Forum Members ABFAS/ABPM

[newpodgrad]

Hey guys

While looking for jobs , I inquired with a few local hospitals about how to go about getting privileges.

Several of them sent me info and I wanted to highlight a board concern.

Not sure how to really take it, but here’s a excerpt from one of the docs re: board status.

“Board Certification Requirement means certification from one of the following boards: the American Board of Medical Specialties, the American Osteopathic Association, the American Board of Foot and Ankle Surgery, or those Boards which may be approved by the Executive Committee to satisfy this Requirement”

As a disclaimer, I’m not a HUGE surgery pod. I enjoyed it , and did it in residency because, well, that’s what we had to do. And I’m fine with my forefoot procedures. I believe I’ve done well with them at my current level. I don’t care to do TARS, scopes mid foot fusions etc. I have no problem referring them out. I took the ABFAS qualifying tests etc, because again, it’s encouraged in residency and passed them.

Looking at this doc, it almost seems like this board required if you wanted to be on staff. The little statement at the end regarding “or those boards” seems like it might open the door for ABPM with some petitioning or something.

What do you guys make of this? I have heard from others that ABPM will get involved with issues regarding privileges etc. Is there more to this picture than meets the eye?

Thanks in advance for everyone’s take

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[Pronation]

I think concerns are understandable as this further confuses the non podiatry world. If I am doing ankle charcot, ex fix, flap cases and not able to get ABFAS cert that is very unfair if that leads to lack of privileges at hospital I work at. This APBM with CAQ might be the way forward for podiatrist who do just that for a living. But both boards need to work together to help podiatrist get privileges based on their training and experience. Both boards at this stage have left the individual podiatrist to fight their own fights at hospitals. I had to politic and navigate it myself and when I reached out to ABFAS for help I didn't get a reply. It has been the most stressful part of my job.

People on this forum need to show some decorum. Everyone in surgery decides to create a practice that they want. Not all general surgeons are doing Whipples. And personally attacking someone because of type of pathology they decide to treat is lame.

With all due respect, I find it hard to believe that anyone regularly doing ankle Charcot recons, ex fixes, and fasciocutaneous flaps also does not have the capability/training to do all of the other stuff that would get them ABFAS cert. If you aren't/can't do all foot/ankle surgery then you aren't going to get ABFAS certified and also shouldn't be doing the above cases either. I am certainly open to hearing why my opinion might be wrong though.

 

[CutsWithFury]

“Increasing the scope of practice of podiatry in all states. Creating a unified scope of practice in ALL states”

Agreed 100%. This needs to happen ASAP... just like how we weren’t considered “physicians” with the VA until 4 years ago (Took long enough for that to pass...).

It won't happen because after all the posturing and all the internet tears on SDN that posters are violating TOS etc etc etc when it comes to really changing the laws and making a unified scope of practice for podiatry it will require a lot of time, money and fierce litigation to get it changed. AOFAS and AAOS will fight to the death. Our leaders are too busy making new schools and messing around with board exams to really focus on our real professional problems.

 

[diabeticfootdr]

You are not doing 1000-1200 cases in a year. Maybe procedures. Maybe.

I’m sorry, you’re just plain wrong. And you don’t know me or my practice. I’m the busiest surgeon in the whole University Hospital, as a podiatrist. If that conflicts with your world view and the tearing down of our profession on SDN … I’m sorry.

This was my last month’s report (June 2022) of OR cases … in the “real OR” of a major university hospital. “Real surgeries” under anesthesia.

So please, check your ego, and maybe say something beneficial to the discussion instead of just attacking people you don’t know or have no personal knowledge of.

 

[diabeticfootdr]

With all due respect, I find it hard to believe that anyone regularly doing ankle Charcot recons, ex fixes, and fasciocutaneous flaps also does not have the capability/training to do all of the other stuff that would get them ABFAS cert. If you aren't/can't do all foot/ankle surgery then you aren't going to get ABFAS certified and also shouldn't be doing the above cases either. I am certainly open to hearing why my opinion might be wrong though.

I agree with the point that if you are doing all these limb salvage cases, you know the anatomy, surgical techniques, and principles of internal and external fixation, but … if you specialize in the diabetic foot you don’t have the case diversity. I don’t do acute trauma. I don’t do regular bunions or hammertoes. I’ve never done an arthroscopy since residency. Can’t remember the last time I did a calcaneal fx. But I just booked a total calcanectomy (post-traumatic fx non-union with OM in DM) and will 3D print a new calcaneus implant from a contralateral CT. So who’s judging?

I’m not complaining about it and I don’t ask for those privileges because I don’t need them and others are better at them. But I want to do what is in my expertise.

Luckily for me, I’ve never had a problem. Every hospital I’ve practiced in considered ABPM primary BC. But some people do have a problem. And that’s why we help people.

