President’s Message
While Artificial Intelligence has been around for some time, it has continuously evolved and has clearly become a buzz word over the past several years, especially with the development and advancement of user-friendly interfaces such as ChatGPT and other AI platforms.
At our recent Board Meeting, we spent several hours learning about this topic from two physician consultants who are AI experts and had a productive discussion on how the ABOS could use and harness the powers of AI to better assess Diplomates while hopefully reducing burden for all stakeholders. We also discussed possible challenges and threats that this new technology could bring to our board certification process in our mission “to protect the public.”
To further the discussion and explore our opportunities and challenges that no doubt will be in our future, I have asked ABOS Vice President Dr. Scott Porter to lead a Task Force that will be looking into these topics related to AI. We have a diverse group of orthopaedic surgeons who will investigate AI concepts with outside experts and consultants in order to see where we are headed, not just in the immediate future but longer term as well. The ABOS will still be the preeminent certifying board for orthopaedic surgeons but how we go about determining the competency of an orthopaedic surgeon, may need to evolve and change as we consider adopting AI and machine learning into assessing candidates and diplomates.
While we want to investigate the potential of AI for the future, we also know that in our current state, practicing orthopaedic surgeons are still our best asset in helping us carry out our mission. They are the ones writing examination questions, which undergo scrutiny through an arduous process to ensure the questions meet the highest standards for assessment. Until we evaluate the powers of AI more thoroughly and understand its limits, the ABOS has a current policy that prohibits our question writers from using AI to generate questions. In addition, ABOS Diplomates are currently the ones conducting Oral Examinations for Board Certification. Whether AI can help us in this domain remains uncertain, but clearly, we must investigate this potential. AI technology is in its infancy but will no doubt gain rapid acceptance into everyday life as it exponentially grows in its powers. Although AI chat bots may currently seem confident in their answers, they are not always right—they sometimes suffer from “hallucinations.” Clearly, AI is still evolving.
The advancements with AI are coming so quickly that I am afraid what I am writing now might be outdated by the time you read this. However, it is the responsibility of our Orthopaedic profession to keep up with changes in medicine as well as advances in technology. Nothing will change the ABOS’ mission of protecting the public.
James D. Kang, MD
President, American Board of Orthopaedic Surgery
Executive Director’s Report
Customer service seems to be getting worse. When you call a company, you often go through many prompts and may not ever reach a human. The American Board of Orthopaedic Surgery (ABOS) is different. When you call us during business hours, there will be a friendly, helpful person on the other end of the line.
The ABOS offers concierge service to our Residents, Candidates, and Diplomates. Every orthopaedic surgeon has a Certification Specialist for whom they are assigned, based on the first letter of their last name. When a Diplomate calls the office, the person who answers the phone will likely transfer him or her directly to the appropriate Certification Specialist. If that person is unavailable, there will always be someone else who can assist.
When we include a question about customer service on an ABOS survey, our staff always receives high marks. Not only are they friendly but are usually able to answer questions or solve issues promptly. Our four Certification Specialists have been working for the ABOS for an average of 14 years. Even if a Diplomate has a unique situation, they have probably encountered it before and know how to help.
However, if a staff member is not able to help you, please reach out to me directly at dmartin@abos.org.
You may not even need to reach out to us. The ABOS is working to reduce burden and make our Board Certification and Maintenance of Certification programs beneficial to orthopaedic surgeons while staying true to our mission of protecting the public. If you do need to contact us, you will realize we have a dedicated staff to help you.
David F. Martin, MD
Executive Director, American Board of Orthopaedic Surgery
90 Years of Doing the Right Thing
In 1934—90 years ago—the American Board of Orthopaedic Surgery (ABOS) was established in Chicago at the Palmer House—the hotel where the ABOS still conducts Oral Examinations! Throughout this year, the ABOS will be looking back at those 90 years and looking forward to the future.
What memories do you have? Taking the Part I Examination in basement of the Hyatt Regency in Chicago? Bringing a suitcase to the Oral Examination at the Palmer House full of patient records and images? While much has changed over time, the organization’s commitment to protecting the public has not. All Board decisions are based on how best to protect the public and increase the value of ABOS Board Certification, while also minimizing any burden to orthopaedic surgeons.
