Failing case review ABFAS

[philafootdoc]

Hi. So I failed my first attempt at case review for ABFAS. They scored me 470, needing 500 to pass. The reasons they gave were horrible including word for word : “Some residual HA after correction” or “IMA not fully corrected” or “patient had pain at implant site” (despite the pain resolving after implant was removed subsequently.) And of course all the surgeries healed fine and the patients were happy in the end.

Nonetheless, my question is my qualification expires in 2024, does anyone know if they nitpick less if it’s your last attempt or do they still fail you? Has anyone attempted ABFAS certification but didn’t pass and their qualification expired and now can’t do surgery anymore? That’s my fear. That I will have wasted my whole life pursuing this career only to have it taken away forever because of someone deciding my IM correction wasn’t good enough for them or acting like complications never happen.

---

Members don't see this ad.

 

[Feli]

It happens to many people.

I passed the new CBPS (and old ones too, obviously), but failed cases this cycle also... almost same score as yours.
My failing reasons given were mostly lack of pre-op eval/justification (other surgeons who work with or near me at past jobs and present do the conservative care and then send me some Haglund, ankle, flat foot, Lapidus, etc cases - some send even Austins and such - and my chart records could have been better (and naturally, a couple of those cases were selected). I lost a ton of points on one of those recon that was sent to me... a few procedures, so points off for each "inadequate justification for procedure," repeat, repeat. I got one ding about a screw being too long (of course I leave it if it bit bone well and is not going to be a problem... only a fool would lose bite to create a better XR). But, those were fair, I suppose. Subjective, but fair... and I still would've passed at that point.

I was surprised to be dinged a few times on a trauma case of a diabetic neuropathic fracture that loosened my fixation a bit (active guy but incapable of NWB, which is why I did ORIF), and I recognized and charted the post-op loosening yet didn't revise (healed fine, back to baseline of DM shoes at end of chart, never needed HWR). The review said they couldn't see my plate well on the immed post-op XR through CAM boot, so it might not have been good reduction. The reviewer took more points off suggesting I should probably have not done the surgery at all (oblique fx in neuropathic diabetic A1c of 10... not great yet basically average A1c at my IHS job at that time with FPs and midlevels doing DM mgmt). Well, if it loosened with ORIF, imagine how much it'd have displaced in a neuropathic without the plate... that plate's probably the only thing that saved a bad malunion or even a fracture fragment ulcerating, lol! They also suggested I should have revised it once loosening occurred (no need if still holding... I counseled pt and they healed acceptable, fit into shoes).

I think it basically comes down to getting a selection of your cases (possibly random set... but sure seems they choose many more bone/joint/fixation than soft tissue... so they can critique XRs?). When they pick, hope that.... .... ....
-the ones they select went well
-hope you charted well
-hope you have pre-op and final WB xray and the pt was not lost to f/u
-hope you're getting a reviewer in a good mood
-getting a reviewer who knows every surgeon has complications or hurried chart days
-you get the cooperation of past office and hospitals if it's not your present gig
-etc?
The stars of the ABFAS definitely have to align between the cases picked, the reviewer, the surgery, the charting, and whatever else. I think everyone agrees it's highly subjective; they could fail or pass almost anyone who submits (hence why they allow a case review appeal process). I am not one of those conspiracy theory DPMs who think they intentionally fail you a time or two... then pass you to make more money, but the cases process is subjective to say the least.

No worries, though... you have two more cycles to apply; you will do fine. If anything, as I told a local colleague yesterday, I would imagine you'd also get at least one more shot due to COVID extension or something - should you need it. You can't count on that, but I don't think it's in the common interest of our profession (or ABFAS' own finances) to have people who pass all of the ABFAS multiple choice and CBPS tests to then fail on a subjective case reviews section only.... and therefore not get dues from those people for decades to come. General, vasc, plastics, etc don't have the case reviews (since they don't have XRs, obviously)... they simply have to send in hospital logs and pass written and oral (maybe now CBPS instead?) exams.