 

[Feeter]

With all due respect, I find it hard to believe that anyone regularly doing ankle Charcot recons, ex fixes, and fasciocutaneous flaps also does not have the capability/training to do all of the other stuff that would get them ABFAS cert. If you aren't/can't do all foot/ankle surgery then you aren't going to get ABFAS certified and also shouldn't be doing the above cases either. I am certainly open to hearing why my opinion might be wrong though.

You aren't wrong. One may choose not to do TARs or trauma. Or due to local demand or job that you chose may not lead to the diversity of cases. Another reason is also the fact that board cert pass rate is very low. I know several surgeons who have failed it but are incredible surgeons. Several on this forum have also commented on this issue.

Otherwise yes I agree ABFAS can tweak a few things to be more inclusive so we don't need ABPM CAQ just to do limb salvage cases at a hospital.

 

[DexterMorganSK]

Personally attacking other users with no proof is not allowed. I've said it multiple times now. Please refrain from causing any more inflammatory posts and stay on topic.

 

[DPM TRUTH]

Good morning everyone…you know I had to come out of the wood work for this one everyone!

Who is surprised this was going to happen? After close to 25years of being a part of ABPM/ABFAS/ACFAS I did not re-certify a couple years ago due to problems I had with their organization over the past decade. I tried to call them to inquire about things I did not agree with and they did not care at all. Nope, not one bit. They treated me like a “dinosaur” and never followed up with me. I have had more well-trained DPMS fail that case review process after looking at all their cases personally.

So this is great news for the profession as a whole. Now PMS trained podiatry will be allowed to practice what they are good at vs. being extorted (YES EXTORTED) by the ABFAS for case “diversity”. Now instead of paying 4k for “case review, review”, many highly talented people in our profession will finally be able to do what they are good at. A lot of others on here say “just do your toes and bunions, no one is stopping you”. I got news for you “abfas/acfas mavericks” – your colleagues are stopping them. Why you ask? After doing a 3- year PM&S-36, a resident doing a hammertoe (not board certified) needs to worry about ANY complication that is NOT their fault. Why you ask, even though they have 500+ logged? Because there will be a GRANDFATHERED in ABFAS “foot and ankle certified” DPM who will take 4500 bucks to testify AGAINST them if ANYTHING happens…their fault or not. This GRANDFATHERED IN DPM will spend the entire trial telling the 3-year trained DPM is incompetent. I am sick of defending residents who are highly competent who get frivolous suits with experts being GRANDFATHERD IN DPMS. But now that ends. Now they will be board certified by the American Board of Podiatric Surgery. Now they can go after the GRANDFATHERED IN DPMS at trial and turn it on them and ask how they got a surgery certificate without a surgery residency or only doing a 6 month clerkship?

So to all my “New ABFAS Crowd”, I hope is was fun while it lasted. The meetings in Hawaii, the fake case review process (being reviewed by DPMS being sued for things they are reviewing), and being able to extort the other 85% of the profession to a closed process (for 4k we will let you have another shot – are you for real???). The ABFAS is about to find out how much hate there is out there for their organization….not only from the new graduates but from a lot of people in my age group who watched the ABFAS drive our profession into the ground. We are all here to support this new move by the APBPM. It was needed due to the misdirection the ABFAS has gone. PERIOD.

Also, that response Friday night from ABFAS was terrible. It sounded so desperate, kinda like a kid who got caught. But “believe us now”. Got news for the ABFAS – the biggest public threat is residents doing procedures they are NOT comfortable with but need for “case diversity”. The ABFAS forcing others to perform the cases “they deem OK”. That is what’s dangerous, forcing newly trained residents to due procedures they don’t feel comfortable with.

 

[JewOnThis]

I will say this. Dr Rogers is the best thing that has ever happened to ABPM. The last president was a total……

 

[deleted1138023]

Damn did @CutsWithFury get banned?

Anyways… I support the ABPM here. ABFAS is a cruel process that seems to be in it for money only, I believe ABPM has way better intentions.

 

[deleted1138023]

Also, that response Friday night from ABFAS was terrible. It sounded so desperate, kinda like a kid who got caught. But “believe us now”. Got news for the ABFAS – the biggest public threat is residents doing procedures they are NOT comfortable with but need for “case diversity”. The ABFAS forcing others to perform the cases “they deem OK”. That is what’s dangerous, forcing newly trained residents to due procedures they don’t feel comfortable with.

Absolutely. Why does no one talk about this?

 

[Shiyuan]

Anyways… I support the ABPM here. ABFAS is a cruel process that seems to be in it for money only, I believe ABPM has way better intentions.

Agreed 100%.

In my eyes, ABPM now looks like the “better” board certification.... in the sense that it certifies Podiatrists based on ALL aspects of podiatric medicine (including surgery) and allows us to obtain a CAQs based on our personal practice sub-specialties/interests.

(Not to say that I don’t respect ABFAS and their excellent CME opportunities, meetings, etc.... ABPM just does better reflecting the podiatric physician as a whole)

 

[Feli]

Agreed 100%.

