03/21/2023    Rod Tomczak, DPM, MD, EdD

APMA Board Certification Summit (ABPM Board of Directors)

"Those who cannot remember the past are condemned
to repeat it." George Santayana wrote the above in
1905. Podiatry is approaching the board
certification intersection controversy once again
and it may serve the profession well to review the
history of ABPS.

ABPS was founded in 1978 when I was a first year
resident. The orthopedic surgeons in Philadelphia
immediately told us we had a weak board and
becoming board certified in podiatric surgery was
about as difficult as getting a library card.
When I finished my second year I was considered
board eligible by the ABPS. One very prominent
podiatrist told me the best way to get hospital
privileges was to get a part time job as a scrub
tech and show surgeons I knew what I was doing in
the operating room and some

how back door my way into surgical privileges.
Another podiatrist, one of the fathers of
podiatric surgery told me we would walk into a
staff meeting where I was going to give a
presentation on bunion surgery and open my
resident surgical logs for all to see. We did the
latter.

I became board certified in foot and ankle surgery
the quickest I could according to the rules of
ABPS, in 1981. In a year or two all ABPS members
were hit by a surcharge to pay legal fees in our
defense of a lawsuit filed against ABPS by minimal
incision podiatric surgeons who wanted the same
certification I had. This lawsuit was settled and
minimal incision surgeons were granted
certification by ABPS under a separate subsection.

I reviewed cases submitted by applicants and had
to reject some because of substandard care. We
had a mentor to talk to when we suspected a denial
was in order so denial of a case was not a
solitary decision.

Next was the committees and then oral examiner.
For awhile oral exams were monitored by an
experienced examiner to ensure new examiners were
capable to examine. Then exam sessions were tape
recorded. Examiners could not examine candidates
they knew and exam takers could eliminate
examiners they felt like rejecting. Supposedly,
the only reason for rejecting an examiner was a
personal relationship, but reputations often came
into play. Examiners were to remain anonymous,
but it's a small profession.

Like many boards, ABPS evolved. Psychiatry and
neurology which had been a single board, split
into separate boards and ABPS introduced forefoot
and rear foot sections allowing podiatrists who
had not done enough rear foot and ankle cases to
become board certified giving them access to
hospital privileges and insurance panels under the
aegis and auspices of ABPS. ABPS underwent a name
change to American Board of Foot and Ankle
Surgery. Regardless of the limitation, forefoot
or rear foot and ankle, the certifying board was
still the ABFAS. It could be argued, to the
casual credentialer at an insurance company or
hospital, the podiatrist was board certified in
podiatric surgery and was placed on a panel or
granted privileges.

I would really like to think the ABFAS board exam
is very difficult. I would hate to think a
nonchalant orthopedic surgeon could sit for the
ABFAS boards and ace it. Young MD/DO physicians
study before taking their respective boards. Some
have study groups that meet once a week during the
first year of practice in preparation. I wonder
how foot and ankle orthopedic surgeons would score
on our LEAD program. I'd like to think they score
in the same ball park as we do.

We do not want to be accused again of having weak
boards and we don't want to return to the days of
lawsuits and intra-professional animosity.

Rod Tomczak, DPM, MD, EdD

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