Again, a ton of DPMs, myself included, are in the same boat as you are: passed all ABFAS written tests, good training, doing good surgery, but being held up by semi-subjective case review process based on XR angles or, even worse, words (or lack of) in a chart, or trouble getting old XR or charts from past jobs or hospitals. It is what it is. I will keep taking better care of my patients than my notes and just hope they grab a different set of my cases and/or different reviewer next time around...

 

[air bud]

Hi. So I failed my first attempt at case review for ABFAS. They scored me 470, needing 500 to pass. The reasons they gave were horrible including word for word : “Some residual HA after correction” or “IMA not fully corrected” or “patient had pain at implant site” (despite the pain resolving after implant was removed subsequently.) And of course all the surgeries healed fine and the patients were happy in the end.

Nonetheless, my question is my qualification expires in 2024, does anyone know if they nitpick less if it’s your last attempt or do they still fail you? Has anyone attempted ABFAS certification but didn’t pass and their qualification expired and now can’t do surgery anymore? That’s my fear. That I will have wasted my whole life pursuing this career only to have it taken away forever because of someone deciding my IM correction wasn’t good enough for them or acting like complications never happen.

Who cares, get em next time champ. I failed foot my first time. I have a buddy who did a great program, has a great job does Big Time stuff does a great job and he actually failed rear foot computer exam three times. Passed case review first time.

 

[philafootdoc]

It happens to many people.

I passed the new CBPS (and old ones too, obviously), but failed cases this cycle also... almost same score as yours.
My failing reasons given were mostly lack of pre-op eval/justification (other surgeons who work with or near me at past jobs and present do the conservative care and then send me some Haglund, ankle, flat foot, Lapidus, etc cases - some send even Austins and such - and my chart records could have been better (and naturally, a couple of those cases were selected). I lost a ton of points on one of those recon that was sent to me... a few procedures, so points off for each "inadequate justification for procedure," repeat, repeat. I got one ding about a screw being too long (of course I leave it if it bit bone well and is not going to be a problem... only a fool would lose bite to create a better XR). But, those were fair, I suppose. Subjective, but fair... and I still would've passed at that point.

I was surprised to be dinged a few times on a trauma case of a diabetic neuropathic fracture that loosened my fixation a bit (active guy but incapable of NWB, which is why I did ORIF), and I recognized and charted the post-op loosening yet didn't revise (healed fine, back to baseline of DM shoes at end of chart, never needed HWR). The review said they couldn't see my plate well on the immed post-op XR through CAM boot, so it might not have been good reduction. The reviewer took more points off suggesting I should probably have not done the surgery at all (oblique fx in neuropathic diabetic A1c of 10... not great yet basically average A1c at my IHS job at that time with FPs and midlevels doing DM mgmt). Well, if it loosened with ORIF, imagine how much it'd have displaced in a neuropathic without the plate... that plate's probably the only thing that saved a bad malunion or even a fracture fragment ulcerating, lol! They also suggested I should have revised it once loosening occurred (no need if still holding... I counseled pt and they healed acceptable, fit into shoes).

I think it basically comes down to getting a selection of your cases (possibly random set... but sure seems they choose many more bone/joint/fixation than soft tissue... so they can critique XRs?). When they pick, hope that.... .... ....
-the ones they select went well
-hope you charted well
-hope you have pre-op and final WB xray and the pt was not lost to f/u
-hope you're getting a reviewer in a good mood
-getting a reviewer who knows every surgeon has complications or hurried chart days
-you get the cooperation of past office and hospitals if it's not your present gig
-etc?
The stars of the ABFAS definitely have to align between the cases picked, the reviewer, the surgery, the charting, and whatever else. I think everyone agrees it's highly subjective; they could fail or pass almost anyone who submits (hence why they allow a case review appeal process). I am not one of those conspiracy theory DPMs who think they intentionally fail you a time or two... then pass you to make more money, but the cases process is subjective to say the least.

No worries, though... you have two more cycles to apply; you will do fine. If anything, as I told a local colleague yesterday, I would imagine you'd also get at least one more shot due to COVID extension or something - should you need it. You can't count on that, but I don't think it's in the common interest of our profession (or ABFAS' own finances) to have people who pass all of the ABFAS multiple choice and CBPS tests to then fail on a subjective case reviews section only.... and therefore not get dues from those people for decades to come. General, vasc, plastics, etc don't have the case reviews (since they don't have XRs, obviously)... they simply have to send in hospital logs and pass written and oral (maybe now CBPS instead?) exams.