In my eyes, ABPM now looks like the “better” board certification.... in the sense that it certifies Podiatrists based on ALL aspects of podiatric medicine (including surgery) and allows us to obtain a CAQs based on our personal practice sub-specialties/interests.

(Not to say that I don’t respect ABFAS and their excellent CME opportunities, meetings, etc.... ABPM just does better reflecting the podiatric physician as a whole)

This is shooting the arrow ... the painting the bullseye around it once one sees where it lands. That has to be called out.

There is nothing ABPM does to help a DPM that they can't get from ABFAS. The ABFAS cert will do everything the ABMP does and much more for any practicing DPM in terms of privileges, job recognition, respect of peers, ACFAS membership and CME, etc. It is not ABFAS' fault that residencies vary widely in quality/volume. I'm sure they'd love to cash more member cert checks and have more people pass (and I bet they are scrambling to find ways to do so without making total joke tests), but it's not their fault half the residency programs don't really set DPMs up well to pass F&A surgery exams. Our training has changed a lot.

There are tons of 'limb salvage' DPMs who are still cert ABFAS. Hundreds, probably thousands. I was going to list a few, but there are way to many to even start. To say the ones who didn't or couldn't get ABFAS didn't want it or just chose ABPM is just not accurate... that would be a tiny percentage.

The ABPM as single board or CAQ for surgery way may very well catch on over time, but that does not make it better. It simply makes it easier... anyone with half a brain walks around a 25 foot high brick wall instead of climbing over it or busting through it. The fact that one can graduate from the worst residency in the country, pay a bit of money, pass a few easy tests, get a CAQ with no proof of cases? There is no MD surgical specialty that has that. It has potential to make us all look very sloppy.

...CME is totally different than board cert. ACFAS meetings and journal vs those of APMA or sorry ASPS is a pit bull compared to a gerbil and a chipmunk. It's no contest. 95% good science versus 95% junk and info-mercials from the latters. It's not even close. ABFAS itself doesn't do CME, though (only affiliates with ACFAS and others for best info for exams, standards, etc).

Again, we will probably figure out in the next decade or so how this pans out and what ACFAS chooses to do. They are the make-or-beak entity here. They have 'limb salvage' DPMs as leaders, contributors, past prez (who all miraculously managed to pass ABFAS). As it stands, PI meetings/group are probably the wisest... they just sit on the sidelines, have good CME, have well-trained lecturers for the most part, and avoid taking sides pretty well. Stay tuned

 

[air bud]

Agreed 100%.

In my eyes, ABPM now looks like the “better” board certification.... in the sense that it certifies Podiatrists based on ALL aspects of podiatric medicine (including surgery) and allows us to obtain a CAQs based on our personal practice sub-specialties/interests.

(Not to say that I don’t respect ABFAS and their excellent CME opportunities, meetings, etc.... ABPM just does better reflecting the podiatric physician as a whole)

Confusing ABFAS and ACFAS although in lock step.

 

[deleted1138023]

ITT: abfas cert docs trying to gatekeep and keep a "leg" up on competition.

 

[Shiyuan]

As y’all have mentioned... until our profession has retired all the grandfathered “dinos” and we are one coherent cohort of 4 yr schooling + 3yr surg PMSR grads ONLY.... things likely wont change much.

And yes, I meant ACFAS. Word salad 🤪🤪🤪

 

[dtrack22]

The best part of the ABFAS “diversity” requirements (that I believe they did away with a year or 2 ago?) is that they were created by someone who literally only fixed a bunion one way. This was according to an individual who was a resident for said ABFAS board member/Pres. So ABFAS had old ABPS grandfathered-in podiatrists actively making certification more difficult for a group of graduates who are inarguably better trained than many of the people making the rules. It’s a scam and in reality its anti-competitive measures disguised as “patient safety” and “professional legitimacy.”

I have a friend who was denied STSG privileges despite being ABFAS certified. Hospital still asked to prove competency/experience with case logs. If ABFAS cert doesn’t just automatically let you take a split thickness skin graft, then what is the argument for it? It clearly doesn’t stop a facility from requiring case logs for a relatively uncomplicated procedure. Which is how privileging/credentialing should be, based on training and experience/competency. ABFAS doesn’t change any of that. Neither does ABPM. But ABFAS has written themselves into state regs and facility bylaws so, we’re stuck with it.

 

[619]

Public Notice Concerning the ABPM CAQ in Podiatric Surgery

The Council on Podiatric Medical Education (CPME) is aware of the recent announcements by the American Board of Podiatric Medicine (ABPM) to offer a Certificate of Added Qualification (CAQ) in podiatric surgery. The Council does not recognize or approve any CAQs within its current policies and procedures for board recognition. CAQs are not equivalent to certification, and they cannot lead to certification in any specific content area. Further, the Council believes it would be confusing to the public to provide a qualification in podiatric surgery when there is a surgical certification board within the profession.

