Osteopathic Specialty Board Certification AOA ...

AOA COMMUNICATION

Osteopathic Specialty Board Certification Ronald E. Ayres, DO; Stephen Scheinthal, DO; Cheryl Gross, MA, CAE; and Elaine C. Bell, BA

Specialty board certification, though voluntary, has become an indispensable designation for many osteopathic physicians. The authors report rates of osteopathic specialty board certification and recertification. On the recommendation of the Bureau of Osteopathic Specialists—and as a result of recent action by the American Osteopathic Association Board of Trustees—a new osteopathic continuous certification model will be used by all 18 member boards. This model firmly establishes osteopathic specialty board certification as an ongoing process that helps to ensure patient health and safety by measuring and monitoring physician competence. In addition, time limits on board eligibility have been established for certification candidates. As the healthcare environment continues to evolve, the American Osteopathic Association, the Bureau of Osteopathic Specialists, and the 18 osteopathic specialty boards continue to adapt to meet the professional needs of osteopathic physicians. J Am Osteopath Assoc. 2009;109:181-190

T

he Bureau of Osteopathic Specialists (BOS) (previously known as the Advisory Board of Osteopathic Specialists) was established in 1939 by the American Osteopathic Association Board of Trustees (AOA BOT) to assess the skills of osteopathic physicians (DOs) in response to the growth of medical specialization.1 The BOS is the authoritative body that develops, reviews, and enforces all policies and requirements for osteopathic certification as approved by the AOA. The Bureau views the certification process as an assessment tool, a method of enhancing healthcare quality, and a means of protecting the public.

From the Departments of Obstetrics and Gynecology (Dr Ayres) and Psychiatry (Dr Scheinthal) at the University of Medicine and Dentistry of New JerseySchool of Osteopathic Medicine in Stratford, where Dr Scheinthal also serves at the New Jersey Institute for Successful Aging. Also from the American Osteopathic Association (AOA) Department of Education’s Division of Certification and Trainee Services (Ms Gross and Ms Bell). Dr Ayres currently serves as chairman of the AOA Bureau of Osteopathic Specialists; Dr Scheinthal as vice chairman, and Ms Bell as secretary. Address correspondence to Department of Education, American Osteopathic Association, 142 E Ontario St, Chicago, IL 60611-2864. Submitted January 8, 2009; revision received February 4, 2009; accepted February 6, 2009.

Ayres et al • AOA Communication

The AOA has 18 approved specialty certifying boards, each of which elects one representative to the BOS. The American Osteopathic Board of Radiology, the first approved certifying board, was established in 1939. Thereafter, additional certifying osteopathic specialty boards were created in response to the evolving needs of the public and the osteopathic medical profession (Appendix). Since 1939, the Bureau has issued a total of 31,562 general, special, and added qualification certifications. As of December 31, 2008, a total of 21,472 DOs held AOA certification, representing a combined total of 24,662 active certificates. In 2008, a total of 986 certificates were awarded in primary specialty and subspecialty areas (Table 1). In addition, 43 certificates of added qualifications were granted last year (Table 2). Finally, a total of 731 recertifications (ie, general certifications and certificates of added qualifications) were issued during that time by the profession’s 18 osteopathic specialty boards (Table 3).

New Time Limits for Osteopathic Specialty Board Eligibility As a next step in the evolution of the model of osteopathic specialty board certification,4 the BOS updated the osteopathic specialty board eligibility requirement. Previously, guidelines allowed certification candidates to pursue this credential indefinitely. This policy, among others, has been modified as a result of “the quality movement” that has emerged in the past decade.4 In the past year, based largely on the initiative of several member boards—and in their ongoing efforts to protect patients—the BOS took steps to establish time limits on board eligibility. Last February, the BOT approved Resolution B28 (M/2008), Amendment to Board Eligibility Requirement for AOA Board Certification (https://www.do-online.org/pdf/cal _midyr08res28.pdf). This new policy limits to 6 years the amount of time a physician is considered eligible for osteopathic board certification. Candidates who do not complete the certification process within that amount of time have the option to petition their certifying board for one-time reentry into the certification process, however. If the board grants the physician reentry in the JAOA • Vol 109 • No 3 • March 2009 • 181

