Forum Members ABFAS/ABPM

[newpodgrad]

Hey guys

While looking for jobs , I inquired with a few local hospitals about how to go about getting privileges.

Several of them sent me info and I wanted to highlight a board concern.

Not sure how to really take it, but here’s a excerpt from one of the docs re: board status.

“Board Certification Requirement means certification from one of the following boards: the American Board of Medical Specialties, the American Osteopathic Association, the American Board of Foot and Ankle Surgery, or those Boards which may be approved by the Executive Committee to satisfy this Requirement”

As a disclaimer, I’m not a HUGE surgery pod. I enjoyed it , and did it in residency because, well, that’s what we had to do. And I’m fine with my forefoot procedures. I believe I’ve done well with them at my current level. I don’t care to do TARS, scopes mid foot fusions etc. I have no problem referring them out. I took the ABFAS qualifying tests etc, because again, it’s encouraged in residency and passed them.

Looking at this doc, it almost seems like this board required if you wanted to be on staff. The little statement at the end regarding “or those boards” seems like it might open the door for ABPM with some petitioning or something.

What do you guys make of this? I have heard from others that ABPM will get involved with issues regarding privileges etc. Is there more to this picture than meets the eye?

Thanks in advance for everyone’s take

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[DYK343]

If you read through the ABFAS case requirements you know exactly what they will ask for. If you are in a crappy pp job you can plan ahead and print/save XR of all your surgical patients and print notes of their post op visits in the global period. Then you don't need to ask your old boss for anything. You are only trapped by yourself.

Another thing is LOG EVERY CASE RIGHT AWAY. DON'T WAIT. Many friends are years behind on logging and feel overwhelmed. You log every case in residency. Keep logging once you graduate...simple as that.

If people want to blame ABFAS for failure to plan they can.

The problem isn't ABFAS its the schools, CPME, AACPM and their greed. I've said many times everything needs to be cut in half (schools, residencies) and residency case requirements need to be doubled. SELECTIVITY NEEDS TO INCREASE in order for the ABFAS CERTIFICATION RATE TO INCREASE. Just because you scraped through school and did a nail jail residency doesn't mean you should pass. Ortho is so selective from the beginning they can afford to have a less strict certification process. The ABFAS requirements are published and straight forward. DO GOOD NOTES, DO GOOD WORK, DOCUMENT WHAT IS REQUIRED (Get those pre-op XR and post-op WB XR, etc) and its fairly straight forward. You know exactly what they will request and can have everything ready to go ahead of time if you prepare.

Yes the ABFAS cert process could be improved with a lot of things being overly tedious and time-consuming, but for now this is the best we have as a profession. The anger is directed in the wrong direction. ABFAS is not failing anyone, the training system as a whole is.

This is a really good post.
Directly out of residency I read over the ABFAS instructions in detail and did basically everything above.
Explain your reasoning for the selected procedure over alternatives.
WAAAAY over document everything.
Remove funny looking screws even if functional (I dont agree but...)
You will pass.

 

[Feli]

.... If you are in a crappy pp job you can plan ahead and print/save XR of all your surgical patients and print notes of their post op visits in the global period. ...

I agree, that's the goal. But try doing that while starting your own PP, moving cross-country, etc

A lot of times, when it comes to a head at a job (PP or even hospital), things happen fast.
I personally have taken records from some past jobs... definitely not all.

Plenty of solid surgeons have been fired or left or let go or resigned in short order (compensation difficulty, replaced by new associate, admin changes, etc etc). It probably shouldn't be a deathblow to their board cert chances, but for ABFAS, it can be to the candiate's detriment. The hospital logs and op report and the candidate passing the written speak for themselves for most MD surgical boards. I dunno.

As it stands, our ABFAS BC process rewards taking records or sticking out a first job... just as much as it evaluates doing the cases and passing the tests. That's a major shortcoming. We'd be better talking tips and techniques or books to read for boards... as opposed to how to satisfy clerical requirements. Not only does it bar the people who can't pass the tests or don't do many/any of the cases, it also bars many who can and do.

 

[newfeet]

Hey guys

While looking for jobs , I inquired with a few local hospitals about how to go about getting privileges.

Several of them sent me info and I wanted to highlight a board concern.

Not sure how to really take it, but here’s a excerpt from one of the docs re: board status.

“Board Certification Requirement means certification from one of the following boards: the American Board of Medical Specialties, the American Osteopathic Association, the American Board of Foot and Ankle Surgery, or those Boards which may be approved by the Executive Committee to satisfy this Requirement”

As a disclaimer, I’m not a HUGE surgery pod. I enjoyed it , and did it in residency because, well, that’s what we had to do. And I’m fine with my forefoot procedures. I believe I’ve done well with them at my current level. I don’t care to do TARS, scopes mid foot fusions etc. I have no problem referring them out. I took the ABFAS qualifying tests etc, because again, it’s encouraged in residency and passed them.

Looking at this doc, it almost seems like this board required if you wanted to be on staff. The little statement at the end regarding “or those boards” seems like it might open the door for ABPM with some petitioning or something.

What do you guys make of this? I have heard from others that ABPM will get involved with issues regarding privileges etc. Is there more to this picture than meets the eye?

Thanks in advance for everyone’s take

That’s an opening for ABPM. I would ask and make sure. If this isn’t the bylaws get the bylaws. If ABPM is an option it might be in those. I’m at the point of my career where I won’t apply to a job that doesn’t clearly say ABPM. I’m not going to try and get ABFAS. Unless House ABPM is completely removed from the game I’m done.

 

[Shiyuan]

ABPOPPM or bust 🥸

 

[newfeet]

ABPOPPM or bust 🥸

Unfortunately Dom isn’t leading us…

 

[dtrack22]

Explain your reasoning for the selected procedure over alternatives.
WAAAAY over document everything.
Remove funny looking screws even if functional (I dont agree but...)
You will pass.

There is no reason a board certification process alone should dictate how you document patient encounters or how you fixate something in an operating room.

