ABFAS board requirements modified

[CutsWithFury]

2020 Case Review Prep: Changes for 2020 Case Submission

ABFAS has made two important changes to the 2020 Case Review exam. First, we have deleted the requirement of a minimum 10 RRA Elective Osseous and minimum 2 RRA Nonelective Osseous in Appendix B. Instead, you will need to log 13 cases from any procedures listed below.

RRA Elective Osseous
• 5.2.4 midfoot, rearfoot, or ankle fusion
• 5.2.5 midfoot, rearfoot, or tibial osteotomy
• 5.2.9 ankle implant
• 5.2.10 corticotomy or osteotomy with callus distraction/correction of complex deformity of the midfoot, rearfoot, ankle, or tibia

RRA Nonelective Osseous
• 5.4.1 open repair of adult midfoot fracture
• 5.4.2 open repair of adult rearfoot fracture
• 5.4.3 open repair of adult ankle fracture
• 5.4.4 open repair of pediatric rearfoot/ankle fracture or dislocation
• 5.4.5 management of bone tumor/neoplasm (with or without bone graft)

This change should help you qualify for RRA case review. Registration opens on November 4, so please make sure you are logging your cases in PLS to see if you qualify for the 2020 exam.

Second, when you take the exam, you will only need to upload 11 cases, not 13. This will benefit you by not reducing the number of cases remaining in your selection pool in case you need to sit for Case Review again.
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Thoughts?

I feel this is a step in the right direction to allow more DPMs to sit for boards. Hopefully by doing this the ABFAS takes into consideration to modifying how they score the exams. All other medical specialties have a board certification pass rate in the 90%. Only podiatry has to make it ridiculously hard to pass boards. If the ABFAS feels compelled to have such dismal passing percentages year in and year out then the entire podiatry education and residency training model needs to be looked at and dissected. If podiatry school education and residency training are not producing residents who can regularly pass the podiatry board certification exam at comparable rates to other specialties then that is a huge red flag for our profession entirely. There is really no other way to explain it.

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[heybrother]

Winners?
-People who couldn't get trauma. Yay. They've acknowledged the reality of different practice environments.
-People who could get trauma. Yay. You get more credit for those cases now. Also, just thinking outloud - I've seen a lot of ankle fractures that are easier to rehab than fusions. If you are so fortunate as to be a podiatrist who gets ankle fractures - congrats, a good snow this December and you may be done with rearfoot osseous by January.

The things I wonder about:
-My program didn't do cottons. We realigned through the 1st TMTJ. Probably irrelevant since if I'm doing a cotton I'm probably also doing an Evans or something in the calc, but I still wonder if I'm depriving myself of something. There's just something funny about identical purposes accomplished 1cm apart being scored differently.
-I can see how they drew the dividing line, the complications that would have ensued (is this a lapidus or a midfoot fusion), and hell - the fact that its called (R)earfoot (R) (A)nkle but it still seems artificial to call midfoot proximal to the TMTJ. If you are doing lisfranc trauma you are probably going for RRA.

 

[air bud]

I wouldn't worry about a cotton or 2. In residency we always consented for cottons on flatfoots, but did maybe 10 percent of time. An evans is so crazy powerful that once that is done, never ended up needing it. To date, the only cottons I have done are on peds flatfoot. I do evans, occasionally MCDO (not as much as some who just add it regardless to a flatfoot recon), and love TN fusions. If you are over 300 lbs its a fusion regardless of what joint looks like.

plus you are getting credited for the case since likely did an evans and not a cotton. you just are not getting credit for the procedure. usually what ends up happening is you are short on cases not procedures for qualifying.

But yes, overall this is a good step. Now lets see a better pass rate and a computer exam that is not terrible.

 

[dtrack22]

The rest of medicine has realized that boards are a joke and mostly about making money for people who run the board. Therefore, higher pass rates = more dues paying members = more money. They are not difficult and 96+% are board certified in their second year out in practice.

Only podiatry, with our massive inferiority complex, thinks that boards should be in any way selective. As if ABFAS is some standard for which we should all strive, yet not all of us will achieve.

One of the best parts of ABFAS is, historically, who has been behind many of the changes that have made it increasingly difficult to get certification. One of the biggest offenders is a residency director in MN who does basically zero rearfoot surgery, has basically zero diversity in procedure selection for bunions (for example), and yet was the most vocal person when it came to adding diversity requirements in both the foot category and RRA.

 

[CutsWithFury]

Only podiatry, with our massive inferiority complex, thinks that boards should be in any way selective. As if ABFAS is some standard for which we should all strive, yet not all of us will achieve.

Food for thought. ABFAS is not regulated by the American Board of Medical Specialties (ABMS). Therefore it will never be accepted as legitimate to the rest of the medical community. Especially foot and ankle orthopedics

One of the best parts of ABFAS is, historically, who has been behind many of the changes that have made it increasingly difficult to get certification. One of the biggest offenders is a residency director in MN who does basically zero rearfoot surgery, has basically zero diversity in procedure selection for bunions (for example), and yet was the most vocal person when it came to adding diversity requirements in both the foot category and RRA.

