Fig. 1 The American Board of Orthopaedic Surgery Web-based Longitudinal Assessment dashboard lets Diplomates see how many questions they have answered for the year and track their performance over time. They also can access their Knowledge Sources and questions.
Courtesy of the American Board of Orthopaedic Surgery


Published 1/1/2019
Terry Stanton

ABOS Launches Web-based ‘Open Book’ MOC Pathway

Participants can view source material now to prepare for assessment window in April–May

With the new year comes the implementation of the new Knowledge Assessment pathway in Maintenance of Certification (MOC) from the American Board of Orthopaedic Surgery (ABOS).

The Web-based Longitudinal Assessment (ABOS WLA) program allows currently ABOS Board-Certified orthopaedic surgeons (Diplomates) to pursue and fulfill MOC Part III requirements through completion of a single annual assessment using a web-based interface to answer questions on a computer or laptop.

In 2018, the announcement of the new certification pathway was greeted as welcome news by those who do not relish the prospect of taking an all-or-nothing computer-based or oral exam to preserve their standing as an ABOS Board-Certified orthopaedic surgeon. Diplomates who choose the WLA pathway will, during a five-week window opening April 15, answer questions in an open-book setting derived from more than 100 Knowledge Sources from all areas of orthopaedic surgery; Diplomates may view all of the Knowledge Sources but will pick 15 to study in-depth for their assessment questions.

ABOS has now posted those Knowledge Sources—journal articles, practice guidelines, appropriate use criteria, and other similar resources—onto each Diplomate’s ABOS WLA portal (Fig. 1). The Knowledge Sources were chosen by practicing orthopaedic surgeons from across the country who were selected by representatives of the Academy and orthopaedic specialty societies.

More than a test

“The ABOS WLA program represents another effort by ABOS to decrease the burden of MOC yet make it valuable and meet our Diplomates at their practice,” said David F. Martin, MD, executive medical director of ABOS. “It also serves our mission to stimulate continued learning. It is a place where we all worked together to come up with a program that gives us a knowledge assessment from the public’s standpoint, and from the Diplomates’ standpoint allows them do this while keeping up-to-date in the current literature and continuing their education.”

When the ABOS WLA was announced last year, then-AAOS President William J. Maloney, MD, said at the AAOS Annual Meeting that the new pathway “represents the outcome of concerted advocacy on behalf of the membership by the Academy’s leadership to ABOS to express our belief that a one-time, high-stakes examination is not the best way to demonstrate ongoing competency.” Noting that the ABOS WLA is an “ongoing assessment that occurs every year through a series of questions that the Diplomate has some discretion to select,” Dr. Maloney told his audience, “Keep up, and you will never have to take a high-stakes exam again.”

“This is a type of assessment that other American Board of Medical Specialties boards have implemented and found successful,” Dr. Martin explained. “With the help and encouragement of the Academy and our own ABOS Diplomates survey, we were able to develop a program with input from Diplomates, Academy leadership, and specialty societies. They also assisted in putting together groups to choose the literature that was thought to be important—and then helped us write the questions. At the base level, we need to assess the orthopaedic surgeon’s knowledge and to serve the public by affirming that their knowledge is up-to-date. For surgeons already keeping up with the literature, this allows them to formalize that [effort] and get credit for it.”

The ABOS WLA meets the Part III requirement of the ABOS MOC program; however, Diplomates still must meet the other requirements of the ABOS MOC process, including completing an application, paying an application fee, entering a case list, and earning the requisite continuing medical education and Self-Assessment Examination credits.

For those wishing to use the ABOS WLA pathway, now is the time to go to the ABOS website and follow the instructions, which provide detailed information by the expiration year of a Diplomate’s ABOS certificate. After reviewing the posted Knowledge Sources and choosing 15 for in-depth study, participants should be mindful of these upcoming milestones:

April 15: Go to your ABOS dashboard, finalize the choices of 15 Knowledge Sources, pay the assessment fee, and start answering questions.

May 20: All 30 questions must be answered by 11:59 p.m. ET.

Diplomates will have three minutes to answer each question and can answer as many in one sitting as desired, as long as all 30 questions are answered during the assessment window. Two questions will come from each of the Knowledge Sources chosen by the Diplomate. The ABOS WLA is open book, and Diplomates can use the Knowledge Sources if the questions are answered within the three-minute window and the answers represent the Diplomate’s own work. Questions are presented in a multiple-choice format.

There is a $260 assessment fee for each year of participation ($300 for those who hold a Subspecialty Certificate). The fee is paid at the time the Diplomate begins answering questions.

A Diplomate must have an unexpired ABOS Board Certificate to participate in the ABOS WLA. Those holding a Subspecialty Certificate can participate in the ABOS WLA and utilize the ABOS WLA to recertify both their General Orthopaedic Recertification and their Subspecialty Certification. Diplomates who have recertified and currently have a certificate that expires in 2029 or later, as well as those in nonoperative and nonpracticing areas, should contact ABOS for application requirements.

Dr. Martin said that the ABOS WLA process is designed not just to test what a surgeon knows but to encourage learning. “Going through the process is an educational activity,” he said. “It is supposed to be thought-provoking, as opposed to just sitting and studying and taking a test.”

For orthopaedic surgeons who are inveterate test takers and are inclined to stick with the traditional computer-based or oral examinations—which remains an option—Dr. Martin counseled, “Take a look at this, and try it out. It’s unlike anything you’ve seen, and you might find it preferable to the other options.”

No matter where they may be in terms of MOC expiration, Dr. Martin encourages every surgeon to get familiar with the ABOS WLA. “We know that for people who just passed their exam, or those whose deadline is six to eight years from now, when we try to talk to them about this, it’s just white noise. But you should still look at this now, because if you are in year one, you can start this program and satisfy the knowledge assessment requirement in the first four to five years,” he said.

For complete information on the ABOS WLA program, including an instructional video, visit

Terry Stanton is the senior science writer for AAOS Now. He can be reached at