American Board of Orthopaedic Surgery

June 2018 Diplomate

Posted On: June 1, 2018

President’s Message

This month I will discuss the American Board of Orthopaedic Surgery (ABOS) Research Committee, which is chaired by Greg Mencio, MD, of Vanderbilt University.

The ABOS allows researchers to use select de-identified candidate data for analysis. Individuals who would like to utilize ABOS data must complete a research proposal which is then reviewed by the ABOS Research Committee. At least 19 peer-reviewed articles from this data have appeared in 12 different medical journals over the last five years. The ABOS believes that providing the data is important to advancing the science of orthopaedic surgery.

The next ABOS research proposal deadline is November 15. Those who apply by that deadline will be placed into the review process. Approved project principal investigators are required to pay $2,800 to cover IT and data management expenses. For more information on submitting a research proposal to the ABOS, click on this link.

In addition, the Research Committee has also been instrumental in the successful rollout of Patient Reported Outcomes (PROs) usage for Part II Candidates. PROs are outcome measures that are directly reported by patients to help their physicians better understand a treatment’s efficacy. Part II Candidates submit a Case List for all surgeries performed from 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 the Patient-Reported Outcomes Measurement Information System (PROMIS) Physical Function survey. This survey is very brief, and 7,270 patients participated in the pilot. Ninety-nine percent of the Part II Candidates have had at least one patient agree to participate in the pilot program.

The ABOS sent six- and 12-month follow-up questionnaires to repeat the survey and evaluate the patient’s physical function post-operatively. Candidates will get the PRO results of all participating patients. The results will also be a part of the materials Examiners receive during the Part II Oral Examinations in July. The PROs results have been very popular with Candidates and some have requested that the ABOS utilize platforms to continue the collection of PROs. The ABOS is currently reviewing options for such a program and will communicate information as it becomes available. For 2019, the PROMIS Pain Interference survey will also be used.

The ABOS occasionally funds research projects. The most recent call for funding involved surgical skill simulation training and was organized in collaboration with the Orthopaedic Research and Education Foundation (OREF). More than 100 letters of intent were submitted earlier this year for $300,000 grants to study simulation training in orthopaedic surgery residency. We were impressed by the number of researchers who showed interest in this funding opportunity. Formal proposals are due later this month and will be reviewed by a panel of ABOS and OREF representatives.

For the last three years, the ABOS has partnered with the American Board of Medical Specialties (ABMS) on their Visiting Scholar program. Junior faculty, residents/fellows, individuals holding advanced degrees in public health, health services research, and other relevant disciplines apply to participate in this exciting and dynamic one-year part-time program that facilitates research projects related to Board Certification and Maintenance of Certification. The Research Committee is currently evaluating excellent candidates for this position.

As you can see, the Research Committee has an important role in furthering the mission of the ABOS. I encourage those of you interested in research to take advantage of our database.

It is an honor to serve the public as the President of the American Board of Orthopaedic Surgery. As always, if you have any feedback, please email me at

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

Executive Medical Director’s Report

ABOS WLA – Comprehensive Overview

In my recent travels to orthopaedic conferences and meetings, I have heard a lot of excitement about the upcoming January 2019 launch of the American Board of Orthopaedic Surgery Web-Based Longitudinal Assessment Program (ABOS WLA). This new ABOS Maintenance of Certification (MOC) assessment program has also generated many questions. The purpose of this communication is to provide a comprehensive overview of the ABOS WLA assessment option and answer some of the common questions that have arisen.

Beginning in 2019, the ABOS is offering Diplomates this new pathway in order to satisfy the Knowledge Assessment portion (Part III) of the ABOS MOC program. While this program will offer a new open-book assessment option, none of the current programs will be discontinued. Diplomates will still be able to choose the current Computer or Oral Assessment pathways as options for satisfying the Part III Knowledge Assessment portion of the ABOS MOC Program.

Under the ABOS WLA pathway, each January Diplomates will be given access to approximately 100 Knowledge Sources (journal articles, practice guidelines, appropriate utilization criteria, and other similar options) on the ABOS website. From these Knowledge Sources, Diplomates will choose 15 to review in-depth, with the potential for the ABOS to require a Knowledge Source that every Diplomate must review. Each April, a five-week window will open in which Diplomates will be presented 30 questions based on the 15 Knowledge Sources that they have chosen in that particular year. Three minutes will be allotted to answer each question, administered in an open-book fashion on a personal computer. The questions can be answered in multiple sittings or in one sitting. All questions must be answered during the five-week window.

A “Quality Year” under the ABOS WLA will be defined as correctly answering at least 24 out of the 30 questions. Five Quality Years are needed to successfully complete the ABOS WLA Pathway. Alternatively, reaching a level of 120 questions answered correctly over six years of participation can satisfy the requirement for successful completion of the ABOS WLA program. Meeting one of these standards will satisfy the Part III Knowledge Assessment requirement for the ABOS MOC program for that 10-year cycle. For those Diplomates who would like to participate in the ABOS WLA with Certificates that expire in less than five years, ABOS Board Certification will be extended as long as the Diplomate is earning Quality Years. Those individuals who have their Certificates extended will have a shorter term to complete the ABOS WLA in their next 10-year cycle. Those Diplomates with extended Certificates who do not meet the passing standard of the ABOS WLA in any year will be required to take a Computer or Oral Recertification Examination.

Those Diplomates who participate in the ABOS WLA pathway must also complete a Recertification Application and submit a Case List as well as meet the minimum standard of 240 orthopaedic-related Category 1 Continuing Medical Education (CME) credits. Forty of the 240 credits must be from scored and recorded Self-Assessment Examinations (SAE). The ABOS also obtains Peer Review as part of the MOC process.