That sounds very podiatry

 

[dtrack22]

Food for thought. ABFAS is not regulated by the American Board of Medical Specialties (ABMS). Therefore it will never be accepted as legitimate to the rest of the medical community. Especially foot and ankle orthopedics

The only thing that makes it legitimate or not is hospital and surgery center bylaws. It doesn't matter if any one individual physician respects or accepts our boards. That, in and of itself, wouldn't have an impact on how you practice, were you can work, what you can do, what insurance plans you can get on, etc. If a facility requires ABFAS and does not accept ABPM for certain privileges, ABFAS is very much a "legitimate" board, and in those cases a "more legitimate" board than ABPM.

The actual food for thought would be: There are very few MD/DOs who know anything about our board certification process or that multiple boards even exist. The ONLY reason that ABFAS is often times the only board accepted by a facility is because ANOTHER PODIATRIST got it written in. There is not a single orthopedic surgeon in the country who would care enough, or even have enough knowledge about our boards to do that. It is driven entirely by members of our own profession...chew on that for a bit

 

[G0dFather]

The rest of medicine has realized that boards are a joke and mostly about making money for people who run the board. Therefore, higher pass rates = more dues paying members = more money. They are not difficult and 96+% are board certified in their second year out in practice.

Only podiatry, with our massive inferiority complex, thinks that boards should be in any way selective. As if ABFAS is some standard for which we should all strive, yet not all of us will achieve.

One of the best parts of ABFAS is, historically, who has been behind many of the changes that have made it increasingly difficult to get certification. One of the biggest offenders is a residency director in MN who does basically zero rearfoot surgery, has basically zero diversity in procedure selection for bunions (for example), and yet was the most vocal person when it came to adding diversity requirements in both the foot category and RRA.

THIS! ... The fact that every ****** SIX MONTHS they keep making a change shows how much of a JOKE this is .... keep an eye out for more changes coming soon to this sham/scam of a board, what a shame

 

[DYK343]

THIS! ... The fact that every ****** SIX MONTHS they keep making a change shows how much of a JOKE this is .... keep an eye out for more changes coming soon to this sham/scam of a board, what a shame

Im not going to call it a sham/scam but I agree. They need to be consistent.

 

[DYK343]

There are very few MD/DOs who know anything about our board certification process or that multiple boards even exist.

True. But I have zero clue what the opthamology boards are and which one is good and which one is BS. Most of medicine has multiple boards some legitimate and some laughable. Podiatry has 3-6 "board certifications" and so do most professions.

Most of us know its all just a game and if you're good you're good. If you're bad we all figure it out and send our patients elsewhere. Board certification really doesnt mean much with the exception of privilaging. The anesthesiologist I was working with a couple weeks ago randomly went off over his boards (without provocation). We got to talking about board ceritifications and he said somewhere around 80% pass rate 1st time.

I am a little mad at ABFAS for constantly changing their requirements to make that $$$ but its all a game. Get the certification and move on.

...honestly if you cant make 11-15 rearfoot cases your first 7 years out you shouldnt be doing rearfoot surgery.

 

[Scrantonicity]

True. But I have zero clue what the opthamology boards are and which one is good and which one is BS. Most of medicine has multiple boards some legitimate and some laughable. Podiatry has 3-6 "board certifications" and so do most professions.

Most of us know its all just a game and if you're good you're good. If you're bad we all figure it out and send our patients elsewhere. Board certification really doesnt mean much with the exception of privilaging. The anesthesiologist I was working with a couple weeks ago randomly went off over his boards (without provocation). We got to talking about board ceritifications and he said somewhere around 80% pass rate 1st time.

I am a little mad at ABFAS for constantly changing their requirements to make that $$$ but its all a game. Get the certification and move on.

...honestly if you cant make 11-15 rearfoot cases your first 7 years out you shouldnt be doing rearfoot surgery.

That last bit is VERY true. If something goes terribly wrong because of your incompetence in a rearfoot/ankle case--no court of law is going to allow you to hide behind your ABFAS Rearfoot/Ankle Board Certification. That will be a non-issue.

 

[CutsWithFury]

...honestly if you cant make 11-15 rearfoot cases your first 7 years out you shouldnt be doing rearfoot surgery.

I don't think anyone in this thread is worried about their volume to sit for boards. Personally I am more concerned about how obnoxiously graded the cases are. I met an attending that was starting an ACFAS fellowship who failed their boards. I met another attending who is affiliated with an ACFAS fellowship who failed their boards twice before passing on the third time. These are podiatrists who are training future fellowship trained DPMs. That's preposterous in my opinion. I work with an orthopedist who probably needs to go back to residency and do the entire 5 years over again to become a competent surgeon. That person passed their ortho boards 2nd year out. Insanity.