The Joint Committee on the Recognition of Specialty Boards (JCRSB) was restructured as a standing committee of the Council as the Specialty Board Recognition Committee (SBRC) as of March 2022 and is no longer a joint committee with APMA. However, the ruling made by the JCRSB in 2018 is still in effect and states that although the ABPM was offering CAQs, all language on the actual CAQ provided to its certificants must state that the CAQ is not a CPME-recognized product.

The Council had already appointed an ad hoc advisory committee to begin the rewrite of the SBRC documents beginning fall 2022. Consistent with CPME’s procedures, this will be a clear and transparent process that includes input from the entire community of interest. The Council’s rules and procedures are the result of a thoughtful and deliberative process, and CPME will continue to vigorously enforce its existing and future standards with due process.

CPME requests, for the best interest of the profession, that all specialty boards refrain from implementing CAQs, including the CAQ in podiatric surgery, until the rewrite process is complete.

CPME is making this public statement so there is no ambiguity in its current position with respect to CAQs thus ensuring that stakeholders (e.g., hospitals making privileging decisions) have accurate facts about the Council's prevailing policy.

 

[deleted1138023]

I'm sure there is no conflict of interests between the CPME and ABFAS. *sarcasm*

LOL

 

[dtrack22]

CPME are the same asshats who approved a 10th podiatry school in spite of “the best interest of the profession.” So they can get off their high horse and go pound sand…

 

[icebreaker32]

https://www.acfas.org/ACFAS/media/ACFAS_Media/ACFAS-Statement-on-Board-Certification.pdf

ACFAS Statement

 

[deleted1138023]

the fact that our profession remains so divided is sad. I support the idea behind the ABPM mission.

 

[wakaflocka88]

Is it too much to ask for cpme, ABPM, ABFAS, ACFAS, ABLES to unify together for one night and make a public statement that podiatrists are not pedicurists? Then they can resume their battle.

 

[icebreaker32]

Is it too much to ask for cpme, ABPM, ABFAS, ACFAS, ABLES to unify together for one night and make a public statement that podiatrists are not pedicurists? Then they can resume their battle.

You forgot ABMSP …..Champions of Podiatry, and AMIFAS

 

[Pronation]

I support whichever board is cheaper to get certified in.

 

[deleted1138023]

I support whichever board is cheaper to get certified in.

one of them has a pass rate of like 35% last I checked so

 

[DPM TRUTH]

I was hoping I would not have to comment again on this thread but after the CPME/ACFAS response today I had to weigh in……

FIRST, to The CPME……..wow, just wow. It’s amazing how much time and effort you have to weigh in on podiatry politics. When was the last time your organization posted a statement like today like your response to the ABPM? Your organization, yes you know who YOU are, should stop weighing in on podiatry politics and focus on the big problem…..residency surgery numbers. I have spoken to many residents (AS HAVE TONS OF COLLEGUES) who still have not received a response from CPME concerning their specific concerns for their “residency numbers”. They have been waiting for a statement (like you made today about your concerns) about their lacking surgery numbers. It’s unfortunate that YOU continue to promote PM&S-36 programs that should not be anything further than a PSR12. Why you ask? Because the 3rd years are struggling to get just enough 1st ray procedures. They have to allow other first and second year residents’ to “cover” for them so they can scrub the cases. If they don’t they won’t meet the MINIMUN CASE LOAD to graduate. MINIMUM CASE LOAD – do you want your pilot to “just meet the minimum requirements”? Anyone want to say this does not happen podiatry? Yes, there are 40% of the programs that meet (some barely) the PM&S-36 true case requirements, the other 60% do not. Yes, live with this reality CPME. But what does the CPME keep doing? They come by, have lunch, chit chat a little with the section chief, and “re-certify” the program every couple years. Does anyone from the CPME ever meet with the residents? Do they ever meet with the hospital CMO? The answer is No, No. They hear what they want from their “members”. So before the CPME starts to weigh in on podiatry politics, please fix the HUGE problem of residents NOT getting their numbers. Then, forcing them to do procedures, they don’t feel comfortable doing to get “board certified”. This is all due to the CPME certifying programs that do NOT MEET the minimum requirements for a PM&S-36 program surgical loads. PERIOD.

ACFAS….really? Ask ACFAS board Members’ what they think about attending The AOFAS (American Orthopaedic Foot and Ankle Society – have to be a MD from medical school to join, no DPMs) Conference in September and getting a great big DPM (sometimes in bright red) badge to wear around their neck the conference? How many do you think attend yearly? They make it very easy to distinguish DPM’s vs. the MD Orthopedic Surgeons at the conference. ACFAS hates when AOFAS does it to them but it’s okay ACFAS goes after DPM colleagues because they don’t attempt cases they are not comfortable doing? It’s OK, keep dividing the profession everyone. You guys at ACFAS are the “gatekeepers” and get to decide what every one thinks. Did you meet with the APMA/ABPM to discuss this issue and try to resolve it before that statement? Nope, because “THEY DON’T HAVE TO”! Question to ACFAS, is it okay for someone that did a 6 month clerkship to be “ACFAS” but someone who is boarded in podiatric surgery by ABPM after a PM&S-36 is not ok to be “ACFAS”? Let me guess, you don’t have any ACFAS Members that did 6 month clerkships right? Also, I bet ACFAS “never heard” there are problems getting surgery numbers with residents. So again ladies and gentleman, you can be a member of ACFAS by NOT doing a surgical residency. Then they wonder why orthopedics wonders...

