the Supervising Diplomate has signed-off on activity logs, a letter of explanation must be submitted and bound within each copy.

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VII. Program questions or concerns: Any resident who has a concern with his/her Residency Program should discuss the question or concern with his/her Program Director or appropriate local institutional official. If the question or concern can not be satisfactorily addressed at the local level and the resident believes the ACVS can be of assistance, then a letter should be directed to the Board of Regents care of the ACVS Office.

CREDENTIALS APPLICATION PROCEDURE

Following completion of the Veterinary Surgery Residency Program, Residents may submit a Credentials Application to the Resident Credentialing Committee (c/o the ACVS Office) to determine eligibility to take the certifying examination.

I. Application Deadline: Applicants must submit their credentials for receipt at the ACVS Office on or before August 1 of the year preceding the anticipated examination. The training program must be completed by the application deadline. Late or incomplete applications will be returned without being processed or reviewed.

II. Application Time Limits: Any applicant within 5 years of the completion of his/her program may apply under current requirements or the requirements in effect at the initiation of his/her program. Any resident whose credentials have not been accepted within 5 years of completion of his/her residency program must apply under the requirements currently in effect at the time of application. (Applies to residents starting their Programs on or after June 15, 1996.) Any Resident whose credentials are denied, must only correct the deficit to reapply and is under no time limit for reapplication.

III. Credentials Application Packets: A current Credentials Application Packet is available through the ACVS Office and in the APPENDIX (See pg. 63) of this Brochure. The application packet contains several documents including "Guidelines for Submission of Credentials " and "Checklist for Submission of Credentials to the ACVS."

A. The credentials must verify the successful completion of a surgical residency training program. The accuracy and availability of all required credentials rests with the applicant. Four (4) complete Credentials Applications must be submitted. The following materials must be submitted in each copy of the Credentials Application Packet:

1. Completed Application Form2. Resident Advisor's Statement (See ACVS FORM 11, pg. 43). This is not considered a

letter of reference (See number 3. below). The Resident Advisor must provide a letter of reference in addition to this statement.

3. Letters of Reference. Three (no more) confidential form letters of reference with four copies of each, each in individually sealed envelopes, must accompany the credentials packet as described below. A specific letter of reference form (See APPENDIX, pg. 65) is included in the Credentials Application Packet. There must be a letter from the Resident Advisor(s) of each year and institution involved in the residency training program. Two of the required letters must be from Diplomates of the ACVS. Diplomates used as references must have had Diplomate status during the period of residency. All letters must be from persons familiar with the applicant's postgraduate surgical training program. In the event that only one ACVS Diplomate works directly with the resident, a second ACVS Diplomate must be identified who is familiar with the applicant’s training program and can substantiate the qualifications of the applicant as requested in the letter of reference form. Requests by the applicant for reference letters from the resident advisor(s) and referees should be made early. Applicants should ask each referee to place four signed copies of his/her letter of reference in four (4) individual envelopes, seal the envelopes, and give the sealed envelopes to the applicant. Referees should not send letters directly to the ACVS Office. It is the applicants' responsibility to make certain that a sealed envelope from each referee is appropriately secured in each of the four copies of the credentials application. Applications that do not contain reference letters will be considered incomplete and will not be reviewed.

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Reference letters must collectively document the following:a. Verification of satisfactory completion of residency training and level of Diplomate

supervision.b. The applicant's proficiency, judgment, competence as a veterinary surgeon, and

academic readiness to sit the examination.c. The commitment of the applicant to the Constitutional objectives of the ACVS.d. The moral and ethical standing of the applicant within the veterinary profession.

4. Publication– Candidates accepted to take the examination must have made a significant contribution to veterinary surgery, as represented by publication and demonstrated by a high standard of proficiency in the specialty. In keeping with the Constitutional objectives of the ACVS, each credentials applicant must demonstrate willingness to contribute to the literature. In addition to contributing to the literature, manuscripts originating from basic or clinical research enhance a Resident's education by the learning of scientific methodology, which may lead to the discovery of new concepts, or substantiate or refute established methods. Manuscripts should demonstrate intellectual curiosity and should further the state of surgical knowledge or other closely related biological sciences. The minimum requirement is one publication fulfilling the following criteria:

Criteria for Acceptance of a Publication

a. The applicant must be first or sole author. The publication must have resulted from the applicant's research or clinical investigation. The date of publication cannot be more than five years old by the deadline for credentials submissions.

b. Manuscript must be accepted in an approved journal (See APPENDIX - APPROVED JOURNAL LIST, pg. 18) prior to August 1 of the year of application. A manuscript is considered accepted when the author receives a final letter of acceptance from the editor and further review by a reviewer is not required. Editorial notations or changes affecting sentence structure are acceptable. A copy of the manuscript, including figures and photographs, with planned or final editorial notations or changes and a copy of the final letter of acceptance must be submitted in the Credentials Application.

c. The manuscript must follow the scientific method, containing:1. an introductory statement2. a hypothesis or objective3. a description of techniques used4. a report of the results5. a discussion6. a conclusion

d. Papers such as book chapters, proceedings, review articles and case reports, are not acceptable.

e. The information in the publication must not have been published previously by the same author, other than in abstract or proceedings form.

f. Clinical studies which fulfill the above criteria are acceptable.

5. Final Resident Surgery Case Log, Resident Activity Log, Resident Oral Seminar Log, Documentation of Training in Anesthesiology, Radiology, Internal Medicine and Pathology, and copies of all correspondence from the ACVS Office on all previously submitted logs including all log evaluation sheets from the Resident Credentialing Committee.

6. Application fee (See FEES AND LOCK BOX ADDRESS, pg. 14).

7. Self-addressed, stamped, blank postcard. The ACVS Office will return this to the applicant upon receipt of the application materials. Receipt of this postcard confirms that the ACVS Office received your application and does not imply that the application has been reviewed, evaluated, or accepted. The ACVS Office will not evaluate your application for completeness.

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B. Organization of Credentials Packets: The applicant must submit four (4) complete copies of the application materials. The application materials must be divided, arranged in the sequence listed in A. (above), indexed and bound in four folders to prevent loss and to facilitate review. A 9 by 12-inch envelope should be bound into each folder and a sealed letter of reference from each referee placed in this envelope. The preferred method for binding will allow the pages to lie flat as turned (plastic spiral, 19 pin PVC binding). The applicant's name and “1999 Credentials Application” should be on the front of each folder. Three-ring notebooks are not acceptable. If the credentials are accepted by the Resident Credentialing Committee and approved by the Board of Regents, the applicant will be notified by the ACVS Office by no later than mid November. Successful applicants will be notified of the dates and procedure of examination.

C. Submissions: All candidates must submit the standard application form of the College along with other required documents to the ACVS Office and the application fee to the ACVS lock box address (See FEES AND LOCK BOX ADDRESS, pg. 14).

IV. Notification: The ACVS Office will notify unsuccessful applicants by no later than mid November with a letter explaining the deficiency in credentials.

V. Resubmission of Credentials Application that has been Denied:

A. Reapplication Deadline: Applicants must submit their credentials for receipt at the ACVS Office on or before August 1 of the year preceding the anticipated examination.

B. Reapplication Packet: Four (4) complete copies of the application materials must be arranged, bound and submitted in the manner previously described. All correspondence regarding application procedures and notification should be addressed to the ACVS Office. All submitted application materials become the sole property of the ACVS and will not be returned to the applicant. Candidates should be sure that the ACVS Office has their current addresses. Reapplication following an unsuccessful credentials application must include:

1. a new application form 2. three (no more) current letters of reference. Applicants may use the same referees but must

obtain current letters of reference.3. pertinent correspondence to include:

a. letter(s) from the Resident Credentialing Committee explaining the previous deficiency in credentials

b. letter(s) documenting the appeal process/appeal decision (if applicable)c. letter(s) specifying the correction of credentials found deficient

4. publication. Include only if credentials were previously denied based on the publication requirement. Do not resubmit a previously approved publication(s).

5. application fee

EXAMINATION

Following the successful acceptance of a Credentials Application, candidates intending to sit for the following year’s examination must submit a signed and notarized Examination Contract, Accommodations for Examines with Disabilities form, photographs, checklist and appropriate fee (See FEES, pg.14) to the ACVS Office for receipt on or before December 15. The ACVS Office will send a current Examination Information Pamphlet to all eligible examination candidates by no later than mid-November. The Examination Information Pamphlet provides additional information regarding examination rules and security, the examination schedule, and a suggested reading list. Sample examination questions are available on the ACVS web site (www.acvs.org).

The examination will test all phases of surgery in all species and types of animals as well as competence in areas of specialization. The examination is composed of three sections. There are separate examinations for large and small animal examinees. The examinee must choose to be tested in either

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small or large animal surgery.

1. The written section consists of approximately 185 multiple choice questions with one correct answer. Approximately 25% of the questions are general in nature and will appear on both the large animal and small animal examinations. The remaining 75% pertain to either small or large animals, depending on which examination has been chosen. Questions cover all body systems (gastrointestinal, cardiovascular, respiratory, musculoskeletal, urogenital, neurologic, special senses and integument). Within body systems, questions pertain to basic science (anatomy, physiology and pathology) pharmacology/ anesthesia, surgical techniques, diagnosis, treatment and prognosis.

2. The practical section of the exam is designed to test interpretive skills and the questions are based on visual material of surgically related diseases or conditions. Material may depict anatomical specimens, instruments, surgical diseases, pathologic and histologic specimens, and imaging studies. Upon viewing the material, the candidate may be asked to give information regarding diagnosis, method of treatment, interpretation of diagnostic studies, or identification of instruments or equipment. The answers are short written answers of one word or phrase. There will be 25 case-oriented question sets, with 4 minutes provided to answer the questions for each set.

3. The case-oriented oral examination tests surgical principles in and case management prior to, during, and after surgery. The exam is divided into two parts: 1.) orthopedics/neurosurgery and 2.) soft tissue surgery. Candidates should be prepared to answer questions covering all areas of surgical practice. Each part of the oral examination will be administered in approximately 25 minutes and will be tape-recorded.

The integrity of the certification examination will be maintained by the ACVS to insure the validity of scores awarded to candidates.

All three portions of the examination must be successfully completed to become certified by the American College of Veterinary Surgeons. Candidates sitting for the examination for the first time must take all three sections. Candidates sitting for the examination for the second or third time must take all sections not successfully completed previously. Candidates are allowed three attempts to pass all sections of the examination. Candidates who fail one or more sections of the examination the first or second time and plan to retake those sections must notify the ACVS Office of their intentions before December 15 in the year immediately preceding the next scheduled examination. Candidates should be sure that the ACVS has their current addresses.

Failure to successfully complete all three sections of the examination after three attempts will require submission of a new credentials application to the Resident Credentialing Committee and complete re-examination. The applicant must consult with the Chairs of the Resident Credentialing and Examination Committees. The Examination Committee will provide a written critique of the applicant's performance on previous examinations, including recommendations for future preparations.

Subsequent credentials applications following three unsuccessful examination attempts must be bound as described in the section on CREDENTIALS APPLICATION PROCEDURE (pg. 10) and include:

1. A completed Credentials Application form 2. Two confidential letters of evaluation (four copies of each, each in individually sealed envelopes), at

least one of which should be from an ACVS Diplomate. These letters should specifically address the moral and ethical standing of the applicant within the veterinary profession.

3. All pertinent correspondence: This should include a list of all dates of previous applications and appropriate correspondence.

4. An application fee.5. Self-addressed, stamped, blank postcard.

APPEAL PROCEDURE

A person or persons who believe they have been adversely affected by an American College of Veterinary Surgeons' (ACVS) decision may petition for reconsideration only on the grounds that the decision: (a) disregarded the established criteria for certification or approval, (b) failed to follow its stated

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procedures, or (c) failed to consider relevant evidence and documentation presented.

A written petition must include a statement of the grounds for reconsideration with supporting documentation and be sent to the Chair of the Board of Regents via the ACVS Office. The petition must be received by the ACVS Office within 90 days of the date on which the ACVS decision was announced. The Chair, subject to review and approval by the Executive Committee, will initially present relevant information concerning all appeals to the Internal Review Committee (IRC). The IRC reviews the factual information and the background with respect to all appeals from credentials determination by the Resident Credentialing Committee and exam results authorized by the Examination Committee. A Board of Regents conference will be arranged for review and determination after the Chair of the Board of Regents receives the results of a recommendation of the IRC. A quorum of voting Regents must participate in all such meetings or conferences and determinations are made by majority vote. The affected party(ies) may be invited to meet with the Board of Regents. The ACVS Board of Regents will meet in executive session to reach a final decision. The Board of Regents' decision will be sent to the affected person(s) not more than 30 days after it is made.