Most of the posts above are the same old ABFAS justifications for the flawed portions of their process.

“Just bring the patient back again even though they have no pain and are out of the global and it will unnecessarily cost the patient and the system $.”

“Take out that screw even though it’s not limiting function or causing pain because the ABFAS grader will take off points.”

“Take free time (because you have nothing else better to do and your podiatry practice boss pays you sooo much money) to copy mountains of chart information and copy XR pictures”

“If you have good training you will pass, just get the certification.” Even though the best trained DPMs routinely fail portions of the exam/case review. Often multiple times.

 

[DYK343]

There is no reason a board certification process alone should dictate how you document patient encounters or how you fixate something in an operating room.

I agree

Most of the posts above are the same old ABFAS justifications for the flawed portions of their process.

“Just bring the patient back again even though they have no pain and are out of the global and it will unnecessarily cost the patient and the system $.”

I didnt say that. I never brought a patient back again

“Take out that screw even though it’s not limiting function or causing pain because the ABFAS grader will take off points.”

I did say that in a less direct way. I admit I changed a couple screws out because they looked funny/slightly long. But also patients look at those post op and ask questions so I usually do it anyway.

“Take free time (because you have nothing else better to do and your podiatry practice boss pays you sooo much money) to copy mountains of chart information and copy XR pictures”

I uploaded cases in a day. It was a solid day and it wasnt fun. But I got it done in a day.

“If you have good training you will pass, just get the certification.” Even though the best trained DPMs routinely fail portions of the exam/case review. Often multiple times.

I feel a lot of people just dont take it seriously. Were busy raising kids, running a practice, doing I&Ds, etc, etc. But it needs to be studied for. The written is totally passable. The CBPS is really dumb and doesnt test anything other than computer skills and how to take a simulated exam to beat it. Its passable with some prep though.

Case review. Well I stated my opinion on that above. No funny looking screws and over documented notes. Document like you think youre going to get sued and need to defend yourself. Anyone that I thought was a possible surgical candidate from day #1 had solid thoughtout notes. I feel that was the most annoying part of preboards. The over documentation. It was pretty annoying. Also have to really document why procedure A is the chosen procedure based on XYZ over procedure B.

But I passed foot/RRA. First time.

 

[RollingstonePod]

There is no reason a board certification process alone should dictate how you document patient encounters or how you fixate something in an operating room.

Most of the posts above are the same old ABFAS justifications for the flawed portions of their process.

“Just bring the patient back again even though they have no pain and are out of the global and it will unnecessarily cost the patient and the system $.”

“Take out that screw even though it’s not limiting function or causing pain because the ABFAS grader will take off points.”

“Take free time (because you have nothing else better to do and your podiatry practice boss pays you sooo much money) to copy mountains of chart information and copy XR pictures”

“If you have good training you will pass, just get the certification.” Even though the best trained DPMs routinely fail portions of the exam/case review. Often multiple times.

Case reviewers must follow a process when evaluating cases. Proper documentation is a necessity to check the boxes of any particular case. Pre,immediate post,and delayed post op imaging is required to properly evaluate an osseous case for healing. Those are the rules. Reviewers don’t just willy-nilly fail a case b/c they don’t like the orientation of a screw. If a case doesn’t pass, it is checked and rechecked by different reviewers. There is then a consensus on that particular case not passing. If a candidate fails case review then at least 3 of the submitted 10 cases failed for any number of reasons. Reviewers are generally on the side of the candidate and want to see good work. Alternate cases are sometimes used when a chosen case doesn’t meet the documentation requirements for no fault of the candidate, e.g. patient lost during follow up and the case cannot be properly scored.

 

[Feli]

Case reviewers must follow a process when evaluating cases. Proper documentation is a necessity to check the boxes of any particular case. ....

Yes, but is there any talk of going back to face-to-face board cert? That'a a huge shortcoming of ABFAS vs any MD surgery board cert process, such as ortho below.

As ABFAS case reviews BC process sits, it's almost all about clerical success (or failure).
The president had a good ABFAS website vid of how the process works with the room full of computers and reviewers, but there is no meaningful eval of the candidate thought process (outside of written exams the candidate has already passed by that point that covered indications, complications, principles, etc). It's just chart review. There is zero communication with the candidates. The case reviewer can only guess as to what the candidate did and why, and they can't ask for any more details - nor can the candidate provide any. The level of subjectivity and assumption is quite high.

The candidate can only hope they were not busy or rushed on their notes on that case selected, must hope they didn't leave the job and have XR or notes missing or done poorly by other later docs, etc. With today's BC case review completely digital and anonymous, candidate DPMs just have to bargain for a bit with Dr. Venson to get cases they don't have full records for replaced as best they can, then they press submit and hope for the best and get a pass or fail letter 6 weeks later. It is definitely not ideal. Well, I suppose a small comment box was added to the ABFAS case submit this 2023 year, and that is improvement... yet still very minimal as opposed to f2f interviews.

...For example, the ABOS board, which ABFAS is clearly trying to emulate (and wisely so), has f2f for part II exam... the x-rays, labs, etc are merely what the candidate uses to tell the story or show the results. No one piece of a case is a dealbreaker. All can be explained. The process blends academic and practical skill. There is no ticky-tack reading of the digital charts and dinging people for "improper pre-op biomechanical eval" (might have been done, just wasn't documented... can't ask) and no penalizing for a final note that had carried over "1+ edema" on accident or a missing XR for final 9mo showing final fusion. Instead, the candidate at the oral just explains those things, particularly the decisions and any deficiencies. That interactivity of oral exam is the difference we need to shoot for...

ABOS part 2 cert oral exam mock example (12 candidate cases, interactive... bottom vid on ABOS page plays after click on link):



Mock Oral Examination

 

[Shiyuan]

ABFAS case reviewer: “Let’s see, have we failed the candidate adequate times yet? Gotta get that money!” 😎

 

[dtrack22]

I didnt say that. I never brought a patient back again

Never said you did, but other have admitted they did and there are even posters here who have lost points in a case because of 6 week post ops that the reviewer didn’t like despite asymptomatic patients who had no need or desire to come back and be billed outside of the global when they don’t have pain.

