American Board of Orthopaedic Surgery

The Diplomate E-Newsletter Fall 2020

Posted On: December 2, 2020

Immediate Past President’s Message

A year ago, I wrote a message here as the new President of the American Board of Orthopaedic Surgery (ABOS). I laid out my goals. But of course, those changed greatly with the COVID-19 pandemic.

One of my initiatives was the development of an “ABOS Ambassador Program.” For many years, our Executive Medical Director and Board Members have spoken at orthopaedic society meetings across the country. The goal of the new program was to formally reach out to all ABOS Diplomates across our profession by making an effort to visit each State, Regional, and Subspecialty orthopaedic society meeting and delivering our message in person. We had many presentations scheduled and were able to attend some of those gatherings in person toward the end of 2019 and the beginning of 2020. The presentations provided a platform where we were able to interact with Diplomates and answer their questions regarding ABOS’s Board Certification Program. Those meetings that we attended were valuable to us as well because we were able to hear directly from our Diplomates their questions and concerns. We have continued to speak virtually in some cases, and hope to resume in-person visits once these meetings resume.

When the pandemic struck, the ABOS Board and staff worked together to come up with a plan that allowed us to continue to offer our programs and assessments in ways that were safe for everyone but kept us true to our mission of protecting the public. I am proud of what we accomplished. We extended the assessment window for the ABOS Web-Based Longitudinal Assessment (ABOS WLA) and more than 12,000 Diplomates participated. We also extended the window for the ABOS Part I Examination to allow all Candidates the opportunity to schedule and complete the Examination. The Computer-Based Recertification Examinations and Subspecialty Certification Examinations took placed as scheduled in late Summer and early Fall, but we allowed those Diplomates who were uncomfortable about participating to defer until 2021. Those orthopaedic surgeons who were applying for the 2021 ABOS Part II Examination were given additional time to collect surgical cases. Our staff, including a team of psychometricians and examination development experts, ensured that all ABOS examinations remained valid assessment tools, even as changes were made.

The biggest change, which Dr. Martin explains in his article below, was transitioning the 2020 ABOS Part II and Oral Recertification Examinations into the 2020 ABOS Case Based Examinations. With the dedication of more than 350 orthopaedic surgeon volunteers, we successfully evaluated nearly 1,000 orthopaedic surgeons with this new program without compromising our commitment to patients. It was a major accomplishment. We have heard positive reviews of the program from Examiners and Examinees and are looking forward to receiving the results of a formal survey soon.

I want to thank my partner for the last year—ABOS Vice President Dr. Joshua Jacobs. We have worked together through this year with our fellow Board Members and the staff to ensure the ABOS stayed true to its mission of protecting the public and advancing safe, effective, and ethical care in our profession, even when it has been difficult and challenging.

The ABOS is in good hands with Dr. Michael Bednar taking over as President and Dr. Jack Flynn taking over as Vice President. I have known both for many years. They are dedicated to the organization and to helping the field of orthopaedic surgery.

Thank you for your trust and support over the last year – it has been an honor and privilege to lead the ABOS forward.

Rick W. Wright, MD
Immediate Past President, American Board of Orthopaedic Surgery

President’s Message

It is an honor to be the new President of the American Board of Orthopaedic Surgery (ABOS). We have all faced challenges this year due to the COVID-19 pandemic. Each of you may be practicing differently, but you continue to provide the highest standard of orthopaedic care in a safe, ethical, and effective manner. The ABOS also has adjusted and modified many of our programs to give our Diplomates the opportunity to obtain or maintain their Board Certification during the pandemic. Changes to our processes have allowed the ABOS to ensure the safety of our Diplomates and Staff while making sure that we stay true to our mission of protecting the public.