If the ACVS declines to reconsider or amend its decision to the satisfaction of the affected person(s), the affected person(s) may request mediation by the American Board on Veterinary Specialties (ABVS) of the AVMA.

If a meeting is requested by either party to the dispute and if one of the parties will accept the responsibility for the expenses of the meeting and provide a deposit of $1,000 towards these expenses, the Chairman of ABVS may call a meeting of the parties in dispute or their representatives. The meeting may be held at the AVMA headquarters and may be chaired by the Chairman of ABVS. The parties in dispute would be guided to seek equitable solutions.

FEES AND LOCK BOX ADDRESS

Information pertaining to the following fees can be obtained by calling or writing the ACVS Office. Checks should be made payable to the American College of Veterinary Surgeons in United States currency and mailed separately to the ACVS lock box address: American College of Veterinary Surgeons, c/o Crestar Bank, P.O. Box 79484, Baltimore, MD 21279-0484. Make certain your name appears on the check.

1. A credentials application (or reapplication) fee must be sent to the lock box address and postmarked by August 1 (currently $250 and non-refundable after the submission deadline).

2. The examination fee (currently $700 and non-refundable after the submission deadline) must be submitted with a completed examination contract after the applicant's credentials are approved and before December 15.

3. If any portion of the examination has to be retaken, an appropriate fee will be assessed (currently $350 and non-refundable after the submission deadline).

4. Annual dues must be paid to the ACVS Office on or before March 31 of each year (currently $200). New Diplomates are not responsible for dues for the year in which they pass the examination. Dues will start the following calendar year.

GUIDELINES FOR THE USE OF DIPLOMATE STATUS

As stated in the Constitution and Bylaws of the American College of Veterinary Surgeons, Article VII, Section 1, the College authorizes the use of the designations "Diplomate, American College of Veterinary Surgeons" or "Diplomate ACVS" for individuals approved for membership in the College. These designations can only be used by Diplomates accepted as Charter Members or who have passed the examination of the College. An individual conferred honorary membership shall be designated as "Honorary Diplomate of the American College of Veterinary Surgeons".

Telephone directory listing: Diplomates may choose to list themselves under the separate heading "Veterinarians - DVM - Surgeons", as per guidelines outlined by the AVMA in the Advertising Regulations: Principles of Veterinary Medical Ethics. Only individuals who are board certified should present themselves as specialists. To comply with the recommendations of the AVMA, the ACVS can condone

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the use of this section of the telephone directory only by Diplomates.

An individual who has completed residency training but is not board certified may only indicate that their practice is "limited to the practice of surgery". No connection to the ACVS may be implied. The terms "board eligible" or "board qualified" should not be used. An individual who identifies their professional credentials using these terms may be eliminated from the credentials application or examination process.

Job listings in professional journals: An advertisement should outline specifically the type of individual desired, i.e.: 1) Diplomate of the American College of Veterinary Surgeons, 2) individual who has completed residency training and/or, 3) individual with credentials accepted by ACVS.

Letterheads and business cards: It is appropriate to indicate diplomate status on letterheads and business cards. The full designation "Diplomate, American College of Veterinary Surgeons", or "Diplomate of the American College of Veterinary Surgeons" should be used. This is done by indicating the diplomate status directly below the name:

John Doe, D.V.M., M.S.Diplomate, American College of Veterinary Surgeons

ACVS Logo: The logo seal of the ACVS is registered and may only be used on official communications and letterheads of the College. Diplomates may use the specially designed logo on their practice and professional stationery, business cards and advertisements. The ACVS logo and guidelines for its use are available to all Diplomates through the ACVS Office.

HUMANE CARE AND USE OF ANIMALS

The ACVS, recognizing its responsibility, promotes high quality and humane care of animals whether for companionship, agricultural use, sporting events, teaching, or research. The use of animals in teaching and research is viewed as a unique privilege with inherent responsibilities and not as an absolute right. Advances in surgical and medical care of animals and people require research which must at times involve the use of animals, as does the training of veterinary students, interns, residents, and graduate veterinarians. Laboratory animals serve an important role in these essential teaching and research efforts but their use must be justified and their humane care insured by teachers, scientists, and local peer review committees. Alternatives to the use of live animals should always be considered and animal use reserved for those times when acceptable alternatives are not available. The use of animals, whether for teaching, basic research, or clinical trials, must be carefully scrutinized to insure that meaningful results are obtained for the benefit of animal or human health. Survival after surgery is important for many research and teaching projects but must be justified and the animals cared for in a humane and conscientious manner; humane care and high quality of life must be a priority.

The American College of Veterinary Surgeons promotes and encourages treatment of animals with high-quality professional care and humane concern. To help achieve these goals, the following guidelines are established:

A. Care of Individual Animals

1. The ACVS endorses guidelines set forth by the National Institutes of Health "Guide for the Care and Use of Laboratory Animals" (#85-23) and "The Animal Welfare Act of 1966" (P.L. 89-544) with its amendments of 1979 (P.O. 91-579) and 1976 (P.L. 94-279).

2. Techniques for euthanasia should follow guidelines established by the American Veterinary Medical Association Panel on Euthanasia (JAVMA, Feb. 1986).

B. Diplomate's Responsibility

1. Diplomates should follow the guidelines set forth in the National Institutes for Health "Guide for the Care and Use of Laboratory Animals" and the "Animal Welfare Act of 1966" (P.L. 89-544), its 1970 amendment (P.L. 91-579), and 1976 amendment ( P.L. 94-279).

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2. Diplomates at educational and research institutions should encourage and assist their institutions in becoming accredited by the American Association for Accreditation of Laboratory Animal Care (AALAC).

3. Diplomates at educational and research institutions should assist in the development of an "Animal Care and Use Committee." Diplomates should take a leadership role in establishing and reviewing protocols for animal use.

4. Diplomates should always consider alternative methods of teaching and research which do not require the use of living animals. For example:

a. Basic surgical techniques, such as aseptic preparation, instrument handling, knot tying and suturing, should be taught using artificial materials, audiovisual instruction or cadavers before students engage in exercises using living animals.

b. Wherever possible, simulated models should be instituted to teach fundamental techniques of surgery.

c. The number of teaching laboratories using living animals should be kept to a minimum and the exercises selected to maximize the principles of surgery rather than specific techniques.

5. Diplomates should promote a sensitivity and concern among students, interns, and residents of the need for humane care and treatment of animals.

6. Non-survival teaching laboratories, in which the animal is anesthetized, does not regain consciousness, and is humanely killed at the conclusion of the laboratory, are recommended. Survival teaching procedures are discouraged and should be justified only if the learning experience of the student is materially enhanced and the knowledge gained cannot reasonably be obtained in another way.

C. College's Responsibility

1. The ACVS accepts the obligation to remain current on all issues concerning ethical and moral issues of animal usage and to keep the members apprised of alternatives to animal use and of the laws pertaining to animal use.

2. The ACVS, through its Symposium Committee, shall carefully scrutinize all submitted abstracts for appropriate and humane care of animals and shall only accept those that follow NIH guidelines and the Animal Welfare Act.

3. The ACVS, through its publication, Veterinary Surgery, shall not publish any manuscript in which the materials and methods are not consistent with NIH guidelines and the Animal Welfare Act.

4. The ACVS, through its Research Committee, shall fund research only at institutions which have AALAC accreditation or which follow NIH guidelines. Each proposal submitted for consideration must contain a statement, signed by the diplomate investigator (or co-investigator), that this requirement has been met.

While the College supports and encourages the implementation of the NIH guidelines for the care and use of laboratory animals, it is not responsible for the actions of individual members.

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APPENDIX

Page(s)

Approved Journal List 18

Residency Program Overview Checklist 19

List of Suggestions for Resident Logs and Credentials 20

Forms for Residents Who Started Their Program after July 1, 1996 21-43

Residents who started their program on or after July 1, 1996 must submit two (2) surgery logs to the ACVS: the first will be a complete, consecutively numbered (and chronologic) log of surgery cases; and the second will be a surgery log with a separate page(s) for each of the major headings within the core curriculum requirements.

Forms for Residents Who Started Their Program before July 1, 1996 44-53

These Residents may continue to use whatever method (or software) to compose their surgical logs that they have used to date. Many Residents are using the software distributed by the ACVS Residency Program Committee in 1992-1993. This form of the log will continue to be acceptable for Residents currently using it. While the program is useful in sorting data, the printout from it is very difficult for evaluators to read and its use will be phased out over time by attrition of residents allowed to use it.

ACVS Research Grant Application 54-62

Credentials Application Packet 63-72

Examination Reading List 73

The Examination Committee makes annual changes in the reading list. The current examination is subject to each year’s current reading list. The updated reading list for the next examination is available early November.

Change of Address Form 74

Annual Veterinary Surgical Symposia Calendar 75

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APPROVED JOURNAL LIST

VETERINARY JOURNALS

American Journal of Veterinary ResearchAustralian Veterinary JournalBritish Veterinary JournalCanadian Journal of Veterinary ResearchCanadian Veterinary JournalEquine Veterinary JournalJournal of Small Animal PracticeJournal of the American Animal Hospital AssociationJournal of the American Veterinary Medical AssociationJournal of Veterinary Internal MedicineJournal of Veterinary Pharmacology and TherapeuticsNew Zealand Veterinary JournalVeterinary AnesthesiaVeterinary Comparative Orthopedics and TraumatologyVeterinary PathologyVeterinary Radiology and UltrasoundVeterinary RecordVeterinary Surgery

NON-VETERINARY JOURNALS

American Heart JournalAmerican Journal of PathologyAmerican Journal of PhysiologyAmerican Journal of SurgeryAmerican Journal of Sports Medicine, TheAnesthesiologyAnatomic RecordArthritis and RheumatismArthroscopy: The Journal of Arthroscopic and Related Surgery CancerClinical Orthopaedics and Related ResearchJournal of Applied PhysiologyJournal of Bone and Joint SurgeryJournal of Clinical InvestigationJournal of Investigative Surgery Journal of Orthopedic ResearchJournal of RheumatologyJournal of Surgical Research

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RESIDENCY PROGRAM OVERVIEW CHECKLIST

YEAR 1 (week 1 through 52)1. File Program Director’s Statement within first 30 days (Form 1).2. If a graduate from non-AVMA accredited veterinary school, request waiver from Board of Regents3. Initiate Logs and Review Core Curriculum (Forms 2-Eq,. 2-FA, 2-SA)

a. Case Log (number case log and CC log consecutively from year 1 through year 3, Form 7)b. Activity Log (Form 8)c. Resident Oral Seminar Log (Form 9)d. Rounds Summary (Form 9)

4. Develop Residency Plan (read ACVS Information Brochure, Sections I, II, III, IV, V, VI, VII)a. Must include 94 weeks ACVS Diplomate supervised clinics, 30 weeks Specialty Rotationsb. Specialty Training (anesthesiology, radiology, pathology, internal medicine, Form 10)c. Identify Resident Advisor by second quarterd. Publication/research (Publication must be FULLY accepted by approved journal prior to

August 1 of the year in which credentials are submitted)5. Performance and progress review with Resident Advisor (RA) twice yearly (Section III E)6. Submit Year 1 logs prior to August 1 of Year 2 to ACVS Office

YEAR 2 (week 53 through 104)1. Reconcile discrepancies in Year 1 log based on Resident Credentialing Committee report2. Continue to maintain all logs

a. Review progress toward satisfactory completion of core curriculum requirements3. Continue specialty training requirement (A/R/P/IM)

a. Submit cumulative documentation each year with log submission4. Research project and publication preparation should be in progress.5. Performance/progress in residency should be assessed every 6 months with RA 6. Submit logs for Year 2 by August 1 of Year 3

a. Do not re-submit Year 1 or 2 log unless requested by Resident Credentialing Committee (RCC)

b. Include RCC review of Year 2 log and any additional documentation needed

YEAR 3 (week 105 through 156)1. Read Credentials Application Packet2. Reconcile discrepancies in Year 2 log evaluations identified by Resident Credentialing Committee3. Continue to maintain all logs (Review progress in core curriculum, 94 weeks of supervised clinics,

and 30 weeks Special Rotations)4. Continue specialty training requirement (A/R/P/IM); Submit cumulative documentation each year5. Publication must be FULLY accepted before credentials application submission6. Review performance/progress in residency every 6 months with RA 7. Submit logs for Year 3 by August 1

a. Do not resubmit Year 1 or 2 logs unless requested by the RCCb. Include review of Year 1 and 2 logsc. Include cumulative Activity Log, Presentation Log, and Specialty Trainingd. Include log within credentials application if applying this year

CREDENTIALS APPLICATION1. Read Credentials Application section of Information Brochure2. Include letter from editor of FULL acceptance of manuscript unless already published3. Include ALL signed specialty training forms4. Include ALL log evaluations and communications from Resident Credentialing Committee and

ACVS 5. Include Resident Advisor’s Statement(s)6. Include Activity and Presentation logs as cumulative for entire residency

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LIST OF SUGGESTIONS FORRESIDENT LOGS AND CREDENTIALS

1. Check your math. Miscounting numbers has been a problem.

2. Read the criteria for core curriculum! Do not over count or double count cases.

3. Include all previous log evaluations from the Resident Credentialing Committee.

4. DO NOT include previous year’s case log.

5. DO include cumulative activity and presentation logs.

6. You must change the numbers on the Log Summary Form to those verified by the Resident Credentialing Committee on the log evaluation form. If you do not make these changes, you must get approval for not making the change from the Chair of the Resident Credentialing Committee.