I uploaded cases in a day. It was a solid day and it wasnt fun. But I got it done in a day.

I was referring to copying all of your surgical patient charts in case you change jobs which was alluded to above you

The CBPS is really dumb and doesnt test anything other than computer skills and how to take a simulated exam to beat it.

It should be eliminated completely. ABFAS could even charge a little more for the other exams in order to make up for the lost revenue and nobody would care

Pre,immediate post,and delayed post op imaging is required to properly evaluate an osseous case for healing. Those are the rules.

Except when you have a 6-8 week follow up that doesn’t show complete osseous union and then patient doesn’t come back because they are asymptomatic and don’t feel the need to show up to their follow up and the candidate loses points for it

If a candidate fails case review then at least 3 of the submitted 10 cases failed for any number of reasons.

11 cases, 22 total. 10 more than ortho.

Alternate cases are sometimes used when a chosen case doesn’t meet the documentation requirements for no fault of the candidate, e.g. patient lost during follow up and the case cannot be properly scored.

Lol if by “sometimes” you mean “very rarely.” I have numerous colleagues who have failed cases because of lost to follow up patients and they were explicitly denied the opportunity to have a different case selected by ABFAS.

ABFAS has some easy fixes that could/should be made. None of them would affect “patient safety” even though we all know that’s a dumb talking point that people use to limit competition. Ortho uses it to limit podiatrists. Podiatrists use it to weaponize ABFAS and limit other podiatrists. Physicians use it to limit mid-level scope. Etc. The primary reason they won’t is ego. Which is sad. The fixes would even solve any “ABPM problem” as the best way to limit their influence is to make them unnecessary. Clearly the “backdoor our cert into bylaws by getting diplomats to implement it at their facilities,” doesn’t work. It doesn’t even appear to be legal. Make it so people like me don’t even consider getting ABPM. Currently ABFAS is moving in the wrong direction in that regard.

 

[dtrack22]

Yes, but is there any talk of going back to face-to-face board cert?

I’m sure there is not. But it’s one of a few easy improvements. You’d still fail people that should fail but the pass rate would increase. Though that does mean less $$$ for ABFAS and they surely don’t like that.

-get rid of the CBPS. Nobody else does this and it’s an awful exam. It’s not necessary. Include more case specific questions and make the didactic longer if you must I guess.

-defined logging period. It can be 12 months if for some reason less than that would be inadequate but it doesn’t need to be in perpetuity

-12 cases total. 6 and 6 if you need to keep the RRA designation (I would get rid of RRA entirely but ABFAS never will)

-eliminate the diversity requirements that (I believe) started under the Mindy Benton regime. Which is very ironic 🙄🤡

-in person case review. Surgery is complex and we have all seen numerous colleagues get hosed by reviewers when no discussion regarding decisions made by the candidate can be had.

I’m sure I’m missing some that I’ve mentioned before, but that’s a good start.

 

[dtrack22]

Reviewers don’t just willy-nilly fail a case b/c they don’t like the orientation of a screw. If a case doesn’t pass, it is checked and rechecked by different reviewers. There is then a consensus on that particular case not passing. If a candidate fails case review then at least 3 of the submitted 10 cases failed for any number of reasons. Reviewers are generally on the side of the candidate and want to see good work.

@air bud might disagree with some of the above lol

I really do appreciate ABFAS joining the conversation instead of reporting posts from the shadows. But to come on and try to gaslight every one with stuff like the above quote…do you guys think the folks here haven’t been through the process ourselves to know that some of what has been posted so far is just outright lies? I mean if the board is moving towards these things being universally true, then Bravo. But there is still too much arbitrary/subjective processes involved in ABFAS cert. Future grads would be much better served if y’all would put egos aside. Some day. Maybe. Everyone should get ABPM after residency and not hold their breath though.

 

[air bud]

I’m sure there is not. But it’s one of a few easy improvements. You’d still fail people that should fail but the pass rate would increase. Though that does mean less $$$ for ABFAS and they surely don’t like that.

-get rid of the CBPS. Nobody else does this and it’s an awful exam. It’s not necessary. Include more case specific questions and make the didactic longer if you must I guess.

-defined logging period. It can be 12 months if for some reason less than that would be inadequate but it doesn’t need to be in perpetuity

-12 cases total. 6 and 6 if you need to keep the RRA designation (I would get rid of RRA entirely but ABFAS never will)

-eliminate the diversity requirements that (I believe) started under the Mindy Benton regime. Which is very ironic 🙄🤡

-in person case review. Surgery is complex and we have all seen numerous colleagues get hosed by reviewers when no discussion regarding decisions made by the candidate can be had.

I’m sure I’m missing some that I’ve mentioned before, but that’s a good start.

We know this doesn't work because
..
..
...
Podiatry...


Ortho takes a job and has cases immediately from call and the backlog waiting for them to start.... podiatry can take 6 to 9 months to get up and going because " you need to go out and market yourself" and " you are still not on insurances so to go ahead and bill under the owners" and....

 

[RollingstonePod]

@air bud might disagree with some of the above lol

I really do appreciate ABFAS joining the conversation instead of reporting posts from the shadows. But to come on and try to gaslight every one with stuff like the above quote…do you guys think the folks here haven’t been through the process ourselves to know that some of what has been posted so far is just outright lies? I mean if the board is moving towards these things being universally true, then Bravo. But there is still too much arbitrary/subjective processes involved in ABFAS cert. Future grads would be much better served if y’all would put egos aside. Some day. Maybe. Everyone should get ABPM after residency and not hold their breath though.

I do not represent ABFAS in any official capacity. Gaslighting is not my objective, just telling you how it is. There is no trickery or a "mustache pod" just waiting to find that nonunion or misplaced screw so they can fail you, hahahahaha. I have been involved with system for a while and I know how it works. We all get complications. It's part of doing surgery. You don't fail a case because a complication occurred. Failing to address the complication within the standard of care is what usually leads to a case failing. Your cases are reviewed by your colleagues and as I said before, more than one decides if a case passes or not. You are correct, there is some "subjectivity" but most of it has been eliminated as the process has improved over the years.

