ABOS Partnerships and Collaboration

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To achieve its mission of protecting the public, the American Board of Orthopaedic Surgery (ABOS) actively partners and collaborates with other organizations. To help fulfill this mission, the ABOS is engaged with many other organizations. In this article, we highlight the key groups that work together to address critical issues regarding the care of patients in this country. It is important to understand the origins of the ABOS in order to better define its role in the field of orthopaedic surgery and in organized medicine. The ABOS was formed in 1934 by several members of the American Orthopaedic Association (AOA), the parent organization for both the American Academy of Orthopaedic Surgery (AAOS) and The Journal of Bone and Joint Surgery, Inc. (JBJS, Inc.). Subsequently, the AOA established the Council of Orthopaedic Residency Directors (CORD). These partnerships have proven valuable to the public and other stakeholders, particularly in the areas of graduate and continuing medical education (CME), which are key components of both initial and continuing certification. Table I contains several examples of key initiatives that have been developed in coordination with these entities. Additionally, members of the ABOS Board of Directors are nominated by the AOA, the AAOS, and the American Medical Association (AMA). TABLE I - Mutually Supported Efforts of the ABOS and Other Orthopaedic Surgery Organizations* AAOS CME SAE OITE ABOS KSB essential procedures JBJS, Inc. CME: scientific articles, reviews, and case reports SAE Clinical Classroom Web-based learning and assessment provider CORD and ARCOS KSB program pilots, evaluation, and implementation *ABOS = American Board of Orthopaedic Surgery, AAOS = American Academy of Orthopaedic Surgery, CME = continuing medical education, SAE = self-assessment examination, OITE = Orthopaedic Surgery In-Training Examination, KSB = Knowledge, Skills, and Behavior Program, JBJS, Inc. = The Journal of Bone and Joint Surgery, Inc., CORD = Council of Orthopaedic Residency Directors, and ARCOS = Association of Residency Coordinators in Orthopaedic Surgery. As part of its core mission for graduate medical education, the ABOS recently developed the ABOS Knowledge, Skills, and Behavior (KSB) program to document resident achievements in preparation for initial certification. The ABOS has worked closely with CORD, the AAOS, the Accreditation Council for Graduate Medical Education (ACGME), and the Association of Residency Coordinators in Orthopaedic Surgery (ARCOS). The ABOS nominates members to the Orthopaedic Residency Committee of the ACGME, and the Executive Director of the ABOS also attends those meetings as an ex-officio member. Table II provides examples of ABOS partnerships related to graduate medical education. TABLE II - ABOS Efforts in Education* KSB Program ACGME Residency Committee Resident operative log/procedural assessment integration Milestones 1.0 and 2.0 project CORD/ARCOS pilot studies Postgraduate year 1 simulation curriculum OREF grants in simulation AAOS/ABOS-sponsored symposia on simulation *ABOS = American Board of Orthopaedic Surgery, KSB = Knowledge, Skills, and Behavior, ACGME = Accreditation Council for Graduate Medical Education, CORD = Council of Orthopaedic Residency Directors, ARCOS = Association of Residency Coordinators in Orthopaedic Surgery, OREF = Orthopaedic Research and Education Foundation, and AAOS = American Academy of Orthopaedic Surgery. Initial Certification and Maintenance of Certification Collaborations The American Board of Medical Specialties (ABMS) represents 24 certifying boards that oversee >1 million active board-certified physicians. The ABOS-ABMS collaboration has unified the ABOS with other medical specialties with regard to the standards for initial board certification and maintenance of certification (MOC). The development of the ABOS MOC Program originated in collaboration with the ABMS. It includes evidence of professional standing, lifelong learning and self-assessment, cognitive expertise, and performance in practice. The ABOS peer review process serves to assess both the professional standing and performance in practice components. When professionalism concerns are raised during the credentialing process, the ABOS collaborates with state licensing boards and hospital credentialing to obtain additional information. Lifelong learning and self-assessment are exemplified by records of CME and self-assessment examinations (SAEs), which are obtained from partner organizations, including the AAOS and JBJS, as well as specialty societies, state societies, and institutional affiliations. The ABOS now collaborates with the Accreditation Council for Continuing Medical Education (ACCME) to improve and streamline the reporting of CME to the ABOS. Evidence of cognitive expertise is provided by a computer-based oral examination, the ABOS Web-Based Longitudinal Assessment (ABOS WLA) Pathway. The ABOS relies heavily on volunteer diplomates for the design and execution of these assessments. The reliability and validation of the examinations are assessed with the aid of psychometricians. Evidence of performance in practice includes a stringent peer review process as well as the submission of a case list. Peer review assessments are obtained by local and regional orthopaedic surgeons who respond to a confidential ABOS survey about orthopaedic surgeons who are applying for initial certification or recertification. The ABOS is the only certifying board to obtain peer review in this fashion. This process highlights the ABOS focus on quality patient care, professionalism, and patient safety. Evidence-Based Research Initiatives Although the case list is requested to assess performance in practice for orthopaedic surgeons, it has also been used for research purposes, which are overseen by the ABOS Research Committee. Interested orthopaedic surgeons may submit proposals to the Research Committee regarding clinical questions that may be important to advance the specialty. The ABOS also works with the AAOS and other specialty societies, as well as the Orthopaedic Research and Education Foundation (OREF), to fund pilot projects that focus on the development and testing of surgical simulation programs that are aimed to facilitate training and improve quality for residents and early-career surgeons. Partnerships with Specialty Boards The recognition that surgery of the hand requires multidisciplinary expertise led to the collaboration of the ABOS, the American Board of Plastic Surgery (ABPS), and the American Board of Surgery (ABS) to create a subspecialty certification in hand surgery. The goal of this collaboration was to provide equivalent assessment of the quality of care of patients receiving hand surgery rather than varying examinations leading to variations in care assessment. Additionally, since surgery for sports injuries is primarily performed by orthopaedic surgeons, the American Orthopaedic Society for Sports Medicine (AOSSM) similarly felt the need for an advanced certification for surgical sports medicine to standardize the assessment of surgery being performed by these specialists. It is through these collaborative efforts that the ABOS continues to provide the highest standard of certification and protect the public.

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