Change in our programs requires effective communication from the ABOS to our Diplomates. There are three distinct groups of orthopaedic surgeons with whom I look forward to communicating over the next year. The first is our orthopaedic surgery residents. We will soon roll out a Dashboard that will help residents track their progress in meeting the standard of the orthopaedic knowledge, surgical skills, and professional behavioral attributes needed to be Board-Certified orthopaedic surgeons. Last summer the ABOS conducted focus groups with residents to better understand their needs, and this fall the Board approved the addition of a Residency Advisory Panel. Over the next several months, we will be expanding our resident communication program based on these interactions.

The second group consists of orthopaedic surgeons who are in the initial process of attaining ABOS Board Certification. Earning Board Certification is a major career milestone. This is the group for whom the COVID-19 pandemic has altered the certification processes the most. We are making every effort to ensure these candidates have the opportunity to complete this process in a timely fashion. The ABOS has modified and adapted our programs to maximize safety without sacrificing our principles. For instance, the institution of the Case Based Examination permitted a majority of Candidates to demonstrate that they have met the standards for Board Certification this year, rather than waiting to take the in-person Oral Examination in 2021. Communication of changes for this coming year will be a major focus of the ABOS staff. If you are in this group and have questions about the process, please reach out to us.

For the third group, around 20,000 ABOS Diplomates who are in the process of maintaining their ABOS Board Certification, we want to ensure they know their options to make their Recertification pathway as practice-specific as possible. Our goal continues to be having each Diplomate choose a knowledge assessment option that fits best with their practice and subspecialty. Options include 10 Practice-Profiled Computer-Based Examinations, an Oral Examination, and the ABOS Web-Based Longitudinal Assessment (ABOS WLA) program. The Board would like to thank the many Diplomates who responded to the survey about MOC knowledge assessment option. Based on your responses, we will maintain all three options and will be communicating changes about improving the program.

One of the other initiatives for this year will the ABOS Volunteer Program. The ABOS would not be able to function without the dedicated support of hundreds of volunteers, who are Board Certified, practicing orthopaedic surgeons who take time away from their practices and their families to write examination questions, serve as oral examiners, and ensure our examinations assess for the high standard of orthopedic care. Thank you for your efforts! We also look forward to adding new volunteers who will bring fresh ideas, different perspectives, and diversity to our processes. If you are interested in becoming an ABOS Volunteer, please go to your ABOS Diplomate Dashboard and click on the “Volunteer” button on the left-hand menu. By filling out the Volunteer form there, you will be added to our list. There are descriptions of the available positions. Please choose as many opportunities as you would like.

Finally, I want to thank Dr. Rick Wright and Dr. Joshua Jacobs, the most recent ABOS past President and past Vice President, for leading this organization through a challenging year. I look forward to continuing to work with Dr. Jack Flynn, the new ABOS Vice President. Through his foresight and creativity, he has been instrumental in two of ABOS’s most recent initiatives: the Virtual Practice Evaluation, which led to the creation of the ABOS Case-Based Examination, and the ABOS WLA. But most importantly, I look forward to working with you, the Diplomates and orthopaedic residents, to maintain the public trust in our profession.

Feel free to reach out to me at president@abos.org if I can be of assistance.

Michael S. Bednar, MD
President, American Board of Orthopaedic Surgery

Executive Medical Director’s Report

As we discussed in the July issue of The Diplomate, the American Board of Orthopaedic Surgery (ABOS), did not conduct the in-person July ABOS Part II or Oral Recertification Examinations. However, we were successfully able to conduct the ABOS Case Based Examination.

As is done with the traditional in-person Oral Examinations, the Examinees submitted a list of all surgical cases for a specified time period. The ABOS then selected 12 of those cases for presentation at the examination. In the spring, the Examinees uploaded pertinent documents and images for each of those 12 surgical cases into the ABOS’s Scribe Portal. That process did not change in 2020.

The 2020 ABOS Case Based Examination consisted of three stages. This examination format allowed the ABOS to perform an in-depth multi-stage evaluation of each Examinee’s practice remotely, eliminating the potential health risks associated with in-person gatherings.