7. Include ALL communications from the ACVS.

8. Include ALL signed specialty training forms; not just the current year’s.

9. If submitting credentials, ONLY submit ONE year 3 log included in credentials packet.

10. Number cases sequentially from Year 1 through Year 3. Do not start with “1” each year. Number core curriculum logs consecutively from Year 1 through Year 3 with independent numbers from main log.

11. Do not include non-operative procedures.Closed reduction of coxofemoral luxationCast application, change, removalDiagnostic endoscopySimple procedures are not recommended to be included:

Drain abscessChest tube placementFeline DDF tenectomySimple implant removal (e.g., transphyseal bridge removal – equine)Changing dental packingRoutine dental extractionPEG tube placement (endoscopic)External Fixator removalIncisional biopsy

12. Do not mis-classify weeks in “S”, “D” and “C”. Read the instructions carefully.

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LIST OF FORMS AND DOCUMENTS USEDIN ACVS RESIDENCY PROGRAMS

BEGINNING ON OR AFTER JULY 1, 1996

These forms will be used by the Resident, Resident Advisor, and Program Director:

Document Code Document or Form Title

ACVS Form 1 Program Director’s Statement

ACVS Form 2-EQ Large Animal Curriculum (Equine Emphasis)

ACVS Form 2-FA Large Animal Curriculum (Food Animal Emphasis)

ACVS Form 2-SA Small Animal Curriculum

ACVS Form 3 Residency Training Documentation

ACVS Form 4-LA ACVS Resident’s Log Summary-Large Animal

ACVS Form 4-SA ACVS Resident’s Log Summary-Small Animal

ACVS Form 5 Surgery Case Log: Index of Supervisors

ACVS Form 6 Cover Sheet For Surgery Case Log

ACVS Form 7 Surgery Case Log (Prototype Sheet)

ACVS Form 8 Resident Activity Log

ACVS Form 9 Resident Oral Seminar Log and Resident Rounds Summary

ACVS Form 10 Documentation of Training in Veterinary Anesthesiology, Veterinary Radiology, Veterinary Internal Medicine, and Veterinary Pathology

ACVS Form 11 Resident Advisor’s Statement

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INSTRUCTIONS FOR COMPLETING FORMS USED IN ACVS RESIDENCY PROGRAMS BEGINNING ON OR AFTER JULY 1, 1996

General Instructions:

The attached forms and documents are used in the documentation and verification of an ACVS Veterinary Surgery Residency Program. The Program Director, the Resident Advisor, the Diplomate Supervisor, the Resident, and the ACVS have responsibilities for documentation and verification of satisfactory training for each resident. It is strongly recommended that every participant in a Residency Program review the entire description of an ACVS Veterinary Surgery Residency Program, which can be found in the current ACVS Information Brochure.

If you have questions, please, first consult the current ACVS Informational Brochure for clarification. If the question still cannot be resolved, do not hesitate to contact directly the Chair of the Resident Credentialing Committee.

ACVS Form 1 -- Program Director’s Statement:

The Program Director is responsible for verification of pre-residency training, and presence of suitable surgical facilities, equipment, and supplies within 30 days of program initiation by sending a Program Director’s Statement to the ACVS Office. The Resident is not considered to be in an official, sanctioned ACVS Residency Program until this form is filed. Requests for retroactive approval of programs lacking such sanction will be denied. Program Directors must file a form for each Resident under their supervision, including transfers from other programs. A Program Director’s Statement must be filed for each resident when a Program Director changes.

ACVS Form 2 -- Large and Small Animal Curricula:

These documents describe the specific requirements for the Large Animal Curriculum (Equine Emphasis, Form 2-EQ), Large Animal Curriculum (Food Animal Emphasis, Form 2-FA), and Small Animal Curriculum (Form 2-SA).

For the Large Animal Curricula: please note that there are two Large Animal Curricula, one for Residents with an Equine Emphasis, and one for Residents with a Food Animal Emphasis. The arthroscopic and upper respiratory surgical procedures have been reduced in the Food Animal Emphasis curriculum and replaced by an equal increase in the abdominal urogenital-penile, and udder and teat categories. The intention to complete a Large Animal Curriculum with Food Animal Emphasis must be elected at the initiation of the Residency Program and submitted with the Program Director’s Statement, signed by both the Resident and the Resident Advisor.

For the Small Animal Curriculum: For residents training at institutions where neurosurgery is not performed by Diplomates of the ACVS, rotations on neurosurgical services headed by individuals who are not ACVIM Diplomates (Neurology) must be counted as “Surgical Rotations Not Supervised By an ACVS Diplomate”. Rotations on neurosurgical services headed by ACVIM Diplomates (Neurology) may be counted toward any of the Residency Program’s 156 weeks.

ACVS Form 3 -- Residency Training Documentation:

This form will be the first page to appear in the packet containing the Surgical Case Log, Resident Activity Log, Resident Presentation Log, and related forms

Please note that each packet must have all of the sheets organized in a specific order (See the last portion of ACVS Form 3).

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ACVS Form 4 -- ACVS Resident’s Log Summary:

These forms summarize all components of the Surgical Case Log, Resident Activity Log, and Resident Presentation Log. There are 2 variations of this form: one for large animal surgery residents (ACVS Form 4-LA), and one for small animal surgery residents (ACVS Form 4-SA).

For the ACVS Resident’s Log Summary-Large Animal: For any given year, the total number of arthroscopic cases would be listed adjacent to the code (AR), and specific cases would be listed adjacent to 1 of 6 subcategories in this section. Arthroscopic surgery cases should be coded in the Surgery Case Log (ACVS Form 7) using the most specific subcategory code, e.g., AF-C, AR-F, etc.

ACVS Form 5 -- Surgery Case Log: Index of Supervisors:

The instructions for completing ACVS Form 5 are on the form.

ACVS Form 6 -- Cover Sheet for Surgery Case Log:

The Resident Advisor only needs to sign the Cover Sheet for the surgery log, not each sheet.

The Cover Sheet indicates that the Resident’s performance was satisfactory, thus if the Resident leaves a residency program and goes to another program, he/she will be able to use the weeks spent in the first program towards fulfilling ACVS requirements.

ACVS Form 7 -- Surgery Case Log:

The instructions for completing ACVS Form 7 are on the form.

The Resident may be considered to be the primary surgeon when that individual can document a significant role in all of the following aspects of management: determination or confirmation of the diagnosis, provision of preoperative care, selection and performance of the appropriate operative procedure, direction of the postoperative care, and accomplishment of sufficient follow-up to be acquainted with both the course of the disease and the outcome of its treatment.

Only one procedure per patient per anesthetic episode may be used in fulfillment of the Core Curriculum. Multiple procedures done in the same patient during the same anesthetic period may NOT be entered into multiple Core Curriculum categories.

The Resident Credentialing Committee recommends that Year One Residents perform at least 50% of their procedures with an ACVS Diplomate at the operating table. This recommendation is NOT a requirement.

Please note that every copy of the bound documentation submitted to the ACVS Office on August 1 of each year must include 2 surgical logs (See ACVS Form 7 for details on what must be included in these 2 surgical logs).

ACVS Form 8 -- Resident Activity Log

The Resident should indicate for each week of the year the predominate activity that occurred during that time period. The weeks must be consecutively number from 1 to 52. Each week should have a code assigned to it. By the end of the 156 week Program each Resident must have a minimum of 94 weeks of surgical rotations supervised by an ACVS Diplomate (exception: See rules governing ACVIM Neurologist substituting for ACVS Diplomate) and a minimum of 31 weeks of special rotations.

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ACVS Form 9 -- Resident Oral Seminar Log and Rounds Summary:

On the Resident Oral Seminar Log, the Resident lists ONLY the seminars he/she wishes to count towards the “6 seminar” requirement.

Program Directors at smaller institutions or practices need to be sure that their Residents do in-depth presentations to peer audiences. Lectures, case rounds presentations or reviews of single journal articles will not count toward this requirement. Oral seminars may not include multiple presentations of the same topic or lecture.

In the “Rounds Summary” the Resident should indicate the type of rounds and the scheduling of those rounds for the year. List the typical daily or weekly formal interactions with Diplomates, residents, students, etc. These activities may include morning rounds, evening rounds, weekly discussion groups, etc.

ACVS Form 10 -- Documentation of Training in Veterinary Anesthesiology, Veterinary Radiology, Veterinary Internal Medicine, and Veterinary Pathology:

For further information on these requirements, please refer to section IV, part B of the ACVS Veterinary Surgery Residency Program description, which can be found in the current ACVS Information Brochure (“blue book”).

These requirements must be fulfilled under a program mutually agreeable to the ACVS and ACVA/ACVR/ACVIM/ACVP Diplomates at the institution(s) involved in the surgery resident program and the required specialty rotations.

When submitting logs for annual evaluation, the Resident should submit each of the 80-hour verification forms for anesthesiology, radiology, internal medicine, and pathology as they are completed throughout the residency program. When submitting logs at the completion of the residency program, Residents should include copies of all verification forms, certifying that each of the 80-hour training experiences in the related experiences has been completed.

ACVS Form 11 -- Resident Advisor’s Statement:

The Resident Advisor’s Statement verifies that the Resident has satisfied the requirements of the ACVS Veterinary Surgery Residency Program; the semi-annual progress and performance evaluations were completed; and, the Surgery Case Log, Resident Activity Log, and Resident Oral Seminar Log were verified.

The Resident Advisor is responsible for submitting this form at the completion of the residency program (or partial completion, in the event that a Resident transfers to a new program).

This form must be submitted to the ACVS Office in the Resident’s bound documentation at the completion of the Residency Program.

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ACVS Form 1PROGRAM DIRECTOR’S STATEMENT

I have read the current description of a Veterinary Surgery Residency Program as adopted by the American College of Veterinary Surgeons and ___________________________________________ (print Resident’s name) has fulfilled the prerequisite requirements for admission to the Program and has initiated a (Large Animal - Equine Emphasis/ Large Animal - Food Animal Emphasis/ Small Animal) [Circle Program] Program on _________________________ (date).

I have read the current ACVS Information Brochure and attest that I can provide access to all facilities, equipment and specialists in other disciplines required for an ACVS Residency Program.

Diplomate (print): __________________________________________________________

Signature: __________________________________________________________

Date: __________________________________________________________

Address: __________________________________________________________

__________________________________________________________

__________________________________________________________

Telephone: __________________________________________________________

Fax: __________________________________________________________

E-mail: __________________________________________________________

Resident (print): __________________________________________________________

Degree: __________________________________________________________

Address: __________________________________________________________

__________________________________________________________

__________________________________________________________

Telephone: __________________________________________________________

Fax: __________________________________________________________

E-mail: __________________________________________________________

(Check if applicable) ____ This form indicates a change in Program Director.