Colleagues….a house divided will eventually fall. The more the ABFAS/ACFAS/CPME continues to fight this, the more people from “my generation” will be coming out of the woodwork to SUPPORT the ABPM. What do we know though, we only have been doing this for 30+ years.

 

[Pronation]

Did anybody read this wall of text? If so, can I get some cliffs notes? Thanks in advance.

 

[dtrack22]

Question to ACFAS, is it okay for someone that did a 6 month clerkship to be “ACFAS” but someone who is boarded in podiatric surgery by ABPM after a PM&S-36 is not ok to be “ACFAS”?

I think you meant “ABFAS”

ACFAS is a college. It exists for continuing education. It’s not a certifying agency or board. ACFAS has no bearing on what, how, where, etc you practice.

Did anybody read this wall of text? If so, can I get some cliffs notes? Thanks in advance.

He/she raises some good points about CPME not caring about subpar surgical volume in residency (at many programs). But he/she also might not know what the difference between ABPM, ACFAS, APMA, ABFAS, CPME, etc and what each of their functions actually is.

 

[DexterMorganSK]

This sounds so complicated.

I’m a Australian podiatrist with a bachelors degree in podiatry.

I was looking for any prospects where I could get permission to sit for the APMLE exam. So far I’m not allowed.

The only way for me is to do a 4 year DPM in one of the 10 pod schools.

Why would you be allowed to take the APMLE? The two degrees (BS/BA vs. the DPM) are different. You are not qualified to sit for the APMLE. Even Physicians from other countries (IMGs/FMGs) that have passed the USMLE Step 1 and 2 are usually placed in the 2nd-year of a Podiatry program in the US. They repeat the last two years and the three years of residency.

 

[Shiyuan]

Why would you be allowed to take the APMLE? The two degrees (BS/BA vs. the DPM) are different. You are not qualified to sit for the APMLE. Even Physicians from other countries (IMGs/FMGs) that have passed the USMLE Step 1 and 2 are usually placed in the 2nd-year of a Podiatry program in the US. They repeat the last two years and the three years of residency.

I had an Egyptian MD colleague in pod school... started from year 1 like everyone else.

He was an orthopod, BTW. Great, humble, very pro-podiatry.

 

[Pronation]

I should be allowed to take the APMLE to demonstrate I have the knowledge and skills to the standards of a DPM. The bachelors level podiatry degree (BSc) and a masters in Podiatric surgery is easily equivalent to a DPM degree if not higher.

What’s the worse that could happen if I’m allowed to sit for the APMLE exams? That I score higher than a U.S DPM?

Oh yea, that totally makes sense that a foreign bachelors degree in chiropody and a master’s degree in toenail avulsions is equivalent to a US doctorate degree. I can’t believe they wouldn’t let you sit for the APMLE!

 

[Scrantonicity]

How about we come together as the United States before we start trying to unify the profession Internationally...still can't do Brostrom repairs in some states...

 

[air bud]

How about we come together as the United States before we start trying to unify the profession Internationally...still can't do Brostrom repairs in some states...

What?

 

[deleted1138023]

What?

You heard the man

 

[Pronation]

What if there’s some pus on the ATFL, can I operate on it then?

 

[icebreaker32]

What if there’s some pus on the ATFL, can I operate on it then?

Scope of practice can vary by state and change. Even before they changed and expanded some were doing ankle scopes and careful when they dictated to mention the word foot, talus and not mention ankle and tibia etc. Same with lateral ankle stabilization.

Depending on your state there is a black and white and then there are grey areas and you have to decide how you practice.

Some have gone beyond scope with peroneal nerve decompression in their state as an example and others have had another MD come in for that part of the procedure and dictate they were assistant for that procedure (even though they were the surgeon).

If you do an I&D and you go just beyond scope be carefull with wording when dictate. If it goes way beyond your scope irrigate, pack etc finish case and hand off patient or have another MD if you are real friendly with ortho or surgery swing by the room for a couple minutes if they agree to be put on case as surgeon and go more proximal.

If it is an elective surgery and something goes really wrong you are definitely putting yourself at risk by practicing beyond your scope.

 

[Pronation]

Ok well let’s say I’m the total toenail surgeon on call at my local nursing home and I get a call in the middle of the night for an ankle fracture that extends from the ankle joint up to the tibial tubercle?