Again, a ton of DPMs, myself included, are in the same boat as you are: passed all ABFAS written tests, good training, doing good surgery, but being held up by semi-subjective case review process based on XR angles or, even worse, words (or lack of) in a chart, or trouble getting old XR or charts from past jobs or hospitals. It is what it is. I will keep taking better care of my patients than my notes and just hope they grab a different set of my cases and/or different reviewer next time around...

Appreciate the thorough response. I guess I’m just thinking of worst case if I fail again twice and I’m out. But I hope we all pass next time

 

[philafootdoc]

Who cares, get em next time champ. I failed foot my first time. I have a buddy who did a great program, has a great job does Big Time stuff does a great job and he actually failed rear foot computer exam three times. Passed case review first time.

Thanks man. I hope they pass me next year and the worst case doesn’t happen.

 

[air bud]

Thanks man. I hope they pass me next year and the worst case doesn’t happen.

Seriously. I literally failed a case because one person though they saw a open growth plate on a lapidus I did on A 14 year old girl. Great outcome happy patient. Couldnt appeal.

Narrator: there was no growth plate.

My residency director a former ABFAS president said sorry bro you got screwed and sucks can't do anything about it.

 

[Utvolsdpm]

Oddly enough I passed foot and rra case review no problem but somehow cbps is a battle for me. My score was in the 400s as well and the only feedback I got was fail for all 4 sections of cbps so obviously that feedback doesn’t help. I can’t fathom how I could fail selecting things like - palpate ankle, perform anterior drawer, etc…

Also - for rra a lot of cases selected were done pre Covid and followed up (or didn’t) after Covid. Not sure how they factor that in.

 

[air bud]

As has been stated in ofher threads. Board wizards for the computer part is 100 percent legit. I know multiple including myself who have used it after failing and it is legit. It's not about the info known, it's about how to take the test.

 

[heybrother]

A friend shared their Wizards account with me when I studied for the qualifier. I didn't take every single test, but taking the test felt like just another round of practicing. Didn't sit for the cert this time because of having a kid / a death in the family but I will 100% pay for Wizards for my certification portion in the fall or wahtever. Its a bunch of money and I don't give a crap. The amount of times I want to take the electronic portions is once. The sooner I'm Foot certified the sooner I can drop ABPM and its MOC.

EDIT: Wizards Computer / CBPS portion just to be clear.

 

[DYK343]

Not going to help OP but for any resident about to graduate over document your notes. Many fail due to poor documentation.

Every single note that was a surgical candidate was a monster of a note. Straight up book. I almost feel bad for the reviewers having to read all those notes.

Document. Document. Document.

Im done with boards but I still document in case a J.D. comes knocking on my door some day.


....and sadly yes you sometimes gotta change out a perfectly good screw to make for a prettier xray if you're submitting for boards. Its wrong to change out in every way shape and form. But you gotta do it.

 

[icebreaker32]

I was very close to passing, but failed my first time. I think it is a combination of the reviewer you get and luck on your amount of documentation for which cases they pick.

Like they said: document, document. If patient was non compliant or had trauma in post-operative period make sure to mention that. If a minor complication happened explain all factors that might have contributed and explain how you managed it.

Think positive, try again and do the other podiatry board as a back up if need be.

Probably only half at most pass both cases and exams first time,

Your life MIGHT (I know many in PP and it makes no difference for them) be easier with ABFAS, but is definitely not over without it.

 

[icebreaker32]

Not going to help OP but for any resident about to graduate over document your notes. Many fail due to poor documentation.

Every single note that was a surgical candidate was a monster of a note. Straight up book. I almost feel bad for the reviewers having to read all those notes.

Document. Document. Document.

Im done with boards but I still document in case a J.D. comes knocking on my door some day.


....and sadly yes you sometimes gotta change out a perfectly good screw to make for a prettier xray if you're submitting for boards. Its wrong to change out in every way shape and form. But you gotta do it.