Previous Program Director (Print Name):

______________________________________________________________________________NOTE: This form must be submitted to the ACVS Office within 30 days of program initiation.

(Form 1, 6/6/99)

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ACVS Form 2-EQ

LARGE ANIMAL CURRICULUM (Equine Emphasis)

The large animal core curriculum consists of a minimum of 250 procedures. These procedures can be completed on any large animal species.* These numbers refer to numbers of animals undergoing surgical procedures. Cases listed in the Surgery Logs to satisfy core curriculum requirements must be performed on live animals with spontaneously occurring disease. Procedures performed on cadaver limbs and dead animals are not allowed. Effective July 1, 1999, animals undergoing bilateral procedures may be counted only once per anesthetic period in the Core Curriculum log. Animals undergoing separate anesthetic episodes can be counted as undergoing separate procedures. These requirements need to be completed prior to applying to take the ACVS certifying examination. There is no time limit on the completion of the requirement._________________________________________________________________

Category, subcategory, and (codes) Number_________________________________________________________________

Abdominal surgery (AB), including colic, 25 ruptured bladder repair, caesarian section,ovariectomy, etc. Although these procedures should be coded under one of the two followingsubcategories, there is no minimum requirementfor either subcategory of abdominal surgery.

Colic/gastrointestinal (AB-GI)Urogenital (AB-UG)

Internal fixation of fractures (FRX)

Lag screw fixation (FRX-S) 4Plated long bone fracture (FRX-P) 1

Wounds, reconstructions, and debridements (WRD) 15

Tendon injuries and deformities (TEN)

Distal check desmotomy (TEN-D) 2Proximal check desmotomy (TEN-P) 2Tendon lacerations and other tendon 2

procedures (TEN-L)

Surgical treatment of angular limb deformities (ALD)

Periosteal strippings (ALD-PS) 5Transphyseal bridging (ALD-TB) 1

Surgery of the foot (FT), including debridement 5 of osteomyelitis, neurectomy, etc

Dental and paranasal sinus procedures (DS) 5

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LARGE ANIMAL CURRICULUM (Equine Emphasis) continuation

Urogenital surgery (UG)

Routine castration/surgery of the penis (UG-CP) 4(cryptorchid castrations can be substituted in this subcategory)

Cryptorchidectomy (UG-CR) 3Rectovaginal procedures (UG-RV), including 4

lacerations, fistulae, urethroplasty, etc

Ophthalmic surgery (OPH), including eyelid 2lacerations, corneal-scleral transpositions, etc

Upper respiratory surgery (UR)

Prosthetic laryngoplasty (UR-L) 5Any other upper respiratory procedure (UR-O) 5

Arthroscopic surgery (AR), a total of 30 cases 30including:

Carpus (AR-C) 5 or more Fetlock (AR-F) 5 or moreTarsocrural joint (AR-T) 5 or moreFemoropatellar joint (AR-FP) 3 or moreFemorotibial joint (AR-FT) 2 or moreOther joints (AR-O)

______________________________

Subtotal of specified procedures: 120

Minimum of an additional 130 surgeries of any type, 130excluding routine castration. Please note that additional surgical procedures should beclassified under the categories/subcategorieslisted above; if this is not possible, use thecode (O).

TOTAL PROCEDURES: 250_________________________________________________________________

* There are two Large Animal Curricula: one for Residents with an Equine Emphasis, and one for Residents with a Food Animal Emphasis. The arthroscopic and upper respiratory surgical procedures have been reduced in the Food Animal Emphasis curriculum and replaced by an equal increase in the number of surgical procedures in the number of surgical procedures in the abdominal, urogenital-penile, and udder and teat categories. The intention to complete a Large Animal Curriculum with Food Animal Emphasis must be elected at the initiation of the residency program and submitted with the Program Director's Statement, signed by both the Resident and the Resident Advisor.

(Form 2 EQ, 6/6/99)

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ACVS Form 2 FA

LARGE ANIMAL CURRICULUM (Food Animal Emphasis)

The large animal core curriculum consists of a minimum of 250 procedures. These procedures can be completed on any large animal species.* These numbers refer to numbers of animals undergoing surgical procedures. Cases listed in the Surgery Logs to satisfy core curriculum requirements must be performed on live animals with spontaneously occurring disease. Procedures performed on cadaver limbs and dead animals are not allowed. Effective July 1, 1999, animals undergoing bilateral procedures may be counted only once per anesthetic period in the Core Curriculum log. Animals undergoing separate anesthetic episodes can be counted as undergoing separate procedures. These requirements need to be completed prior to applying to take the ACVS certifying examination. There is no time limit on the completion of the requirement._________________________________________________________________

Category, subcategory, and (codes) Number_________________________________________________________________

Abdominal surgery (AB), including colic, 35 ruptured bladder repair, caesarian section,ovariectomy, etc. Although these procedures should be coded under one of the two followingsubcategories, there is no minimum requirementfor either subcategory of abdominal surgery.

Colic/gastrointestinal (AB-GI)Urogenital (AB-UG)

Internal fixation of fractures (FRX)

Lag screw fixation (FRX-S) 4Plated long bone fracture (FRX-P) 1

Wounds, reconstructions, and debridements (WRD) 15

Tendon injuries and deformities (TEN)

Distal check desmotomy (TEN-D) 2Proximal check desmotomy (TEN-P) 2Tendon lacerations and other tendon 2

procedures (TEN-L)

Surgical treatment of angular limb deformities (ALD)

Periosteal strippings (ALD-PS) 5Transphyseal bridging (ALD-TB) 1

Surgery of the foot (FT), including debridement 5 of osteomyelitis, neurectomy, etc

Dental and paranasal sinus procedures (DS) 5

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LARGE ANIMAL CURRICULUM (Food Animal Emphasis) continuation

Urogenital surgery (UG)

Routine castration/surgery of the penis (UG-CP) 9(cryptorchid castrations can be substituted in this subcategory)

Cryptorchidectomy (UG-CR) 3Rectovaginal procedures (UG-RV), including 4

lacerations, fistulae, urethroplasty, etc

Surgery of the udder and teats (UD) 5

Ophthalmic surgery (OPH), including eyelid 2lacerations, corneal-scleral transpositions, etc

Upper respiratory surgery (UR)

Prosthetic laryngoplasty (UR-L) 2Any other upper respiratory procedure (UR-O) 3

Arthroscopic surgery (AR), a total of 15 cases 15including:

Carpus (AR-C) 2 or more Fetlock (AR-F) 2 or moreTarsocrural joint (AR-T) 2 or moreFemoropatellar joint (AR-FP) 1 or moreFemorotibial joint (AR-FT) 1 or moreOther joints (AR-O)

______________________________

Subtotal of specified procedures: 120

Minimum of an additional 130 surgeries of any type, 130excluding routine castration. Please note that additional surgical procedures should beclassified under the categories/subcategorieslisted above; if this is not possible, use thecode (O).

TOTAL PROCEDURES: 250_________________________________________________________________

* There are two Large Animal Curricula: one for Residents with an Equine Emphasis, and one for Residents with a Food Animal Emphasis. The arthroscopic and upper respiratory surgical procedures have been reduced in the Food Animal Emphasis curriculum and replaced by an equal increase in the number of surgical procedures in the number of surgical procedures in the abdominal, urogenital-penile, and udder and teat categories. The intention to complete a Large Animal Curriculum with Food Animal Emphasis must be elected at the initiation of the residency program and submitted with the Program Director's Statement, signed by both the Resident and the Resident Advisor.

(FORM 2 FA, 6/6/99)

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ACVS Form 2 SA

SMALL ANIMAL CURRICULUM

The small animal core curriculum consists of the following minimum number of surgical procedures. These procedures can be completed on any small animal species. Cases listed in the Surgery Logs to satisfy core curriculum requirements must be performed on live animals with spontaneously occurring disease. Procedures performed on cadaver limbs and dead animals are disallowed. Effective July 1, 1999, animals undergoing bilateral procedures may be counted only once per anesthetic period in the Core Curriculum log. These requirements need to be completed prior to applying to take the ACVS Certifying Examination. There is no time limit on the completion of the requirement._________________________________________________________________

Category and (codes) Number_________________________________________________________________

Neurologic Surgery* (NE) 40 Such as intervertebral disc decompression/fenestration; thoracolumbar spinal fracturestabilization; atlantoaxial stabilization; and lumbosacral disease.

Thoracic Surgery (TH) 15Such as exploratory thoracotomy, includingsternotomy; ligation of patent ductusarteriosus; lung lobectomy; esophagotomy;and pericardiectomy.

Gastrointestinal Surgery (GI) 50Such as exploratory with biopsies of liveror intestines; intestinal resection/anastomosis; partial gastrectomy; liverlobe excision; partial colectomy; portosystemic shunt ligation; gastropexy;cholecystectomy; cholecystoenterostomy;perineal hernia.

Abdominal Surgery (AB) 5Abdominal surgery not associated with thegastrointestinal or urogenital tract, suchas adrenalectomy, splenectomy, inguinalhernia, and diaphragmatic hernia.

Urogenital Surgery (UG) 30Such as cystotomy, ectopic ureter repair,perineal or scrotal urethrostomy, prescrotalurethrotomy, nephrectomy, ovariohysterectomyfor pyometra, and prostatic surgery

.

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SMALL ANIMAL CURRICULUM continuation

Head/Neck Surgery (HN) 20Such as ear canal ablation, salivary glandremoval, bulla osteotomy, rhinotomy, mandibular fractures, partial maxillectomyor mandibulectomy, thyroidectomy, arytenoidlateralization for laryngeal paralysis, andstaphylectomy.

Skin/Reconstructive Surgery (SR) 20Such as skin graft, pedicle flap, axialpattern flap, degloving injuries, perianalfistulas, removal of superficial tumors,mastectomy, anal sacculectomy.

Orthopedic Surgery (OR) 120Such as cruciate ligament repair, arthrodesis,limb amputation, fracture repair with externalor internal fixation, total hip replacement,femoral head and neck ostectomy, triple pelvicosteotomy, and joint exploration.

Other Surgery (O)Surgeries that do not fit into the above corecurriculum areas.

______________________________

Subtotal of specified procedures: 300

Minimum of an additional 80 surgeries of any type 80 (to exclude routine ovariohysterectomies,castration, declaws, and dental prophylaxis).

TOTAL PROCEDURES: 380_________________________________________________________________

Only the core curriculum codes given in parentheses are acceptable. Use of these codes on the surgery logs for all cases is mandatory.

* For residents training at institutions where neurosurgery is not performed by Diplomates of the ACVS, rotations on neurosurgical services headed by individuals who are not ACVIM Diplomates (Neurology) must be counted as Surgical Rotations Not Supervised By an ACVS Diplomate. Rotations on neurosurgical services headed by ACVIM Diplomates (Neurology) may be counted toward any of the Residency Program’s 156 weeks including supervised surgery rotations.

(Form 2 SA, 6/6/99)

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ACVS Form 3RESIDENCY TRAINING DOCUMENTATION

(To be completed by the Resident. -Please type)ALL LOGS MUST BE MAILED-NO FAXES ACCEPTED

Date: ____________ Name: __________________________________Degree____________

Institution: _______________________________________________________Address I wish to be contacted at: _______________________________________________________

_______________________________________________________Work phone: ________________ Home phone: _________________ FAX number: ________________E-mail address: ________________________________________Resident advisor:__________________________________________________________________

(must be an ACVS Diplomate-See Information Brochure)

Program director: _________________________________________________________________ (must be an ACVS Diplomate-See Information Brochure)

Program director's statement filed: [ ] yes [ ] noProgram type: [ ] large animal [ ] large animal (with food animal emphasis) [ ] small animal

Pre-approvals, if any:_____________________________________________________________

Program initiated on: ________________ Program year:_________________________________

These logs cover my: [ ] 1st yr [ ] 2nd yr [ ] 3rd yr [ ] other (specify)

Will submit my complete credentials for review this year: [ ] yes [ ] no

I have previously received evaluation for my: [ ] 1st yr [ ] 2nd yr [ ] 3rd yr

Pre-residency training and experience:a. Veterinary School: where: ______________________________________________b. Internship: [ ] no [ ] yes, where:__________________________________________c. Private practice: [ ] no [ ] yes, where: _____________________________________

Concurrent graduate degree training:a. Formal graduate courses (alone): [ ] no [ ] yesb. Formal graduate courses leading to degree: [ ] no [ ] yes, degree attained:__________

CONTENTS: (Please make 4 bound packets and check that each packet has all the sheets organized in the following order):

[ ] Residency Program Documentation

[ ] Previous year(s) evaluation(s) from Resident Credentialing Committee

[ ] ACVS Resident's Log Summary

[ ] Surgery Case Log: Index of Supervisors

[ ] Cover Sheet For Surgical Case Log

[ ] Surgical Case Log (Consecutively Numbered)

[ ] Surgical Case Log (Separate Page For Each Major Heading of the Core Curriculum Requirements)

[ ] Resident Activity Log

[ ] Resident Presentation Log

[ ] Documentation of Training in: _________ Anesthesiology __________ Internal Medicine (List date completed) _________ Pathology __________ Radiology

(Form 3, 6/6/99)

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ACVS Form 4 LA

ACVS RESIDENT’S LOG SUMMARY–LARGE ANIMAL To be completed by the resident. Please type.