 

[icebreaker32]

Ok well let’s say I’m the total toenail surgeon on call at my local nursing home and I get a call in the middle of the night for an ankle fracture that extends from the ankle joint up to the tibial tubercle?

Then you are dreaming, they don't consult podiatry for that.

 

[wakaflocka88]

Then you are dreaming, they don't consult podiatry for that.

Let’s not break the bad news to these new fellows that just finished and starting their real job.

 

[newfeet]

The APMA has now spoke on the matter…​

A Statement from APMA on the Announcement of a Certificate of Added Qualification in Podiatric Surgery by the American Board of Podiatric Medicine​ APMA's mission is to defend our members' ability to practice to the full extent of their education and training to best serve the public health. In fulfilling that mission, APMA depends on board certification through the two CPME-recognized boards, the American Board of Foot and Ankle Surgery (ABFAS) and the American Board of Podiatric Medicine (ABPM). The rigorous board certification processes established by these two organizations support APMA's work to demonstrate our members' education, training, experience, and ongoing commitment to quality care. APMA has concerns about the announcement by ABPM of a new Certificate of Added Qualification (CAQ) in Podiatric Surgery: We have heard from members in support of and in opposition to this new CAQ. There are strong feelings on both sides, creating division and discord within a small profession that depends on unity and collaboration to accomplish its goals. The profession has long recognized that there are two distinct specialties in which to be board certified: medicine and surgery. Our single, standardized Podiatric Medicine and Surgery Residency provides access to either or both certifying boards, depending on the choice and practice activity of the individual physician. Our current president, Laura J. Pickard, DPM, is among those physicians who hold certification from both boards. In 2019, APMA convened a Blue-Ribbon Panel to examine specialty board recognition. One outcome of that process, in which both ABFAS and ABPM participated, was a recommendation that APMA reaffirm its longstanding policy of recognizing only one certifying board for each unique area of clinical practice. Recognizing only one board in each area was deemed critical to serving the public interest and mitigating confusion in the health-care community. A CAQ in Podiatric Surgery offered by ABPM would seem to be a duplication of what is already offered by the recognized board for certification in surgery. APMA believes there is a strong possibility that a CAQ in Podiatric Surgery could confuse and mislead the public. A physician who has just completed residency is eligible to earn this CAQ. For those more than three years out of residency, ABPM requires only 25 total cases (five cases from each of five categories) with no requirement for diversity within those categories. Compare these scenarios to ABFAS certification in foot surgery, which requires at least 65 cases. The CAQ in Podiatric Surgery has a high potential to mislead a patient to believe a surgeon has more experience and expertise than they do. The CAQ also causes greater confusion for other health-care specialties, insurance companies, state legislators, and hospitals, which already frequently mischaracterize podiatrists' education, training, and certification. In light of these concerns, APMA consulted with the Council on Podiatric Medical Education. While ABPM notes that CAQs are not recognized by CPME, CPME does have oversight of the boards through its Specialty Board Recognition Committee (SBRC). CPME issued a statement on August 11 requesting that specialty boards "refrain from implementing CAQs, including the CAQ in podiatric surgery," until CPME has an opportunity to complete the planned rewrite of its SBRC documents. APMA supports CPME's statement and its request for delayed implementation. APMA also has reached out to ABFAS and ABPM in an effort to mediate the current situation and broker an outcome that is most beneficial for our members and their patients.

 

[Scrantonicity]

What?

? Yeah. At least you can finally amputate toes in South Carolina. Progress...

 

[DPM TRUTH]

Ok, APMA we got it. It's confusing for the public? Really? Thats it right?

Ok got it APMA, but it's okay to have ABFAS board members that NEVER did a surgical residency advertise as surgeons? Does the APMA think that is misleading to the public? What does APMA think of ABFAS boarding UNQUALIFIED DPMs that NEVER did a surgical residency? Come on APMA, address this FACT!

Better be careful APMA, wouldn't want some whistle-blowers to call out your compete BS!

 

[deleted1138023]

podiatry is hilarious. the highest bidder will determine the superior board certification. pretty obvious.

 

[Shiyuan]

The public does not care and does not know any different. Same with allopathic and osteopathic physicians... they could not care less.