You claim I have been spewing "outright lies". Please tell me what you think I have lied about.

 

[dtrack22]

Ortho takes a job and has cases immediately from call and the backlog waiting for them to start.... podiatry can take 6 to 9 months to get up and going because " you need to go out and market yourself" and " you are still not on insurances so to go ahead and bill under the owners" and....

Ortho doesn’t enter their case list (logging) period until 8-9 months after they would have started their first job out of residency. And the logging period resets every year. So if you failed part II, you do not keep logging forever until you pass, you just resume logging the next April 1.

 

[DMEpod]

ABFAS case reviewer: “Let’s see, have we failed the candidate adequate times yet? Gotta get that money!” 😎

Although sarcastic, this is why ABFAS has a predatory feel to many young pods. I was lucky enough to have passed my 4 BQ tests in residency but for many that is not the case. The pass rates for the 4 exams are abysmal and new grads have to keep paying into the system to re take. I'm unsure of all programs, but in my residency it was very heavily implied that you have to take ABFAS and pass it to be able to do anything. With how low the pass rates are many people have to take it again and again which is terrible. If that test really is indicative of our training and skills then the pass rates show that a large sum of pods should not be in the surgical realm and only furthers the divide between the MD surgeons and ourselves.

I do agree that our schools and especially residency programs are a big part of the problem but ABFAS very much seems like a good ol boys club for a profession that is already an outcast in the medical field.

 

[RollingstonePod]

Although sarcastic, this is why ABFAS has a predatory feel to many young pods. I was lucky enough to have passed my 4 BQ tests in residency but for many that is not the case. The pass rates for the 4 exams are abysmal and new grads have to keep paying into the system to re take. I'm unsure of all programs, but in my residency it was very heavily implied that you have to take ABFAS and pass it to be able to do anything. With how low the pass rates are many people have to take it again and again which is terrible. If that test really is indicative of our training and skills then the pass rates show that a large sum of pods should not be in the surgical realm and only furthers the divide between the MD surgeons and ourselves.

I do agree that our schools and especially residency programs are a big part of the problem but ABFAS very much seems like a good ol boys club for a profession that is already an outcast in the medical field.

More than 10,000 podiatrists have earned ABFAS Board Certification by successfully demonstrating competency and proficiency in the specialty field of foot and ankle surgery. How is over 10,000 members in a small profession considered a "good ole boys club"?

 

[Shiyuan]

More than 10,000 podiatrists have earned ABFAS Board Certification by successfully demonstrating competency and proficiency in the specialty field of foot and ankle surgery. How is over 10,000 members in a small profession considered a "good ole boys club"?

Cue @DPM TRUTH 😂

 

[DPM TRUTH]

Hi everyone!

Rollinstonepod

Can you clarify your last statement?

Out of those 10,000 dpms you mentioned, who received board status with abfas, how many were:

A. Grandfathered in
B. Got in via the alternative method (no surgical residency)
C. actually passed post 2012

You wanna call someone with their foot and ankle certificate "proficient in foot and ankle surgery", when they never touched an ankle in residency? This is why so many call it an "old boys club". The grandfathered in/alternative method crew played by completely diff set of rules. They are who started this "club".

I know the abfas gurus wanna act like "everyone played by the same rules" - they did not! Wishing something never happened doesn't erase it!

 

[PalpablePulse]

More than 10,000 podiatrists have earned ABFAS Board Certification by successfully demonstrating competency and proficiency in the specialty field of foot and ankle surgery. How is over 10,000 members in a small profession considered a "good ole boys club"?

The higher ups at ABFAS are absolutely a good old boys club. Majority of the Denver folks are enormous douchebags.

Unfortunately - these same guys are big players in ACFAS as well. You never see anyone from these organizations leading meaningful change for this profession by addressing the elephant in the room, the root source of all problems podiatry - saturation. Instead - let’s talk about TARS, and softly stroke our Versajet soaked egos. In general, it’s why podiatry sucks and I discourage anyone from going into it. Too risky for the ROI, competing with a ton of med school rejects with bruised egos.

It is absolutely a good ol boy network. I doubt it was always that way, but it is absolutely the perception and the reality.

 

[Pronation]

a large sum of pods should not be in the surgical realm

Well…

 

[RollingstonePod]

Hi everyone!

Rollinstonepod

Can you clarify your last statement?

Out of those 10,000 dpms you mentioned, who received board status with abfas, how many were:

A. Grandfathered in
B. Got in via the alternative method (no surgical residency)
C. actually passed post 2012

You wanna call someone with their foot and ankle certificate "proficient in foot and ankle surgery", when they never touched an ankle in residency? This is why so many call it an "old boys club". The grandfathered in/alternative method crew played by completely diff set of rules. They are who started this "club".

I know the abfas gurus wanna act like "everyone played by the same rules" - they did not! Wishing something never happened doesn't erase it!

The grandfathered DPM's you speak of were a part of the old ambulatory foot surgeons and were grandfathered into ABPS as part of a lawsuit settlement. Those individuals are long gone and have since retired. Prior to 1991 diplomates of the ABPS had a certificate in "foot and ankle surgery". That certificate no longer exists. Those individuals were not grandfathered into anything, they simply have a different certificate. They went through the process as everyone else did. As you are well aware, the current certificates offered are Foot Surgery and Reconstructive Rearfoot and Ankle Surgery (RRA). If you have a F&A certificate you can choose to relinquish it by passing the RRA exam which many individuals in NY did when the law changed to gain access to ankle surgery. What exactly is your issue with pre 2012 individuals?

 

[Sweatshirt]

I already know of several young DPMs that graduated residency in my city that are not bothering to renew their ABFAS dues or pursue the case review process. Several of the other residents (from multiple programs) that are graduating with me aren't even bothering to pursue ABFAS when we graduate in June. I encourage every young DPM to do the same until ABFAS financially dies out or massive changes occur within the organization

 

[DPM TRUTH]

Rollingstonepod

I think your a little confused.

