VSB ABS Hot Topics ASH MANSOUR, M.D. VASCULAR SURGERY BOARD OF THE AMERICAN BOARD OF SURGERY 2017 APDVS MEETING APRIL 1, 2017

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1 VSB ABS Hot Topics ASH MANSOUR, M.D. VASCULAR SURGERY BOARD OF THE AMERICAN BOARD OF SURGERY 2017 APDVS MEETING APRIL 1, 2017

2 Conflict of Interest None 2

3 Topics to discuss Board expansion New Board members Results of last year s exams Structure of exams Resident/fellow operative experience V SCORE initiative THE AMERICAN BOARD OF SURGERY

4 Mission Statement of the ABS The American Board of Surgery serves the public and the specialty of surgery by providing leadership in surgical education and practice, by promoting excellence through rigorous evaluation and examination, and by promoting the highest standards for professionalism, lifelong learning, and the continuous certification of surgeons in practice. THE AMERICAN BOARD OF SURGERY 4

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6 The VSB-ABS Vascular Surgery Board of the American Board of Surgery (VSB ABS) founded in 1998 Defines all requirements, policies and processes related to vascular surgery examination and certification Members are nominated from APDVS (2), SCVS (1), SVS (4) and VESS (1) for one 6 year term June 2017 expansion by 5 members EVS, NESVS, MW, S, W 6

7 VSB-Membership Associate Executive Director Bruce Perler VSB Chair Vivian Gahtan VSB Vice Chair Ash Mansour Completing terms June 2017 Amy Reed, Karl Illig (APDVS, VESS) Continuing members Daniel Clair, Erica Mitchell, Ronald Dalman, Gib Upchurch K Craig Kent (ABS Exec Committee),* Spence Taylor (ABS Vice Chair)* New members June 2017 VESS APDVS Plus 5 from the regional societies THE AMERICAN BOARD OF SURGERY 7

8 New VSB members in 2017 APDVS: Mal Sheehan VESS: Bernadette Aulivola EVS: Marc Mitchell MWVS: Kellie Brown NEVS: Keith Ozaki SAVS: Tom Huber WVS: Vince Rowe THE AMERICAN BOARD OF SURGERY 8

9 Vascular Surgeon Definition Vascular surgery encompasses the diagnosis and comprehensive, longitudinal management of disorders of the arterial, venous, and lymphatic systems, exclusive of the intracranial and coronary arteries. Diplomates in vascular surgery should have significant experience with all aspects of treating patients with all types of vascular disease, including diagnosis, interpretation of vascular ultrasound imaging, medical treatment, critical care and reconstructive vascular surgical and endovascular techniques. Diplomates in vascular surgery should possess the advanced knowledge and skills to provide comprehensive care to patients with vascular disease, understand the needs of these patients, teach this information to others, provide leadership within their organizations, conduct or participate in research in vascular disorders, and demonstrate self assessment of their outcomes. Paraphrased from Vascular Surgery Board Definition 9

10 Vascular Surgery Board certificates: 3767 Vascular recertification: 2373 Vascular surgery fellowships: 106 Integrated vascular residencies: 53 THE AMERICAN BOARD OF SURGERY 10

11 ABS Board Certificates GEN SURG VASC SURG PED SURG SCC SURG ONC HAND HOSPICE Certificate Cert receert Column1 THE AMERICAN BOARD OF SURGERY 11

12 Examinations VSITE QE (Knowledge) CE (Decision making) MOC 12

13 Vascular Surgery QE Stats Qualifying Examination Year # Examinees Pass Rate % % % % % THE AMERICAN BOARD OF SURGERY 13

14 2016 Vascular Surgery QE Examinee Type # Examinees Pass Rate Certified in General 88 94% Surgery Not Certified in 68 88% General Surgery Integrated (0+5) 33 91% Graduate Independent (5+2) % Graduate ESP (4+2) Graduate 1 100% THE AMERICAN BOARD OF SURGERY 14

15 Vascular Surgery CE Stats Certifying Examination Year # Examinees Pass Rate % % % % % THE AMERICAN BOARD OF SURGERY 15

16 2016 Vascular Surgery CE Examinee Type # Examinees Pass Rate Certified in General % Surgery Not Certified in 63 82% General Surgery Integrated (0+5) 27 96% Graduate Independent (5+2) % Graduate ESP (4+2) Graduate 3 100% THE AMERICAN BOARD OF SURGERY 16

