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Turning Residents Into Competent Orthopaedic Surgeons

By David F. Martin, MD

    • Industry Insights

The American Board of Orthopaedic Surgery (ABOS) depends on collaboration with multiple organizations to stay true to the ABOS mission.

One of those valuable collaborations is with the American Orthopaedic Society for Sports Medicine (AOSSM). The ABOS would not be able to accomplish what we do without the support of the AOSSM leadership as well as the many Members who serve faithfully as ABOS volunteers.

AOSSM Members Matthew D. Pepe, MD (right) and Christopher C. Dodson (center) are joined by Rothman Orthopaedics colleague Alexander Vaccaro, MD, PhD, on field for a Philadelphia Eagles game. The three team physicians are all Board-certified in their subspecialty by ABOS.

Another longtime collaborator with the ABOS is the Accreditation Council for Graduate Medical Education (ACGME). Part of the ABOS mission is to set high standards for residency education and we accomplish that in part with the ACGME. The ABOS has formed a new partnership with the ACGME that will benefit orthopaedic surgery residents along with their Program Directors and Coordinators.

This new collaboration integrates Resident Case Log entry with the ABOS Knowledge, Skills, and Behavior (ABOS KSB) Program into one web portal and mobile app. In one place, residents can enter their surgical cases to create case logs as required by the ACGME, and easily request ABOS KSB Surgical Skills Assessments required by the ABOS. This provides residents the opportunity to request and receive formative surgical skills feedback while allowing easy access to logging surgical cases. Residents log all their ACGME Case Logs via the ABOS KSB+ app and/or web portal through this program. Starting July 1, 2025, all residents who wish to sit for the ABOS Part I Examination will be required to have participated in the ABOS KSB Program.

Graduate medical education is transitioning from time-based programs for the acquisition of knowledge and skills to promoting competency-based curricula. Validated tools to measure competency are critical to this transition. The ABOS KSB Program provides orthopaedic residents and Program Directors assessment tools with the necessary technology in the areas of orthopaedic knowledge, critical surgical skills, and professional behavior to assist in the transition to competency-based medical education and, long-term, to orthopaedic practice.

In addition to surgical skills, the ABOS KSB Program looks at Knowledge through a collaboration with the American Academy of Orthopaedic Surgeons Orthopaedic In-Training Examination (AAOS OITE). Residents also request Professional Behavior assessments from faculty after each rotation and participate in a yearly 360 Professional Behavior evaluation where residents are rated by co-residents, orthopaedic faculty, and evaluators that are identified by the program as having interacted with orthopaedic residents such as nurses, ED Faculty, outpatient staff, and more. Currently, 105 orthopaedic surgery residency programs are participating in the ABOS KSB Program. We strongly encourage programs to onboard now to allow residents and faculty time to process this change prior to participation becoming a requirement to enter the ABOS Board Certification process.

Residency programs that have already onboarded into the ABOS KSB Program have started transitioning to the new web portal/app and will continue throughout the next two academic years. Residency programs not currently enrolled in the ABOS KSB Program will be able to join the ABOS KSB Program and utilize the new integrated web portal/app once the currently enrolled programs have transferred to ABOS KSB+. ABOS staff will reach out to a residency program once the integrated platform is available to their institution.

All surgical residents in ACGME-accredited programs (no matter the discipline) must enter ACGME Case Logs. The ABOS is the first board to offer a tool that integrates competency-based medical education and the entry of ABOS’s KSB Surgical Skills requirements with the ACGME’s Case Log Entry requirements. Residents will log all their surgical cases into ACGME Case Logs via the ABOS KSB app or Web Portal. All surgical cases must be logged, not just those cases that a resident is submitting for ABOS KSB assessment.

When I was training to be an orthopaedic sports medicine surgeon, I received general feedback from my attendings. I wish the ABOS KSB Program was around during my residency so I could have taken advantage of the useful feedback mechanisms that it provides between residents and faculty. Residents have told us that the most valuable information they receive is from the comments from their attendings that are stimulated by the program. Faculty have told us that it is very easy to provide assessments and an overwhelming majority of faculty who receive requests ABOS KSB Surgical Skills or Professional Behavior rating requests from residents complete them in a timely manner. Faculty members also appreciate that they can choose whether to receive the assessment requests through email or text.

Receiving this formative feedback in the critical areas of resident orthopaedic knowledge, resident surgical skills, and professional behavior can assist in letting program Directors know the strengths and weaknesses of each of their residents, thus leading to the advantage of them being able to provide specific help to residents in areas where it is most needed.

As a reminder, starting July 1, 2025, the ABOS KSB Program will be required for all residents sitting for the ABOS Part I Examination. For more information on ABOS KSB Program, visit https://www.abos.org/abosksb.

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