Many years ago they required a variety of fixation for boards for ABPS. So a doctor that liked screws would use k-wires and absorbable fixation sometimes also just for boards. You could fail boards a long time ago just for doing all bunions with screws. You probably only needed bunions for boards that long ago.

 

[Feli]

Not going to help OP but for any resident about to graduate over document your notes. Many fail due to poor documentation...

Yes, for some reason, they don't like my comprehensive "pt saw Dr X prior for conservative cares of insoles, injections, PT, and bla bla. Pt wishes to proceed with elective surgery at this time due to failed conservative. Exam and XR shows deformity. Pt will be scheduled."

Oh, and from the score report, they reeeally didn't like my co-signing a Dr. Y note [my same hospital and EMR] saying I spoke to the pt, agree with Dr Y exam, and would write up the surgery boarding... with no full note of my own pre-op.

 

[king22]

I would imagine you'd also get at least one more shot due to COVID extension or something - should you need it. .

I was under the impression that no extensions are to be given due to covid. I do hope I'm wrong.

 

[air bud]

Not going to help OP but for any resident about to graduate over document your notes. Many fail due to poor documentation.

Every single note that was a surgical candidate was a monster of a note. Straight up book. I almost feel bad for the reviewers having to read all those notes.

Document. Document. Document.

Im done with boards but I still document in case a J.D. comes knocking on my door some day.


....and sadly yes you sometimes gotta change out a perfectly good screw to make for a prettier xray if you're submitting for boards. Its wrong to change out in every way shape and form. But you gotta do it.

This is also critically important with billing. As I heard at the ACFAS billing course (sorry @ExperiencedDPM ) think out loud on paper. If it is not in your note, it didn't happen. Fortunately you can make stuff up in your note and bill for it and hopefully get paid and not get audited. Disclosure this is not investment advice.

 

[ExperiencedDPM]

This is also critically important with billing. As I heard at the ACFAS billing course (sorry @ExperiencedDPM ) think out loud on paper. If it is not in your note, it didn't happen. Fortunately you can make stuff up in your note and bill for it and hopefully get paid and not get audited. Disclosure this is not investment advice.

If it’s not in your note it didn’t happen, is as basic as it gets and something we were ALL taught in every risk management course given.

And if it IS in your notes, you’d better be damn sure it DID happen.

That’s my free course.

 

[ExperiencedDPM]

One of my former residents called me yesterday and his boss wants him to sign up for the upcoming course. He said that it’s being “taught” by a female DPM. He said Dr. Boffelli isn’t listed on the course.

Anyone have any idea who she is?

 

[air bud]

One of my former residents called me yesterday and his boss wants him to sign up for the upcoming course. He said that it’s being “taught” by a female DPM. He said Dr. Boffelli isn’t listed on the course.

Anyone have any idea who she is?

Probably Danielle Buhtto

 

[Boba Foot]

Probably Danielle Buhtto

She did the ACFAS intro to billing course. Wasn’t worth the money. Barely learned a thing.

 

[CutsWithFury]

She did the ACFAS intro to billing course. Wasn’t worth the money. Barely learned a thing.

Buuuuuuurn

 

[ExperiencedDPM]

Probably Danielle Buhtto

And who is she? What’s her claim to fame?

 

[Feli]

And who is she? What’s her claim to fame?

Fellowship.

If you didn't do one, you ain't nothin.

 

[ExperiencedDPM]

Fellowship.

If you didn't do one, you ain't nothin.

Okay, so you do a fellowship and now you’re the guru who can teach a course in coding. Hmm.

 

[air bud]

Okay, so you do a fellowship and now you’re the guru who can teach a course in coding. Hmm.

This is the way.

Even better is a recent Hyper fellow giving lectures to practicing physicians before practicing. Or even talking about burnout before getting into practice and being burned out.

Or how he likes to do things even though he's been told how to do things his entire training so far. Oh and then also putting it on social media to make himself appear important.

 

[Beetlejuice7]

Oddly enough I passed foot and rra case review no problem but somehow cbps is a battle for me. My score was in the 400s as well and the only feedback I got was fail for all 4 sections of cbps so obviously that feedback doesn’t help. I can’t fathom how I could fail selecting things like - palpate ankle, perform anterior drawer, etc…

Also - for rra a lot of cases selected were done pre Covid and followed up (or didn’t) after Covid. Not sure how they factor that in.

