The American Board of Orthopaedic Surgery (ABOS) is committed to ensuring that all ABOS programs and processes are bias-free while upholding the highest standards that allow patients to make confident decisions regarding their orthopaedic surgeon.
It is important that we address any potential bias in our ABOS Board Certification and Maintenance of Certification (MOC) Programs to ensure that each Candidate or Diplomate is evaluated solely on the merits of their orthopaedic knowledge, surgical treatment, skills, and professionalism. By upholding this merit-based approach, the ABOS Board Certification credential will maintain its distinguished reputation and credibility.
Some examples of our commitment include:
- In 2019, the ABOS made Board Certification more accommodating for those becoming parents. We changed orthopaedic residency educational requirements to allow the required 46 weeks of education per year to be averaged over the full five years of orthopaedic residency education. In 2024, we also added Alternate Dates for the annual computer-based examinations after adding an Alternate Date for the oral certification examinations in 2023. These changes allow for ABOS Board Certification to fit more seamlessly within orthopaedic surgeons’ lives without compromising the high standards of education and training required.
- In 2023, to investigate possible areas of bias, the ABOS hired a consultant. Thousands of ABOS Diplomates, orthopaedic residents, and ABOS Staff shared their experiences in surveys and listening sessions to help the ABOS implement changes that would make a meaningful difference. In 2024, the ABOS engaged psychometricians to analyze candidates’ performance on 1,202 ABOS Part I Examination questions by race and gender. Their analysis found no evidence of overt bias and sensitivity issues in the examination questions. However, that does not mean the work is done – the ABOS will continue to work with question writers and other experts to uphold the integrity and fairness of future examinations.
- During the annual ABOS Part II Oral Examinations, Examiners interact directly with each Examinee. This personal interaction creates the potential for unconscious or implicit biases to influence the evaluation process. Therefore, it is important that we address any potential bias and ensure that each Candidate is evaluated solely on the merits of their knowledge, surgical treatment, skills, and professionalism. To that end, before each year’s examinations, ABOS Oral Examiners undergo specialized training focused on implicit bias identification and mitigation with a goal of minimizing potential positive or negative bias. We will continue to evaluate the ABOS Oral Examination process and work with experts to uphold the integrity and fairness of future examinations.
- In 2023 and 2024, the ABOS conducted a research study to evaluate ABOS Oral Examination performance and scoring for across races and ethnicities. We found that pass rates on the ABOS Part II Oral examination are lower among Black and Hispanic candidates. However, the study showed that these Candidates had similar scores when their race and ethnicity were visible to the Examiners as when race and ethnicity were unknown. Therefore, we believe the ABOS Oral Examination process examines Candidates’ skills and professionalism without identifiable implicit bias related to race and ethnicity. The ABOS is committed to identifying the root causes of this disparities in examination results and is collaborating with other orthopaedic organizations to ensure that ABOS educational/evaluation systems address these issues.