My board status, as per the abfas.org find a surgeon page, is "Foot and Ankle Certified". Please elaborate on how this certificate "doesn't exist"? It does exist, and the old guys weaponize the ankle part.

So with this being said, how is it fair that I have a foot and ankle certificate but NEVER touched an ankle in my life? Yet a PM&S-36 trained dpm has to pay THOUSANDS just to get a foot certificate!

Is this better for patient safety and confusion? Why still have ankle in my board status? Should be simple to make all foot and ankle certificates to be moved to foot surgery only (of course rra if they passed the rra test). Why hasn't this happened in the past 25 years everyone?

You will have to check with the "old boys club" to see why they have an issue with this! They will direct your attention to that abpm sx caq - "it's making the sky fall everyone"! Doesn't matter the grandfathered in guy is taking 120 mins to finish his Austin with absorbable pin. Think about it everyone!

 

[Boba Foot]

More than 10,000 podiatrists have earned ABFAS Board Certification by successfully demonstrating competency and proficiency in the specialty field of foot and ankle surgery. How is over 10,000 members in a small profession considered a "good ole boys club"?

Seems like prime meme material here, @air bud

 

[dtrack22]

More than 10,000 podiatrists have earned ABFAS Board Certification by successfully demonstrating competency and proficiency in the specialty field of foot and ankle surgery. How is over 10,000 members in a small profession considered a "good ole boys club"?

So this one isn’t an outright lie but it is incredibly disingenuous and misleading. Only a fraction of those 10,000 DPMs went through anything that resembles the current process. And 10,000 is the total number throughout the history of our profession. Including whatever board existed prior to ABFAS/ABPS/etc.

I’ll let @DPM TRUTH handle this one but I worked for a DPM who had the certificate that our ABFAS representative friend says doesn’t exist.

Anybody else notice how the new poster never responds to any discussion about changes that could/should be made to ABFAS? No “I agree,” no “those are a bad idea and here’s why.” Just silence.

 

[RollingstonePod]

Rollingstonepod

I think your a little confused.

My board status, as per the abfas.org find a surgeon page, is "Foot and Ankle Certified". Please elaborate on how this certificate "doesn't exist"? It does exist, and the old guys weaponize the ankle part.

So with this being said, how is it fair that I have a foot and ankle certificate but NEVER touched an ankle in my life? Yet a PM&S-36 trained dpm has to pay THOUSANDS just to get a foot certificate!

Is this better for patient safety and confusion? Why still have ankle in my board status? Should be simple to make all foot and ankle certificates to be moved to foot surgery only (of course rra if they passed the rra test). Why hasn't this happened in the past 25 years everyone?

You will have to check with the "old boys club" to see why they have an issue with this! They will direct your attention to that abpm sx caq - "it's making the sky fall everyone"! Doesn't matter the grandfathered in guy is taking 120 mins to finish his Austin with absorbable pin. Think about it everyone!

The certificate does exist, what I meant is that it is no longer offered, I apologize for the confusion. Many of those individuals with F&A certificates are retired or soon will be. At the time, pre 1991, once you attained BC it was a lifetime certificate and could not be taken away. That was the policy then. Post 1991 the certificate required re-certification every 10 years. I don't disagree with you regarding having an F&A certificate and never have touch an ankle. That cert was over 30 years ago and times have changed. Most places nowadays that allow DPM's to do advanced ankle surgery require the RRA cert.

What's your issue pre 2012? Don't understand that one

 

[PalpablePulse]

The certificate does exist, what I meant is that it is no longer offered, I apologize for the confusion. Many of those individuals with F&A certificates are retired or soon will be. At the time, pre 1991, once you attained BC it was a lifetime certificate and could not be taken away. That was the policy then. Post 1991 the certificate required re-certification every 10 years. I don't disagree with you regarding having an F&A certificate and never have touch an ankle. That cert was over 30 years ago and times have changed. Most places nowadays that allow DPM's to do advanced ankle surgery require the RRA cert.

What's your issue pre 2012? Don't understand that one

“Advanced” ankle surgery. Like a fibular takedown? Or an ORIF?
Where exactly is the line where it becomes advanced?

An ATFL repair?

Listen to how you sound. Even better - do a big bag of mushrooms and then spend the evening reading this forum, maybe it will open up your mind.

 

[DMEpod]

More than 10,000 podiatrists have earned ABFAS Board Certification by successfully demonstrating competency and proficiency in the specialty field of foot and ankle surgery. How is over 10,000 members in a small profession considered a "good ole boys club"?

I've worked with plenty of old pods in residency that have been RRA "certified" but probably haven't seen an ankle since cadaver lab in school

 

[dtrack22]

The certificate does exist, what I meant is that it is no longer offered, I apologize for the confusion. Many of those individuals with F&A certificates are retired or soon will be. At the time, pre 1991, once you attained BC it was a lifetime certificate and could not be taken away. That was the policy then. Post 1991 the certificate required re-certification every 10 years. I don't disagree with you regarding having an F&A certificate and never have touch an ankle. That cert was over 30 years ago and times have changed. Most places nowadays that allow DPM's to do advanced ankle surgery require the RRA cert.

What's your issue pre 2012? Don't understand that one

Why did you use the 10,000 number when that refers to the total all time number of DPMs who have obtained certification since the 70’s? Including ABPS or any board that predated it. And not active ABFAS diplomats? Is it because you were repeating ABFAS talking points and didn’t know better or are you being purposefully misleading?

Are you ignorant or purposefully deceitful to make it sound more inclusive/common?

 

[Poddy2Hotty]

Although sarcastic, this is why ABFAS has a predatory feel to many young pods. I was lucky enough to have passed my 4 BQ tests in residency but for many that is not the case. The pass rates for the 4 exams are abysmal and new grads have to keep paying into the system to re take. I'm unsure of all programs, but in my residency it was very heavily implied that you have to take ABFAS and pass it to be able to do anything. With how low the pass rates are many people have to take it again and again which is terrible. If that test really is indicative of our training and skills then the pass rates show that a large sum of pods should not be in the surgical realm and only furthers the divide between the MD surgeons and ourselves.