Have you passed RRA CBPS? I most recently failed from March exam after last failing it four years ago. I did Board Wizards and felt confident leaving the exam, but we all know how that goes. People talk about the shotgun approach and I’ve been told directly from the person who created the CBPS exam (have had many conservations with ABFAS personnel given my horrible exam taking history) that this method is not appropriate.

I’m at a point where I just don’t know if pursuing rearfoot certification is worth the time, energy, effort, and money. I’m foot certified and I’m not limited in any capacity with foot and ankle surgery.

Any advice would help.

 

[Beetlejuice7]

Hi. So I failed my first attempt at case review for ABFAS. They scored me 470, needing 500 to pass. The reasons they gave were horrible including word for word : “Some residual HA after correction” or “IMA not fully corrected” or “patient had pain at implant site” (despite the pain resolving after implant was removed subsequently.) And of course all the surgeries healed fine and the patients were happy in the end.

Nonetheless, my question is my qualification expires in 2024, does anyone know if they nitpick less if it’s your last attempt or do they still fail you? Has anyone attempted ABFAS certification but didn’t pass and their qualification expired and now can’t do surgery anymore? That’s my fear. That I will have wasted my whole life pursuing this career only to have it taken away forever because of someone deciding my IM correction wasn’t good enough for them or acting like complications never happen.

I feel for you. I failed my first attempt at foot, scored 490/500 and the reasoning was absolutely unjustified (stated that a fracture site didn’t heal when the last radiographs showed it was healed and a revisional first MPJ implant case that docked me points from the initial case when the case being reviewed was the second or revisional case).

I was actually advised to appeal the case review and I gambled the $4000 (yes, I had to write a check for $4000 and send it in for them to go through with the case review appeal process for foot). I had to write up a big letter with my argumentative points for every point they docked me. Thankfully, it worked and I won and they returned my $4000 and I received my foot certification.

To your concern, I don’t think that they would nitpick you less just because it’s your last attempt. They don’t care. They’re making their thousands on a poorly, subjective, highly failed, questionable certification process. Do you really think that if you don’t get certified in your 7 year timeframe that the police will show up the very next day and take away your podiatry surgery badge? Is this what your employer has told you? You would not have wasted your whole life if you failed, I promise. Couldn’t you just take the qualification exams again if you really needed to?

 

[Utvolsdpm]

Have you passed RRA CBPS? I most recently failed from March exam after last failing it four years ago. I did Board Wizards and felt confident leaving the exam, but we all know how that goes. People talk about the shotgun approach and I’ve been told directly from the person who created the CBPS exam (have had many conservations with ABFAS personnel given my horrible exam taking history) that this method is not appropriate.

I’m at a point where I just don’t know if pursuing rearfoot certification is worth the time, energy, effort, and money. I’m foot certified and I’m not limited in any capacity with foot and ankle surgery.

Any advice would help.

I passed Part 1 rra but not the new cbps rra. Board wizards seems to be targeted versus shotgun. I only used it for foot but I passed foot.

 

[icebreaker32]

I feel for you. I failed my first attempt at foot, scored 490/500 and the reasoning was absolutely unjustified (stated that a fracture site didn’t heal when the last radiographs showed it was healed and a revisional first MPJ implant case that docked me points from the initial case when the case being reviewed was the second or revisional case).

I was actually advised to appeal the case review and I gambled the $4000 (yes, I had to write a check for $4000 and send it in for them to go through with the case review appeal process for foot). I had to write up a big letter with my argumentative points for every point they docked me. Thankfully, it worked and I won and they returned my $4000 and I received my foot certification.

To your concern, I don’t think that they would nitpick you less just because it’s your last attempt. They don’t care. They’re making their thousands on a poorly, subjective, highly failed, questionable certification process. Do you really think that if you don’t get certified in your 7 year timeframe that the police will show up the very next day and take away your podiatry surgery badge? Is this what your employer has told you? You would not have wasted your whole life if you failed, I promise. Couldn’t you just take the qualification exams again if you really needed to?