Board certification should be a means to an end not a means of being exclusive. I said it above before. If 4 years of "podiatric medical school" and 3 years of residency training with RRA credentialing can't get you to pass our boards then entire educational and residency model needs looked at and dissected.

Nobody in the medical community gives a damn about foot and ankle. Only podiatry obsesses over every facet of every procedure. "Sorry you got docked 1 point because your sesamoids were not anatomic on your bunion"...even though the notes dictate that the patient loves it and has improved pain control.

Today's podiatrists are graded so rigorously. Especially by those who were either grandfathered in by the ABFAS or have NEVER done an ankle fracture, ankle scope, or any type of complex procedure in their LIVES. Hypocrisy

 

[malleolusman]

Im not going to call it a sham/scam but I agree. They need to be consistent.

lol typical podiatry move. Why not call it what it is? Classic boot licker. Are you close to joining the club and don’t want to bite the hand that feeds?

If it’s not a sham, then what is it? It exists to protect the public. Be honest, is it doing that?! HOW MANY PODIATRISTS WERE GRANDFATHERED IN?
MD/DO boards are the same, it’s all a money grab.
At least they have the “integrity” to see it for what it is - hence the wink and nod pass, and not the failing score for “mislogging” a case.

 

[DYK343]

lol typical podiatry move. Why not call it what it is? Classic boot licker. Are you close to joining the club and don’t want to bite the hand that feeds?

If it’s not a sham, then what is it? It exists to protect the public. Be honest, is it doing that?! HOW MANY PODIATRISTS WERE GRANDFATHERED IN?
MD/DO boards are the same, it’s all a money grab.
At least they have the “integrity” to see it for what it is - hence the wink and nod pass, and not the failing score for “mislogging” a case.

Im certified ABFAS. I already joined the club. Get the certification and move on.

What is it? A board that we need to pass to do surgery at most hospitals.

They fail people. All boards do. ABFAS I agree possibly too many. We have 7 years to pass. Just pass it and move on.

Log the cases correctly its in plain english how to do it. If someone fails a case for mislogging thats on the applicant. Read the directions it takes 5 minutes.

We're not the only profession who dislikes their board process. See my anesthesia comments above.

 

[DYK343]

Personally I am more concerned about how obnoxiously graded the cases are. I met an attending that was starting an ACFAS fellowship who failed their boards. I met another attending who is affiliated with an ACFAS fellowship who failed their boards twice before passing on the third time.

One of my main attendings who I really look up to took several attempts to pass boards. TAR skin to skin 60min.

I agree they probably nit pick a little too much. I also agree with you on the grandfathering in phase is kinda sketch especially when they are the ones grading us.

 

[dtrack22]

True. But I have zero clue what the opthamology boards are and which one is good and which one is BS. Most of medicine has multiple boards some legitimate and some laughable. Podiatry has 3-6 "board certifications" and so do most professions.

that’s not the point. The point is that it isn’t other specialties (ie ortho) who are requiring certain board certifications to operate/get privileges. Just like you aren’t telling optho what boards they need to phacos at your facility. It’s podiatry screwing other podiatrists. We really are the worst in terms of medical specialties. Well most of US aren’t, it’s the older insecure guys/gals who ironically got grandfathered in and couldn’t pass the process/exams/reviews they put into place for us

 

[DYK343]

that’s not the point. The point is that it isn’t other specialties (ie ortho) who are requiring certain board certifications to operate/get privileges. Just like you aren’t telling optho what boards they need to phacos at your facility. It’s podiatry screwing other podiatrists. We really are the worst in terms of medical specialties. Well most of US aren’t, it’s the older insecure guys/gals who ironically got grandfathered in and couldn’t pass the process/exams/reviews they put into place for us

To be honest I am not up on the ortho boards and what is required for them to operate.

The anesthesia provider I mentioned above was going off about how he had to pass or he couldnt keep his job at the hospital and its an 80% pass rate. This is possible its regional/the hospital I was working at but I dont believe its just podiatry.

And in anticipation of the comment to come about our horrible pass rates... yes I know our pass rate was 60 some percent last exam which is quite low and should be looked at.

In the end we should have multiple chances to get the numbers to sit for the exam. Just pass it and move on.

 

[DYK343]

it’s the older insecure guys/gals who ironically got grandfathered in and couldn’t pass the process/exams/reviews they put into place for us

And not to get political... But I think you just described baby boomers in general. Basically everything they did made it worse off for the younger generation(s) and I'm not referring to just podiatry with this comment.

 

[G0dFather]

And not to get political... But I think you just described baby boomers in general. Basically everything they did made it worse off for the younger generation(s) and I'm not referring to just podiatry with this comment.

I genuinely LOL when i read this .. thank you ! hahaha