Immediate Past President’s Message
Looking back at the article I wrote a year ago as I was starting my year as President of the American Board of Orthopaedic Surgery (ABOS), there were two subjects I highlighted that I want to revisit, both related to graduate medical education.
The first is the linking of the ABOS Part I Examination with the American Academy of Orthopaedic Surgeon’s Orthopaedic In-Training Examination (AAOS OITE). Thousands of orthopaedic surgery residents recently took the AAOS OITE, and early next year results will be posted on their ABOS Dashboard that will allow them to see how their score relates to the passing standard for the ABOS 2023 Part I Examination. This is the fourth year of this linking initiative. We are proud to have helped guide this initiative and partnership with the AAOS.
In last year’s article, I also talked about the ABOS Knowledge, Skills, and Behavior (ABOS KSB) Program. We now have 105 orthopaedic surgery residency programs enrolled. In the last year, 12 of the programs have started participating in the new ABOS KSB+ Program. On the ABOS KSB+ app/web portal, residents can request ABOS surgical skills assessments and enter their ACGME case logs in one place. It has been a great collaboration with the ACGME that benefits residents and residency programs and ultimately, patients. Orthopaedic Surgery is currently the only specialty with this type of collaboration with the ACGME.
Other items over the past year for which we are proud of include:
- Creating an Alternate Date ABOS Oral Examination to provide an option to those Examinees dealing with specific life events that made attendance at the July examination dates not possible.
- Conducting a DEI audit of all ABOS operations and processes and starting/continuing DEI initiatives.
- Modifying the ABOS MOC Program.
While I had the title of President for the last year, none of this could have been done without the full support of the Board, especially our Vice President Dr. Fred Azar. We talked weekly and I can see how dedicated he is to not only the ABOS but also to the profession of orthopaedic surgery.
I have confidence that Dr. Jim Kang and Dr. Scott Porter will be able to continue the progress and will add their own ideas as the ABOS continues to move forward.
April D. Armstrong, MD
Immediate Past President, American Board of Orthopaedic Surgery
Orthopaedic surgery is constantly changing. As President of the American Board of Orthopaedic Surgery (ABOS) for the next year, I want to make sure that the ABOS keeps up with the changes and continues to be forward thinking.
The Board needs to start looking at how artificial intelligence (AI) may impact the organization. The Chairs of all ABOS Committees are starting to determine how AI may affect their Committees and their programs. I want the ABOS to look at the potential threats and the potential opportunities that AI presents. Over the next five years, AI is going to be part of our reality, so we need to start preparing now. I want the Board to meet with AI experts inside and outside orthopaedic surgery. We hope that AI can help make the ABOS Board Certification and Maintenance of Certification processes more valuable, while decreasing the burden for orthopaedic surgeons.
As the first Asian American President of the ABOS, it gives me great pride to represent Asian American orthopaedic surgeons. I want to continue the DEI work of my predecessors as it is important to make sure that our programs and our assessments are free from bias. The Board has done a lot of work in the area of DEI, but there’s still more that needs to be done. One thing I want to make clear is that diversity and high standards can co-exist. The Board’s mission is to protect the public and our patients deserve to know that all ABOS Board Certified orthopaedic surgeons have gone through a rigorous—but fair—Board Certification process.
I will also be President as the ABOS turns 90. Over the next few months, you will see how the organization plans to celebrate this achievement. The ABOS has a long history of doing the right thing. That must continue – even when it is hard.
It is a great honor to serve as ABOS President. Dr. April Armstrong and Dr. Fred Azar did a tremendous job leading the Board over the last year. I will work very closely with our Vice President Dr. Scott Porter, a talented musculoskeletal oncologist in South Carolina, to ensure that our programs remain relevant, fair, and not overly taxing.
I look forward to updating you over the next year about our progress. If you need to reach me, you can email me at firstname.lastname@example.org.
James D. Kang, MD
President, American Board of Orthopaedic Surgery
Executive Director’s Report
Earlier this year, the American Board of Orthopaedic Surgery (ABOS) hired GOODSTOCK Consulting to conduct a Diversity, Equity, and Inclusion (DEI) audit of our entire organization. At the ABOS Summer Board Meeting in July 2023, GOODSTOCK presented their recommendations to the ABOS Board of Directors and at the ABOS Fall Board Meeting, the Board created a plan to address their important recommendations. In this report, I would like to share with you the background of the audit and talk about the ABOS response.
The ABOS Mission is to ensure the safe, ethical, and effective practice of orthopaedic surgery. The ABOS accomplishes that by maintaining the highest standards for education, practice, and conduct through examination, certification, and maintenance of certification for the benefit of the public.