AOA COMMUNICATION Table 1 American Osteopathic Association: General Certification Awarded by Osteopathic Medical Specialty Boards, 2004-2008* Certifying Board/ General Certification Awarded 䡲 ▫ 䡲 ▫ 䡲 ▫ 䡲 ▫ ▫ 䡲 ▫ ▫ ▫ ▫ ▫ ▫ ▫ ▫ ▫ ▫ 䡲 ▫ 䡲 ▫ ▫ ▫ ▫ 䡲 ▫ 䡲 ▫ ▫ ▫ ▫ 䡲 ▫ ▫ ▫ ▫

Anesthesiology Anesthesiology Dermatology Dermatology Emergency Medicine Emergency Medicine Family Physicians Adolescent and Young Adult Medicine Family Practice and OMT Internal Medicine Cardiology Endocrinology Gastroenterology Hematology Infectious Diseases Internal Medicine Nephrology Oncology Pulmonary Diseases Rheumatology Nuclear Medicine Nuclear Medicine Neurology and Psychiatry Child Neurology Child Psychiatry Neurology Psychiatry Neuromusculoskeletal Medicine Neuromusculoskeletal Medicine and OMM Obstetrics and Gynecology Gynecologic Oncology Maternal and Fetal Medicine Obstetrics and Gynecology Reproductive Endocrinology Ophthalmology and Otolaryngology Facial Plastic Surgery Ophthalmology Otolaryngology Otolaryngology and Facial Plastic Surgery

2004

2005

Year 2006

2007

2008

8 (1)

20 (2)

12 (1)

12 (1)

19 (2)

14 (1)

18 (2)

22 (2)

20 (2)

31 (3)

104 (10)

120 (12)

118 (9)

119 (12)

144 (15)

0 445 (42)

0 343 (34)

0 391 (30)

1 (⬍1) 338 (34)

0 178 (18)

26 (2) 0 9 (1) 2 (⬍1) 3 (⬍1) 118 (11) 7 (1) 4 (⬍1) 6 (1) 3 (⬍1)

4 (⬍1) 1 (⬍1) 3 (⬍1) 0 0 155 (15) 3 (⬍1) 5 (⬍1) 5 (⬍1) 0

29 (2) 0 12 (1) 5 (⬍1) 6 (⬍1) 259 (20) 4 (⬍1) 7 (1) 5 (⬍1) 3 (⬍1)

0 0 1 (⬍1) 0 1 (⬍1) 58 (6) 4 (⬍1) 2 (⬍1) 3 (⬍1) 0

28 (3) 2 (⬍1) 7 (1) 3 (⬍1) 2 (⬍1) 169 (17) 4 (⬍1) 0 8 (1) 2 (⬍1)

0

0

0

0 0 10 (1) 6 (1)

0 4 (⬍1) 1 (⬍1) 11 (1)

28 (3)

62 (6)

1 (⬍1) 0 36 (3) 0

1 (⬍1) 0 50 (5) 2 (⬍1)

0 10 (1) 1 (⬍1) 9 (1)

0 10 (1) 1 (⬍1) 27 (3)

1 (⬍1) 2 (⬍1) 20 (2) 8 (1) 110 (8)

0

0

0 3 (⬍1) 0 4 (⬍1)

0 0 14 (1) 10 (1)

43 (4)

13 (1)

0 1 (⬍1) 85 (6) 0

1 (⬍1) 1 (⬍1) 85 (9) 0

0 2 (⬍1) 85 (9) 0

0 11 (1) 0 11 (1)

0 11 (1) 0 20 (2)

0 6 (1) 0 17 (2) (continued)

* Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2008). Abbreviations: OMM, osteopathic manipulative medicine; OMT, osteopathic manipulative treatment.

