I've been hearing for some time now the possibility of implementing regulations that will allow general surgery residents to begin their fellowship in pediatric, vascular, oncology, or CT surgery after 4 years of general surgery training instead of the usual 5 years. I think this raises some important questions that should be considered and would like your input. First off, how would a program director feel if the potential candidate they were considering for a categorical G.S. residency was going to bail out on the residency after the 4th year to start a fellowship? Wouldn't they be concerned that many residents could potentially not stay with the program for their 5th (chief) year and instead opt to start their fellowship one year earlier? Secondly, it is currently a requirement by the ABS to complete a minimum of 5 years of general surgery training to be eligible to become board certified in general surgery. Furthermore, most surgical fellowships require that the candidate be board certified in G.S. BEFORE they are eligible to take the board exam in that surgical subspecialty. This raises the issue of what will happen to those individuals who decide to leave their G.S. training after 4 years to start a fellowship. Will they still be eligible for board certification in G.S. after only 4 years of G.S. training? If not, does that mean that they'd only be board certified in their surgical subspecialty and not general surgery? Finally, can G.S. training be reduced to 4 years with the new work hour regulations?