Celebrate that the ABOS is the longest standing certifying board for orthopaedic surgeons. For 90 years, the ABOS has been doing the right thing, protecting patients, and continuing to adapt and improve our processes. For the next 90 years, the ABOS will continue to innovate and make sure that the Board Certification and Maintenance of Certification processes are meaningful to orthopaedic surgeons.
The ABOS has created a video history of the organization, which you can view here: https://www.abos.org/about/history/.
Reducing Bias in Examination Questions
The American Board of Orthopaedic Surgery (ABOS) is committed to eliminating bias in all ABOS assessments. The goal of ABOS computer examinations is to measure the knowledge of the orthopaedic surgeon, no matter the Examinee’s background. The rigor of the ABOS assessments does not change; what may change is how a question is written.
The ABOS is conducting a Differential Item Functioning (DIF) Analysis with psychometricians to look for potential bias in ABOS examination questions. The DIF analysis will determine whether measurement bias exists in questions in the Part I Certification Examination. Measurement bias tells us whether an item performs differently for examinees matched on the same ability level but with different sex/gender or race/ethnicity. Because some questions will perform better or worse due to chance, measurement bias does not determine if the flagged question is biased. Once questions with measurement bias are identified, a panel, who are experts in DEI in examination preparation, will review the questions to determine if item bias exists. If questions are identified to have item bias, the questions will then be reviewed by a panel of orthopaedic surgeons trained in written question bias. Questions that are identified as biased will be removed from the question pool for future examinations and will be used to educate question writers in the future.
In addition, the ABOS will be conducting an item writing bias training session for all question writers. The session will be led by an expert in question item bias in all types of written examinations, not just medical certification examinations. Question writing in general is not easy, and the ABOS appreciates those orthopaedic surgeons who can write quality questions. Bias training teaches ABOS question writers how to screen for and eliminate potential bias in questions.
The ABOS believes that there is no place for bias or discrimination within the field of orthopaedic surgery or within our organization. Question item review is another step in following this guiding principle.
Alternate Date for Oral Examinations
In 2023, the American Board of Orthopaedic Surgery (ABOS) offered an alternate date for the ABOS Oral Examinations for those who had a life event making it impossible for them to take the 2023 Oral Examination in July. At a recent ABOS Board Meeting, the Board approved offering an alternate date option for 2024 and beyond to Examinees who are unable to participate in the regularly scheduled Oral Examinations due to a life event including, but not limited to, death in the immediate family, serious injury or illness, military deployment, or recent or impending childbirth.
Those who have registered for a 2024 Oral Examination have received an email from the ABOS about how they can apply for the Alternate Date Oral Examination. The requirements and deadlines do not change for those who are approved by the ABOS Credentials Committee to take an Oral Examination on the Alternate Date. The Alternate Date is for those who have a life event and cannot be used for vacation or travel.
In 2024, the ABOS will also offer an Alternate Date for the ABOS Part I Examination. Residents who have signed up for the Examination have been informed about this option.
The ABOS believes that meeting the Board Certification and Recertification requirements should not be a burden on orthopaedic surgeons and are finding ways to assist while maintaining the highest standards that are expected of ABOS Board Certified Orthopaedic Surgeons.
Automatic Transfer of CMEs and SAEs
As was mentioned in the last issue of the Diplomate, the American Board of Orthopaedic Surgery (ABOS) 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 to a Diplomate’s ABOS Dashboard.
CME and SAE activities from the American Academy of Orthopaedic Surgeons (AAOS) are being transferred to the ABOS after a Diplomate “claims” the credit on their AAOS Learning Portfolio. Additionally, organizations for which the AAOS has a joint-providership have their activities automatically come to the ABOS after a Diplomate claims the credit.
Currently, credits earned from activities with the American Orthopaedic Foot and Ankle Society (AOFAS), American Society for Surgery of the Hand (ASSH), Arthroscopy Association of North America (AANA), and several hospital systems are directly reporting their CME and SAE credits.