 

[Feeter]

The APMA has now spoke on the matter…​

A Statement from APMA on the Announcement of a Certificate of Added Qualification in Podiatric Surgery by the American Board of Podiatric Medicine​ APMA's mission is to defend our members' ability to practice to the full extent of their education and training to best serve the public health. In fulfilling that mission, APMA depends on board certification through the two CPME-recognized boards, the American Board of Foot and Ankle Surgery (ABFAS) and the American Board of Podiatric Medicine (ABPM). The rigorous board certification processes established by these two organizations support APMA's work to demonstrate our members' education, training, experience, and ongoing commitment to quality care. APMA has concerns about the announcement by ABPM of a new Certificate of Added Qualification (CAQ) in Podiatric Surgery: We have heard from members in support of and in opposition to this new CAQ. There are strong feelings on both sides, creating division and discord within a small profession that depends on unity and collaboration to accomplish its goals. The profession has long recognized that there are two distinct specialties in which to be board certified: medicine and surgery. Our single, standardized Podiatric Medicine and Surgery Residency provides access to either or both certifying boards, depending on the choice and practice activity of the individual physician. Our current president, Laura J. Pickard, DPM, is among those physicians who hold certification from both boards. In 2019, APMA convened a Blue-Ribbon Panel to examine specialty board recognition. One outcome of that process, in which both ABFAS and ABPM participated, was a recommendation that APMA reaffirm its longstanding policy of recognizing only one certifying board for each unique area of clinical practice. Recognizing only one board in each area was deemed critical to serving the public interest and mitigating confusion in the health-care community. A CAQ in Podiatric Surgery offered by ABPM would seem to be a duplication of what is already offered by the recognized board for certification in surgery. APMA believes there is a strong possibility that a CAQ in Podiatric Surgery could confuse and mislead the public. A physician who has just completed residency is eligible to earn this CAQ. For those more than three years out of residency, ABPM requires only 25 total cases (five cases from each of five categories) with no requirement for diversity within those categories. Compare these scenarios to ABFAS certification in foot surgery, which requires at least 65 cases. The CAQ in Podiatric Surgery has a high potential to mislead a patient to believe a surgeon has more experience and expertise than they do. The CAQ also causes greater confusion for other health-care specialties, insurance companies, state legislators, and hospitals, which already frequently mischaracterize podiatrists' education, training, and certification. In light of these concerns, APMA consulted with the Council on Podiatric Medical Education. While ABPM notes that CAQs are not recognized by CPME, CPME does have oversight of the boards through its Specialty Board Recognition Committee (SBRC). CPME issued a statement on August 11 requesting that specialty boards "refrain from implementing CAQs, including the CAQ in podiatric surgery," until CPME has an opportunity to complete the planned rewrite of its SBRC documents. APMA supports CPME's statement and its request for delayed implementation. APMA also has reached out to ABFAS and ABPM in an effort to mediate the current situation and broker an outcome that is most beneficial for our members and their patients.

I am loving this drama though. Wonder how this will end. Anybody have any inside information on what CPME wants to do?

 

[Feli]

The public does not care and does not know any different. Same with allopathic and osteopathic physicians... they could not care less.

I don't know man... I fully encourage all pts to go through ABMS boards and/or appropriate specialty societies when they need PM&R, ID, ortho, etc specialist. They don't ask me often, but some planning total knee, vascular eval, looking for PCP, needing Endo, etc do ask who is good in the area.... I direct them how to search appropriate board or specialty society websites.

Some people are dumb enough to just search online and throw darts, most tend to at least ask their PCP, and some ask PCP and also search board cert websites. I would imagine PCPs are asked every single day how to find X specialist or Y surgeon.

I search that way for the rare GI, Derm, etc consult I might want for myself or partner.
Would you want a cardiologist, OB, onco, etc who did not pass their specialty's boards... heart surgeon, plastic surgeon?

 

[Feli]

I am loving this drama though. Wonder how this will end. Anybody have any inside information on what CPME wants to do?

Wonder?
CPME sided against CAQs, ACFAS sided against, APMA against... I would say it's a fairly dead issue?

The APMA recognized (JCRSB) is the end of the game... the ABPM is recognized, but CAQs aren't.
The CAQ surgery one might be something like ABLES or ABMSP that people can use to try to fool small hospitals (assuming CAQ survives in some form), but there is likely to be serious continued pushback on the surgery CAQ attempt.

It's no small miracle ABPM didn't lead with that one when they started CAQs, lol. The wound CAQ was an obvious one that'd get some interest and not inflame anyone, but surgery CAQ was gonna be a panacea for some and draw fire from many others. I would say it's a foregone conclusion that surgery CAQ will probably disappear based on responses to it thus far... and the CAQs might now be toast altogether (or it'd be limited to pod med stuff like biomech, sport, wound, derm, etc). I have a feeling ABPM will have to apologize on surgery cert confusion, backtrack, make some "emergency med" CAQ or something, which maybe a dozen ppl will actually do (just like any CAQ besides would or surgery).

The only possible path for success of surgery CAQ was that it gets allowed (or at least basically ignored) by APMA and CPME, then many ppl adopt it, eventually ACFAS allows surgery CAQ ppl to join, and ABFAS falls off since people will always take the easy route to get something that says "surgery" from an APMA/JCRSB recognized board (why ABLES is a joke and doesn't work). Bingo, bam... single podiatry board domination by ABPM. Regardless, that was a whoooole lot of stars that needed to align for ABPM's power play, and zero of them fell into formation.

I agree it was a fun week for some ppl to hope for a possible backdoor route to surgery privileges (besides ABLES!)... welp, back to studying and building cases for ABFAS

 

[dtrack22]

I direct them how to search appropriate board or specialty society websites.