Name:Institution/Practice:____________________________________________________________________________

FILL IN NUMBERS FOR ALL YEARS YOU HAVE COMPLETED.*Required

Resident Activity Log Yr 1 Yr 2 Yr 3 Yr 4 Cumulative Minimum

#Weeks Surgical Rotations Supervised by an ACVS Diplomate ____ ____ ____ ____ _____ 94 weeks#Weeks Surgical Rotations NOT Supervised by an ACVS Diplomate ____ ____ ____ ____ _____#Weeks Special Rotations ____ ____ ____ ____ _____ 31 weeks (including research, meetings)#Weeks Vacation ____ ____ ____ ____ _____

TOTAL WEEKS IN PROGRAM ____ ____ ____ ____ _____ 156 weeks

Special Rotation Requirements # Hours Anesthesia ____ ____ ____ ____ _____ 80 hrs # Hours Pathology ____ ____ ____ ____ _____ 80 hrs

# Hours Radiology ____ ____ ____ ____ _____ 80 hrs# Hours Internal Medicine ____ ____ ____ ____ _____ 80 hrs

Residents Presentation Log# Seminars Presented ____ ____ ____ ____ _____ 6 seminars

Resident Case LogTotal # of Surgeries ____ ____ ____ ____ _____ 250

Total # of Emergency Cases ____ ____ ____ ____ _____

# of Cases as Primary Surgeon ____ ____ ____ ____ _____

# of Cases with Diplomate ____ ____ ____ ____ _____ (ACVS Diplomate scrubbed in or present in the room)

Manuscript Preparation (Please circle appropriate stage)

Work in progress Work completed Draft Submitted Accepted

*Numbers listed should reflect those verified on any previous log evaluations.

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ACVS RESIDENT’S LOG SUMMARY-LARGE ANIMALTo be completed by the resident. Please type.

Name:Institution/Practice:____________________________________________________________________________________

FILL IN NUMBERS FOR ALL YEARS YOU HAVE COMPLETED.*

Required Minimum Equine Food An.

Resident Case Log Yr 1 Yr 2 Yr 3 Yr 4 Cumulative Emphasis Emphasis

Abdominal (AB) ____ ____ ____ ____ _____ 25 35 Fracture fixation (FRX) Lag screw fixation (FRX-S) ____ ____ ____ ____ _____ 4 4 Long bone plating (FRX-P) ____ ____ ____ ____ _____ 1 1Wounds, Reconstruction, Debridement (WRD) ____ ____ ____ ____ _____ 15 15Tendon Inj./Deformities (TEN) Distal check des. (TEN-D) ____ ____ ____ ____ _____ 2 2 Proximal check des.(TEN-P) ____ ____ ____ ____ _____ 2 2 Tendon lac./other (TEN-L) ____ ____ ____ ____ _____ 2 2Angular limb deformities (ALD) Periosteal strip. (ALD-PS) ____ ____ ____ ____ _____ 5 5 Transphys. bridge (ALD-TB) ____ ____ ____ ____ _____ 1 1Foot (FT) ____ ____ ____ ____ _____ 5 5Dental/Sinus (DS) ____ ____ ____ ____ _____ 5 5Urogenital (UG) Castration/Penile (UG-CP) ____ ____ ____ ____ _____ 4 9 Cryptorchid (UG-CR) ____ ____ ____ ____ _____ 3 3 Recto-vaginal (UG-RV) ____ ____ ____ ____ _____ 4 4Udder/Teat (UD) ____ ____ ____ ____ _____ 0 5Ophthalmic (OPH) ____ ____ ____ ____ _____ 2 2Upper respiratory (UR) Laryngoplasty (UR-L) ____ ____ ____ ____ _____ 5 2 Upper resp-Any other(UR-O) ____ ____ ____ ____ _____ 5 3Arthroscopic (AR) ____ ____ ____ ____ _____ 30 15 Arthroscopy must include: Carpus (AR-C) ____ ____ ____ ____ _____ (5) (2) Fetlock (AR-F) ____ ____ ____ ____ _____ (5) (2) Tarsocrural (AR-T) ____ ____ ____ ____ _____ (5) (2) Femoropatellar (AR-FP) ____ ____ ____ ____ _____ (3) (1) Femorotibial (AR-FT) ____ ____ ____ ____ _____ (2) (1) Other joints (AR-O) ____ ____ ____ ____ _____ Other Surgeries (O) ____ ____ ____ ____ _____Total Number of Cases ____ ____ ____ ____ _____ 250 250

*Numbers listed should reflect those verified on any previous log evaluations.

I have read the Resident Credentialing Committee’s Log Evaluation and have corrected my logs to match the numbers verified by the Committee. If I did not change my Log Summary Form, then I have included written documentation to justify why the discrepancies were not corrected.

Signed: ____________________________________________ Date: _____________________________

(Form 4 LA, 6/6/99)

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ACVS Form 4 SAACVS RESIDENT’S LOG SUMMARY–SMALL ANIMAL

To be completed by the resident. Please type.Name:Institution/Practice: ___________________________________________________________________________________

FILL IN NUMBERS FOR ALL YEARS YOU HAVE COMPLETED.*Required

Resident Activity Log Yr 1 Yr 2 Yr 3 Yr 4 Cumulative Minimum#Weeks Surgical Rotations Supervised ____ ____ ____ ____ _____ 94 weeks by an ACVS Diplomate#Weeks Surgical Rotations NOT ____ ____ ____ ____ _____ Supervised by an ACVS Diplomate#Weeks Special Rotations ____ ____ ____ ____ _____ 31 weeks (including research, meetings)#Weeks Vacation ____ ____ ____ ____ _____TOTAL WEEKS IN PROGRAM ____ ____ ____ ____ _____ 156 weeks

Special Rotation Requirements # Hours Anesthesia ____ ____ ____ ____ _____ 80 hrs # Hours Pathology ____ ____ ____ ____ _____ 80 hrs

# Hours Radiology ____ ____ ____ ____ _____ 80 hrs# Hours Internal Medicine ____ ____ ____ ____ _____ 80 hrs

Residents Presentation Log# Seminars Presented ____ ____ ____ ____ _____ 6 seminars

Resident Case LogTotal # of Surgeries ____ ____ ____ ____ _____ 380Total # of Emergency Cases ____ ____ ____ ____ _____# of Cases as Primary Surgeon ____ ____ ____ ____ _____# of Cases with Diplomate ____ ____ ____ ____ _____ (ACVS Diplomate scrubbed in or present in the room)

Neurologic Surgery (NE) ____ ____ ____ ____ _____ 40Thoracic Surgery (TH) ____ ____ ____ ____ _____ 15Gastrointestinal Surgery (GI) ____ ____ ____ ____ _____ 50Abdominal Surgery (AB) ____ ____ ____ ____ _____ 5Urogenital Surgery (UG) ____ ____ ____ ____ _____ 30Head/Neck Surgery (HN) ____ ____ ____ ____ _____ 20Skin/Reconstructive Surgery (SR) ____ ____ ____ ____ _____ 20Orthopedic Surgery (OR) ____ ____ ____ ____ _____ 120Other (O) ____ ____ ____ ____ _____Total Number of Cases ____ ____ ____ ____ _____ 380

Manuscript Preparation (Please circle appropriate stage)Work in progress Work completed Draft Submitted Accepted

*Numbers listed should reflect those verified on any previous log evaluations.

I have read the Resident Credentialing Committee’s Log Evaluation and have corrected my logs to match the numbers verified by the Committee. If I did not change my Log Summary Form, then I have included written documentation to justify why the discrepancies were not corrected.

Signed: ____________________________________________ Date: _____________________________ (Form 4 SA, 6/6/99)

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ACVS Form 5

SURGERY CASE LOG: INDEX OF SUPERVISORS

Type the names and initials of the Diplomates of the American College of Veterinary Surgeons included in this log and the year that Diplomate status was granted for each individual.

Year Diplomate Status Was Name Initials Granted

Type the names and initials of supervisors included in this log that are not Diplomates of the American College of Veterinary Surgeons. Include any residents or clinical instructors. If the individual has received board certification in other areas, list the specialty board and the year that Diplomate status was granted.

Year DiplomateSpecialty Status Was

Name Initials Board(s) Granted

(Form 5, 4/15/97)

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ACVS Form 6

COVER SHEET FOR SURGERY CASE LOG

1. The information for surgical case ___________ to _________ , performed from ____________ (start no.) (end no.) (start date)

to __________ is true and accurate. (end date) Resident Signature ______________________________________________________

Name (Print or Type) ______________________________________________________

Date ______/_______/______

Resident Advisor’s Signature ______________________________________________

Name (Print or Type)_____________________________________________________

Date _____/_______/_______

2. During the time that the above surgeries were performed, the resident’s overall performance in the residency program was judged satisfactory.

Resident Advisor’s Signature ______________________________________________

Date _____/_______/_______

(Form 6, 6/15/97)

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SURGERY CASE LOG* ACVS Form 7

Name: Program (circle one): LA or SAInstitution/Practice:

No. CC Code Date Case Number Species Diagnosis Surgical Procedure L/M P/A Supervisor D/N

* General Instructions: 1. This is the format for all surgical logs. Hospital computer printouts and other formats will not be accepted.2. Residents should submit two (2) separate, typewritten surgery case logs:

a. The first log is a complete, consecutively numbered (and chronologic) log of ALL surgery cases.b. The second log will be used to document completion of the core curriculum requirements. This surgery log must have a separate page(s)

for each of the major categories within the core curriculum requirements. 3. All surgical procedures listed in either surgery log should be classified under one of the existing major category (or subcategory, if applicable)

headings of the core curriculum requirements.Specific Instructions: No.: Number cases consecutively throughout entire program. Record all surgical cases except diagnostic work-ups without surgery, routine

dental cases with or without tooth extraction, and elective small animal neutering procedures. Research surgery should be recorded on a separate surgical research log.

CC Code: If possible, classify all cases by appropriate core curriculum code. See core curriculum sheet for classifications.Date: List date of surgery.Case Number: List case number assigned by your practice/institution.Species: Please type full name.Diagnosis and Surgical Procedure: For ease of evaluation, it is recommended that Diagnosis and Surgical Procedures be written out. The use of

abbreviations should be minimized. Any abbreviations used must be defined.L/M: List whether the case was an Elective (L) or an Emergency (M) procedure.P/A: List whether you were Primary (P) or Assistant (A) surgeon during surgery. See Information Brochure for more details.Supervisor: List initials for supervisor for each surgery and put an asterisk by the initials of ACVS Diplomates. Initials should correspond to those

listed in your Index of Supervisors.D/N: If an ACVS Diplomate (or ACVIM-certified neurosurgeon) was present in the room, list D. If not, list N.

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(Form-7, 4/15/97)

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ACVS Form 8

RESIDENT ACTIVITY LOG:*

Name: Program: LA SAAddress:

Week No.

