In medicine, we are privileged to be a profession that has been given the opportunity to self-regulate. For the most part, physicians monitor other physicians, through state medical boards and certification boards, like the American Board of Orthopaedic Surgery (ABOS). That is the way it should be.
There are several certification boards for orthopaedic surgeons, but we believe that the ABOS is the most reliable for ensuring that patients are treated by safe, effective orthopaedic surgeons. The ABOS has created a reliable Board Certification program that is not overly burdensome for orthopaedic surgeons. Even if you may have some concerns about specific elements of the ABOS Board Certification program, would you want a close family member or friend to be seen by an orthopaedic surgeon who was not ABOS Board Certified? The Board has worked hard to maintain a valuable Board Certification program, while still addressing concerns from ABOS Diplomates.
The ABOS is now working to help orthopaedic residency programs identify residents who may not have the surgical skills or professional behavior that is expected of a Board-Certified orthopaedic surgeon. Through the ABOS Knowledge, Skills, and Behavior Program (ABOS KSB), Program Directors (and residents) can learn in real-time about any deficiencies and correct them prior to the end of a resident’s educational process.
Prior to being allowed to sit for the ABOS Part II Oral Examination (the last step in the ABOS Board Certification process), a Candidate’s Case List is reviewed for outliers. In addition, peer review is performed for all Candidates. In many situations, orthopaedic surgeons provide useful information regarding surgeons in their region. Candidates who have issues with either their Case List or Peer Review will be evaluated by the ABOS Credentials Committee. Based on that review, Candidates may be deferred or considered for a Site Visit of their practice to gather more information.
For more than 35 years, ABOS Diplomates have been required to maintain their certification and participate in a recertification process every 10 years. This is important as every year we find Diplomates who have successfully attained ABOS Board Certification, but issues come up later in their practice that need to be investigated. That is why we continue to conduct Peer Review and review Case Lists for each Diplomate every 10 years. Initial Board Certification is not enough – a continuous process ensures that ABOS Board Certified orthopaedic surgeons remain up-to-date and meet standards of patient care and professionalism.
While Continuing Medical Education credits are important, the ABOS is committed to a process that also involves a rigorous Peer Review and Case List evaluation to ensure that Diplomates continue to practice safe medicine. CME credits are not enough to verify safe, effective care. That is why we cannot depend on only CMEs when recertifying ABOS Diplomates.
The Board has worked hard to make the ABOS MOC program more beneficial to Diplomates, while also protecting patients. Many of you are reviewing the ABOS Web-Based Longitudinal Assessment (ABOS WLA) Knowledge Sources now. You are reading articles that you may not have known about or had time for previously. This pathway has been especially popular, and we have heard from many Diplomates who have changed their practice based on the articles they read as part of the ABOS WLA Pathway.
The Board continues to work on improving processes, and we appreciate feedback from ABOS Diplomates who provide valuable suggestions as we strive to improve our programs.
April D. Armstrong, MD
President, American Board of Orthopaedic Surgery
Executive Director’s Report
I have served as the Executive Director at the American Board of Orthopaedic Surgery (ABOS) for nearly seven years. Prior to that, I served as a member of the ABOS Board of Directors for 10 years. Over those 17 years, I have heard many of the same questions from ABOS Diplomates, and I want to use this month’s column to address several of them.
Question: Why does the ABOS not offer an Emeritus Status or give ABOS Diplomates who have recertified two times a lifetime certificate?
Response: The American Board of Medical Specialties (ABMS) and the ABOS require Diplomates to recertify on a regular basis. With the profession constantly changing, it is important to make sure that Diplomates are keeping up with those changes throughout a long career. The ABOS’s mission is to protect the public, and we need to make sure that ABOS Diplomates continue to provide safe, ethical, and effective care. The ABOS will be offering a way for Diplomates to Retire in Good Standing. The details of that program will be announced in the next few months.
Misconception: Certain Diplomates were “grandfathered” and do not have to recertify. Why is that?
Response: Up until 1986, the ABOS provided lifetime certification to all Diplomates. Starting in the 1970s, the Board began to investigate a process of recertification and spent many years determining the best way to accomplish that. The ABOS has not “grandfathered” any Diplomates – the ABOS has chosen to honor the Lifetime Certificates that the ABOS awarded to those Diplomates who attained ABOS Board Certification prior to 1986. Further, lifetime certificate holders are continually reviewed by the ABOS Credentials Committee to be sure that they abide by the ABOS Rules and Procedures.
