American Board of Orthopaedic Surgery

January 2018 Diplomate

Posted On: January 1, 2018

President’s Message

This month, I will highlight the Subspecialty Certification Committee. This committee oversees the process for development of ABOS’s two Subspecialty Certifications: Subspecialty Certification in Surgery of the Hand and Subspecialty Certification in Orthopaedic Sports Medicine. This important committee is chaired by Ann Van Heest, MD, of the University of Minnesota. It’s a timely topic, as the deadline to apply for either the 2018 Subspecialty Certification Examination in Hand Surgery or in Orthopaedic Sports Medicine is February 1.

There are approximately 1,800 Diplomates who hold a Subspecialty Certificate in Surgery of the Hand. Another 2,400 have the Orthopaedic Sports Medicine Subspecialty Certificate. In addition, there are 40 Diplomates who hold both! I am proud to have held a Subspecialty Certificate in Surgery of the Hand since 1996.

The purpose of the Subspecialty Certificates is to provide recognition to those ABOS Board Certified orthopaedic surgeons who have demonstrated additional qualifications in Orthopaedic Sports Medicine or Surgery of the Hand. This is possible by virtue of additional fellowship training in an ACGME accredited program, a practice characterized by a volume of cases in sports medicine or hand surgery, and significant contributions to the field of hand surgery or sports medicine.

This Committee, which I have previously chaired, also works on issues related to Subspecialty Certification. For instance, the Committee recently reviewed the process by which ABOS Diplomates renewed both their General Orthopaedic Certificate and Subspecialty Certificate. The decision was made, in order to help streamline the MOC/Recertification process, to adjust the Diplomate’s expiration date of the Subspecialty Certificate so that it matches the expiration date of the general ABOS Certificate.

In addition, the Committee, with the ABOS Board’s ultimate approval, recently made the decision to allow those ABOS Diplomates who do not hold a Subspecialty Certification to recertify their General Orthopaedic Certificate by taking the Surgery of the Hand or Orthopaedic Sports Medicine Examination as a Practice-Profiled Recertification Examination option. An added benefit of this decision is that ABOS Diplomates, who qualify for a Subspecialty Certification, can now take one examination to satisfy both their General Certificate Recertification and their examination for initial Subspecialty Certification. The Committee is actively working on ways to further the value and relevance of the Subspecialty Certificates.

The Surgery of the Hand Examination is developed and administered by the Joint Committee on Surgery of the Hand. This three board committee is composed of representatives from the American Board of Orthopaedic Surgery, the American Board of Plastic Surgery, and the American Board of Surgery. The Subspecialty Committee also works with subspecialty societies such as the American Society for Surgery of the Hand, the American Association for Hand Surgery, and the American Orthopaedic Society for Sports Medicine. (See the article in this issue about the ABOS summit with the American Society for Surgery of the Hand.)

Each examination consists of 175 multiple-choice questions and is given over a four-hour time period. The examination is designed to evaluate the candidate’s cognitive knowledge relevant to Orthopaedic Sports Medicine or Surgery of the Hand. The initial Subspecialty Certification Examination is offered through Prometric Testing Centers across the United States on one day each year, while the Combined and Practice-Profiled Recertification Examinations are administered over a two-week period. Upon passing the examination for initial Subspecialty Certification, ABOS Diplomates receive the Subspecialty Certificate with an expiration date matching their General Certificate. Recertification of both Certificates will then be obtained by taking one Combined Examination—currently offered as either a Computer-Based or an Oral Examination. If you are interested in applying for a Subspecialty Certification Examination after obtaining initial Board Certification please refer to our website:

The application for the 2019 Subspecialty Examination should be available on in August 2018.

I’m always interested in feedback from Diplomates. You can reach me through the ABOS office or by emailing

Peter M. Murray, MD
President, American Board of Orthopaedic Surgery

Executive Medical Director’s Report

In May, I reported that Patient Reported Outcomes (PROs) are now part of the Part II Oral Examination application process. I am happy to report that initial responses from Candidates and patients have been positive.