Stage 1: Remote Case Based Practice Examination
In the first stage, Examiners remotely reviewed the documents and images related to the selected cases without the Examinee present. The 12-selected cases from all Examinees were evaluated and scored in that first stage. The ABOS has developed and tested this “virtual” examination format over the last several years, and found it to be a reliable method to evaluate most Examinees’ practices. Examiners were provided a scoring rubric to allow them to evaluate each of the cases in a standard fashion. They worked individually and independently on their own computers, and they also participated in orientation and debriefing sessions during the examination window. There were Examinees who had practices that were not amenable to evaluation using the methods of Stage 1 alone. Those Examinees took part in a second stage of the process.

Stage 2: Remote Case Based Oral Examination
The second stage, which was performed on a subset of Examinees who completed Stage 1, consisted of a remote online case based oral examination, with each Examinee undergoing two one-hour sessions. In each of these two sessions, the Examinee interacted through Zoom with two Examiners. In total, four Examiners examined each Examinee participating in Stage 2, again utilizing a standard scoring rubric.

Stage 3: Final Evaluation
A third stage of evaluation is being conducted now by the ABOS Board of Directors. The materials provided by all Examinees and Examiners in the first two stages are available for review, evaluation, and decision-making.

Later this month, the ABOS will deliver the results of the 2020 ABOS Case Based Examinations to the Examinees. Examinees who are successful in the 2020 ABOS Case Based Examination will become either ABOS Board-Certified or will recertify their ABOS Board Certification. If, however, through this process, the ABOS Board of Directors is unable to conclude that an Examinee met the standards for ABOS Board Certification, then the Examinee will be eligible to participate in the 2021 ABOS Oral Examination with no additional Examination Fees and no loss of Board Eligibility/Certification. These Examinees will be classified as “not enough information to pass” for the 2020 Oral Examination administration.

While this is a new model, the ABOS Board of Directors is confident that the process allowed identification of those safe, ethical, and effective orthopaedic surgeons who would have been successful during a traditional ABOS Oral Examination. We appreciate those volunteer orthopaedic surgeons who have helped pilot the foundation of the Stage 1 process over the past three years. Those trials provided the ABOS with the data and feedback necessary to implement the Case Based Examinations due to this year’s unanticipated circumstances.

We sincerely thank the 350 Examiners who helped the ABOS complete the Case Based Examinations this year. The Examinations would not have been possible without the dedication of these talented orthopaedic surgeons.

David F. Martin, MD
Executive Medical Director, American Board of Orthopaedic Surgery

ABOS Announces Its 2020-2021 Board of Directors

The Board of Directors of the American Board of Orthopaedic Surgery (ABOS) recently selected its 2020-2021 Officers and elected a new Director-Elect and a new Public Member.

Michael S. Bednar, MD, Chief of Hand Surgery at Loyola University Medical Center and Professor of Orthopaedic Surgery and Rehabilitation at Loyola University Chicago Stritch School of Medicine, will serve as ABOS President. He, along with the President-Elect, Vice President, and Secretary, hold their offices for one one-year term.

John Flynn, MD, Richard M. Armstrong Jr. Endowed Chair in Pediatric Orthopaedic Surgery and Chief of Orthopedics at Children’s Hospital of Philadelphia, will serve as ABOS Vice President.

Gregory A. Mencio, MD, Neil E. Green Professor of Orthopaedics and Chief of Pediatric Orthopaedics at Vanderbilt University, will serve as ABOS President-Elect.

Ann E. Van Heest, MD, Professor and Vice-Chair of Education in the Department of Orthopaedic Surgery at the University of Minnesota, will serve as ABOS Secretary.

Frederick M. Azar, MD, Chief of Staff of Campbell Clinic Orthopaedics and Professor at the University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery and Biomedical Engineering, has been re-elected as ABOS Treasurer for a one-year term.