Question: Why do I receive a request to complete Peer Review for someone with whom I am unfamiliar?
Response: On Initial Certification and Maintenance of Certification (MOC) Applications, the ABOS asks for references – practice partners, hospital officials, and colleagues. The ABOS then sends Peer Review questionnaires to those individuals. In addition, the ABOS sends Peer Review to nearby orthopaedic surgeons, located by zip code lists. If you receive an email asking you to review someone with whom you are not familiar, there is a link to check to indicate that you do not know this person.
Misconception: My practice is in an area with a lot of competition so I know that those surgeons will not provide me a fair Peer Review.
Response: Overall, nearly all Diplomates fairly rate other Diplomates, even “competitors.” In cases of negative Peer Review, those individuals providing that Peer Review are contacted for more information. We depend on the professionalism of all those involved to ensure reasonable information. All of the information obtained is carefully reviewed by the ABOS Credentials Committee, which makes every effort to verify a fair, effective process.
Question: Why do I have to submit a Case List if I am not taking an Oral Examination?
Response: The Case List is a critical part of the ABOS Maintenance of Certification process. First, all Case Lists are evaluated using an algorithm that looks for outliers. Are there too many or too few complications? Are inappropriate cases being performed? For any Case Lists that are flagged, a practicing orthopaedic surgeon will review them for possible consideration for further evaluation by the ABOS Credentials Committee. Second, the Case List is for self-improvement. When your cases are entered, a surgeon can reflect on them and consider whether anything could have been done differently. The ABOS sends each surgeon a Case List Feedback Report so that he or she can see how their cases and case lists compare to their peers—types of procedures, complication rates, and other points of interest. That information can then be used to guide Continuing Medical Education activity choices.
Misconception: The ABOS includes general orthopaedic surgery question on the Practice-Profiled Examinations that are used for Recertification (MOC).
Response: While this was previously true, there have been no general orthopaedic surgery questions on any of the Practice-Profiled Examinations for more than five years. You can see the blueprints for these examinations here.
Question: Why does it take so long to receive Knowledge Assessment (examination) results?
Response: For each ABOS Knowledge Assessment (examination), no final scores are given until the end of the examination period, allowing all scores to be used in the final evaluation that is used to set passing standards. While individuals do receive an initial score for the ABOS Web-Based Longitudinal Assessment Pathway (ABOS WLA), the score does have the potential to be adjusted once all of the results are evaluated. For the ABOS Computer-Based Recertification Examinations, we look at how each question performs prior to finalizing a passing standard. While there is a significant amount of evaluation and review prior to a question becoming part of an ABOS Knowledge Assessment, there are times when questions do not perform well. In that situation, the question is discarded prior to the final scoring and, in the case of the ABOS WLA Pathway, credit for the question is given. We work with psychometricians to ensure the validity of all ABOS Examinations. For the ABOS Oral Examination, the raw scores from the Oral Examiners are evaluated, taking into account the severity of Examiner scoring and the difficulty of each scoring facet prior to setting passing standards. These processes take time and that is why results are not reported immediately.
Misconception: You have to be in active surgical practice to be to maintain ABOS Board Certification.
Response: That is false. To apply for the ABOS Part II Examination, you must have at least 35 surgical cases over the collection period. However, once an individual is ABOS Board Certified, there are pathways for all Diplomates to maintain their ABOS Board Certification, despite the fact that they may not be performing surgery or may not be seeing patients. ABOS Diplomates who no longer operate or see patients should contact their Certification Specialist for instructions on how to proceed with the MOC process.
Question: My certificate has lapsed. How long am I ABOS Board Eligible?
Response: Board Eligibility is only granted after passing the ABOS Part I Examination, lasting five years and not counting time spent in fellowship. Board Eligibility continues until an individual passes the ABOS Part II Examination. Once a Certificate lapses, an individual is no longer Board Certified. To re-enter, the requirements include passing an ABOS Oral Examination.
Misconception: If I call the ABOS Office, that will negatively affect my Board Certification.
Response: That is false. We welcome your calls and emails, and the ABOS Certification Specialists are happy to help. We just ask that you treat the ABOS staff with respect.
David F. Martin, MD
Executive Director, American Board of Orthopaedic Surgery
ABOS Recertification Case List Open
Diplomates whose American Board of Orthopaedic Surgery (ABOS) Board Certification expires in 2024-2029 can start working on their Case List as part of the ABOS Maintenance of Certification (MOC) Program. The Application will be available in March. The Application and Case List, along with the submission of 240 Category I, orthopaedic-related CMEs, of which 40 must be scored and recorded SAEs, are due by December 1, 2023.