Week Start Date

Assignment CNSV Supervisor Supervisor’s Signature

1234567891011121314151617181920212223242526

*Instructions:

Week No.: Week Number. Provide a separate row for each of the 52 weeks. Do not split weeks.Assignment: Type in the primary activity for the specified week. Examples: Research, Meeting, Equine

Orthopedics, Neurosurgery, Combined Soft/Ortho, Anesthesia, Vacation, etc. C= Surgical rotation supervised by an ACVS Diplomate or an ACVIM Diplomate (Neurology).N= Surgical rotation NOT supervised by an ACVS Diplomate.S= Special rotation (Research, Graduate, Meeting, Manuscript, Specialty Rotation, etc.)V= Vacation

(Form 8, 4/14/97)

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RESIDENT ACTIVITY LOG (Continuation):

Name: Program: LA SAAddress:

Week No.

Week Start Date

Assignment CNSV Supervisor Supervisor’s Signature

2728293031323334353637383940414243444546474849505152

Resident’s Name (Type or Print): _____________________________________________

Resident’s Signature: _____________________________________________

Advisor’s Name (Type or Print): _____________________________________________

Resident Advisor’s Signature: _____________________________________________Signatures certify that information is true and accurate.

(Form-8, 4/15/97)

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ACVS Form 9

RESIDENT ORAL SEMINAR LOG

(Please type)

Name: _______________________________________________________

Address: _____________________________________________________

Institution: ____________________________________________________

Program: L or S

Seminars

Number1 Date Title Type of

Audience2Number in Attendance

1 List a maximum of six.

2 Students (S), Residents (R), Faculty (F), or Continuing Education (CE).

RESIDENT ROUNDS SUMMARY

Types of Rounds Routine Schedule Of Rounds

Rotations During Which You Attend Rounds

Resident’s Signature _________________________________________________________

Resident Advisor’s Signature _________________________________________________

Signatures certify that information is true and accurate.

(Form 9, 4/15/97)

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ACVS Form 10American College of Veterinary Surgeons

Veterinary Surgery Residency Program

DOCUMENTATION OF TRAINING IN VETERINARY ANESTHESIOLOGY,VETERINARY RADIOLOGY, VETERINARY INTERNAL MEDICINE,

AND VETERINARY PATHOLOGY

Resident (print name): ___________________________________________________________

ANESTHESIOLOGYThe Resident must obtain at least 80 hours of training under the supervision of a Diplomate, American College of Veterinary Anesthesiologists. I have read the above requirements, and to the best of my knowledge, ___________________________ has accomplished at least 80 hours of training in anesthesiology under my supervision.

Date: _____________________________ Signed: _______________________________

Address: _____________________________ Name (print): ____________________________

_____________________________ Specialty Board: _________________________

RADIOLOGYThe Resident must obtain at least 80 hours of training under the supervision of a Diplomate, American College of Veterinary Radiology. I have read the above requirements, and to the best of my knowledge, ___________________________ has accomplished at least 80 hours of training in radiology under my supervision.

Date: _____________________________ Signed: _______________________________

Address: _____________________________ Name (print): ____________________________

_____________________________ Specialty Board: _________________________

INTERNAL MEDICINEThe Resident must obtain at least 80 hours of training under the supervision of a Diplomate, American College of Veterinary Internal Medicine. I have read the above requirements, and to the best of my knowledge, ___________________________ has accomplished at least 80 hours of training in internal medicine under my supervision.

Date: _____________________________ Signed: _______________________________

Address: _____________________________ Name (print): ____________________________

_____________________________ Specialty Board: _________________________

PATHOLOGYThe Resident must obtain at least 80 hours of training under the supervision of a Diplomate, American College of Veterinary Pathology (specialty in Veterinary Pathology or Veterinary Clinical Pathology). I have read the above requirements, and to the best of my knowledge, ___________________________ has accomplished at least 80 hours of training in pathology under my supervision.

Date: _____________________________ Signed: _______________________________

Address: _____________________________ Name (print): ____________________________

_____________________________ Specialty Board: _________________________

(Form-10, 6/15/97)

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ACVS Form 11

RESIDENT ADVISOR’S STATEMENT

I have read the current description of a Veterinary Surgery Residency Program as

adopted by the American College of Veterinary Surgeons and have supervised

(Resident’s name) __________________________________________ during the period

beginning (date: month/year) ___________ and ending (date: month/year) __________

and can attest that he/she has satisfied the requirements of the ACVS Veterinary Surgery

Residency Program. Furthermore, the semiannual progress and performance

evaluations were completed and the Surgery Case Log, Resident Activity Log, and

Resident Presentation Log were verified.

Diplomate (print): _________________________________________________

Signature: _________________________________________________

Date: ________/_________/________

Address: ________________________________________________

________________________________________________

________________________________________________

NOTE: This form must be submitted to the ACVS Office in the Resident’s bound documentation at the completion of the Residency.

(Form 11, 6/6/99)

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THE FOLLOWING FORMS CAN BE USED BY THOSE RESIDENTS WHO STARTED THEIR PROGRAMS PRIOR TO JULY 1, 1996.

These Residents may continue to use whatever method (or software) to compose their surgical logs that they have used to date. Many Residents are using the software distributed by the ACVS Residency Program Committee in 1992-1993. This form of the log will continue to be acceptable for Residents currently using it. While the program is useful in sorting data, the printout from it is very difficult for evaluators to read and its use will be phased out over time by attrition of residents allowed to use it.

These forms are the same or similar to those forms used by Residents who have started their program on or after July 1, 1996. A Resident starting their program prior to July 1, 1996 may also use the same forms used by Residents starting on or after that date.

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RESEARCH GRANT PROCEDURES & APPLICATION

SURGEON-IN-TRAINING RESEARCH GRANTS

In keeping with the objectives of the Constitution of the American College of Veterinary Surgeons, whereby the ACVS encourages its members to pursue original investigations and to contribute to the veterinary literature, the ACVS and the ACVS Research and Education Foundation have established a research grant awards program. Surgically related clinical and basic research proposals will be considered for funding.

Surgeon-In-Training Research Grants are available to candidates in ACVS residency programs. It is expected that the resident will substantially participate in developing and writing the proposal. Residents should apply during their first two years as the project should be completed by the end of their training. The amount to be awarded is determined annually.

APPLICATION MATERIALS: Application materials may be obtained from the ACVS Office or through the ACVS web site (www.acvs.org).

APPLICATION DEADLINE: To be considered for current funding, proposals must be received at the ACVS Office by December 1.

SUBMISSION OF PROPOSALS: Proposals should be assembled in appropriate order (A - G) and six copies submitted to the ACVS Office. Only complete proposals will be considered for review. Only one proposal will be considered from each Resident per funding cycle.

FUNDING CONSIDERATIONS: ACVS funds may be used only for direct expenses of the project. Travel, consultative fees, publication fees, personnel costs, and institutional overhead will not be funded by the grant.

Partial funding of a project is possible providing there is appropriate recognition of the ACVS Research and Education Foundation’s contribution in all resulting publications and presentations and that full funding is obtained within six months of the date on the letter of notification of the award. Payment will be initiated when the balance of funding has been secured and documentation thereof is provided to the Chair of the Research Committee. If the investigator fails to obtain full funding within six months, the award will be withdrawn.

If the proposed length of the study is greater than one year, partial payments may be awarded at the discretion of the Foundation’s Board of Directors. A time limit of two years is suggested for completion of the research, although the Board of Directors may make exceptions.

INSTITUTIONAL ANIMAL CARE AND USE COMMITTEE FORM (FORM F): An approved Institutional Animal Care and Use Committee (IACUC) form for all proposals involving animals protected by the Animal Welfare Act must be received by the ACVS Office by January 15, for a proposal to be considered for funding. Those in private practice may submit a completed approved form from their regional institutional IACUC (i.e., medical school, veterinary school, research institute, etc.).

PROPOSAL PROCESSING: Several months are required for processing. A proposal is processed as follows:

1. Proposals (6 copies) are sent to the ACVS Office by December 1, and the receipt of each proposal is acknowledged.

2. The ACVS Office forwards proposals to the ACVS Research Committee. The Research Committee

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consists of two members of the ACVS Board of Regents and three Diplomates-at-Large. Other qualified Reviewers may be asked to judge the merits of the proposal.

3. Proposals are scored on a 10-point system: need for and potential impact of study weighed with humane treatment of animals (2 pts), quality of proposal (5 pts), appropriateness of budget (1 pt), ability to carry out the investigation and likelihood of timely completion (2 pts). The first three categories are scored with the Research Committee blind to the applicant and institution. [The name of the applicant and institution should not appear in the body of the proposal (Form G)]. Once the proposals are scored for these criteria, the Research Committee is provided with information (Forms A - F) regarding the investigator(s) and facilities. The score for the final category is then based on the ability to carry out the investigation and likelihood of timely completion.

4. Each ACVS Research Committee member will grade each proposal. Following discussion by a Research Committee member appointed as Lead Discussant to each grant, Research Committee members finalize scores, scores are averaged and a list of those proposals with scores of 7.0 or greater are submitted to the ACVS Board of Regents in rank order. The Board of Regents, based on Research Committee recommendations, will decide which proposal(s) will be funded, based upon monies available. The ACVS Board of Regents notifies the ACVS Research and Education Foundation Board of Directors of the recipients for final ratification. All candidates will be notified of the Board of Directors' action by March 1.

5. If funded, a Memorandum of Agreement must be completed by the applicant's institution or a non-institutional individual Diplomate and returned to the ACVS Research Committee Chair c/o the ACVS Office. The Memorandum of Agreement will then be signed by the Executive Secretary, and payment will be initiated as determined by the Foundation’s Board of Directors.

6. An educational critique will be sent to all unsuccessful candidates.

REPORTINGA yearly report on the progress and results of the study must be submitted to the ACVS Research Committee Chair by January 1, each year, until the project is completed.

It is expected that within one (1) year of completion of the project, a manuscript will be submitted to a refereed journal, preferably Veterinary Surgery. A report of the publication of the manuscript will be submitted to the Chair of the ACVS Research Committee, who will inform the ACVS Office who will publish the information about the publication in the ACVS Newsletter.

INFORMATIONFor more information, contact the ACVS Office: 4401 East West Highway, Suite 205, Bethesda, MD 20814. Phone: 301-913-9550; Fax: 301-913-2034; Email: [email protected].

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Date received:________________A. COVER PAGE

AMERICAN COLLEGE OF VETERINARY SURGEONSGRANT APPLICATION

TO BE COMPLETED BY INVESTIGATOR(S):

1. Title of Proposal:

2. Investigators:Diplomate Supervisor* Surgeon-In-Training

Name, degree ______________________________Name, degree ______________________________

Title ______________________________ Title ______________________________

Signature ______________________________ Signature ______________________________

Mailing address: Mailing address:(include dept., service (include dept., serviceor laboratory) or laboratory)

Telephone _______________________________ Telephone _________________________________Fax _______________________________ Fax _________________________________

E-mail _______________________________ E-mail _________________________________

3. Dates of Proposed Project: From: _______________ To: ________________

4. Total Budget: $________________ Amount Requested: $ __________________

5. Performance Site(s):

*Signature indicates that the Diplomate Supervisor agrees to final responsibility for conduct, completion of the study and reporting. Unless justified, failure to submit yearly reports by January 1 could preclude receipt of future grant awards.

TO BE COMPLETED BY ADVISOR OR INSTITUTIONAL REPRESENTATIVE

6. Applicant Organization:

7. Name, title, phone number of official(s) signing for Applicant Organization:

8. Type of Organization: _____ Federal _____ State _____ Local _____ Other (specify):

9. Name, title, address, and phone number of official(s) in Business Office who should be contacted as to where funds should be sent:

10. Organization to received credit for the Grant:

11. Name of the institution to which the check is made payable:

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B. RESEARCH OBJECTIVESAMERICAN COLLEGE OF VETERINARY SURGEONS

GRANT APPLICATION

Privileged Communication

Name and Address of Applicant or Applicant Organization:

Title of Project:

Use this space to ABSTRACT your Proposed Research, Outline Objectives and Methods.

Name, Official Title, Department, project responsibilities and time commitment of all professional personnel engaged in project:

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C. BIOGRAPHICAL SKETCHAMERICAN COLLEGE OF VETERINARY SURGEONS

GRANT APPLICATION

[Complete for Diplomate or Diplomate Supervisor, Surgeon-in-Training, other Co-Investigators)

Name: Title:

Year ACVS Board-Certified: Year of Residency (Surgeon-in-Training only):

Education (Begin with baccalaureate training and include Postdoctoral):Institution and Location Degree Year Conferred Scientific Field

Honors:

Major Research Interest:

Role in Proposed Project (be specific):

Previous and Current Research Support (Title and dollar amount):

Research and/or Professional Experience—Starting with the present position, list training and experience relevant to area of this project. List five publications (not abstracts or proceedings) of applicant that are relevant to this project. An additional page may be used.