So they get a list of every specialist in the area? Or at least the ones willing to pay for whatever college/continuing Ed society dues that are required to join? You should actually figure out who is good and who isn’t before you refer people to specialists. I have a board certified neurologist nearby that literally makes a tarsal tunnel dx on every EMG/NCVS that gets does. But if I just told patients to search for a nearby board certified neurologist they would all end up there.

There are several local podiatrists that are ABFAS certified because they were grandfathered in with ABPS. They are not well trained and don’t do a lot of surgery…but they would pop up on ABFAS and ACFAS type directories. Maybe all of the patients should go to them?

Would you want a cardiologist, OB, onco, etc who did not pass their specialty's boards... heart surgeon, plastic surgeon?

But they’re all board certified. They have 98-99% pass rates. How does a non board certified physician practice medicine in 2022?

This is the whole point. “Board Certified” is a meaningless designation in medicine. Everyone is board certified.

 

[air bud]

So they get a list of every specialist in the area? Or at least the ones willing to pay for whatever college/continuing Ed society dues that are required to join? You should actually figure out who is good and who isn’t before you refer people to specialists. I have a board certified neurologist nearby that literally makes a tarsal tunnel dx on every EMG/NCVS that gets does. But if I just told patients to search for a nearby board certified neurologist they would all end up there.

There are several local podiatrists that are ABFAS certified because they were grandfathered in with ABPS. They are not well trained and don’t do a lot of surgery…but they would pop up on ABFAS and ACFAS type directories. Maybe all of the patients should go to them?


But they’re all board certified. They have 98-99% pass rates. How does a non board certified physician practice medicine in 2022?

This is the whole point. “Board Certified” is a meaningless designation in medicine. Everyone is board certified.

^except for podiatrists

 

[Feli]

So they get a list of every specialist in the area? Or at least the ones willing to pay for whatever college/continuing Ed society dues that are required to join? ....

Yeah, I agree... but at least MD/DO specialty societies require cert in the primary specialty.

Eg, AAHKS requires AAOS board cert gen ortho (and they'll obviously have at least a little interest/exp in total joints).

The patient won't get somebody who failed ortho boards, lost license, etc. That is a start. Much better than nothing (general surgeon "plastic", gen ortho "pediatric," non board cert ENT, etc).

The Endo, Card, Pain, etc societies ensure at least basic cert in the underlying discipline (IM for those) and interest in that specialty (and, like you said, the MD wrote the check to join... hopefully from interest/exp, but they're at least baseline board cert also).

... How does a non board certified physician practice medicine in 2022?... This is the whole point. “Board Certified” is a meaningless designation in medicine. Everyone is board certified.

I wish it was that way.

They can still do PP... any MD can usually have a state license if they did at least 2yrs of residency (I think passed USMLE also but I might be wrong). Some slip through residency and graduate but can't pass boards. Some of the Caribb MD grads and others do a couple transition years (no real residency) and then just go at it. They can still usually get on MCR/MCA or can get on all plans if some group on the plans will hire them.

A lot who fail boards do locums... hide out in VA or IHS, etc. That is a large part why directory for hospital staff of govt employ docs and some other hospitals is so hidden and it's a small miracle if you can find their training, CV, etc. You are right that they typically won't get privileges at any decent hospital without board cert, but they absolutely still exist - even surgeons or purported ones who didn't board or even do residency/fellowship in their advertised and practiced "specialty." Many advertise as something they're not trained for or just took a workshop for... fake society or board names usually.

Some do shady office surgery centers or ASC (not unlike some DPMs). It happens more than you think.... tiny percentage of MD/DOs in USA, but still a considerable number overall. The high cash pay specialties are the worst for it (derm, plastic, gender reassign, fertility, hair transplant, HGH, etc) due to the amount of people looking to save a buck. Some who aren't board cert target immigrant areas where many people don't know any better.

Basically, you'd be surprised how many ppl fall for it. I think it's a decent start to at least to get ppl to the appropriate ABMS site. Jmo

...There are several local podiatrists that are ABFAS certified because they were grandfathered in with ABPS. They are not well trained and don’t do a lot of surgery…but they would pop up on ABFAS and ACFAS type directories. Maybe all of the patients should go to them?...

Oh for sure. But I'd still say 4000% that they'd be better going off the ABFAS or FootHealthFacts or AOFAS find-a-doc to find a F&A surgeon than just Googling foot surgery or podiatrist or ankle surgery. Would you say that for your area? (ok ok, for the nearest metro 600 miles away )

For example... search my closest city on FHF search... four results, I'd trust 3 of the 4 to do surgery on my family. The other is maybe not ideal, but one could still do a lot worse. If you search Google podiatrist for that city... wowza. It's the same for next closest bigger metro (~75% high quality others acceptable on FHF, much lower % of area pods in general).