Formal training program in colon and rectal surgery in Houston was a vision of Dr. Donald Butts when he was a general surgery resident at Hermann Hospital in the late 1960s. Once he knew he wanted to pursue colon and rectal surgery, he convinced Dr. J. Wade Harris, a prominent Houston colon and rectal surgeon, to start the program. Dr. Harris collaborated with Dr. Herbert Hayes, Dr. James Hampton, and Truitt Melton, colon and rectal surgeons in the area, to form the residency program. After creating this collaboration, Dr. Herbert Hayes, the first proctologist in Houston, called on Mr. Bill Smith, a prominent Houston oil and gas executive, and good friend, to donate $100,000 to Hermann Hospital to start the residency program in 1968.

Although all the founding members of the training program were diplomats of the American Board of Colon and Rectal Surgery, their formal training varied. Dr. James Hampton had spent a year training in colon and rectal surgery at Temple University in Philadelphia under Dr. Harry Bacon after completing his residency in general surgery at Hermann Hospital. Dr. Harris had completed about six months of colon and rectal surgery training at the Mayo Clinic in Minnesota. Dr. Melton had trained under Dr. Hayes. Once the program was established, Dr. Donald Butts was the first resident, starting in 1969, with Dr. J. Wade Harris as the program director. Four years later, Dr. Ernest Max completed the training program and joined the partnership, followed by Dr. Luis Zamora, who would play a prominent role in the advancement of colon and rectal surgery in Houston. In 1976, Dr. James Hampton became the program director and expanded the residency program to 2 in 1978. Dr. H Randolph Bailey assumed the program director role in 1984 and gradually expanded the program to four residents by 1993. In 2005, Dr. Michael Snyder became program director and remains program director at this time.