The ABOS is working with other orthopaedic societies to be part of the ACCME’s Program and Activity Reporting System (PARS) in order for the transfer to happen. Other types of CME activities, such as a hospital’s grand rounds, can be eligible for the program assuming they are entered into the ACCME’s PARS system 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, especially after meeting the ABOS MOC CME/SAE 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. However, now half of those credits need to be earned in years 1 -5 of the 10-year cycle and the other half need to be earned in years 6 – 10. More details can be found at https://www.abos.org/moc-modifications/.
Peer Review and Case List Evaluation
Peer Review and Case List Evaluation are important parts of the American Board of Orthopaedic Surgery’s (ABOS) Board Certification and Maintenance of Certification (MOC) programs. They provide valuable ways for surgeons to evaluate other surgeons—self-regulation in medicine is important, and the ABOS is working hard to make sure that orthopaedic surgeons are appropriately, adequately, and fairly assessed.
All Candidates applying for ABOS Board Certification must submit a six-month Case List consisting of all surgical cases performed from January through June of the year prior to their ABOS Part II Oral Examination. From that six-month Case List, 12 cases are selected for presentation at the ABOS Part II Oral Examination. Candidates are provided with a list of the items that are required for the Oral Examination (patient documents and images), and those are uploaded by the Candidates to the ABOS portal. During the Oral Examination, both the Examinee and the Examiner see those records and then the Examiner will ask questions about the cases. The Board believes that the Oral Examination is one of the most effective ways to determine an orthopaedic surgeon’s competency and suitability for ABOS Board Certification. While the ABOS Part I Examination tests knowledge, the Part II Examination measures if an orthopaedic surgeon is practicing safe, effective medicine.
Once every 10 years, ABOS Diplomates are required to submit a Case List as part of the ABOS Maintenance of Certification (MOC) process. While few Diplomates take an Oral Recertification Examination, the Case List is still an important part of the ABOS MOC process for several reasons. The Case List is reviewed to search for outliers. If outliers appear, the Board investigates further. Outliers can include never events, complication rates, and procedures with questionable indications. In addition, each ABOS Candidate or Diplomate who submits a Case List (Part II and MOC) receives a Case List Feedback Report, which shows norms and allows a comparison to their peers. The Reports are uploaded to the surgeon’s Dashboard in the fall of the year following submission of the Case List. The report can help the surgeon select CME activities.
Peer Review is also an essential part of the ABOS Board Certification and ABOS MOC processes. When orthopaedic surgeons complete an ABOS Part II Application or an ABOS Professional Standing Update for Recertification, they must include the names and email addresses of practice partners, hospital chiefs in various departments, and other orthopaedic surgeons familiar with their practice. The ABOS emails an ABOS Peer Review questionnaire to each of those listed, asking questions about patient care skills, surgical skills, behavior, and communication. Also, the ABOS emails Diplomates who practice nearby—and who were not included on the Application—the same questionnaire.
If you receive an ABOS Peer Review Survey, please complete it if you know the Candidate or Diplomate. It does not take much time, and it is important to our profession. It is extremely helpful to the ABOS, our field, and our patients if you are familiar with a surgeon’s practice and can provide candid, honest feedback.
The ABOS conducts further investigation for those whose Peer Review evaluations are less than expected. That often includes confidential interviews conducted by orthopaedic surgeons to verify the feedback. The ABOS Credentials Committee reviews the information collected regarding all Candidates and Diplomates and then determines the next steps.
Peer Review is critical to the ABOS Initial Board Certification and MOC Programs and allows the ABOS to ensure safe, ethical, and effective orthopaedic care for our patients.
Thank You Volunteers!
More than 400 American Board of Orthopaedic Surgery (ABOS) Diplomates volunteered for the ABOS in 2023. Nearly 50 of them are first-time volunteers. Thank you!
Much of the work of the Board—especially with the development of all assessments—is conducted by practicing orthopaedic surgeons for orthopaedic surgeons with ABOS staff helping to direct operations. Assessments are designed for what you should know.
