Only 40.4% of surgical residents participate as members of the American College of Surgeons, with significant disparities based on training pathways and specialties.

• Specialties with dual training pathways (integrated and independent) had much higher ACS representation than those with integrated-only pathways (19.1% vs 4.2%).
• Highest ACS membership was seen in vascular surgery (26.5%) and lowest in ophthalmology (0.9%) and obstetrics/gynecology (1.3%).

As surgical training models evolve, programs may need targeted strategies to enhance broader engagement in the surgical community, beyond specialty-specific memberships.