President's Message

By Wilford K. Gibson, MD
VOS President


Wilford Gibson
Wilford K. Gibson, MD

VOS PresidentpostitnoteNPs and PAs

Maintenance of Certification

"There is nothing more difficult to plan, more doubtful
of success, nor more dangerous to manage than the
creation of a new order of things." 
- Machiavelli's The Prince

This is the way  American Board of Medical Specialties (ABMS) CEO and President Stephen H. Miller, MD, MPH described Maintenace of Certification (MOC) in Clinical Orthopaedics and Related Research in August 2006.  If  MOC is sneaking up on you, you are not alone.  If you don't know about MOC, or haven't made your own plan for MOC, then you really need to keep reading.

Currently, the ABMS and it's 24 Member Boards are transitioning to a four part continous maintenance of certification process that builds six core competencies for patient care.  Part 1:  Licensure and Professional Standing requires you to hold a valid, unrestricted license.  Part 2:  Lifelong Learning and Self Assessment requires specialty-specific educational programs and self-assessment.  Continuing Medical Education (CME) requirements, defined by the American Board of Orthopaedic Surgery (ABOS), include 120 hours of specialty specific CME and 20 hours of self-assessment CME every three year cycle.  Each of the self-assessment activities must be a minimum of 10 hours each.  Part 3:  Cognitive Expertise requires that you demonstrate your knowledge and skills through examination.  The ABOS has several pathways, including the computer based examination or oral examination.  This testing is required prior to the expiration of your time-limited ABOS certificate.  For those with certificates issued before 1986, MOC is voluntary.  Remember, your application is due the year before you plan to take the exam.  You may test two years prior to your expiration date.  This requires you to  start collecting your three year cycle of CME four years before your planned test date.  If there are six or more years before your planned recertification date, don't forget that you must have CME for two cycles of three years.  If you are feeling confused, you are not alone.  Fortunately, much of this is covered in more detail at www.abos.orgPart 4:  Practice Performance Assessment requires you to demonstrate your use of best evidence and practices compared to peers and national benchmarks.  The ABOS website refers to a "quality improvement model" to assess this.  Don't forget your application requires a three month case list for the computer based exam and six month case list for the oral exam.  There are examples of the clinical data that are required on the ABOS website.  This is fairly detailed and includes questions about complications, prophylactic antibiotics, DVT prophylaxis, "sign your site" and "time-outs" prior to surgery.
If you are wondering about those six core competencies, they are patient care, medical knowledge, practice-based learning, interpersonal and communication skills, professionalism and systems-based practice.  I refer you to the ABMS website ( and the ABOS website ( for discussion of these topics. 

Many tools are available through the American Academy of Orthopaedic Surgeons, the American Orthopaedic Society for Sports Medicine, the Journal of Bone and Joint Surgery and the American Society for Surgery of the Hand.  At this time, these are the only organizations that provide acceptable CME for the twenty hours of self-assessment required each three year cycle.  
I hope this has stimulated anyone sitting on the fence concerning MOC to go to the ABOS website and verify your personal requirements.  Remember, it is your personal responsibility to keep a log of your CME and get your application in on time!
If you are looking for a pleasant, enjoyable way  to obtain several hours of CME, please join us at Wintergreen for our 61st Annual Meeting and 75th Anniversary, May 2-4, 2008.  We already have sponsors getting in line for exhibition space and accommodations.  Remember to register early and make arrangements for accommodations.  Our website www. is your online site for upcoming requests for abstracts and meeting activities.  I'll see you in Wintergreen!

Wilford K. Gibson, MD
President, Virginia Orthopaedic Society     

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