PROs are outcome measures that are directly reported by patients to help better understand a treatment’s efficacy. PROs have been used at many facilities to assist surgeons in evaluating their practices. ABOS Board Certification Part II Candidates will receive PROs survey results to assist in their practice improvement efforts and in their examination preparation.

Part II Candidates submit a Case List for all surgeries performed in April through September of the year prior to their examination. In 2017 (for the 2018 Examination), Candidates were required, for surgeries performed during the months of May and June, to ask each surgical patient for an email address that would be entered into the ABOS Scribe Case List System. The ABOS then emailed a link to each patient pre- (or peri-) operatively. The email linked the patient to a Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function survey. This was a quick survey, and 7,270 patients completed it. We recently sent a follow-up questionnaire to repeat the survey and evaluate the patient’s physical function six months post-operatively. We will do a 12-month follow-up evaluation as well.

Ninety-seven percent of the Part II Candidates have at least one patient who has completed the first questionnaire. Candidates will be provided with the PROs results for their participating patients. With regard to the ABOS Part II Oral Examination, individuals who participate in the case selection process for the examination will be able to choose cases with PROs information. In addition, the PROs data will be another way that individuals conducting the examination can evaluate patient outcomes. Candidates who have not had patients participate in the PROs program will not be disadvantaged. PROs will be one of many areas that are evaluated as part of the examination.

The ABOS PROs program has been successful and will continue for this year, with Candidates for the 2019 ABOS Part II Oral Examination participating. Those orthopaedic surgeons who are potentially eligible for the 2019 Part II Oral Examination will receive information in February explaining the PROs requirements. I would recommend informing your colleagues considering the 2019 ABOS Part II Oral Examination that the PROs feedback will be valuable to them as young orthopaedic surgeons. They should look forward to more information in February.

I’m always happy to talk with you about any ABOS questions that you have. You can email me at or call me at the ABOS offices at 919-929-7103.

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

ABOS Participates in ASSH Summit

In December, the American Board of Orthopaedic Surgery (ABOS) was invited to participate in a Maintenance of Certification (MOC) Summit hosted by the American Society for Surgery of the Hand (ASSH). The ABOS was joined by representatives from the American Board of Surgery (ABS) and the American Board of Plastic Surgery (ABPS). Since 1989, the three Boards have collaborated to produce a Subspecialty Certification Examination in Surgery of the Hand. Diplomates who have completed a 12-month ACGME-accredited fellowship in Surgery of the Hand are eligible for Subspecialty Certification in Hand Surgery (formerly known as the CAQ or Certificate of Added Qualification in Hand Surgery).

The goal of this meeting was to “improve the MOC experience for ASSH members.” We discussed with ASSH leadership the many changes we have made to MOC over the last few years, including:

  • Adding three new Practice-Profiled Examinations: Pediatrics, Orthopaedic Trauma, and Foot and Ankle
  • Allowing any Diplomate to take an Orthopaedic Sports Medicine or Surgery of the Hand Practice-Profiled Examination in order to satisfy MOC requirements for general orthopaedic surgery
  • Eliminating general orthopaedic questions from Recertification Examinations

For the new Practice-Profiled Examinations, the ABOS worked with the appropriate subspecialty societies to find practicing orthopaedic surgeons from across the country to create a Blueprint, identifying the topics that should be included on the examination and what percentage should be devoted to each topic. Similarly, a Blueprint Workgroup will be assembled in February in Philadelphia to create an outline for the Hand Subspecialty Examination. This Blueprint Workgroup will be composed of subject matter experts identified from the American Academy of Orthopedic Surgeons, the American Association for Hand Surgery, and the American Society for Surgery of the Hand.

Also agreed upon was a plan to develop a study guide of questions and answers to be offered by ASSH that will parallel the content of the initial Hand Certification and Recertification Examination which will help orient the study of the Candidate and Diplomate.

These are just additional examples of how the ABOS continues to collaborate with the AAOS as well as subspecialty societies to improve the MOC process.

Peter M. Murray, MD
President, American Board of Orthopaedic Surgery

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


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