American Board of Orthopaedic Surgery

American Board of Orthopaedic Surgery
Name	American Board of Orthopaedic Surgery
Formation	1934
Type	Professional certification board
Headquarters	Chicago, Illinois
Region served	United States
Leader title	President

American Board of Orthopaedic Surgery is a nonprofit organization that certifies orthopaedic surgeons in the United States through written and oral examinations and oversees ongoing competence. It operates within a network of medical institutions, specialty boards, and hospital credentialing systems to influence standards of surgical practice and postgraduate training. The board interacts with national medical organizations, surgical societies, and regulatory agencies to align certification with patient safety and clinical advances.

History

The board traces origins to regional and specialty discussions among surgeons tied to institutions such as Johns Hopkins Hospital, Massachusetts General Hospital, Mayo Clinic, Cleveland Clinic, and Children's Hospital of Philadelphia during the early 20th century. Early leaders included figures associated with Harvard Medical School, Yale School of Medicine, University of Pennsylvania School of Medicine, and Columbia University Vagelos College of Physicians and Surgeons, who sought formal credentialing similar to the American Board of Surgery and American Board of Medical Specialties. Major milestones involved collaboration with organizations like American Medical Association, Association of American Medical Colleges, American Academy of Orthopaedic Surgeons, and Joint Commission to formalize standards. Postwar expansion paralleled developments at Walter Reed National Military Medical Center and Veterans Health Administration hospitals, while milestones in subspecialty recognition intersected with institutions such as Hospital for Special Surgery and Shriners Hospitals for Children. The evolution included responses to landmark events tied to patient safety reforms at Institute of Medicine and policy dialogues involving U.S. Department of Health and Human Services and Centers for Medicare & Medicaid Services.

Organization and Governance

Governance comprises a board of directors and exam committees drawn from faculty at centers including Stanford University School of Medicine, University of California, San Francisco School of Medicine, Duke University School of Medicine, Washington University School of Medicine in St. Louis, and University of Michigan Medical School. It interacts with accreditation bodies such as the Accreditation Council for Graduate Medical Education and specialty societies including American Orthopaedic Association, Pediatric Orthopaedic Society of North America, Orthopaedic Trauma Association, Scoliosis Research Society, and American Shoulder and Elbow Surgeons. Executive leadership works with administrative partners in cities like Chicago, New York City, Los Angeles, and Houston while coordinating with stakeholder organizations such as American Board of Medical Specialties, Association of American Physicians and Surgeons, Robert Wood Johnson Foundation, and Johns Hopkins Bloomberg School of Public Health. Committees reflect contributions from practitioners associated with Rush University Medical Center, Mount Sinai Health System, University of Pittsburgh Medical Center, and Thomas Jefferson University.

Certification and Examination Process

Initial certification requirements reference training at programs accredited by Residency Review Committee for Orthopaedic Surgery and institutions including Mayo Clinic Alix School of Medicine, Emory University School of Medicine, Vanderbilt University Medical Center, and Northwestern University Feinberg School of Medicine. Candidates typically complete case logs from hospitals like Bellevue Hospital, Ronald Reagan UCLA Medical Center, and NYU Langone Health and demonstrate competencies aligned with exam content experts from American Academy of Orthopaedic Surgeons, Orthopaedic Research and Education Foundation, and subspecialty societies. The board administers a written Qualifying Examination and an oral/structured Certifying Examination with test development informed by psychometricians and partners such as National Board of Medical Examiners and Prometric. Passing certification is used by credentialing committees at centers like Cleveland Clinic, Mayo Clinic, and Massachusetts General Hospital for privileging decisions.

Maintenance of Certification (MOC)

MOC programs require ongoing assessment activities, continuing medical education credits recognized by Accreditation Council for Continuing Medical Education, performance improvement projects connected to institutions like Kaiser Permanente, and periodic secure examinations. The program aligns with expectations from American Board of Medical Specialties and has been revised in response to policy shifts involving Centers for Medicare & Medicaid Services and litigation that referenced advocacy by groups such as American Academy of Family Physicians and Texas Medical Association. Data submission for MOC may integrate registries like American Joint Replacement Registry, National Trauma Data Bank, and initiatives led by Agency for Healthcare Research and Quality.

Educational Programs and Research

The board supports educational efforts and collaborates on research with academic centers such as Rutgers Robert Wood Johnson Medical School, Icahn School of Medicine at Mount Sinai, Weill Cornell Medicine, Columbia University Irving Medical Center, Georgetown University Hospital, and Yale-New Haven Hospital. Research areas include outcomes research, assessment methodologies, and simulation training developed with partners like Society for Simulation in Healthcare, American Society for Surgery of the Hand, Pediatric Orthopaedic Society of North America, and foundations such as Orthopaedic Research and Education Foundation. Educational tools reference curricula used in residency programs at Uniformed Services University of the Health Sciences and fellowship programs accredited through specialty societies including Adult Reconstruction and Sports Medicine organizations.

Public and Professional Roles

The board provides information relied upon by patients, hospitals, and payers and interfaces with organizations such as Consumer Reports, Centers for Medicare & Medicaid Services, National Committee for Quality Assurance, Leapfrog Group, and specialty societies including American Academy of Orthopaedic Surgeons and American Orthopaedic Association. It issues public statements on professionalism, patient safety, and scope of practice topics that intersect with regulatory entities like State Medical Boards and advocacy groups such as American Association of Hip and Knee Surgeons. The board’s certification status often appears in profiles on hospital websites for systems like UCLA Health, Cedars-Sinai Medical Center, Ohio State Wexner Medical Center, and Barnes-Jewish Hospital.

Criticisms and Controversies

Critiques have come from academic centers, policy groups, and practitioners associated with organizations like American Association of Neurological Surgeons, American Academy of Pediatrics, American College of Surgeons, and state-level associations regarding costs, administrative burden, and relevance of some MOC components. Legal challenges and public debates have involved parties referenced in litigation trends similar to disputes involving Texas Medical Association and physician advocacy groups. Calls for reform cite research by health policy units at Harvard T.H. Chan School of Public Health, Johns Hopkins Bloomberg School of Public Health, University of California, San Francisco, and think tanks such as The Brookings Institution that examine outcomes, credentialing impact, and alternatives including entrustable professional activities promoted by postgraduate educators.

Category:Medical certification boards