The Diplomate February 2016
There is an important change in ABOS leadership that I would like to tell you about.
ABOS Executive Director Dr. Shep Hurwitz has announced his retirement, effective at the end of this month. His eight years of service as Executive Director have been key in helping lead the organization through changes with certification, recertification, and maintenance of certification. He served on the ABOS Board of Directors for two years prior to becoming the Executive Director, and during this total time of 10 years he has shown dedicated leadership to the organization.
He has overseen the Board as it led an initiative to require skills training and developed a simulation curriculum for orthopaedic residency. During his years the Board has seamlessly transitioned to fully electronic written and oral exams and has enhanced its reputation of delivering the most practiced-based exam in medical certification. The leader of a certifying organization often has to deliver unpopular news to groups and individuals. Dr. Hurwitz has done this with grace and fairness and in a way that has made him a respected figure with our diplomates, and a close friend to many. He has enhanced our reputation with other organizations that partner with ABOS.
Dr. Hurwitz is a top clinician and researcher and will remain clinically active on the faculty of the University of North Carolina at Chapel Hill, and will continue to pursue research interests and scholarship in orthopaedic surgery. He is passionate about orthopaedic education and will stay involved with ABOS projects that relate to simulation and education, since these are areas of particular interest to him. I’ve known Shep for many years and have personally seen his dedication to the organization and to the profession of orthopaedic surgery. On behalf of the current and recent past Directors of the Board, I wish him the best of luck in retirement. He has promised he will be available to provide me and the Board with advice and guidance in the upcoming months and I will take advantage of that offer. Please make sure you read Dr. Hurwitz’s article in this issue of The Diplomate.
The Board of Directors has asked Dr. David Martin to fill the role of Executive Director on an interim basis. Dr. Martin is Professor of Orthopaedic Surgery and Director of Sports Medicine at Wake Forest University. If you watch a Wake Forest basketball game, you can often see him near the bench in his role as team physician. The Board was very fortunate Dr. Martin was able to step into this position. He is a great fit since he recently completed his 10th—and final—year on the Board and is a past chair of the MOC committee and past president of the Board. He understands how ABOS works better than almost anyone!
The Board is searching for a permanent Executive Medical Director and you may have seen an email last month announcing the search. If you would like to apply for the position, please send your CV to email@example.com soon. We are pleased to say that we have already received CVs from many qualified candidates and will be screening the applications to develop a short list by the end of February. The job description can be found at www.abos.org/emdsearch.aspx.
Larry Marsh, MD
Executive Director Report:
I was appointed Executive Director of the American Board of Orthopaedic Surgery in 2006, to succeed Dr. G. Paul DeRosa in 2008. At the time I was appointed there were two very important initiatives underway at ABOS: 1) transform board recertification to Maintenance of Certification (MOC) and 2) modernize the Part I and II certifying examinations to computer-based platforms. Another event that occurred during my run-up to assuming the Executive Director position was the inaugural certifying examination in sports medicine in 2007.
At the beginning of my tenure as Executive Director, the greatest emphasis was on smoothing the transition to MOC. A combined task force of AAOS and ABOS members was convened in 2004 to have input from the AAOS in the new MOC process and to help with the dissemination of information to diplomates of the ABOS and fellows of the Academy. That task force is still in effect and still meeting via conference call regularly. Feedback and input concerning the MOC process has been useful over the past six years to modify and simplify the process.
The concerns expressed about MOC by many ABOS diplomates with time-limited certification was widespread and very loud when I first became Executive Director. The volume of complaints has subsided to a very low level of complaint and a very high level of compliance with the MOC process. One comment on the transition to MOC from recertification is the increase in office staff at the ABOS office in North Carolina. We went from seven full-time employees in 2007 to 13 at present, with the additional personnel primarily here to support MOC.