The ABOS will not change its rigorous Board Certification and Maintenance of Certification standards. The Diplomate survey, completed by more than 4,000 ABOS Diplomates, showed that—no matter their opinion of other DEI aspects—ABOS Diplomates believe there is a vital need for fair and unbiased examination procedures. Much of the Board’s work is to ensure that.
In addition to the survey, GOODSTOCK managed online focus groups of Diplomates and one-on-one interviews with leaders in orthopaedic surgery. GOODSTOCK also reviewed ABOS policies and procedures. The goal was a full review of the ABOS and to get an honest assessment of what can be improved.
Overall, GOODSTOCK indicated that the Board is doing a lot of positive work in the areas encompassed by DEI. Many Diplomates noted that in the survey as well. But there are areas that can be improved. Here are some of the initiatives that the ABOS will be undertaking in the next 12 months:
- Work with assessment experts to make every attempt to ensure that questions on ABOS Written Examinations are fair and unbiased
- Conduct training sessions for question writers, focusing on the process of writing unbiased questions
- Investigate and remedy any potential biases within the ABOS Oral Examinations
- Partner with the American Academy of Orthopaedic Surgeons (AAOS), American Orthopaedic Association (AOA), and the American Medical Association (AMA) to ensure that the ABOS is provided with a diverse slate of Board of Director nominations
- Partner with AAOS, AOA, and subspecialty societies on diversity leadership issues in orthopaedic surgery
- Recruit a diverse ABOS Volunteer pool
- Determine if the demographic questions asked on ABOS applications are meeting current standards
- Engage with a Human Resources consultant to review processes and identify any potential staffing issues
Prior to the audit, the ABOS has already started several initiatives including:
- Add an Alternate Date Oral Examination to provide an option for those Examinees dealing with specific life events that make attendance at the July examination dates not possible.
- Implicit bias training for ABOS Oral Examiners
- Create a standing ABOS DEI Committee
- Update the ABOS Strategic Plan to include a section on diversity
- Add demographic questions to ABOS Volunteer applications
- Have a required Knowledge Source about Diversity Communication on the ABOS Web-Based Longitudinal Assessment (ABOS WLA)
Along with the field of orthopaedic surgery, the ABOS is getting better. The first Board of Directors in 1934 consisted of nine white men. The Board recently elected its first Asian-American President, Dr. Jim Kang. Dr. April Armstrong, whose one-year term as ABOS President just ended, was the second woman to serve as President of the ABOS. There are currently three African American members of the ABOS Board of Directors. The Board looks at more than race and gender for diversity. Geographic diversity, practice subspecialty, practice size, and practice type are all important representation areas. All orthopaedic subspecialties currently have at least one representative on the Board and Directors come from across the country.
With diversity, as in everything the ABOS does, the goal of the Board is to do the right thing – even when it is hard. If you see something that the ABOS can improve, please do not hesitate to contact me directly at email@example.com.
David F. Martin, MD
Executive Director, American Board of Orthopaedic Surgery
New Way to Get Credit for CMEs and SAEs
The American Board of Orthopaedic Surgery has recently launched a new initiative with the Accreditation Council for Continuing Medical Education (ACCME), in which Continuing Medical Education (CME) and Self-Assessment Examination (SAE) activities that meet the ABOS’s Maintenance of Certification (MOC) requirements are automatically approved and transferred from accredited providers to a Diplomate’s ABOS Dashboard.
The ABOS is working with orthopaedic societies to be part of the ACCME’s Program and Activity Reporting System (PARS) for transfers to occur. As the American Academy of Orthopaedic Surgeons (AAOS) has this functionality in place, there is no change in reporting activities through the AAOS Learning Portfolio. Through this relationship with ACCME, ABOS has now expanded this functionality to other providers. Other types of CME activities, such as a hospital’s grand rounds, can be eligible for the program assuming they are entered into PARS and are orthopaedic-related.
This new system is an easier way for ABOS Diplomates to meet the ABOS MOC requirements. Diplomates do not need to worry about uploading a certificate. They just need to follow the CME provider’s instructions on how the credits will be transferred. Each organization determines how often their records are sent to the ACCME, which in turn sends them to the ABOS. In addition, Diplomates do not need to wait for staff to approve their credits.
As the ABOS is not a repository for CME and SAE credits, Diplomates can still use the AAOS Learning Portfolio to store their credits and supporting documentation for state and local requirements, especially after meeting the MOC requirements. As a reminder, the CME and SAE rules have been modified. Diplomates still need to earn 240 CME credits, of which 40 are SAE credits, every 10-year MOC cycle.