I don't think you can take qualification again. If needed hope for a covid extension. Can always get non surgical boards also.

 

[Scrantonicity]

Man, I hope the DPM that teaches that course doesn't read this forum. Don't we have enough adversity against our profession without talking bad about one of our own by name??? Not trying to be self righteous (and I agree with the notion that fellowships are a load of BS), but geez...the internet sucks.

 

[DYK343]

I was told shotgun approach was not the way to go.
I talked with upperclassman who all said shotgun is the easiest way to pass because you dont know what exact diagnosis/treatment they want.
So I shotgunned and passed all CBPS first time.

 

[Feli]

I don't think you can take qualification again. If needed hope for a covid extension. Can aways get non surgical boards also.

Yeah, that re-qual is only for pre-2014 grads I believe. It' in the ABFAS documents.
I did that re-qualify... my early cases were scattered around from job-hopping (one office had film XRs at time I worked there, one hospital said won't release records if you're not on staff anymore, some I did didn't have long enough "final" f/u since I left job, etc). The extension re-qual doesn't end up being as helpful as one would think, though... it's pretty hard to take the didactic (MC and CBPS) again many years out of residency, and your own early cases expire after awhile - so you still need to be doing an appreciable volume (esp tough for RRA in many DPM job setups). Plus, the main killer for me, your notes generally get sloppier over the years since you get busier, so while that speeding through notes gets you better income and better hours, that sure doesn't help for the boards case review.

....They don’t care. They’re making their thousands on a poorly, subjective, highly failed, questionable certification process. Do you really think that if you don’t get certified in your 7 year timeframe that the police will show up the very next day and take away your podiatry surgery badge? Is this what your employer has told you? You would not have wasted your whole life if you failed, I promise. Couldn’t you just take the qualification exams again if you really needed to?

Money always matters. On the flip side, ABFAS loses thousands and thousands over years of dues and CME for someone who doesn't get BC. The real money for them is not the exams and the case reviews... it's what comes after that (renews, MOC).

It's logical that they won't have someone who repeatedly fails didactic parts or never does enough surgery to submit cases become cert. But for people who pass the tests, obviously do the surgery (PLS and hospital logs on case submit), submit them for review with fair/good quality... then it doesn't make a ton of sense to exclude them forever and lose tons of money (money they basically hand to ABPM at that point if a candidate's ABFAS BQ expires permanently). That exclusivity is very costly to the board over years of missed renewal dues and CME.

Like I said, general, plastic, neuro, CT, vasc, etc surgeons obviously don't have XRs to submit for their boards... they just do accredited training, pass written, pass oral or computer exam, and they're cert. Pod and ortho are the only ones that get our own cases critiqued, which is an inherently much more subjective process than even an oral or computer exam. If the board fails the cases by saying the surgeon didn't know (usually just didn't document) the indications or pre-op eval or angles and that stuff, then how did that candidate pass all of the didactic tests on that same subject?? When in doubt, follow the money.

And I agree it's not a death blow to not get ABFAS cert. It does crack open the door for one's hospital to limit or expire their privileges, though. It certainly makes getting surg privi at new hospitals toughers - particularly in metro, saturated, near pod school, etc areas. It is much easier to practice with ABFAS cert if a DPM wants to do any appreciable amount or complexity of surgery. There is not reason not to try for it.

 

[ExperiencedDPM]

Man, I hope the DPM that teaches that course doesn't read this forum. Don't we have enough adversity against our profession without talking bad about one of our own by name??? Not trying to be self righteous (and I agree with the notion that fellowships are a load of BS), but geez...the internet sucks.

Not sure anyone posted anything bad about the doctor. One person posted that he/she found the course almost useless.

I don’t know the doctor running the course and simply inquired. The response I received is that she’s fellowship trained and I simply asked if that makes someone qualified (I used the term guru) to teach the course.

If you took an ACFAS course in ankle arthroscopy, internal fixation, TARs, etc., I would hope you’d want it taught by someone with significant experience and expertise.

She may very well have both, I don’t know so that’s why I asked. Nothing more, nothing less.

 

[Scrantonicity]

Not sure anyone posted anything bad about the doctor. One person posted that he/she found the course almost useless.

