American Board of Orthopaedic Surgery Practice of the Orthopaedic Surgeon: Part-II, Certification Examination Case Mix

The American Board of Orthopaedic Surgery (ABOS) is one of the twenty-four separate boards that make up the American Board of Medical Specialties. Of the twenty-four boards, fourteen require an oral examination. At present, the ABOS is the only board with a computerized data collection system that allows for the analysis of the collected information in the database. The ABOS exists to serve the interests of the public and the medical profession by establishing educational standards for orthopaedic residents and by evaluating the initial and continuing qualifications and competence of orthopaedic surgeons. Upon completion of an approved residency program, applicants for board certification must pass a comprehensive, proctored written examination (the Part-I examination). Applicants must then practice orthopaedics for twenty-two months, twelve of which must be in one location. Many elect to begin the practice requirement following a fellowship. The applicants must then satisfactorily complete a thorough credentialing process and pass an oral examination (the Part-II examination) that is based on all of the candidate's operative cases in six consecutive months beginning one year before the oral examination. Before 1998, candidates submitted individual case lists on paper. Beginning in July 1998, candidate case lists were collected as part of a nationwide orthopaedic database as a way of organizing the case lists for review and case selection for oral examination. The computerized lists can be analyzed for the entire candidate group or subgroups. This yields a comprehensive dataset of approximately 700 candidates per year. Candidates for certification enter all operative procedures performed in six consecutive months in the year prior to examination. The candidate's case lists are verified from each hospital or surgical center during the six-month period. The case list from each hospital or surgical center must be notarized by the director of medical records. The ABOS has contracted with …