The modernization of the certifying examinations was accomplished in several stages starting with the Part I examination moving to a Prometric testing site near the candidates’ work or home, compared with a paper examination given in Chicago each July. That occurred in 2009 with virtually no systemic problems. The computer format has allowed inclusion of multimedia test questions, inclusion of many more images, and adjustment of brightness and contrast on images. And despite incurring additional cost to produce the computer-based examination, the examination fee has remained the same from 2009 through 2016.
The Part II examination and the oral recertifying examination has transitioned from paper and sheets of images to a computer-based visual format in stages from 2012-2014. The oral examination is now based upon 12 surgical cases and each candidate/diplomate is examined by eight examiners. A constant during these years has been the service of dedicated volunteer examiners without whom the exam would not be possible. The ABOS has and always will strive to continually improve the oral examination. I look forward to seeing how in the future the organization makes changes in the examination content and format to continue with creating the most valid and reliable examination possible.
There has been a large effort on the part of the office staff in Chapel Hill to educate orthopaedic surgeons about the examination process and MOC. More information is provided on the ABOS website and more emails are sent to diplomates concerning the certification and MOC process, emphasizing the deadlines required by the ABOS. The increase in communications was partnered with reformatting the ABOS website and the creation of a dashboard for each individual diplomate who holds a time-limited certificate. More is being done to effectively communicate with diplomates via the website and more is being done to improve the performance of office staff in responding to questions and problems by diplomates as they arise. All the while, the Board of Directors has made it a priority to hold back any increases in fees and to streamline the application processes.
In the world surrounding certification, there is a near constant stream of changes in licensure, credentialing, reporting, and accountability. The ABOS has tried to hold the line on changes to a simple and manageable series of small steps over the years so as not to overwhelm candidates and diplomates. Information technology alone has been a big driver of change in how certification and MOC take place; e.g., there is no longer any written application transacted by U.S. mail. Everything in the application process is accomplished online via email and the ABOS website. The pace of change will not slow down and the extent to which the ABOS must keep up with the certification, licensing, and accreditation environment will be a driving force for the new leadership of the ABOS.
It has been a very quick eight years since I became the Executive Director. Much of my time was spent trying to communicate the mission of ABOS with candidates, diplomates, residencies, fellowships, partnering organizations, and different elements of the healthcare network. My personal goal of herding the move from recertification to MOC has been successful. The future of orthopaedic surgery and ABOS certification are linked by history and common objectives: to improve the health of the public and to remain accountable to those stakeholders who require certification.
Shep Hurwitz, MD
Kathy Clark, Controller
The fifth employee I will feature is one with whom most diplomates do not have a direct connection, but who is a vital part of the ABOS team.
For the past 16 years, Kathy Clark has been ABOS’s controller. She maintains all aspects of accounting for ABOS including financial reporting, budgeting, internal and external financial controls, and surveillance of investment management. She interacts with external auditors, financial institutions, legal counsel, and insurance brokers. Kathy is a Certified Nonprofit Accounting Professional (CNAP).
To the ABOS staff Kathy does so much more that her financial work as she is also the human resources administrator: managing employee benefits and other personnel tasks. In addition Kathy is required to take off her “accounting hat” frequently in her responsibilities of maintaining ABOS’s 25-year old office building. Over the years Kathy has gained extensive knowledge of heating and air-conditioning, transitioning from fluorescent and incandescent office lights to LED, and she has worked with a number of “critter control” contractors to ensure that the wildlife around ABOS’s offices stay out of our personal work spaces.
Prior to coming to ABOS, Kathy was a business manager for several companies. She grew up along the coast of Mississippi and graduated from the University of Southern Mississippi, where she met her husband. They have several grandchildren, and they love to spend time with them. Kathy is an avid tennis player and enjoys other outdoor activities such as hiking and traveling.
I would like to thank Kathy and all the ABOS team that helps to keep our operations moving forward and the support we provide to our candidates and diplomates the best it can be.
Chief Operating Officer