I do agree that our schools and especially residency programs are a big part of the problem but ABFAS very much seems like a good ol boys club for a profession that is already an outcast in the medical field.

Again the problem comes down to training/education/preparation.

I was "lucky" enough to pass my 4 BQ in residency and my case review Foot/RRA 1st time
My residency director ingrained in us as well that ABFAS is not optional. Its pretty much the final boss - treat it as such.
We all took exam very seriously. I think if more schools/residency programs took more time to mentally prepare residents for what to expect the pass rate would increase greatly.

I felt the written exam portion was extremely fair if you studied
The case review was annoying due to all the requirements and time required to upload everything. But if you plan ahead and keep up with logs its 100% achievable to pass IMO.

There are also problems with certain residencies. There are some residencies where training and education is suboptimal and I remember hearing stories of residents graduating from a certain VA without placing a single screw (don't know how true this is, but I put it in the realm of possibility). And for God's sake abolish the forefoot only residencies already as these do nothing to help the profession nor the disgruntled pods that got screwed into matching there.

The majority of school administrators/educators can't cut their way out of a wet paper bag and/or are 30 years past their prime.
Schools can't continue to offer 150k salaries and expect well trained individuals to educate the next generation. This figure needs to increase to 250k at least and IMO should be closer to 300-350k to lure the best and brightest away from that hospital gig they are crushing it in.

If I was unable to pass ABFAS requirements within 7 years and this hurt me professionally/economically I would consider suing the Podiatry school I graduated from rather than throw a fit over how hard the ABFAS exam was. They failed to adequately prepare you.

Do you remember DeVry University?
“DeVry defrauded thousands of students by selling them on false promises and lies.”
“Thousands of students attended DeVry with high hopes about post-grad job prospects only to learn that they were deceived."

This is exactly what the current schools are doing and opening two more schools in this job market is one of the greediest/saddest things I have seen in a long time. This forum has allowed people to see behind the curtain (Wizard of Oz reference) and better understand what realistic expectations are before making a lifetime debt commitment or moving to Montana and your spouse divorcing you because they hate it there.

Godspeed to all of us and especially anyone entering podiatry school in the coming years.

 

[DPM TRUTH]

It was posted:

At the time, pre 1991, once you attained BC it was a lifetime certificate and could not be taken away. That was the policy then.

Anyone wanna play a game and guess what the BC process was like pre-1991? Lemme give you some facts about how it went.

There was no case diversity
There was no cbps exam
There was no thousand dollar "look at cases again"
There wasn't a 50% pass rate
We helped struggling collegues along

How did the "policy" change so much? More importantly why? Although residencies now have "issues", they are 100% better than our old ppmr/psr12s from 30 yrs ago that banged out several "foot and ankle surgery" certificates!

So we played by a completely diffrent set of rules. For the past 35 years we could all say we were boarded in foot and ankle surgery. Did the profession ever issue a statement telling the pre-1991 crowd to avoid advertising foot and ankle surgery and just use foot surgery for patient safety (since 99% never touched an ankle)? Patient safety right?

 

[Poddy2Hotty]

It was posted:

At the time, pre 1991, once you attained BC it was a lifetime certificate and could not be taken away. That was the policy then.

Anyone wanna play a game and guess what the BC process was like pre-1991? Lemme give you some facts about how it went.

There was no case diversity
There was no cbps exam
There was no thousand dollar "look at cases again"
There wasn't a 50% pass rate
We helped struggling collegues along

How did the "policy" change so much? More importantly why? Although residencies now have "issues", they are 100% better than our old ppmr/psr12s from 30 yrs ago that banged out several "foot and ankle surgery" certificates!

So we played by a completely diffrent set of rules. For the past 35 years we could all say we were boarded in foot and ankle surgery. Did the profession ever issue a statement telling the pre-1991 crowd to avoid advertising foot and ankle surgery and just use foot surgery for patient safety (since 99% never touched an ankle)? Patient safety right?

Evolution bro. More pods today doing waaaaaaaay more complex surgery - Ankle fractures, TARs, Triples, IM nails, MIS Charcot Frames etc

You want to live in the past go for it. Grandfathering older providers in is the only way to raise standards while avoiding screwing over the people who paved the way for the new generation. I have all the respect in the world for the older generation pods. Without them I wouldn't be able to do what I do. They shouldn't become obsolete or lose scope. The purpose is to continue to raise the bar and push the envelope.

Some day I'll be old/outdated, but I hope I will be allowed to continue to do what I love and continue to help patients appropriately.

Also probably at least 25% of residencies are still garbage

The rules are different because the game is changing.

 

[DYK343]

Several of the other residents (from multiple programs) that are graduating with me aren't even bothering to pursue ABFAS when we graduate in June.

Unless you want to be non op or minimally op (surgery center based and maybe I&D at hospital) this is dumb. You will pigeon hole yourselves out of jobs. My last hospital job required ABFAS. My current hospital job im pretty sure another DPM didnt get the position because ABPM only and no ABFAS.

Take the exam. Its expensive and frustrating but not impossible. I dont understand why everyone is throwing a fuss. Its a passable exam. Read the instructions and understand what you gotta do to pass it. Document well. Document aggressive. Dont wait to log all your cases which takes about 10 seconds a case. Do good work and you will pass.

I encourage every young DPM to do the same until ABFAS financially dies out or massive changes occur within the organization

This is bad advice.

 

[air bud]

Again the problem comes down to training/education/preparation.

I was "lucky" enough to pass my 4 BQ in residency and my case review Foot/RRA 1st time
My residency director ingrained in us as well that ABFAS is not optional. Its pretty much the final boss - treat it as such.
We all took exam very seriously. I think if more schools/residency programs took more time to mentally prepare residents for what to expect the pass rate would increase greatly.

