The Diplomate December 2015
As we do every fall, ABOS’s Board of Directors held a two-day meeting in Chapel Hill, North Carolina. It was a productive meeting and this article will share some of what was discussed.
Before we get to that, I want to thank the 5,000 diplomates who completed the survey asking about alternatives to a secure, multiple choice examination every 10 years. It was clear from the responses that most diplomates are not interested in answering one question a week as other specialty boards have either implemented or are considering. We received mixed feedback about a yearly exam as well as other options.
We are addressing diplomates’ concerns by making our recertification exams more relevant. Many diplomates have asked for examinations that mirror their practice. In addition to the subspecialty certificates in sports medicine and hand surgery, we currently have written examinations in adult reconstruction and spine where 60 percent of the multiple choice questions are in the subspecialty area.
We are discussing creating additional examinations that focus on trauma, pediatrics, shoulder, and foot/ankle that will be relevant to specialists in those areas. As we expand the number of exams we need to assess whether there will be enough specialists to take the examination for the examinations to be reliably scored as well as enough experts to write the questions. Also remember that you can take an oral recertification examination based on your cases. By taking an oral examination you are ensured to be examined on your specific practice area.
The Board has been informed of some confusion from diplomates regarding the 240 CME credits needed before being allowed to take a recertification examination and how the two cycles of credit accumulation worked. At the Board meeting we voted on a way to simplify the process.
After earning the initial certification or being recertified, your status on abos.org for the first three years of the 10-year certification cycle will show as “Participating in MOC: Yes”. By the end of the third year of the cycle, diplomates must earn and submit 120 Continuing Medical Education (CME) credits, of which at least 20 are scored and recorded Self-Assessment Exam (SAE) credits, in order for the status to remain as “Participating in MOC: Yes”. SAEs are examinations that are produced by organizations other than the ABOS, but which have been approved by the ABOS for MOC credit intended to measure a diplomate's individual learning needs.
Prior to being allowed to register for a ten-year recertification examination, diplomates will need to submit an additional 120 CME credits of which 20 are scored and recorded SAE credits. The total required to register for the exam are 240 credits, of which at least 40 are scored and recorded SAE credits. Each diplomate will be reminded of these requirements periodically and you can always contact the ABOS offices if you have questions.
Over the past year, the ABOS convened a task force to review and update our strategic plan. The culmination of the work was approved at the October meeting. The following are the three strategic priorities:
Improvement in the Practice of Orthopaedic Surgery
All objectives and tactics fall under one of these priorities. In today’s ever changing climate, the ABOS strives to remain nimble by strategically thinking about our goals and initiatives. Thus our strategic plan shall be a living document with updates and strategic revisions as the Board sees fit.
We also elected two new Directors-Elect: Dr. Gregory Mencio of Vanderbilt University and Dr. Ann Van Heest of the University of Minnesota. More information about them can be found in this issue. We also elected the following officers:
- Dr. Thomas Vail, University of California, San Francisco, as Vice President.
- Dr. James Roberson, Emory University, as President-Elect.
- Dr. James Carpenter, University of Michigan Medical School, as Secretary.
- Dr. Douglas Lundy, Resurgens Orthopaedics in Atlanta, Georgia, as Treasurer.
I look forward to serving as the president and updating you throughout the year. I also would love to hear your thoughts. For feedback or questions, feel free to contact Dr. Shep Hurwitz at firstname.lastname@example.org, Aaron White at email@example.com, or me at firstname.lastname@example.org. Our main number for the ABOS office is 919-929-7103, and we will get you to the right person.
Larry Marsh, MD
Executive Director Report:
The American Board of Orthopaedic Surgery has as its core mission to provide evidence that orthopaedic surgeons are well educated and trained.
Recognition is shown in a series of two certifying exams. The Part I exam is a computer-based exam consisting entirely of multiple choice questions that cover most of what is needed to practice safe and effective orthopaedic surgery in the community. After passing Part I, the surgeon is now Board Eligible.
The Part II exam is an oral exam that evaluates how well a Board Eligible orthopaedist is practicing within his or her community. The oral exam is a test of many of the core competencies that are not tested by a multiple choice knowledge exam: communication, practice-based learning, system-based practice, and professionalism. For those Board-Certified orthopaedists who have done additional fellowship training in surgery of the hand or sports medicine, a subspecialty certification exam is offered in those two subspecialties.
Each exam has a rigorous application process. A major element of applications is the satisfactory completion of the process by the application deadline. The ABOS has a long tradition of providing certifying exams for over 80 years. Consistent with providing high-stakes examinations is the need for strict deadlines. At present there are no exemptions to the final deadline for any of the ABOS exam applications.
The procedure for creating and delivering exams has improved with experience gained by ABOS staff and the use of modern computer and Internet technology. The speed at which information now travels is exceptionally fast, the speed at which humans work is considerably slower than an Internet communication. The current application deadlines precede the administration of an exam by six months for the Part I exam, eight months for the Part II exam and up to 14 months for a re-certifying oral exam.
Many candidates and diplomates express concern and frustration that there is so much advance time from the completion of an application and administration of an exam. Those few who miss an application deadline are particularly frustrated/angry because they feel that deadlines should be closer to the exam, thus giving more time to complete an application.
There are many reasons for the long lead times involved with the ABOS application and exam administration. Much of the time between the application deadline and the exam delivery is spent checking for accuracy of information provided by applicants, reviewing information about medical licensure and hospital privileges, evaluating community-based peer review for the Part II and recertification examinees, coordinating the number of seats needed at testing sites, having the correct number of examiners available for the oral exams and ensuring accuracy in the latest information provided on the ABOS website. Much work goes on behind the scenes at the speed of the human workforce.