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D. DETAILED BUDGET FOR 12-MONTH PERIODAMERICAN COLLEGE OF VETERINARY SURGEONS

GRANT APPLICATION

Privileged Communication

Equipment (Describe and give cost of each item over $100)

Total:

Supplies (Describe and give cost by group or category only)

Total:

Miscellaneous expenses

Total:

FINAL TOTAL:_______________

AMOUNT REQUESTED OF ACVS:_______________

List other available support for this project (source and amount)

List other requested support for this project (source and amount)

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E. FACILITIES STATEMENTAMERICAN COLLEGE OF VETERINARY SURGEONS

GRANT APPLICATION

Privileged Communication

Facilities Statement: (not to exceed one typed double-spaced page)Describe the facilities and equipment available for use in this project.

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F. HUMANE CARE AND USE OF ANIMALSAMERICAN COLLEGE OF VETERINARY SURGEONS

GRANT APPLICATION

Privileged Communication

Protocol number:

Title of proposal:

Investigators:

Pursuant to policy established by the Regents of the American College of Veterinary Surgeons, I certify that the above described protocol follows guidelines set forth in the National Institutes of Health “Guide for the Care and Use of Laboratory Animals” (#85-23) and the “Animal Welfare Act of 1966” (PL 89-544) as amended.

_____________________________________________ Chairman, Institutional Animal Care and Use Committee

_____________________________________________ Name of Institution

_____________________________________________ Date

NOTE: This completed form must be in receipt in the ACVS Office by January 15 of the funding year for proposal consideration by the Board of Regents. Proposals from private practice must seek local/regional institutional approval.

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G. RESEARCH PROPOSALAMERICAN COLLEGE OF VETERINARY SURGEONS

GRANT APPLICATION

Privileged Communication

NOTE: The names of investigators or of their institutions should not appear in this portion of the grant application.

All pages must be typed double-spaced.

1. Hypothesis: (Not to exceed ½ page)Concisely state your hypothesis as a statement or series of related statements that can be tested by experiment. The statement(s) should be followed by a brief explanation of how the hypothesis would be tested.

2. Specific aim: (Not to exceed ½ page)Describe what the proposed research is intended to accomplish within the one-year funding period.

3. Background and Significance/Preliminary Studies: (Not to exceed 2 pages)Briefly discuss the background of the proposal by critical evaluation of existing knowledge and by identification of gaps which would be addressed by the proposed research. State concisely the importance of the proposed research by relating the specific aims to the broad, long-term objectives of the proposed investigation and the field of veterinary surgery. Applicants may also use this section to describe preliminary studies that are pertinent to the application or to provide other information that will help establish the competence of the investigator to undertake the proposed research.

4. Experimental approach: (Not to exceed 4 pages)The experimental design and procedures should be described in detail. Include the means by which data will be collected. Discuss potential difficulties and limitations of the proposed procedures and alternative approaches to achieve the stated aim (Section 2 above). Provide a tentative sequence or timetable for the investigation.

5. Statistical methods: (Not to exceed 1 page)Describe how the data will be analyzed and interpreted. State the statistical methods to be used. Specify the number of observations required to yield statistically significant results at a particular confidence level (e.g., 0.05).

6. References: (Not to exceed 2 pages)List appropriate articles in order cited according to the format of Veterinary Surgery.

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AMERICAN COLLEGE OF VETERINARY SURGEONS

CREDENTIALS APPLICATION PACKET

1999

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REVIEW PUBLICATION UNDER: ____PRE-FEBRUARY 1995 REQUIREMENTS ____POST-FEBRUARY 1995 REQUIREMENTS

AREA TRAINED IN: _____SMALL ANIMAL _____LARGE ANIMAL

APPLICATION FEE: $250 CHECK #: ___________

1999 ACVS CREDENTIALS APPLICATION

(Please type) TODAY’S DATE____________________

NAME________________________________________________________________VETERINARY DEGREE _________ (first) (middle) (last)

WORK ADDRESS___________________________________________________________________________________

__________________________________________________________________________________________________

HOME ADDRESS____________________________________________________________________________________

__________________________________________________________________________________________________

PHONE Work (______)_________________ Home (______)___________________ Fax (______)___________________

(Please keep the ACVS Office informed of address changes.)

INTERNSHIP AND RESIDENCY:

Location Dates (Start & End) Diplomate Resident Advisor

____________________________________ ________________________ __________________________________

____________________________________ ________________________ __________________________________

____________________________________ ________________________ __________________________________

PREVIOUS APPLICATION(S) TO ACVS: YES _______ NO _______

If yes, reason(s) for previous refusal (residency program, publication, letters of reference, etc.):

1. _______________________________________________________________________________________________

2. _______________________________________________________________________________________________

3. _______________________________________________________________________________________________

False information or other evidence of fraud will nullify this application and any action of the ACVS resulting therefrom, and will be reason for disqualification of the applicant.

Should this application result in a decision from the ACVS that adversely affects the applicant, the decision may be appealed under certain circumstances. These circumstances and the procedure for appeal are found in the current ACVS Information Brochure.___________________________________________________ _____________________________________________ (signature of applicant) (date)

You will be notified by mail by November 13, 1999 of the Board of Regent’s action regarding this application.

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AMERICAN COLLEGE OF VETERINARY SURGEONS1999 CREDENTIALS APPLICATION

LETTER OF REFERENCE

Thank you for agreeing to complete the following letter on behalf of(Applicant's name and address):

______________________________________________

______________________________________________

______________________________________________

______________________________________________

Please return this original letter and three copies, sealed in four individual envelopes, and marked confidential, to the applicant. The letters will be enclosed with the other required application materials.

Please answer the following questions: Yes No Cannot Answer

1. I verify that the applicant named above has satisfactorily completed a residency training program in (circle one) small or large animal surgery.

2. The level of Diplomate supervision was appropriate and consistent with ACVS requirements.

3. In my opinion, the applicant's proficiency, judgment, competence as a veterinary surgeon, and academic readiness is at a level appropriate to allow him/her to sit the examination.

4. The applicant is committed to the constitutional objectives of the ACVS.

5. The applicant has a moral and ethical standing that is appropriate for membership in the ACVS.

6. I am an ACVS Diplomate and had ACVS Diplomate status during the applicant’s residency training.

7. If "Yes" to #6, I am the applicant's Resident Advisor, and advised from _________________________________ (Month/Year to Month/Year)

__________________ (signature) (date)

_____________________________________________ (type or print)

Thank you for agreeing to serve as a referee on behalf of the above named applicant. If you would like to comment specifically in support of the applicant, please attach your personal comments or use the back of this form.

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Checklist

Submission of Credentials to the ACVS

1. I have read and understand the enclosed guidelines for submission of credentials.

2. I understand my completed application and all related materials are due in the ACVS Office on or before August 1.

3. I have submitted to the ACVS Office (ACVS, 4401 East West Highway, Suite 205, Bethesda, MD 20814-4523) four bound, indexed folders that contain:

a. Application form (signed)

b. Resident Advisor’s Statement

c. Three letter of reference forms:i. Referee #1 - four copies, each in a sealed, labeled envelope;

one envelope in each of the four bound folders.ii. Referee #2 - four copies, each in a sealed, labeled envelope;

one envelope in each of the four bound folders.iii. Referee #3 - four copies, each in a sealed, labeled envelope;

one envelope in each of the four bound folders.

d. Publication

e. Third Year (i.e., Final) Residency Log, all previous log evaluation forms, and all communications from the Resident Credentialing Committee.

f. Additional documentation if I started my residency before July 1, 1989.

4. I mailed a check for $250 to the ACVS lock box (ACVS, PO Box 79484, Baltimore, MD 21279-0484). The check number is written on the application form and the check has my name on it. I enclosed a photocopy of the application form with my check.

5. I have submitted one stamped, self-addressed blank postcard to confirm receipt of my application in the package with the four bound folders.

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Guidelines for Submitting Credentials to the ACVS

I. General

1. Completed applications must arrive in the ACVS Office on or before August 1 of the year preceding the anticipated examination. When August 1 falls on a Saturday or Sunday, completed applications must arrive in the ACVS Office no later than the following Monday. LATE OR INCOMPLETE APPLICATIONS WILL BE RETURNED WITHOUT BEING PROCESSED OR REVIEWED.

2. It is your responsibility to ensure that the application is complete. Follow these guidelines precisely and use the enclosed checklist. The ACVS Office will forward the application you submit to the Resident Credentialing Committee; THE ACVS OFFICE WILL NOT REVIEW THE APPLICATION FOR COMPLETENESS.

3. All requirements for admission must be complete by August 1 of the year preceding the anticipated examination. This includes acceptance of the publication and successful completion of the residency program.

4. A complete application includes the following:a. Application formb. Resident Advisor’s Statementc. Three confidential letter of reference formsd. Publicatione. Third Year (i.e., Final) Residency Log (including Resident Case Log, Resident Activity Log,

Resident Oral Seminar Log, Documentation of Training in Anesthesiology, Radiology, Internal Medicine and Pathology), all previous log evaluation forms, and all communications from the Resident Credentialing Committee.

f. Application fee (sent to the ACVS lock box in a separate envelope)g. Self-addressed, stamped blank postcard for confirmation of receipt

NOTE: If you started your residency before July 1, 1989, your application must include additional information. Please refer to Section VIII.

5. Four copies of items 4a through 4e must be submitted. These documents must be arranged in the sequence listed, separated by tabbed dividers, indexed and bound in four folders to prevent loss and to facilitate review. A 9 by 12-inch envelope should be bound into each folder and a sealed letter of reference from each referee placed in this envelope. The binding must allow pages to lie flat as turned. Plastic spiral or 19 pin PVC bindings are acceptable. Three-ring notebooks are not acceptable. Type your name and “1999 Credentials Application” on the front of each folder.

6. Submitted application materials become the sole property of the ACVS and will not be returned to the applicant.

II. Application Form

1. Type the application form neatly. Complete all lines.

2. Sign all four copies of the application form.

3. Include area trained in (large or small animal) and application fee check number in the spaces provided in upper right corner.

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III. Resident Advisor’s Statement

Include a copy of your Resident Advisor’s Statement. This is not considered a letter of reference. The Resident Advisor must provide a letter of reference in addition to the statement.

IV. Letters of reference

1. Obtain a letter of reference from three (no more) different referees. As a courtesy to your referees, request reference letters by June 15.

2. One of your referees must be your Resident Advisor. If you had more than one Resident Advisor during your program, each advisor must submit a letter of reference.

3. Two of your referees must be Diplomates of the ACVS who had Diplomate status during the time of your residency. The third referee may be a Diplomate of the ACVS.

4. All referees must be familiar with your surgical residency training program. In the event that only one ACVS Diplomate works directly with the Resident, a second ACVS Diplomate must be identified who is familiar with the applicant’s training program and can substantiate the qualifications of the applicant as requested in the letter of reference.

5. Ask each referee to place four signed copies of his/her letter of reference in four individual envelopes, seal the envelopes, and give the sealed envelopes to you. Referees should not send letters directly to the ACVS Office. Include the envelopes with your application in the manner described in section I.5 of this packet. It is your responsibility to make certain the letters of reference are included in your application. Applications that do not contain reference letters will be considered incomplete and will not be reviewed.

6. Reference letters must collectively document the following:

a. Verification of satisfactory completion of residency training and level of diplomate supervision.b. The applicant's proficiency, judgment, competence as a veterinary surgeon, and academic

readiness to sit the examination.c. The commitment of the applicant to the constitutional objectives of the ACVS.d. The moral and ethical standing of the applicant within the veterinary profession.

7. A specific “Letter of Reference” form is attached and must be completed by each referee.

V. Publication

The ACVS residency program and credentials requirements were changed as of February 1995. Residents who were in residency training programs at that time or who had completed their training programs prior to that time can request that their application be reviewed based on the pre-February 1995 publication requirements or the post-February 1995 publication requirements. The choice of review under the pre- or post-February 1995 requirements must be made by the applicant and clearly indicated in the space provided in the top right corner on the credentials application form. The Resident Credentialing Committee will follow the designated requirements during its review of the publication.