I felt the written exam portion was extremely fair if you studied
The case review was annoying due to all the requirements and time required to upload everything. But if you plan ahead and keep up with logs its 100% achievable to pass IMO.

There are also problems with certain residencies. There are some residencies where training and education is suboptimal and I remember hearing stories of residents graduating from a certain VA without placing a single screw (don't know how true this is, but I put it in the realm of possibility). And for God's sake abolish the forefoot only residencies already as these do nothing to help the profession nor the disgruntled pods that got screwed into matching there.

The majority of school administrators/educators can't cut their way out of a wet paper bag and/or are 30 years past their prime.
Schools can't continue to offer 150k salaries and expect well trained individuals to educate the next generation. This figure needs to increase to 250k at least and IMO should be closer to 300-350k to lure the best and brightest away from that hospital gig they are crushing it in.

If I was unable to pass ABFAS requirements within 7 years and this hurt me professionally/economically I would consider suing the Podiatry school I graduated from rather than throw a fit over how hard the ABFAS exam was. They failed to adequately prepare you.

Do you remember DeVry University?
“DeVry defrauded thousands of students by selling them on false promises and lies.”
“Thousands of students attended DeVry with high hopes about post-grad job prospects only to learn that they were deceived."

This is exactly what the current schools are doing and opening two more schools in this job market is one of the greediest/saddest things I have seen in a long time. This forum has allowed people to see behind the curtain (Wizard of Oz reference) and better understand what realistic expectations are before making a lifetime debt commitment or moving to Montana and your spouse divorcing you because they hate it there.

Godspeed to all of us and especially anyone entering podiatry school in the coming years.

To be fair the new Texas school has legit studs teaching....

 

[air bud]

Unless you want to be non op or minimally op (surgery center based and maybe I&D at hospital) this is dumb. You will pigeon hole yourselves out of jobs. My last hospital job required ABFAS. My current hospital job im pretty sure another DPM didnt get the position because ABPM only and no ABFAS.

Take the exam. Its expensive and frustrating but not impossible. I dont understand why everyone is throwing a fuss. Its a passable exam. Read the instructions and understand what you gotta do to pass it. Document well. Document aggressive. Dont wait to log all your cases which takes about 10 seconds a case. Do good work and you will pass.


This is bad advice.

Not allowed to meme outside of the meme thread....but insert Zoolander crazy pills gif. Take the test. Pass it.

Insert Starsky and Hutch Do it gif

 

[Sweatshirt]

Unless you want to be non op or minimally op (surgery center based and maybe I&D at hospital) this is dumb. You will pigeon hole yourselves out of jobs. My last hospital job required ABFAS. My current hospital job im pretty sure another DPM didnt get the position because ABPM only and no ABFAS.

Take the exam. Its expensive and frustrating but not impossible. I dont understand why everyone is throwing a fuss. Its a passable exam. Read the instructions and understand what you gotta do to pass it. Document well. Document aggressive. Dont wait to log all your cases which takes about 10 seconds a case. Do good work and you will pass.


This is bad advice.

No thanks. All the young docs I talk to are actively trying to phase out ABFAS. We don't want to throw thousands and thousands of dollars at an organization that is corrupt, writes terrible exams, and has a long and horrible board certification process. My hospital employed position (as well as many others) does not require ABFAS so there is no need for us to pursue it. They do nothing for us, the ROI is not there. Also, most hospitals that do require ABFAS for privileging are in violation of the law. This is happening whether you ABFAS gatekeepers like it or not. Young DPMs want them gone and hopefully is 10-15 years we will have totally phased ABFAS into irrelevancy

 

[newfeet]

No thanks. All the young docs I talk to are actively trying to phase out ABFAS. We don't want to throw thousands and thousands of dollars at an organization that is corrupt, writes terrible exams, and has a long and horrible board certification process. My hospital employed position (as well as many others) does not require ABFAS so there is no need for us to pursue it. They do nothing for us, the ROI is not there. Also, most hospitals that do require ABFAS for privileging are in violation of the law. This is happening whether you ABFAS gatekeepers like it or not. Young DPMs want them gone and hopefully is 10-15 years we will have totally phased ABFAS into irrelevancy

I’ve been successful with just ABPM but I was never a surgery person. I wouldn’t tell any new residency grad to rule ABFAS. Most jobs require it and it would take a lot of lawsuits for them to stop.

 

[PatchAdamsFan]

No thanks. All the young docs I talk to are actively trying to phase out ABFAS. We don't want to throw thousands and thousands of dollars at an organization that is corrupt, writes terrible exams, and has a long and horrible board certification process. My hospital employed position (as well as many others) does not require ABFAS so there is no need for us to pursue it. They do nothing for us, the ROI is not there. Also, most hospitals that do require ABFAS for privileging are in violation of the law. This is happening whether you ABFAS gatekeepers like it or not. Young DPMs want them gone and hopefully is 10-15 years we will have totally phased ABFAS into irrelevancy

All of my hospital/MSG employed colleagues (including myself) were comped for the BQ/BC exams if ABFAS was a requirement in their contracts. Paid nothing. I truly hope you are happy in your position and remain at your hospital, but probability is not on your side long term. Most docs switch jobs for various reasons, and as we all know, the job market for these positions is relatively non-existent. For as many surgical positions you know that do not require ABFAS, there are many more that do whether we like it or not. Fight the good fight - I fully support the arguments, but we have to be honest with ourselves that ABFAS isn't going anywhere. If you have the cases, just do it. Or not - that means more opportunities for the certified. The fairness of that is beside the point.

 

[DYK343]

No thanks. All the young docs I talk to are actively trying to phase out ABFAS. We don't want to throw thousands and thousands of dollars at an organization that is corrupt, writes terrible exams, and has a long and horrible board certification process. My hospital employed position (as well as many others) does not require ABFAS so there is no need for us to pursue it. They do nothing for us, the ROI is not there. Also, most hospitals that do require ABFAS for privileging are in violation of the law. This is happening whether you ABFAS gatekeepers like it or not. Young DPMs want them gone and hopefully is 10-15 years we will have totally phased ABFAS into irrelevancy

When was I ever a gatekeeper? I never gatekept anyone. Ever. I also never will. Personally I dont care if someone holds ABPM but I know my employers do/have.