Starting in 2024, Diplomates can apply for Recertification prior to completing all CMEs and SAEs; they just need to be met by the end of their 10-year MOC cycle. For those Diplomates whose ABOS Certificates expire in 2031 or later, there will be two distinct cycles of CME. They must earn 120 CME credits, of which are 20 are SAE credits, by December 31st of year 5 or their ABOS certificate will be revoked. They must earn an additional 120/20 during years 6-10.
While this is a new system for the ABOS, the ACCME has worked with other medical boards on transferring credits in the same way. However, please be patient as we work through any issues.
Upcoming MOC Modifications
In the Spring, the American Board of Orthopaedic Surgery (ABOS) announced through email and The Diplomate modifications to the ABOS Maintenance of Certification Program. The changes will be effective beginning January 1, 2024, and are meant to provide an ABOS MOC Program that is meaningful and valuable to ABOS Diplomates and to the public. The modifications will help to advance the ABOS’ mission to ensure the safe, ethical, and effective practice of orthopaedic surgery for the benefit of our patients. In addition, these changes meet the new Standards for Continuing Certification from the American Board of Medical Specialties (ABMS).
As a reminder, here is what is changing and what is remaining the same:
What’s Not Changing
- The ABOS MOC Program for Board Certification will continue to be on a 10-year cycle. Diplomates will still need to maintain an unrestricted medical license.
- Diplomates will still submit 240 CME credits, of which 40 are SAE credits, for each 10-year ABOS MOC cycle.
- Diplomates will still submit an Application and Case List once every 10 years (submitted together in the same calendar year).
- Diplomates will still be able to choose from the same Knowledge Assessment Pathways (ABOS WLA, Computer-Based Recertification Examination, Oral Recertification Examination).
- Diplomates can still take an ABOS Computer-Based Recertification Examination in years 5-10.
- The ABOS is working with the ACCME, AAOS, and other CME providers to automatically transfer CME credits to the ABOS—there will be no need to remember to save and upload CME certificates.
- The Application will now be called the Professional Standing Update and will be submitted with a Case List in years 7, 8, or 9 of the 10-year cycle.
- Diplomates can take an ABOS Computer-Based Recertification Examination prior to submitting their Professional Standing Update.
- Diplomates can submit their Professional Standing Update prior to meeting the CME/SAE requirements.
- Diplomates earn ABOS Recertification after all aspects of the ABOS MOC Program are complete during their 10-year MOC cycle. Separating these requirements will allow for greater flexibility to complete each step in a timeframe that works with each Diplomate’s unique circumstances.
What’s New for Diplomates whose ABOS Board Certification expire in 2031 or later
- Diplomates must earn half of their CME credits (120 CME credits, of which 20 are SAEs), by December 31st of year 5 (earned in the first 5 years of the 10-year cycle).
- Diplomates who do not meet the requirement by December 31 of year 5 will have their ABOS Board Certification revoked.
- Diplomates must earn the remaining half of their CME credits by December 31st of year 10 of the 10-year cycle or their ABOS Board Certification will be revoked.
- There are two separate cycles of CME/SAE. If Diplomates earn “extra” CME credits during their first 5-year cycle, that credit cannot be transferred to the second 5-year cycle, but Diplomates can still use that CME for state licensure or hospital requirements.
The ABOS Board of Directors has decided to keep ABOS Board Certification on a 10-year cycle. Moving the CME/SAE requirement to the end of year 5—which is currently being met by a majority of ABOS Diplomates by the end of year 3—will help to distribute continuing medical education throughout the 10-year cycle and will allow the ABOS to meet the new ABMS Continuing Certification Standards. These changes emphasize the ABOS mission of protecting the public. The automatic transfer of CME credits to the ABOS from the ACCME as CME credits are earned will streamline this process for ABOS Diplomates.
ABOS Announces Its 2023-2024 Board of Directors
The Board of Directors of the American Board of Orthopaedic Surgery (ABOS) recently selected its 2023-2024 Officers and elected three new Directors.
James D. Kang, MD, the Thomas S. Thornhill, MD, and Karen N. Thornhill Professor of Orthopaedic Surgery at Harvard Medical School, and Chair of Orthopaedic Surgery at Brigham and Women’s Hospital, will serve as ABOS President. He is the first Asian American elected as President of the ABOS. Dr. Kang, along with the President-Elect, Vice President, and Secretary, hold their offices for a one-year term.
Scott E. Porter, MD, MBA, Vice Chair of Operations in the Department of Orthopaedic Surgery at Prisma Health-Upstate, will serve as ABOS Vice President.
Kevin L. Garvin, MD, the L. Thomas Hood, MD Professor and Chair, Department of Orthopaedic Surgery and Rehabilitation, University of Nebraska will serve as ABOS President-Elect.
