Every year between 600 and 800 orthopaedic surgeons become Board Certified after passing the American Board of Orthopaedic Surgery’s (ABOS) Part II Oral Examination in July. It’s an exciting time for them as I’m sure it was for you. Remembering my experience as a Part II Candidate and now taking part in the Part II Oral Examination as the President of the ABOS has caused me to reflect on the history of how the ABOS was formed and became the certifying organization for orthopaedic surgeons.
The first formally organized body representing orthopaedic surgery was the American Orthopaedic Association (AOA), established in 1887. This group met annually for fellowship and the advancement of orthopaedic surgery knowledge and science. In 1931, the AOA formed two committees that eventually changed the entire structure of the American orthopaedic community. The first committee was charged with establishing an organization that would be more broadly based than the AOA and would not have the AOA's membership restrictions. This was the beginning of the American Academy of Orthopaedic Surgeons (AAOS), which was founded in 1933. The second committee was formed by the AOA to investigate the establishment of an orthopaedic specialty board with a distinctly different mission from the AAOS to avoid conflict of interest with the membership organization.
In January 1933, the AOA recommended specific composition of a Board for Orthopaedic Certification consisting of representatives of the AOA, the AAOS, and the Section of Orthopaedic Surgery of the American Medical Association (AMA). In February 1934, Articles of Incorporation were developed setting forth the objectives of the American Board of Orthopaedic Surgery (ABOS). Soon thereafter the ABOS formed an Examinations Committee, an Eligibility Committee, and a Residency Training Committee that was responsible for the evaluation of hospitals and medical schools educating young surgeons to become orthopaedic surgeons.
In 1936, the ABOS published formal requirements for certification that stipulated that a candidate (a) must be a graduate of a medical school approved by the AMA Council of Medical Education and Hospitals, (b) must be of high ethical and professional standing, (c) must be duly authorized to practice medicine in the state or province of his residence, (d) must be a member of the AMA or other society approved by the AMA Council on Medical Education and Hospitals, (e) after 1938 must have three years of concentrated instruction in orthopaedic surgery approved by and acceptable to the ABOS, and (f) must have had two years further experience in the actual practice of orthopaedic surgery and also have knowledge of the basic medical sciences related to orthopaedic surgery. Thus, the first formal educational standards were established for orthopaedic surgery in the United States. While some of the requirements have changed over time, others are either exactly the same or have had minor modifications made to those early principles.
Today, Directors of the ABOS are still elected from slates proposed by the AOA, the AAOS, and the Section of Orthopaedic Surgery of the AMA. Each organization nominates individuals in two of every three years. Thus, each year two new Directors are elected to the ABOS and two are retired. The next election will take place in October 2017.
Originally the ABOS consisted of nine Directors - three from each of the nominating organizations. In 1960, the Board was increased to 12 active members using the nominating process as stated above. In the 1980s, the Board changed its bylaws so that Directors who completed six years of service could remain on for an additional three years as a Senior Director. In 2002, the Board voted to add a public member who is elected for a three-year term and can be reelected for an additional term of three years. A full complement of the Board consists of 21 Directors: two Directors-elect, 12 active Directors, one active Public Member, and six Senior Directors. The Directors serve without compensation for a ten-year term, except for the Public Member who can serve up to six years. The commitment involves approximately 30 days of travel per year in addition to many hours of preparation work and conference calls. I am continually impressed by the dedication to our profession exhibited by my fellow ABOS Directors.
James Roberson, MD
President, American Board of Orthopaedic Surgery
Executive Medical Director's Report
The American Board of Orthopaedic Surgery (ABOS) has published detailed Blueprints for all ABOS Computer-based Examinations on the ABOS website at (www.abos.org). These interactive PDF files list the approximate percentages of questions, per content area, that can be found on the examination. These Blueprints serve as the basis for building and developing each of the examinations.
To find the Blueprint that you are interested in, click on the appropriate link below:
Once you open the PDF of the examination Blueprint, you should be able to click on any content category in the table of contents to access further information on that section of the Blueprint. Alternatively, you can just scroll through the entire document. If you want to return to the table of contents, there is a link at the bottom of each page to take you back to the overall outline.
The first step in creating a valid examination is the development of an examination Blueprint. The ABOS constructs Blueprints for its examination content based on data received from a job task analysis. ABOS job task analyses utilize information garnered from the ABOS Case List Database. That Database contains cumulative data from Case Lists submitted with ABOS Applications for certification and recertification. This process ensures that the examination content accurately reflects those procedures, and the percentage breakdown of those procedures, done by practicing orthopaedic surgeons. The Blueprints are periodically reviewed and modified to accurately reflect changing trends in the practice of orthopaedic surgery.
When the ABOS initiated three new Practice Profiled Examinations in Foot and Ankle, Pediatrics, and Trauma, we first reached out to the American Academy of Orthopaedic Surgeons (AAOS) and the appropriate Specialty Societies for the names of individual specialists to assist our psychometricians in performing a review of the job task analysis in each field. The same groups then participated in the development of examination Blueprints for the three new ABOS Practice Profiled Examinations. I was present at the Blueprint development sessions that were held at the National Board of Medical Examiners in Philadelphia. It was good to see a diverse group of orthopaedic surgeons from across the country volunteering their time to assist the ABOS in the creation of our examination Blueprints.
After that group developed the initial draft Blueprints, we reached out to a larger group of subject-matter experts to review the Blueprints and provide feedback. Our goal is to make sure that the examinations contain information and concepts that practicing orthopaedic surgeons need to know.
These documents will be helpful in examination preparation and educational planning. We sincerely thank the hundreds of orthopaedic surgeons who have volunteered their time to create these Blueprints and hope that you find them helpful.
David F. Martin, MD
Executive Medical Director, American Board of Orthopaedic Surgery