And best of luck to you. You do you. I think you will regret your decision.

To any graduating resident I wouldnt limit yourself.
ABFAS is a stronger board than ABPM and will always hold more weight.
Not pursuing it may close out a road you really wish you would have walked down.
A moderate or heavy surgical job is going to want ABFAS and will question someone who doesnt hold it.

That said if you never see yourself surgical then it probably is a waste as surgery centers likely wont require it for simple FF stuff/bunions/HTs. And from my experience hospitals are begging for anyone to come do a toe amp. To be honest thats a GREAT life and people who pursue that are probably smarter than I.

But most hospitals/ortho/MSG/pod supergroups will not give you a job heavy in surgery without ABFAS. If no desire to fix fractures, midfoot fusions, cavus/ff recons, etc then its probably not in your best interest.

There is no 100% set in stone lacking ABFAS will prevent these jobs. Cant generalize anything and exceptions are true. But lets be honest most of those jobs go to ABFAS certs.

 

[Shiyuan]

I’ve found the more rural you go, the less hospitals give a flip which board you have... but, like I said before, they don’t know the difference anyway.

 

[Feli]

... not bothering to renew their ABFAS dues or pursue the case review process. Several of the other residents (from multiple programs) that are graduating with me aren't even bothering to pursue ABFAS when we graduate in June. I encourage every young DPM to do the same...

 

[FootGuy]

The "ABFAS road" is indeed long, stressful, and at least mild annoying, but it does not in any way close a door for anyone to have the Cert. I must agree, if able it is way better to go for it. I am glad I did. I have no real issues with ABPM cert. doing surgery based on training and experience, but would personally choose an ABFAS doc. as a general rule given the choice, because it shows at least a commitment to the process and some level of competency where the other board doesn't.

Opinion aside, why a young doctor would limit himself or herself based on politics within the profession I can't understand? I would let the "old guard" fight the political battles and focus on trying to carve out some personal success and happiness if in that same situation today. I would at least make the attempt, because you can't lose by having ABFAS cert. You can always engage in the political side and push for change, so I would focus on doing anything I can to make myself in a better position.

Best of luck either way.

 

[RollingstonePod]

“Advanced” ankle surgery. Like a fibular takedown? Or an ORIF?
Where exactly is the line where it becomes advanced?

An ATFL repair?

Listen to how you sound. Even better - do a big bag of mushrooms and then spend the evening reading this forum, maybe it will open up your mind.

The line is drawn by the credentialing institution that requires RRA certification. Many hospitals require it and do not recognize the F&A certificate for ankle privileges.
However it sounds, it is the way it is. This profession has come a long way from the days when we weren’t even allowed to step into a hospital. Btw, mushrooms aren’t my thing.

 

[RollingstonePod]

I've worked with plenty of old pods in residency that have been RRA "certified" but probably haven't seen an ankle since cadaver lab in school

Old pods can’t get an RRA certificate unless they have done RRA surgery post residency. F&A cert is not the same thing.

 

[RollingstonePod]

Why did you use the 10,000 number when that refers to the total all time number of DPMs who have obtained certification since the 70’s? Including ABPS or any board that predated it. And not active ABFAS diplomats? Is it because you were repeating ABFAS talking points and didn’t know better or are you being purposefully misleading?

Are you ignorant or purposefully deceitful to make it sound more inclusive/common?

You are correct, that line is straight out of the talking points. 10,000 have achieved it and over 7,000 are active. Still not the definition of a good ole boys club. It’s comical you think ABFAS is trying to keep people out.

 

[Pronation]

“Advanced” ankle surgery. Like a fibular takedown? Or an ORIF?
Where exactly is the line where it becomes advanced?

An ATFL repair?

Listen to how you sound. Even better - do a big bag of mushrooms and then spend the evening reading this forum, maybe it will open up your mind.

This one is easy to answer. “Advanced” ankle surgery is when you make an incision on the ankle and pus doesn’t start pouring out.

 

[dtrack22]

7,000 are active.

So 40% of practicing DPMs

It’s comical you think ABFAS is trying to keep people out.

I don’t think ABFAS as a whole is trying to keep people out. I think they have a flawed process that they are unwilling to change (because once you are certified there is no incentive to change the process) and that individuals with ABFAS cert, individually use it to decrease competition when they can.

At best ABFAS leadership has used flawed logic in the past to make the certification process increasingly and unnecessarily difficult. But you could make the case that there were several groups of Directors who purposefully changed parts of the certification process to make it harder to obtain certification. Maybe new leadership is better? Nobody should hold their breath.

The mindset of, “we must prove to ortho and the other real doctors that we can do surgery too, so we must make our process as rigorous as possible,” is the most optimistic version of changes made by past leadership. And many of the changes for the worse were made under past-Presidents who didn’t or couldn’t even do procedures that became required for “case diversity” purposes. Which is what you should actually find comical. They could have straight up copied ABOS and it would have been a much better process. But no, the Orthopedic Surgery board examination process would not adequately test competency of non MD/DO Foot & Ankle surgeons

Despite the misleading statements within your recent posts, you’re clearly knowledgeable about the organization, so why does ABFAS not have an in person case review like other surgical specialties? And like ABPS used to?

 

[msion]

Despite the misleading statements within your recent posts, you’re clearly knowledgeable about the organization, so why does ABFAS not have an in person case review like other surgical specialties? And like ABPS used to?

Because then we will find out these case reviewers are actually mustache pods that ask theirs questions based on Pocket Pod.
“Why did you do a lapidus? Do you know a crescentic osteotomy can also achieve triplane correction?”
“Have you considered an Akin to address the DASA?”
“Do you know the origin of the word Pilon? Is it pronounced Pee-long or Pie-long?”