“These orthopaedic leaders—all practicing orthopaedic surgeons—will do a fantastic job leading the ABOS for the next year,” said David F. Martin, MD, ABOS Executive Medical Director. “Like our Diplomates, these Officers represent a wide variety of specialties and bring special talents to the ABOS. Their unparalleled dedication will serve our Diplomates, our profession, and the public extremely well.”

The Board elected Michael D. Daubs, MD, Professor and Chair, Department of Orthopaedic Surgery at UNLV School of Medicine, and Gregory P. Guyton, MD, Director of the Foot and Ankle Division in the Department of Orthopaedic Surgery at the Union Memorial Hospital in Baltimore, MD, as Director-Elects and Eric L. Conley, Executive Vice President at Froedtert Health and President, Froedtert Hospital, as the Public Member.

“The ABOS is excited to have Dr. Daubs, Dr. Guyton, and Mr. Conley as part of the ABOS Board of Directors,” said Martin. “They bring tremendous experience that will benefit orthopaedic surgeons and patients.”

The ABOS Board of Directors consists of 21 members, which includes 12 Active Directors, six Senior Directors, two Directors-Elect, and one Public Member Director. ABOS Board Members serve one 10-year term while the Public Member Director serves a three-year renewable term. Nominations to the ABOS Board of Directors come from the American Orthopaedic Association, the American Academy of Orthopaedic Surgeons, and the American Medical Association. Officers are current Board members elected by other Board members. For a full list of ABOS Board Members, go to here.

Subspecialty Examination Application is Available

If you have completed an ACGME-Accredited Fellowship in Orthopaedic Sports Medicine or Surgery of the Hand, you are eligible for Subspecialty Certification from the American Board of Orthopaedic Surgery (ABOS).

ABOS Subspecialty Certification is for ABOS Board Certified orthopaedic surgeons who have demonstrated qualifications in Orthopaedic Sports Medicine or Surgery of the Hand beyond those expected of other orthopaedic surgeons by virtue of additional training and a practice characterized by a volume and diversity of cases in that subspecialty. This recognizes those Diplomates who have made significant contributions to these fields. More information can be found here.

The Subspecialty Examination Application is available by logging in to your ABOS Diplomate Dashboard and then clicking on “Subspecialty Certification” on the orange left-hand menu. The completed Application, Case List, and Application Fee are due by 4 pm ET on February 1, 2021.

The Four Parts of MOC

The American Board of Orthopaedic Surgery (ABOS) Maintenance of Certification (MOC) program consists of four parts. Once each of those parts is completed, you have met the ABOS MOC requirements and your ABOS Board Certification is extended for 10 years.

  • Professional Standing: You must have an unrestricted medical license as well as hospital and surgical privileges during your entire 10-year MOC cycle. If you are no longer performing surgery, please call the ABOS to discuss your options.
  • Continuing Medical Education: By the end of year three of your 10-year MOC cycle, you must submit and have approved at least 120 orthopaedic-related ACCME Category 1 Continuing Medical Education (CME) credits, of which at least 20 are scored and recorded Self-Assessment Examination (SAE) credits. By the time you submit your MOC Application, you must have an additional 120/20 credits submitted and approved (Total Required CME – 240 CME credits, of which at least 40 are SAE credits).
  • Knowledge Assessment: You must successfully complete one of the following assessment options.
    • ABOS Computer-Based Recertification–pass once every 10 years
      • Choices include:
        1. General,
        2. Adult Reconstruction,
        3. Foot & Ankle,
        4. Oncology,
        5. Pediatrics,
        6. Shoulder & Elbow,
        7. Spine,
        8. Surgery of the Hand,
        9. Sports Medicine,
        10. Trauma
    • ABOS Oral Recertification Examination–pass once every 10 years
    • ABOS Web-Based Longitudinal Assessment (ABOS WLA)–earn five Quality Years
  • Practice Improvement: You must submit a Recertification Application and Case List. After you submit your Application, the ABOS sends peer review forms to those listed on your application as well as those within a close proximity based on zip codes.
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