VSB ABS Hot Topics ASH MANSOUR, M.D. VASCULAR SURGERY BOARD OF THE AMERICAN BOARD OF SURGERY 2017 APDVS MEETING APRIL 1, 2017
Conflict of Interest None 2
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 www.absurgery.org
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 www.absurgery.org 4
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
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 www.absurgery.org 7
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 www.absurgery.org 8
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
Vascular Surgery Board certificates: 3767 Vascular recertification: 2373 Vascular surgery fellowships: 106 Integrated vascular residencies: 53 THE AMERICAN BOARD OF SURGERY www.absurgery.org 10
ABS Board Certificates 63534 24504 3767 2373 1378 888 3930 1744 107 0 321 164 73 1 GEN SURG VASC SURG PED SURG SCC SURG ONC HAND HOSPICE Certificate Cert receert Column1 THE AMERICAN BOARD OF SURGERY www.absurgery.org 11
Examinations VSITE QE (Knowledge) CE (Decision making) MOC 12
Vascular Surgery QE Stats Qualifying Examination Year # Examinees Pass Rate 2012 123 90% 2013 136 93% 2014 141 94% 2015 165 94% 2016 156 92% THE AMERICAN BOARD OF SURGERY www.absurgery.org 13
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) 122 92% Graduate ESP (4+2) Graduate 1 100% THE AMERICAN BOARD OF SURGERY www.absurgery.org 14
Vascular Surgery CE Stats Certifying Examination Year # Examinees Pass Rate 2012 159 85% 2013 132 80% 2014 152 89% 2015 149 91% 2016 171 88% THE AMERICAN BOARD OF SURGERY www.absurgery.org 15
2016 Vascular Surgery CE Examinee Type # Examinees Pass Rate Certified in General 108 92% Surgery Not Certified in 63 82% General Surgery Integrated (0+5) 27 96% Graduate Independent (5+2) 141 86% Graduate ESP (4+2) Graduate 3 100% THE AMERICAN BOARD OF SURGERY www.absurgery.org 16
Vascular Surgery MOC Exam Stats MOC (Recertification) Examination Year # Examinees Pass Rate 2012 216 95% 2013 216 97% 2014 178 94% 2015 169 94% 2016 177 94% Approximately 90% - 98% of diplomates from recent cohorts have recertified. Content outlines for vascular surgery exams are available at www.absurgery.org THE AMERICAN BOARD OF SURGERY www.absurgery.org 17
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 www.absurgery.org 18
Exam Composition CATEGORY # OF ITEMS % OF ITEMS FOR VQE # OF ITEMS % ITEMS FOR MOC Arterial disease 100 40 96.6 46 Venous disease 15 6 12.6 6 Lymphatic disease 2.5 1 2.1 1 Vascular trauma 10 4 8.4 4 Angio access 12.5 5 10.5 5 Complications 10 4 10.5 5 Imaging vascular lab 15 6 16.8 8 Vascular medicine 7.5 3 6.3 3 Miscellaneous vascular 5 2 4.2 2 Vascular applied sicence 10 4 0 0 Core surgery 45 18 31.5 15 Surgical critical care 17.5 7 10.5 5 TOTAL 250 100 210 100 THE AMERICAN BOARD OF SURGERY www.absurgery.org 19
RPVI results Pass Rate Other Cardiology Vasc Med Vascular Radiology 0 10 20 30 40 50 60 70 80 90 100 Radiology Vascular Vasc Med Cardiology Other THE AMERICAN BOARD OF SURGERY www.absurgery.org 20
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 www.absurgery.org 21
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 www.absurgery.org 22
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
Other Relevant Leave Credit for foreign medical education Readmissibility pathways Ethics and professionalism 24
Vascular QE Admissibility 5+2 5+2, 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 5+2 10%, 5+0 6 months) 25
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
Operative Experience 27
Operative Experience
Aneurysm Repair 49 69 87 102 132 Cerebrovascular 45 56 65 78 109 Periph Obstruct 97 133 160 189 237 Abdominal Obstruct 5 8 14 20 29 Upper Extremity 4 8 11 14 21 Extra Anatomic 4 6 9 11 16 Thromb/Mech Thromb 2 6 9 14 22 Misc Endovasc Thera 2 3 6 11 27 Trauma 4 7 11 16 23 Total Major 275 338 379 452 516 Venous 26 39 51 72 102 Endovas Diag 46 79 104 129 156 Misc Vascular 4 8 11 18 27 Vascular Access 2 19 34 54 84 Amputations 5 10 16 24 42 Total Minor 146 200 232 275 354 Total Operations 462 560 637 718 824
Vascular CE Admissibility Successful Completion of QE RPVI Certification Unrestricted Medical License (US or Canada) 30
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
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
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 www.absurgery.org 33
VS QE VS CE Pathways Established VS QE Readmissibility
Questions? ashmans2@me.com Follow the ABS on Facebook www.facebook.com/ambdsurg And on Twitter! @AmBdSurg www.twitter.com/ambdsurg THE AMERICAN BOARD OF SURGERY www.absurgery.org 35