I don’t know the doctor running the course and simply inquired. The response I received is that she’s fellowship trained and I simply asked if that makes someone qualified (I used the term guru) to teach the course.

If you took an ACFAS course in ankle arthroscopy, internal fixation, TARs, etc., I would hope you’d want it taught by someone with significant experience and expertise.

She may very well have both, I don’t know so that’s why I asked. Nothing more, nothing less.

Nah I didn't feel that was problematic. Somebody else posted something about her personally, but then it looks like it was deleted later.

Edit: Not that I'm a moderator or anything--just didn't sit well with me is all...

 

[air bud]

Nah I didn't feel that was problematic. Somebody else posted something about her personally, but then it looks like it was deleted later.

Edit: Not that I'm a moderator or anything--just didn't sit well with me is all...

Yeah it's not like going after that foot ankle Ortho on the other thread...

 

[Scrantonicity]

Yeah it's not like going after that foot ankle Ortho on the other thread...

Haha! Yeah I wasn't even gonna touch that one. Thought maybe it was done to spite my earlier post lol...anyways, that wasn't a DPM so I don't care. Let's trash individual cafeteria ladies and astronauts while we're at it.

 

[ExperiencedDPM]

I’ve made it a point during my entire career to not bash individual doctors. It’s purposeless. And it’s not my style.

 

[Scrantonicity]

I’ve made it a point during my entire career to not bash individual doctors. It’s purposeless. And it’s not my style.

Yeah, again my post wasn't directed at you at all--but yeah, exactly--it gets you nowhere and makes you look insecure.

 

[air bud]

Haha! Yeah I wasn't even gonna touch that one. Thought maybe it was done to spite my earlier post lol...anyways, that wasn't a DPM so I don't care. Let's trash individual cafeteria ladies and astronauts while we're at it.

Dude don't get me started on Agnes, she would constantly f**ked me over on tater tots.

 

[ExperiencedDPM]

Dude don't get me started on Agnes, she would constantly f**ked me over on tater tots.

There’s something about a woman who scoops up those mashed potatoes and does a quick wrist flip to smack them onto your plate……. And the hair net throws me over the top.

 

[air bud]

There’s something about a woman who scoops up those mashed potatoes and does a quick wrist flip to smack them onto your plate……. And the hair net throws me over the top.

Makes you want to write a song about it

 

[Feli]

... Somebody else posted something about her personally, but then it looks like it was deleted later...

I think they just posted she was arrogant, but that's not really a legit knock.

Any decent surgeon knows they are god.

 

[ExperiencedDPM]

I think they just posted she was arrogant, but that's not really a legit knock.

Any decent surgeon knows they are god.

Seriously, I’ve never been impressed by any arrogant surgeon’s skill. The best surgeons I’ve ever met are the most humble people I’ve met.

Arrogance is a sign of some underlying insecurity. I’ve had meals and meetings with neurosurgeons and other specialists who were heads of the Dept at Ivy League institutions and they couldn’t be more down to earth.

I have no idea who she is and never heard about her, and I’m pretty well “connected”.

And I gotta guy…….

 

[DYK343]

Im with Scrantonicity.

Unless someone starts the war we really shouldnt call people out by name.

In the other thread there were shots fired. We get to fire back.

Other people who are teaching courses shouldnt be slandered by name publicly. You should be able to critique the course but not personal comments about a person on a public forum.

Everyone has someone who doesnt like them. Doesnt mean they are a bad person and doesnt mean they should have their name smeared in the mud (especially since none of us have taken that course with that instructor).

 

[ExperiencedDPM]

I didn’t see the slander post that must have been removed. I simply asked who was teaching the course. I don’t know her and agree that no one should be shamed on a forum without the ability to protect herself/ himself.

 

[Scrantonicity]

Haha man let's just forget it--it wasn't that egregious, and I probably didn't need to say anything at all...glad we all agree to be a little more mindful of what we say on semi-anonymous forums, though.

 

[UNVME2]

I feel for you. I failed my first attempt at foot, scored 490/500 and the reasoning was absolutely unjustified (stated that a fracture site didn’t heal when the last radiographs showed it was healed and a revisional first MPJ implant case that docked me points from the initial case when the case being reviewed was the second or revisional case).