The following two sections detail the pre-February 1995 and the post-February 1995 publication requirement.

1. One manuscript is required. The manuscript must fulfill the requirements listed below and must be clearly identified as the "primary" publication in your application folder. Supporting manuscripts that fulfill the requirements may be included. Manuscripts that do not fulfill the requirements, e.g., case reports and review articles, should not be included.

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2. Publication Requirements Pre-February 1995

a. You (the applicant) must be senior or sole author. The manuscript must have resulted from research or clinical investigation that was initiated during your residency program.

b. The manuscript must have been published within five years of the August 1 deadline for submission of application.

c. The manuscript must be fully accepted for publication by August 1 of the year the application is submitted. If your manuscript is in press, you must include correspondence from the editor signifying full acceptance and you must submit complete copies of the manuscript, including figures.

d. The manuscript must be accepted by a refereed journal which has a standing editorial board that requires each submitted manuscript to be critically reviewed and approved by at least one recognized outside authority on the subject.

e. Book chapters, proceedings, review articles and case reports are not acceptable. f. The manuscript must demonstrate your intellectual curiosity and should further the state of

surgical knowledge or other closely related biological sciences. g. The manuscript must follow the scientific method, specifically containing:

1) an introductory statement which summarizes the reason for the study,2) a clearly stated hypothesis or objective,3) an appropriate description of techniques used to satisfy the hypothesis or objective,4) a report of the results appropriate to the study,5) a discussion which interprets the results and their relation to the original hypothesis or objective and,6) a conclusion which summarizes the importance of the study.

h. The information in the manuscript must not have been published previously, other than in abstract or proceedings form.

i. The manuscript must be written or translated in the English language.

3. Publication Requirements Post-February 1995

a. The applicant must be first or sole author. The publication must have resulted from the applicant's research or clinical investigation. The date of publication cannot be more than five years old by the deadline for credentials submissions.

b. The manuscript must be accepted by an approved refereed journal, listed below. VETERINARY JOURNALSAmerican Journal of Veterinary ResearchAustralian Veterinary JournalBritish Veterinary JournalCanadian Journal of Veterinary ResearchCanadian Veterinary JournalEquine Veterinary JournalJournal of Small Animal PracticeJournal of the American Animal Hospital AssociationJournal of the American Veterinary Medical AssociationJournal of Veterinary Internal MedicineJournal of Veterinary Pharmacology and TherapeuticsNew Zealand Veterinary JournalVeterinary AnesthesiaVeterinary Comparative Orthopedics and TraumatologyVeterinary PathologyVeterinary Radiology and UltrasoundVeterinary RecordVeterinary Surgery

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NON-VETERINARY JOURNALSAmerican Heart JournalAmerican Journal of PathologyAmerican Journal of PhysiologyAmerican Journal of SurgeryAmerican Journal of Sports Medicine, TheAnesthesiologyAnatomic RecordArthritis and RheumatismCancerClinical Orthopaedics and Related ResearchJournal of Applied PhysiologyJournal of Bone and Joint SurgeryJournal of Clinical InvestigationJournal of Investigative SurgeryJournal of Orthopedic ResearchJournal of RheumatologyJournal of Surgical Research

c. Manuscripts must be accepted in an approved journal prior to August 1 of the year of application. A manuscript is considered accepted when the author receives a final letter of acceptance from the editor and further review by a reviewer is not required. Editorial notations or changes affecting sentence structure are acceptable. A copy of the manuscript, including figures and photographs, with editorial notations or changes and a copy of the final letter of acceptance must be submitted to the Resident Credentialing Committee.

d. The manuscript must follow the scientific method, specifically containing:1) an introductory statement,2) a hypothesis or objective,3) description of techniques used to satisfy the hypothesis or objective,4) a report of the results,5) a discussion,6) a conclusion.

e. Papers not following the guidelines (in 3d above), such as book chapters, proceedings, review articles and case reports, are not acceptable.

f. The information in the publication must not have been published previously, other than in abstract or proceedings form.

g. Clinical studies, which fulfill the above criteria, are acceptable.h. The publication must be written or fully translated in the English language.

VI. Application Fee

1. The application fee is $250 and is non-refundable after the submission deadline. Send a check or money order to the ACVS lock box in the enclosed envelope or in an envelope addressed to ACVS, PO Box 79484, Baltimore, MD 21279-0484. Credit card payments are not acceptable. Do not send the application fee with your application. Enclose a photocopy of the application form with your check.

2. Include your check number on the application form. Make certain your name appears on the check.

3. Checks should be made payable to the American College of Veterinary Surgeons in United States currency.

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VII. If Your Residency Program Began Prior to July 1, 1989… PLEASE READ THIS

If you started your residency program before July 1, 1989, the following documents must be included (bound and indexed) in your application folder. In the absence of these documents, your application will be considered incomplete and will not be reviewed.

a. A letter from your residency program director that (a) describes your residency program in detail, (b) documents the amount of time (in weeks) that you spent in this program, and (c) certifies that you completed the program. If your residency program director will also serve as a referee, he/she must write a separate letter of reference that is submitted as described in section VI.

b. The signed "Documentation of Training in Veterinary Anesthesiology, Radiology, and Pathology" form that is included in this packet. NOTE: The 100-hour requirements must be completed prior to August 1 of the year the application is submitted.

VIII. If Your Residency Program Began On or After June 15, 1996… PLEASE READ THIS

Any applicant within five years of the completion of his/her program may apply under current requirements or the requirements in effect at the initiation of his/her program. Any resident whose credentials have not been submitted within five years of completion of his/her residency program must apply under the requirements currently in effect at the time of application. (Applies to residents starting their Programs on or after June 15, 1996.) Any Resident whose credentials are denied, must only correct the deficit to reapply and is under no time limit for reapplication.

IX. Confirmation of Receipt of Application Materials

1. Include a stamped, self-addressed blank postcard with your application materials. The ACVS Office will return this to you upon receipt of your application. Receipt of this postcard confirms that the ACVS Office received your application and does not imply that the application has been reviewed, evaluated, or accepted.

2. You are responsible for the accuracy and availability of all required application materials.

NOTE: The ACVS Office will not evaluate your application for completeness. The application materials you send to the ACVS Office will be forwarded to the Resident Credentialing Committee. MAKE CERTAIN YOUR APPLICATION IS COMPLETE.

X. Notification of Acceptance/Rejection of Application

1. You will be notified by no later than mid-November if your application is accepted by the Resident Credentialing Committee and approved by the Board of Regents. Soon thereafter, you will be notified regarding the dates and procedure of the next examination. Unsuccessful applicants will be notified at the same time by a letter explaining the deficiency in credentials.

XI. Reapplication Procedure Following an Unsuccessful Credentials Application

Any Resident whose credentials are denied must only correct the deficit to reapply and is under no time limit for reapplication.

1. Follow the guidelines for submission of credentials outlined above, including formatting, binding and number of copies.

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2. Your re-application must include a new application form and three current letters of reference. (You may use the same referees but you must obtain current letters of reference.)

3. Make certain you include all correspondence sent or received by you that relates to your previous or current application. Examples include:

a. letter(s) from the Resident Credentialing Committee explaining the previous deficiency in your application

b. letter(s) documenting the appeal process/appeal decision (if applicable)c. letter(s) specifying how you corrected the deficiency in your credentials

4. Publication must be included only if credentials were previously denied based on the publication requirement. Do not resubmit a previously approved publication(s).

5. You must submit an application fee.

Mail application folders, reference letters and self-addressed blank postcard to:

American College of Veterinary Surgeons4401 East West Highway, Suite 205

Bethesda, MD 20814-4523

Mail application fee in the enclosed envelope with a photocopy of the application form to:

American College of Veterinary SurgeonsP.O. Box 79484

Baltimore, MD 21279-0484

* * * * *

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ACVS EXAMINATION 1999 READING LIST

The following references and books are suggested minimal reading for ACVS examination preparation. Other textbooks and current references may be pertinent.

ACVS 1999 Selected Reference Textbooks for Small Animal Surgery

1. Bojrab: Disease Mechanisms in Small Animal Surgery, Lea and Febiger, 1993.2. Guyton: Textbook of Medical Physiology (8th ed.), W.B. Saunders and Co., 1991.3. Cohen I, Diegelmann and Lindblad: Wound Healing, Biochemical and Clinical Aspects, W.B. Saunders Co., 1992.4. Slatter: Textbook of Small Animal Surgery (2nd ed.), Vol. 1 & 2, W. B. Saunders Co., 1993.5. Muir and Hubbell: Handbook of Veterinary Anesthesia, Mosby Co., 1994.6. Fossum: Small Animal Surgery, Mosby Co., 19987. Bojrab: Current Techniques in Small Animal Surgery, Williams & Wilkens, 4th Edition

ACVS 1999 Selected Reference Textbooks for Large Animal Surgery

1. Auer, JA: Equine Surgery, W. B. Saunders Co., 1992.2. McIlwraith, CW: Diagnostic and Surgical Arthroscopy in the Horse (2nd ed.), Lea and Febiger, 1990.3. Slatter: Textbook of Small Animal Surgery (2nd ed.), Chapters 1-23, W. B. Saunders Co., 1993.4. Nixon, A: Equine Fracture Repair, W.B. Saunders and Co., 1996.5. McIlwraith, CW, and Trotter, G: Joint Disease in the Horse, W.B. Saunders and Co., 1996.6. Cohen, I, Diegelmann and Lindblad: Wound Healing, Biochemical and Clinical Aspects, W.B. Saunders Co., 1992.7. Guyton: Textbook of Medical Physiology (8th ed.), W. B. Saunders and Co., 1991.8. Muir and Hubbel: Equine Anesthesia, Mosby Co., 1991.9. Stashak: Adam's Lameness in Horses (4th ed.), W. B. Saunders Co., 1987.

Selected Journals

Many journals contain articles pertaining to surgery (both human and veterinary) and should be perused for current literature. A partial list of veterinary journals includes:

Journals for Small Animal Surgery CandidatesAmerican Journal of Veterinary ResearchJournal of the American Animal Hospital AssociationJournal of American Veterinary Medical AssociationVeterinary SurgeryCompendium on Continuing EducationJournal of Veterinary Internal MedicineVeterinary Comparative Orthopedics and Traumatology

Journals for Large Animal Surgery Candidates American Journal of Veterinary Research Journal of American Veterinary Medical Association Veterinary SurgeryCompendium on Continuing Education Veterinary Clinics of North America (Equine and Food Animal Editions)Equine Veterinary JournalVeterinary Comparative Orthopedics and Traumatology

The majority of questions come from literature published in the last five years. Questions may also come from older articles considered significant and essential to the knowledge of the veterinary surgeon.

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NAME/ADDRESS CHANGE FORM

Please let us know if your name, address, phone, fax and/or email change so that the ACVS can keep in touch with you throughout the year. The ACVS and your colleagues will appreciate the update!

Please complete the following:

Name: First: __________________ Middle Initial: _______ Last: ___________________________

ACVS ID # (if known): __________________

Office Address: ___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

City: ___________________________ State: _____ Zip: _________________

Country: ___________________ E-mail address: ___________________________

Tel: (_______) __________________ Fax: (_______) ____________________

Home Address: ___________________________________________________________________

___________________________________________________________________

___________________________________________________________________

City: ___________________________ State: _____ Zip: _________________

Country: ___________________ Tel: (_______) ________________________

Please send this page to:American College of Veterinary Surgeons

4401 East West Highway, Suite 205Bethesda, MD 20814-4523

OR

Fax to: (301) 913-2034

Thank you!

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Calendar of Annual ACVS Veterinary Surgical Symposia

September 30-October 3, 1999 Hyatt Regency San FranciscoSan Francisco, California

September 21-24, 2000 Hyatt Regency Crystal CityArlington, Virginia

October 11-14, 2001 Hyatt Regency ChicagoChicago, Illinois

October 17-20, 2002 Sheraton San DiegoSan Diego, California

To receive meeting information, contact the ACVS Office at (phone) 301-913-9550, (fax) 301-913-2034, or email [email protected].

For a registration form and program overview of the next Symposium, go to the ACVS web site at www.acvs.org.