What’s the Latest?
September 2008

Board Certification
Bernard F. Hearon, M.D.

Board certification is a voluntary process by which physicians demonstrate competence to practice in their chosen specialty. The American Board of Orthopaedic Surgery (ABOS), located in Chapel Hill, North Carolina, administers the certification process for orthopaedic surgeons by evaluating their initial and continuing qualifications and competence. Periodic review of surgeon performance and practice patterns is appropriate due to continuing advances in the field of orthopaedics including new orthopaedic implants and surgical techniques.

Since 1986, the ABOS has issued time-limited certificates which expire ten years after they are granted. Therefore, all orthopaedic surgeons who were certified in 1986 and thereafter must maintain their certification by participating in a rigorous four-step process once every ten years (ref. 1). To remain Board certified in general orthopaedics, these surgeons must:

• Maintain an unrestricted state license to practice medicine
• Complete 120 hours of continuing orthopaedic medical education during two three-year cycles and periodic self-assessment exams
• Undergo a stringent peer review process, including scrutiny of all surgical cases during a three-month period
• Pass a secure written or oral recertification examination

In addition, the ABOS issues two Certificates of Added Qualification to orthopaedic subspecialists in the areas of hand surgery and orthopaedic sports medicine. These subspecialty certifications are also time-limited and are granted only after applicants pass another set of stringent requirements which include minimum subspecialty surgical case volume, peer review and a comprehensive written examination in the subspecialty area (ref. 2).

During my professional career, I have passed the Board review process more than most orthopaedists. In 1990, I was initially certified by the ABOS in general orthopaedics and years later was recertified through 2010. In 1992, I earned subspecialty certification in hand surgery and years later was recertified in that subspecialty. In November 2007, I passed the first ever Subspecialty Certificate in Orthopaedic Sports Medicine Examination administered by the ABOS. Last month, I passed the Combined Hand and General Orthopaedic Recertification Examination administered by the ABOS, thereby maintaining my Board certification in general orthopaedic surgery and my subspecialty certification in hand surgery through 2020. As of this writing, I am the only orthopaedist in Kansas to have earned all three Board certifications - general orthopaedics, orthopaedic sports medicine and hand surgery.

Though some have argued that maintenance of certification exams may not reliably assess physician competence (ref. 3), I believe that the rigorous study required to pass these certification examinations has certainly made me a more knowledgeable orthopaedist. This broad academic knowledge base and the extensive clinical experience accumulated during my 20-year orthopaedic career have prepared me to provide the best possible orthopaedic care for the patients in my practice.

Want more information online? Visit www.abos.org to find out who is Board certified, when they were initially certified and if they were recertified. Orthopaedists certified before 1986 have lifetime certificates and many have never recertified. Some with time-limited certificates nearing the end of their professional careers may also elect to not recertify. Finally, new orthopaedists who have just completed their training are Board eligible but may not become Board certified for at least two years following completion of training (ref. 4).

References

1. Ezaki M, Marcus RE. Orthopaedic Forum: Maintenance of Certification for Orthopaedic Surgeons. J Bone & Joint Surg; 91-A(1): 222-226, January 2009.

2. Bridwell KH, Harner CD, Polly DWJr, Stern PJ. Symposium: Current Status of Orthopaedic Subspecialty Certification. J Bone & Joint Surg; 88-A(9): 2081-90, September 2006.

3. Landon BE. What Do Certification Examinations Tell Us About Quality? Arch Intern Med; 168(13): 1365-67, October 2008.

4. Marcus RE, Callaghan JJ, DeRosa GP. Demystifying the Orthopaedic Certification Process. J Bone & Joint Surg; 89-A(2): 436-41, February 2007.