I was actually advised to appeal the case review and I gambled the $4000 (yes, I had to write a check for $4000 and send it in for them to go through with the case review appeal process for foot). I had to write up a big letter with my argumentative points for every point they docked me. Thankfully, it worked and I won and they returned my $4000 and I received my foot certification.

To your concern, I don’t think that they would nitpick you less just because it’s your last attempt. They don’t care. They’re making their thousands on a poorly, subjective, highly failed, questionable certification process. Do you really think that if you don’t get certified in your 7 year timeframe that the police will show up the very next day and take away your podiatry surgery badge? Is this what your employer has told you? You would not have wasted your whole life if you failed, I promise. Couldn’t you just take the qualification exams again if you really needed to?

Out of curiosity, do you know if the appeal process was a rolling review (pay for the appeal and get your own panel) or did they wait to see how many appeals they had by the deadline and have one panel review everyone?

 

[malleolusman]

My tips for passing case review:

1. Unless you are outright committing malpractice by placing a syndesmotic screw through the ankle, or super constructs for a 1st MTP fusion; you should pass if you have logged all your cases appropriately AND . . .
2. ABFAS case review meets over the course of a weekend for 48-72 hours in hotel rooms.

Let that sink in.

If you are cases aren’t ORGANIZED and EASY to navigate; they will “find” a reason to fail you.

What I mean is this - missing an X-ray but you have a good reason. Attach a letter ADDENDUM to the beginning of your scanned case submission notes explaining why such and such is missing or omitted. Someone else did the follow up care in Tanzania and you don’t have films. Addendum at front of case.

Mislogged a case as a TN fusion but really was a NC fusion. (I did) Addendum.

Couldn’t get hospital to get you labs or CT/radiographs that are critical to your case. Addendum.

Highlight things YOU think they are looking for. Make it super easy for case reviewers to go through your cases. Organize it that way.

If it doesn’t look super organized to you, it’s definitely not organized to them.

Again - they meet over the course of 48-72 hours and need to make decisions quick. If the way it is put together is sloppy. They will assume you are a sloppy surgeon.

Details. Hope this helps. It helped me big time.

 

[Beetlejuice7]

Out of curiosity, do you know if the appeal process was a rolling review (pay for the appeal and get your own panel) or did they wait to see how many appeals they had by the deadline and have one panel review everyone?

I think it’s just one panel that reviews everything.

 

[arez10]

My tips for passing case review:

1. Unless you are outright committing malpractice by placing a syndesmotic screw through the ankle, or super constructs for a 1st MTP fusion; you should pass if you have logged all your cases appropriately AND . . .
2. ABFAS case review meets over the course of a weekend for 48-72 hours in hotel rooms.

Let that sink in.

If you are cases aren’t ORGANIZED and EASY to navigate; they will “find” a reason to fail you.

What I mean is this - missing an X-ray but you have a good reason. Attach a letter ADDENDUM to the beginning of your scanned case submission notes explaining why such and such is missing or omitted. Someone else did the follow up care in Tanzania and you don’t have films. Addendum at front of case.

Mislogged a case as a TN fusion but really was a NC fusion. (I did) Addendum.

Couldn’t get hospital to get you labs or CT/radiographs that are critical to your case. Addendum.

Highlight things YOU think they are looking for. Make it super easy for case reviewers to go through your cases. Organize it that way.

If it doesn’t look super organized to you, it’s definitely not organized to them.

Again - they meet over the course of 48-72 hours and need to make decisions quick. If the way it is put together is sloppy. They will assume you are a sloppy surgeon.

Details. Hope this helps. It helped me big time.

I dont know when you completed case review, but they now SPECIFICALLY say you absolutely cannot addend notes. I recognize there is a difference between revising your progress notes and adding a separate letter at the beginning of the case to explain something, but I think anyone attempting to do this should get the okay from ABFAS first.

 

[Pronation]

Addendum: the patient's bunion came back due to their severe noncompliance. I had specifically told them that they must wear a bunion splint apparatus 24/7 for the next 5 years.