In an effort to get you more acquainted with the governance of the American Board of Orthopaedic Surgery (ABOS), I will continue by highlighting our next committee, the Written Examination Committee, chaired by Michael S. Bednar, MD, of Loyola University. The Vice-Chair of the committee is April D. Armstrong, MD, from Penn State Milton S. Hershey Medical Center. This Committee oversees the ABOS Part I Certification Examination and the eight computer-based Maintenance of Certification (MOC)/Recertification Examinations.
To explain how the Committee works, let me first explain how ABOS written examinations are developed. The first step in creating a “valid examination” is the development of an Examination Blueprint. The ABOS works with the National Board of Medical Examiners (NBME) and the appropriate orthopaedic subspecialty societies to construct Examination Blueprints. These Blueprints are based in part on feedback received from speaking with practitioners in the orthopaedic surgery community. This process ensures that the examination content accurately represents what is being done by practicing orthopaedic surgeons. The Blueprints are periodically reviewed and modified to accurately reflect changing practice trends.
Next comes the writing of examination questions that match the Blueprint. New questions are composed by volunteers as a part of the ABOS Question Writing Task Force (QWTF). The QWTF is made up of approximately 40 experienced orthopaedic surgeons who are ABOS Diplomates and who represent a wide range of practice specialties, practice settings, and geographic regions. The questions are then reviewed by professional editors at the NBME offices in Philadelphia and then later discussed among orthopaedic surgeons who specialize in the subspecialty corresponding to the questions content area. This is done at another face-to-face meeting. If a question is approved by this peer review, it will be added to the ABOS Question Bank. All new questions that are accepted, along with questions that have performed well on previous examinations, are designated for use on one or more examinations, including the Part I Examination or any of the Subspecialty/Practice-Profiled Recertification Examinations.
The ABOS Part I Certification Examination is edited by the ABOS Field Test Task Force (FTTF), which is composed of approximately 20 ABOS Diplomates. Then, another level of editing is performed by the ABOS Written Examination Committee, followed by a final editing by the Chair of the Written Examination Committee and the ABOS Executive Medical Director. All ABOS Directors serve on the Written Examination Committee at some point during their tenure on the Board.
The ABOS has created a bank of more than 3,000 questions. In addition, all questions in the bank are re-edited on a rolling three- to five-year schedule to ensure that each question remains current, applicable, and accurate.
After the examinations are administered, psychometricians summarize the statistical performance of each examination question. A Key Validation Subcommittee reviews the data and poorly performing questions are deleted before the scoring of the examination. It is also at this time that the psychometricians analyze the degree of difficulty for each question and of the overall examination. This process ensures that the examination is valid, reliable, and produces a score which is scalable from one year to the next. With this information, the Written Examination Committee can set the cut score, also known as the pass/fail point, for the examination. The examination is developed so that a Diplomate would have the same statistical likelihood of passing or failing no matter the year the examination is taken. The ABOS does not set an overall pass rate, only a cut score that is scalable year after year.
Part I Examination Statistics
The process of putting together a valid Part I Written Examination requires a tremendous amount of work by our ABOS Directors and our volunteers. None of these individuals receive any type of compensation for their work. We are always looking for volunteers to be part of the QWTF and FTFF. To apply for either of these opportunities (or any ABOS volunteer position), log in to your ABOS Dashboard and click on the “Volunteer” button.
Finally, I would like to take this opportunity to wish you and your family a very Happy Holiday Season. At this time we at the American Board of Orthopaedic Surgery are very thankful for many things, not the least of which is the opportunity to serve you, the Diplomate, as well as the public.
Peter M. Murray, MD
President, American Board of Orthopaedic Surgery
Executive Medical Director’s Report
For the past three years, the American Board of Orthopaedic Surgery (ABOS) and the American Board of Medical Specialties (ABMS) have partnered on a program for young orthopaedic surgeons who are interested in researching professional assessment and education.
The ABMS-ABOS Visiting Scholars Program is a one-year program where Scholars participate in a research project related to Board Certification or Maintenance of Certification. In addition, Scholars are exposed to the fields of professional assessment and education, health policy, and quality improvement. They are offered the opportunity to develop leadership skills critical to their own professional growth and success. Their projects are valuable to them and to the profession.
As you can see below, these Visiting Scholars have conducted some exciting research that will help in the education and training of orthopaedic surgeons. I have gotten to know each of these young surgeons and they are incredible evidence that the future is bright for our profession.
Johnathan Bernard, MD, MPH, Attending, Sports Medicine and Shoulder Surgery, National Sports Medicine Institute, Johns Hopkins Medical Institutions, Lansdowne, VA
Project: The Role of Orthopaedic Surgery Milestones in Assessing Competency of Technical and Arthroscopic Skill of Residents; Development of a Cadaveric Surgical Model on Meniscal Injuries using Arthroscopic Video and Surgeon Point of View Recording
Sandeep Mannava, MD, PhD, Sports Medicine Fellow, Steadman-Philippon Research Institute, Vail, CO
Project: The Evolving Role of Simulation-based Surgery Training in Orthopaedic Surgery
Benjamin Wooster, MD, Orthopaedic Surgery Resident, Duke University, Durham, NC
Project: Does Anatomic Knowledge Correlate with Surgical Competency? A Multi-center Study
In Spring 2018, the Program will be accepting applications for the 2018-2019 class. We will announce in The Diplomate when the application period is open. If you know of anyone who may make a great ABMS-ABOS Visiting Scholar, please encourage that person to apply.
David F. Martin, MD
Executive Medical Director, American Board of Orthopaedic Surgery