Deadlines for all examinations are posted well in advance on the ABOS website and may be discussed with a staff member of ABOS. Help is available with most issues except the request for an extension. There is one flexibility allowed and that concerns hardcopy documents that are mailed by the posted deadline: as long as they are postmarked by the deadline they may arrive at the ABOS office after the deadline without penalty.
Uniformed service members who are deployed and have problems with Internet access or similar communication issues surrounding an application are requested to communicate directly with me prior to the relevant deadline for assistance. And for those applicants who wait until he last day, or last hour, there may not be enough time to complete an application.
The ABOS does not recognize any personal or health-related problem that might interfere with the timely submission of an application. By being thoughtful in making applications in advance of the deadline, ABOS can more accurately administer the examinations and provide optimum service to orthoapedic surgeons examining for eventual or continued Board Certification.
Shepard R. Hurwitz, MD
Denise Frazier, ABOS Examination Coordinator
In this month’s issue of The Diplomate, I will spotlight another one of ABOS’s team members who has worked for the organization for more than 20 years.
Many of you, as you either prepared for your Part II examination or oral recertification examination, have had the pleasure of speaking to Denise Frazier. Denise began working for the ABOS in 1992, right after the Board moved its offices from Chicago to Chapel Hill, North Carolina. Denise came to the ABOS after working for the University of North Carolina (UNC) at Chapel Hill Hospital in the education and personnel department in the 1980s. It was at this position at UNC Hospital that Denise met her future colleague, Patti Scalf, who would proceed her at the ABOS.
Since Denise began working for the ABOS in the early 1990s, her job responsibilities have always included assisting candidates who were preparing for the Part II examination and the credentialing process. While these processes have changed over the years, she still has the same dedication she had more than 23 years ago. Today Denise also manages the scheduling of applicants for both oral recertification and Part II, as well as managing the schedule of the oral examiners.
Denise is a North Carolina native. She has two children: a son still at home and a daughter living in Texas. Denise is expecting her first grandchild in the spring of 2016. While not at work, she enjoys her four dogs, hanging out with her friends by the pool and feeding apples to the horses at her family’s farm.
In the upcoming issues we will tell you more about other ABOS staff members. We hope that these articles will give each of you a little more insight into the staff that work hard to keep you informed of the ABOS requirements and your certification status. Denise, myself, and the entire ABOS are here to assist in you in any way we can and please do not hesitate to reach me or any of them if we can assist you further.
Aaron S. White
Chief Operating Officer
New Board Members Elected:
At their fall meeting, ABOS’s Board of Directors elected two new Directors-Elect: Gregory Mencio, MD, and Ann Van Heest, MD.
Dr. Mencio is Professor and Vice Chairman of Orthopaedics and Rehabilitation at Vanderbilt University and Chief of Pediatric Orthopaedics at Monroe Carell, Jr. Children’s Hospital at Vanderbilt. He has been at Vanderbilt since 1991 and has received Vanderbilt’s Chief Resident Teaching Award four times. Dr. Mencio’s clinical practice focuses on general pediatric orthopaedics, pediatric trauma, and treatment of spinal deformity. Dr. Mencio is active in national organizations including the American Academy of Orthopaedic Surgeons and the Pediatric Orthopaedic Society of North America, where he was president in 2014-2015. In addition, he has coordinated pediatric orthopaedic medical missions for more than 25 years.
Dr. Mencio received his medical degree from Duke University, completed a two-year residency in general surgery at the University of Pittsburgh and did his orthopaedic training at Duke followed by a fellowship in pediatric orthopaedics at Newington Children’s Hospital (now called Connecticut Children’s Medical Center). Dr. Mencio attended Duke as an undergraduate where he was captain of the Duke Blue Devil’s baseball team and made the Atlantic Coast Conference’s All-Academic Team as a member of Duke’s football team.
Dr. Van Heest is Professor and Vice Chair of Education in the Department of Orthopaedic Surgery at the University of Minnesota, where she has been a faculty member since 1993. She also practices at Shriners Hospital and Gillette Children’s Specialty Healthcare. In addition to treating pediatric hand and upper extremity conditions, she treats upper extremity problems related to neuromuscular disorders.
Dr. Van Heest is a recipient of the Parker J. Palmer Courage to Teach Award, the highest recognition for a program director from the Accreditation Council for Graduate Medical Education (ACGME). Dr. Van Heest is recognized as a mentor to female orthopaedic residents. She is past president of the Ruth Jackson Society and the Wallace Cole Society and is active in many other national organizations including the American Orthopaedic Association, American Academy of Orthopaedic Surgery, and American Society for Surgery Hand. She has participated in medical mission trips to Nicaragua.
Dr. Van Heest attended the University of Minnesota Medical School and completed her orthopaedic surgery residency there as well. She completed a hand fellowship at the Brigham and Women’s Hospital and Children’s Hospital Institution at Harvard.
The Board consists of 21 members which include 12 Active Directors, six Senior Directors, two Directors-Elect, and one Public Member Director. All members serve one seven-year term with most serving an additional three years as Senior Directors. The Public Member Director may serve two three-year terms.
Nominations come from the American Orthopaedic Association, the American Academy of Orthopaedic Surgeons, and the American Medical Association. Each organization nominates four physicians two out of every three years and the Board votes for one candidate from each slate. For a full list of members, go to abos.org/about/board-of-directors.aspx.