Diplomates whose Certificate expires in 2024 must apply this year if they have not done so yet, even if they are participating in the ABOS Web-Based Longitudinal Assessment (ABOS WLA) Pathway. The ABOS requires the Application and Case List be submitted by year 9 of the 10-year MOC cycle, but it can be done as early as year 4.
The Cast List consists of the first 75 consecutive surgical cases in which a Diplomate was the primary surgeon, beginning January 1, 2023, and continuing until reaching 75 cases. The Case List should include all orthopaedic cases that involve an incision and anesthesia. The list of procedures that should not be included can be found here: Procedures Not to Include.
ABOS Executive Director David F. Martin, MD, will be hosting a webinar on the ABOS MOC Application and Case List process on Wednesday, February 15, at 7:30 pm ET. To register for the webinar, click on this this link.
When you are thinking about which year to submit your Application, do not forget that Practice-Profiled Examinations are offered every other year, so do not miss the chance by waiting to apply. Your Application and Case List are good until the expiration date of your Certificate. If you successfully complete the ABOS WLA Pathway, you do not need to take an ABOS Computer-Based Recertification Examination.
The following Practice-Profiled Recertification Examinations will be offered only in even numbered years (2024, 2026, 2028, 2030):
- Adult Reconstruction
- Musculoskeletal Oncology
- Orthopaedic Sports Medicine
- Surgery of the Spine
The following Practice-Profiled Recertification Examinations will be offered only in odd numbered years (2025, 2027, 2029):
- Foot and Ankle Surgery
- Orthopaedic Trauma
- Pediatric Orthopaedic Surgery
- Shoulder and Elbow Surgery
- Surgery of the Hand
ABOS WLA Knowledge Sources Posted
The American Board of Orthopaedic Surgery (ABOS) has posted Knowledge Sources for the 2023 ABOS Web-Based Longitudinal Assessment Pathway (ABOS WLA) to the ABOS WLA Portal of Diplomates who are eligible to participate.
While the Assessment Window does not open until April 4th, the ABOS recommends that interested Diplomates start selecting and reviewing the Knowledge Sources. Diplomates who participated last year will not notice any changes to the platform or to the rules, just new Knowledge Sources.
Diplomates who are newly certified or have recently recertified should learn more about the ABOS WLA Pathway by going here. The pathway continues to be a popular choice as more than 14,000 Diplomats participated last year. Diplomates whose certificate does not expire for many years should still considering participating in 2023. Early participation will give an ABOS Diplomate the most opportunities to be successful.
ABOS Resident Advisory Panel Applications Open
For the past two years, the American Board of Orthopaedic Surgery (ABOS) has greatly benefited from engagement with residents through the ABOS Resident Advisory Panel. There have been eight outstanding residents who have served on the panel, and the ABOS is looking to add additional residents later this year. Please make sure any outstanding PGY1, PGY2, or PGY3 residents you work with know about this opportunity.
The ABOS Resident Advisory Panel provides the ABOS with valuable input from a resident perspective and provides a voice for orthopaedic residents as the ABOS considers Graduate Medical Education requirements and Board Certification issues. In addition to being a great networking opportunity, the group has provided recommendations to the ABOS Graduate Medical Education and Communication Committees and have worked on projects that the Board has started implementing. The Panel meets several times a year virtually and annually in-person at the American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting, for which the ABOS pays transportation, hotel, and registration costs.
The application deadline is March 1. More information can be found here: www.abos.org/residents/resident-advisory-panel/.
Apply to Be a Visiting Scholar
For the ninth consecutive year, the American Board of Orthopaedic Surgery (ABOS) has partnered with the American Board of Medical Specialties (ABMS) in sponsoring the Visiting Scholars Program for early-career physician specialists and research professionals.
ABOS-ABMS Visiting Scholars remain at their home organizations and work with self-selected mentors. They participate in interactive webinars where they provide research project updates to their peers and a select panel of subject matter experts and Visiting Scholars alumni who provide guidance, support, and solutions to barriers they may be experiencing in their research work.
The program is open to early-career physicians, medical and surgical specialists, and research professionals, junior faculty, fellows, and residents, as well as individuals holding master or doctorate degrees in public health, health services research, educational evaluation and statistics, public health policy and administration, or other relevant disciplines.