Do I have to start in 2019?
Those Diplomates whose Certificates expire 2025 or sooner are required to begin the ABOS WLA in 2019 if they wish to utilize the ABOS WLA to satisfy Part III of their ABOS MOC. For those Diplomates who hold Certificates that expire in 2026 or later, waiting one to three years is an option, but I advise that they do not as they will have fewer opportunities to meet the passing standard.

What kind of materials make up the Knowledge Sources?
The ABOS is working with orthopaedic organizations to select Knowledge Sources that will cover the gamut of orthopaedic subspecialties. The Sources that are chosen will be announced in January. We anticipate the lists to primarily include journal articles, practice guidelines, appropriate utilization criteria, and other similar options. Diplomates will have three months to read and study these materials.

I expire in 2018. Can I participate in the ABOS WLA program in 2019?
No. The ABOS WLA is only open to those Diplomates who have a current ABOS Board Certificate and who are within their 10-year cycle.

I recertified in the past two years and my current Certificate does not expire until 2029 or 2030, can I start the ABOS WLA in 2019?
No. If a Diplomate has taken and passed a Recertification Examination in 2017 or 2018, or is preparing to take and pass the 2018 Oral Recertification Examination, the 2018 Surgery of the Hand Recertification Examination, or the 2018 Orthopaedic Sports Medicine Recertification Examination, they must wait until their new 10-year MOC cycle begins.

Why do some people have to do five straight quality years while others may opt to answer 120 questions correctly in six years?
The ABOS did not want to limit participation in the ABOS WLA program to only certain Diplomates. The ABOS Board wanted all interested Diplomates to have the opportunity to participate. In order to do that, the Quality Year option had to be implemented as Certificates are being extended.

Will I be able to recertify my Subspecialty Certificate along with my Orthopaedic Board Certification Certificate with the ABOS WLA pathway?
Yes. While you will still need to take a Computer Examination when applying for the Initial Subspecialty Certificate, you will be able to recertify the Subspecialty Certificate with the ABOS WLA pathway. This will be similar to the Combined Examinations for Computer and Oral Recertification that those with Subspecialty Certificates (Surgery of the Hand and Orthopaedic Sports Medicine) currently complete. Interested Diplomates will need to choose five Knowledge Sources from their Subspecialty area each year.

What if I have both Subspecialty Certificates?
You will need to choose five Knowledge Sources from each of the Subspecialty areas each year.

Will I know if I got the answers correct right away?
Yes. Once you submit each answer, you will know if you were correct.

Why do the questions have to be timed?
In order to provide a valid assessment, each question needs to be timed. We believe that three minutes is enough time to read the question and determine the correct response. Certainly, this will be assessed on a regular basis as the ABOS WLA program is rolled out.

Why do you only get one chance to take the questions/get a certain amount right? 
The ABOS believes that this is the best way to assess a Diplomate’s knowledge of that topic.

If I am participating in the ABOS WLA program and I am in the midst of getting my five Quality Years, will the website and any verification documentation be correctly updated for each year that I am “extended” so that I can achieve five Quality Years? I do not want it to look like my Certificate has lapsed.
The website is always accurate and will show in real-time that your certificate has been extended. We also share this same information with the American Board of Medical Specialties on a regular basis. Please do not hesitate to contact the ABOS Offices if there are any problems with your listing.

I have applied for a Recertification Examination in 2019 but I am strongly considering the new ABOS WLA pathway. What do I have to do to begin that process?
The ABOS will provide information later this year about how to enroll in the ABOS WLA program.

Will CME credits be offered for participating in the ABOS WLA program?
The American Academy of Orthopaedic Surgeons (AAOS) is in the process of applying to the Accreditation Council for Continuing Medical Education (ACCME) to provide Diplomates the ability to earn CME for participation in ABOS WLA. Details of that portion of the program will be available soon from the AAOS.

When do I start my Case List and Application?
For those Diplomates who have an ABOS Board Certificate that expire in 2022 or later, the ABOS recommends that the Case List and Application be submitted in year seven of the 10 year MOC cycle. Those documents will also be accepted in years eight or nine. For Diplomates who have ABOS Board Certificates that expire in 2020 or 2021, the Case List and Application should be submitted in 2019.

What is the cost of the ABOS WLA?
The Application Fee, like all ABOS Recertification Pathways, is $1,075. The Assessment Fee will be $1,300 over five Quality Years or $1,500 over five Quality Years for those who hold a Subspecialty Certificate.

If I cannot meet the Passing Standard of the ABOS WLA, will I receive extra time to get ready for the Computer/Oral Recertification Examination?
Each Diplomate will have at least two opportunities to pass an ABOS Recertification Examination.

Who chooses the Knowledge Sources and who writes the questions for the Knowledge Sources? Can I volunteer?
The ABOS Knowledge Source Groups were nominated by the appropriate orthopaedic societies. They will serve a three-year term. That group has been given the opportunity to write questions as well. However, more volunteers are needed. If you would like to volunteer, please complete the ABOS Volunteer Form which can be found by logging in to your ABOS Dashboard and clicking on the “Volunteer” button. Feel free to email me as well (

Will I be able to choose all 15 Knowledge Sources every year or will the ABOS require certain Knowledge Sources?
Diplomates will choose most, if not all, of the Sources they would like to study. There may be a topic that impacts all orthopaedic surgeons; in that case, the ABOS may choose to require certain Knowledge Sources for all participating Diplomates. For the most part, Diplomates are free to choose. However, as noted above, those with a Subspecialty Certificate will need to pick five Sources from their Subspecialty area.

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


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