While the most visible position is the Oral Examiner, the ABOS also needs orthopaedic surgeons to write questions, select ABOS WLA Knowledge Sources, and develop examination blueprints. There are many ways you can participate. The first step is completing the volunteer form found on your ABOS Dashboard.
This list below includes those who have volunteered in 2023 for the first time and those celebrating anniversaries of their volunteer experience with the ABOS. Thank your colleagues who are listed and consider volunteering if you have not done so already.
35 Years
A. Herbert Alexander
25 Years
Stephen A. Albanese
Marybeth Ezaki
20 Years
Joseph B. Koscielniak
Adolph V. Lombardi
Regis J. O’Keefe
Terrance D. Peabody
Scott D. Weiner
15 Years
James E. Carpenter
Nancy M. Cummings
Janos P. Ertl
Frederick C. Flandry
John S. Kirkpatrick
Sheldon S. Lin
John P. Lubicky
J. Lawrence Marsh
Peter M. Murray
Jeffery L. Stambough
David R. Steinberg
Rick W. Wright
Daniel M. Zinar
10 Years
Thomas L. Bradbury
James R. Ficke
Gregory P. Guyton
Craig L. Israelite
Dawn M. LaPorte
Jackson Lee
James F. Mooney
Michael S. Murphy
Mark D. Perry
Heather A. Vallier
Douglas R. Weikert
5 Years
Peter C. Amadio
Alexandre Arkader
Michael B. Banffy
Jennifer S. Barr
James B. Billys
Michael Blankstein
Deborah C. Bohn
Matthew J. Bollier
Jeffrey J. Brooks
Gregory A. Brown
Peter N. Chalmers
Samuel K. Cho
Christopher S. Cranford
Oscar J. Currie
Lisa T. DeGnore
Thomas K. Donaldson
Todd J. Duellman
Daniel C. Farber
Scott D. Gillogly
Melvyn A. Harrington
Joseph Horton
David W. Irvine
James C. Krieg
Aaron J. Krych
Andrew F. Kuntz
Pamela C. Luk
Jeffrey E. Martus
Rakesh P. Mashru
Edward R. McDevitt
Mark A. Mighell
Patrick M. Morgan
Joseph T. Moskal
Gregory P. Nowinski
Hari K. Parvataneni
Daniel T. Phelan
Matthew L. Ramsey
Afshin E. Razi
Harold W. Rees
Peter C. Rhee
Christopher J. Roach
Andrew W. Ryan
Jason W. Savage
Arjun Saxena
Adam P. Schiff
Matthew R. Schmitz
Joseph M. Sewards
Kevin G. Shea
Harvey E. Smith
William R. Spiker
Lisa A. Taitsman
Kenneth F. Taylor
Paul Tornetta
Jennifer L. Vanderbeck
Eric F. Walsh
Christina M. Ward
1 Year
Oluwaseun T. Akinbo
John Alexander
Sameer Badarudeen
Matthew C. Baker
Scott I. Berkenblit
Amit K. Bhandutia
Craig R. Bottoni
Alison L. Cabrera
David C. Carver
Chris Casstevens
Andrew G. Chan
Joseph Y. Choi
Catherine A. Compito
Kyle R. Duchman
Brian J. Galinat
Joseph A. Gil
John G. Ginnetti
Scott E. Hecox
Joshua S. Hornstein
Amit Jain
John J. Jasko
Drew A. Lansdown
Daniel D. Lee
Patrick P. Lin
Nicholas H. Maassen
Matthew J. Meunier
Keith O. Monchik
Elizabeth M. Nolan
Daniel K. Park
Juan A. Pretell
Laura J. Prokuski
Catherine M. Rapp
Aymen Rashid
Comron Saifi
Jonathan W. Shearin
William F. Sherman
Neil P. Sheth
Gbolabo O. Sokunbi
Catherine M. Spath
Joshua T. Steere
Hobie D. Summers
Fernando Techy
Christopher J. Tuohy
Rohit B. Verma
Edward R. Walker Gallego
Tianyi Wang
Jason S. Weisstein
Gregg Wolff
Elizabeth M. Yu