Wayne J. Sebastianelli, MD, the Kalenak Professor in Orthopaedics at Penn State Health Milton S. Hershey Medical Center and Medical Director, Penn State Sports Medicine, will serve as ABOS Secretary.
Kyle J. Jeray, MD, the Chair of the Department of Orthopaedic Surgery at Prisma Health-Update, has been re-elected as ABOS Treasurer for a one-year term.
“This Board has elected an outstanding group of Officers,” said David F. Martin, MD, ABOS Executive Director. “While they are all busy orthopaedic surgeons, they are all leaders in our field, serving on the boards of many organizations.”
The Board elected James R. Ficke, MD, the Robert A. Robinson Professor and Chair of the Department of Orthopaedic Surgery at Johns Hopkins Hospital and School of Medicine; Gregory P. McComis, MD, the President and Orthopaedic Surgeon at North Point Orthopaedics; and Brian R. Wolf, MD, MS, the Kim and John Callaghan Endowed Chair in Sports Medicine at the University of Iowa Hospitals and Clinics as new Directors of the American Board of Orthopaedic Surgery.
“These three orthopaedic surgeons are excellent choices to join the Board,” said Martin. “Their diverse knowledge base and skill set will benefit the public, the ABOS and the profession of orthopaedic surgery for many years.”
ABOS Executive Director Receives Two Recognitions
David F. Martin, MD, Executive Director of the American Board of Orthopaedic Surgery (ABOS), received two recognitions at the recent North Carolina Orthopaedic Association (NCOA) Annual Meeting.
Dr. Martin received the 2023 NCOA Honored Surgeon Award, which is presented yearly to a North Carolina orthopaedic surgeon who has been notably influential in the promotion of the highest standards of orthopaedic care and has distinguished himself/herself among his/her peers for dedication to quality patient care and to the medical profession. The award has been presented since 1986 to some of the finest orthopaedic surgeons to ever practice in the state.
In addition to his leadership role at the ABOS, Dr. Martin is also a faculty member at the Wake Forest University School of Medicine and performs orthopaedic surgery at Atrium Health Wake Forest Baptist. Through the efforts of one of his former residents, W. Dickson Schaefer, MD, Wake Forest announced the establishment of the David F. Martin, MD, Endowed Othopaedic Resident Leadership Award, to be given annually to a deserving Wake Forest Orthopaedic Resident. As an endowed recognition, it will continue to honor Dr. Martin for many years to come.
In reflecting on the awards, Martin said “These types of honors are not achieved in a vacuum. I have been blessed with incredible support from my family and colleagues over many years. I share these awards with them – they deserve significant credit and sincere thanks.”
ABOS WLA Knowledge Sources to be Posted in January
On January 11, 2024, the American Board of Orthopaedic Surgery (ABOS) will post Knowledge Sources for the 2024 ABOS Web-Based Longitudinal Assessment (ABOS WLA) Pathway. This posting will include 223 total Knowledge Sources, with 111 of those being new. This gives each Diplomate many new choices of Knowledge Sources each year that apply to their practice or may be of interest to them. New Diplomates and newly Recertified Diplomates are invited to try the ABOS WLA Pathway in 2024; the earlier Diplomates begin the pathway, the more chances they have to be successful. The 2024 ABOS WLA Assessment Window will be open from April 4th through May 23rd, 2024. The ABOS will host a webinar on the 2024 ABOS WLA on January 16, 2024, at 7:30 pm ET. To register for the webinar, click here. For more details on the ABOS WLA Pathway, go to https://www.abos.org/moc/abos-web-based-longitudinal-assessment-abos-wla/.
Process of Creating ABOS Examinations
Every question on every American Board of Orthopaedic Surgery (ABOS) Knowledge Assessment is written and reviewed by several practicing orthopaedic surgeons in that subspecialty. Later, a professional editor reviews at each question prior to administration. While artificial intelligence (AI) is the latest buzzword, at no time have any ABOS examination items been written with AI assistance. In fact, the ABOS has a policy prohibiting ABOS question writers from using AI in drafting questions. As any AI query is stored in a database, the ABOS wants to make sure that our question bank remain secure. To learn more about the process of ABOS question writing, click on this link: https://www.abos.org/moc/examination-options/how-written-examinations-are-developed/.
New ABOS Diplomates
Congratulations to the 15 new Diplomates of the American Board of Orthopaedic Surgery (ABOS) who passed the 2023 ABOS Part II Oral Examination on the Alternate Date ABOS Oral Examinations in October. The Alternate Date was added in 2023 to provide an option to those Examinees dealing with specific life events that made attendance at the July examination dates not possible.
Coming in 2024