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Published 9/1/2013
Shepard R. Hurwitz, MD

Know the Ins and Outs of Subspecialty Certification

Take combined exams to sync up subspecialty recertification with MOC

Do you specialize in surgery of the hand? Is most of the care you provide related to sports medicine? If you answered in the affirmative to either question, earning and maintaining subspecialty certification in these areas from the American Board of Orthopaedic Surgery (ABOS) may be beneficial to you and your patients.

In this month’s column, I will explore the requirements for subspecialty certifications in surgery of the hand and sports medicine. In addition, I will offer helpful tips for putting your subspecialty recertification examination on the same schedule with the ABOS Maintenance of Certification (MOC) recertifying examination.

Basics of subspecialty certification
The subspecialty certificate in orthopaedic sports medicine—as well as the subspecialty certificate in surgery of the hand—is for board-certified orthopaedists who have demonstrated significant qualifications in the subspecialty area through additional training, who have a practice focused on the subspecialty category, and who have made contributions to the field.

If you are a board-certified orthopaedist who meets this description, you must do the following to be eligible to take a subspecialty certificate examination:

  • Complete a 1-year Accreditation Council for Graduate Medical Education-accredited fellowship in the specialty.
  • For sports medicine, submit a 1-year case list of at least 115 surgical cases and 10 nonsurgical cases; at least 75 of the 115 surgical cases must involve arthroscopy as a component of the procedure.
  • For surgery of the hand, submit a 1-year case list of at least 125 cases that meet the required number of cases in six of nine categories.
  • Applications for the subspecialty certificate examination become available on www.abos.org each August. The 4-hour examination, which is computer-based and consists of approximately 200 multiple-choice questions that evaluate cognitive knowledge related to the subspecialty, is administered the following fall.
  • If you pass the subspecialty certification examination, you will receive a certificate valid for 10 years, as long as you also maintain your board certification.

Subspecialty recertification
If you earned your board certification prior to 1986 and therefore hold time-unlimited board certification, you do not need to participate in MOC to maintain your board certification; however, you must take the subspecialty recertification examination every 10 years to maintain your subspecialty certification.

If, on the other hand, you became board-certified in 1986 or later, you must satisfy the requirements of MOC and must also recertify for your subspecialty certification every 10 years. You can sync up your MOC recertification examination with your subspecialty recertification examination by taking a combined examination, as described below.

Combined examinations
It is easy to get board certification and subspecialty certification on the same schedule, with the same 10-year lifespan. For example, if you earned your board certification in 2005, and then earned your sports medicine subspecialty certification in 2007, you could take a combined examination by 2015 for both board recertification and subspecialty recertification.

The combined examinations, which are computer-based, have the same 80 core orthopaedic questions that the computer-based recertifying exams contain, but also have 110 sports medicine questions (for the sports medicine subspecialty certificate) or 170 hand/wrist/forearm questions (for the surgery of the hand subspecialty certificate). By taking and passing the combined recertifying examination, you then earn both board certification and subspecialty certification for the next 10 years, with both expiring in the same year.

Remember that if you take the combined examination, you must still meet all the same MOC requirements for the computer-based MOC recertification examination pathway as those who are solely seeking board recertification. So, if you wish to recertify in your subspecialty, you need to submit 120 AMA PRA Category 1 CME Credits™—including at least 20 credits from scored and recorded self-assessment examinations—in two, 3-year cycles, as well as a 3-month case list with a 75 case maximum. Once your application is final, the ABOS will send out Applicant Evaluation Forms as part of its own “peer review process,” just as it would do if you were not seeking subspecialty recertification.

Final notes
If you have both time-limited board certification and subspecialty certification and you do not wish to take the computer-based combined examination, it is possible to take the oral recertifying examination for board certification and the computer-based subspecialty recertification examination.

In the future, the ABOS plans to develop an oral examination for those seeking to recertify in their subspecialty, as well as a combined oral examination for both board recertification and subspecialty recertification.

Need more information?
As always, please direct any and all questions about MOC and subspecialty certification to the ABOS, the only official source of information about the ABOS MOC process and ABOS subspecialty certification.

For general questions, visit the ABOS online at www.abos.org or call 919-929-7103. For questions about subspecialty certification, email ABOS staff member Denise Scarboro at dscarboro@abos.org

Shepard R. Hurwitz, MD, is the executive director of the ABOS. He can be reached at shurwitz@abos.org

No more CAQ
The term “certificate of added qualification” (CAQ) has been replaced by “subspecialty certificate.” Subspecialty certificates stipulate that the holder is certified in the subspecialty of surgery of the hand or the subspecialty of sports medicine.