Visiting Scholars are selected based on the quality of their proposed research project, the relevance of their research to the ABMS certification community priorities, and the likelihood of making substantial progress on the project during the year.
To learn more about previous ABOS-ABMS Visiting Scholars and the type of research they conducted, go to www.abos.org/research/visiting-scholars/. Additional information, including this year’s deadline, will be posted soon.
Thank You Volunteers!
While the American Board of Orthopaedic Surgery (ABOS) has an energetic staff and a dedicated Board, the ABOS would not be able to operate without the dedication of hundreds of volunteers, who do everything from writing examination questions to conducting oral examinations. Thank you!
For those who have volunteered in 2022 for the first time, we hope that you will continue to participate. If you have volunteered and the ABOS has not called on as of yet, we will certainly do everything we can to get you involved. For those who have volunteered for years (or even decades), you are amazing.
This list includes those who have volunteered in 2022 for the first time and those celebrating anniversaries of their volunteer experience with the ABOS. Thank your colleagues who are listed and consider volunteering yourself if you have not done so already. The first step is completing the volunteer form found on your ABOS Dashboard.
Frank J Eismont
Patrick John Getty
Robert Daniel Bronstein
Judith Ford Baumhauer
Dana Curtis Covey
Stanley Cecil Graves
Kim Wallace Hammerberg
Gregory Paul McComis
Ronald W B Wyatt
John Soteros Xenos
Robert Harold Ablove
Craig Dunwody Cameron
John Anthony DiPreta
Joshua J Jacobs
Scott Hal Kozin
Kevin Jay Liudahl
Benjamin James Miller
Sanjiv H Naidu
Thomas Erl Nelson
Andrew William Parker
Michael Lawrence Pearl
Richard Michael Schwend
Kim L Stearns
Delwyn Jerome Worthington
Ryan Carter Cassidy
James Thornton Chandler
Caroline Marie Chebli
Norman Barrington Chutkan
Robert Alexander Creighton
Eric William Edmonds
Michael F Fry
Gordon Irwin Groh
Charles Mitchell Jobin
Anish Raj Kadakia
Matthew David Karam
Robert Charles Kramer
Edward Barry McDonough
Aki Sefaro Puryear
Charles Alan Reitman
Adam Brent Shafritz
Andrew John Veitch
Montri Daniel Wongworawat
Reid Allen Abrams
Leslie Anne Fink Barnes
Taizoon Honeid Baxamusa
Jaime Lyn Bellamy
Louis William Catalano
Susan Rose Cero
Todd Eric Chertow
Brian Patrick Conroy
Charles A Daly
Michael Edward Darowish
Ananth Seshu Eleswarapu
John Joseph Faillace
Marc Ruffino Fajardo
David Alan Friscia
Joel B Gonzales
Kanu Shri Goyal
Syed Ashfaq Hasan
Grant Douglas Hogue
Raymond Yeou Hsu
John Victor Ingari
Claudius Damien Jarrett
Marci Dara Jones
Andrew R Jones
Nimish Raj Kadakia
Jaehon Michael Kim
Brian Chun-Wah Law
Cameron Kirk Ledford
Kevin James Malone
Christopher Laurence McCrum
Deana M Mercer
P Ronjon Paul
Diane Elizabeth Sedgwick Payne
Ashok Satty Reddy
Michael Aaron Robinson
Victor Michael Romano
Vani Janaki Sabesan
Robert H Sandmeier
Matthew Carl Sardelli
Micah Kathrine Sinclair
Scott Porter Steinmann
Matthew Dimmick Williams
2022 By the Numbers
- 708 new ABOS Diplomates
- 98 ABOS Diplomates earned ABOS Subspecialty Certification in Surgery of the Hand
- 62 ABOS Diplomates earned ABOS Subspecialty Certification in Orthopaedic Sports Medicine
- 1,019 ABOS Diplomates completed all four parts of the ABOS Maintenance of Certification (MOC) Program and have recertified for another 10 years
Congratulations to all of these Diplomates!
Surgeons Telling Surgeons about Board Certification
As discussed in the Executive Director report, there are some misconceptions about American Board of Orthopaedic Surgery (ABOS) Board Certification and ABOS Maintenance of Certification. The ABOS is trying to clarify those misconceptions through our communications but also appreciate the assistance of ABOS Diplomates who are spreading the word on social media. Below is Dr. Christopher Bono’s statement on the ABOS Web-Based Longitudinal Assessment Pathway (ABOS WLA).