17 Vascular Surgery MOC Exam Stats MOC (Recertification) Examination Year # Examinees Pass Rate % % % % % Approximately 90% - 98% of diplomates from recent cohorts have recertified. Content outlines for vascular surgery exams are available at THE AMERICAN BOARD OF SURGERY 17

18 2017 Vascular Surgery QE Online application will be posted by late April July 5 initial deadline July 17 late deadline Monday, September 11 exam day 6 hour exam on core surgery and vascular surgery THE AMERICAN BOARD OF SURGERY 18

19 Exam Composition CATEGORY # OF ITEMS % OF ITEMS FOR VQE # OF ITEMS % ITEMS FOR MOC Arterial disease Venous disease Lymphatic disease Vascular trauma Angio access Complications Imaging vascular lab Vascular medicine Miscellaneous vascular Vascular applied sicence Core surgery Surgical critical care TOTAL THE AMERICAN BOARD OF SURGERY 19

20 RPVI results Pass Rate Other Cardiology Vasc Med Vascular Radiology Radiology Vascular Vasc Med Cardiology Other THE AMERICAN BOARD OF SURGERY 20

21 Vascular Surgery CE Medical License and RPVI Certification Required to register for Vascular Surgery CE: 1.RPVI Certification Exam offered twice per year May take up to 60 days to receive RPVI results 2.Full and unrestricted medical license Applicants need to allow several months Without these, candidates may lose an exam opportunity THE AMERICAN BOARD OF SURGERY 21

22 New SCC Requirement Applies to integrated program trainees who began training as of July 2015 Must have a minimum of 40 surgical critical care patient management cases (previously 25 cases) At least one case in each of the seven categories: ventilatory management; bleeding (non trauma); hemodynamic instability; organ dysfunction / failure; dysrhythmias; invasive line management and monitoring; and parenteral / enteral nutrition THE AMERICAN BOARD OF SURGERY 22

23 Seven Year Limit Completed training July 2012 and forward QE 4 opportunities in 4 years CE 3 opportunities in 3 years Starts on training completion Delays result in loss of exam opportunities If not completed in this time Readmissibility Pathway 23

24 Other Relevant Leave Credit for foreign medical education Readmissibility pathways Ethics and professionalism 24

25 Vascular QE Admissibility , 4+2 Approved General Surgery QE application, meeting all requirements 5+2, 4+2, 5+0 Complete ACGME/RCPSC accredited vascular program Approved application Training time (48 weeks/year average) No more than 2 programs Primarily engaged in practice of vascular surgery, other graduate education, military duty Prior ACLS/ATLS Operative log (250 major vascular reconstruction, 40 critical care) Research limits (FT %, months) 25

26 Defined Category Minimum Numbers: Vascular Surgery Review Committee for Surgery Category Minimum Endovascular Aneurysm Repair 20 Endovascular Therapeutic Procedures 80 Endovascular Diagnostic Procedures 100 Complex 10 Peripheral 45 Cerebrovascular 25 Abdominal 30 VSB Requirement 250 major cases without minimums in any subcategory 40 Critical Care Cases

27 Operative Experience 27

28 Operative Experience

29 Aneurysm Repair Cerebrovascular Periph Obstruct Abdominal Obstruct Upper Extremity Extra Anatomic Thromb/Mech Thromb Misc Endovasc Thera Trauma Total Major Venous Endovas Diag Misc Vascular Vascular Access Amputations Total Minor Total Operations

30 Vascular CE Admissibility Successful Completion of QE RPVI Certification Unrestricted Medical License (US or Canada) 30

31 Canadian Applicants All same requirements For 5+2 the general surgery training must contain a minimum of 12 months or vascular surgery related rotations Rotations will require review 31

32 Oral exam Vascular CE Use knowledge to safely, effectively and promptly manage a broad range of clinical problems 3 consecutive rooms 30 min each Each room 2 examiners senior and associate 4 selected questions covering specific topic areas Individual grading per case

33 New Grading System for CE Old system: 3 to 7 New system: pass, fail, equivocal No difference in pass/fail THE AMERICAN BOARD OF SURGERY 33

34 VS QE VS CE Pathways Established VS QE Readmissibility

35 Questions? Follow the ABS on Facebook And on THE AMERICAN BOARD OF SURGERY 35