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In the past, surgeons in the United States were required to be board certified by the American Board of Surgery or the American Osteopathic Board of Surgery in order to progress into further sub-specialty training.
However, recently, board certification has been delegated into separate branches, whereby successful completion of a residency in general surgery is not necessarily required, but may well be desired.
Some training in many sub-specialties is still part of the general surgical training program.

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