certification process, the candidate would then start at the beginning of the process with the next available examination administration. Certification candidates are allowed a total of two attempts 182 • JAOA • Vol 109 • No 3 • March 2009

to pass each step of the examination process. If the candidate fails during any step of the examination process, he or she may then again petition the specialty board for reentry. However, with this reentry, the board will establish criteria that Ayres et al • AOA Communication

AOA COMMUNICATION

Table 1 (continued) American Osteopathic Association: General Certification Awarded by Osteopathic Medical Specialty Boards, 2004-2008* Certifying Board/ General Certification Awarded 䡲 ▫ 䡲 ▫ ▫ ▫ ▫ ▫ 䡲 ▫ ▫ ▫ 䡲 ▫ 䡲 ▫ ▫ ▫ 䡲 ▫ 䡲 ▫ ▫ ▫ 䡲 ▫ ▫ ▫ ▫ ▫ ▫

Orthopedic Surgery Orthopedic Surgery Pathology Allergy and Immunology Anatomic Pathology Anatomic Pathology and Laboratory Medicine Forensic Pathology Laboratory Medicine Pediatrics Neonatology Pediatric Pulmonology Pediatrics Physical Medicine and Rehabilitation Physical Medicine and Rehabilitation Medicine Preventive Medicine Preventive Medicine and Aerospace Medicine Preventive Medicine and Public Health Preventive Medicine (Occupational and Environmental) Proctology Proctology Radiology Diagnostic Radiology Radiation Oncology Radiology Surgery General Vascular Surgery Neurological Surgery Plastic and Reconstructive Surgery Surgery (General) Thoracic and Cardiovascular Surgery Urological Surgery

Total

2004

2005

72 (7)

55 (5)

Year 2006

45 (3)

2007

67 (7)

2008

51 (5)

0 0 0

0 0 0

0 1 (⬍1) 0

0 0 0

0 0 0

0 0

0 0

0 0

0 2 (⬍1)

0 1 (⬍1)

0 0 17 (2)

0 0 18 (2)

31 (3)

0 0 25 (2)

2 (⬍1) 2 (⬍1) 50 (5)

0 0 22 (2)

1 (⬍1)

6 (⬍1)

6 (1)

6 (1)

0

1 (⬍1)

2 (⬍1)

6 (1)

1 (⬍1)

2 (⬍1) 1 (⬍1)

0 5 (⬍1)

2 (⬍1) 0

6 (1) 3 (⬍1)

0 2 (⬍1)

1 (⬍1)

0

0

2 (⬍1)

0

28 (3) 0 0

19 (2) 1 (⬍1) 0

29 (2) 3 (⬍1) 0

26 (3) 0 0

28 (3) 1 (⬍1) 0

8 (1) 4 (⬍1) 2 (⬍1) 39 (4) 2 (⬍1) 2 (⬍1)

7 (1) 3 (⬍1) 2 (⬍1) 39 (4) 1 (⬍1) 5 (⬍1)

7 (1) 6 (⬍1) 1 (⬍1) 53 (4) 2 (⬍1) 4 (⬍1)

3 (⬍1) 5 (1) 3 (1) 61 (6) 0 13 (1)

5 (1) 10 (1) 5 (1) 94 (10) 0 16 (2)

1059

1003

1308

984

986

* Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2008). Abbreviations: OMM, osteopathic manipulative medicine; OMT, osteopathic manipulative treatment.

must be met before granting permission for the candidate to reenter the process. All such criteria must be submitted and approved by the BOS Standards Review Committee and the candidate must follow the same steps as outlined in the previous reentry process. If the candidate is unsuccessful in this Ayres et al • AOA Communication

attempt, he or she will have no further opportunity to become osteopathic specialty board certified. Individuals who wish to file an appeal may do so using the standard BOS appeals process. The effective date, July 1, 2009, for this amended board eliJAOA • Vol 109 • No 3 • March 2009 • 183

AOA COMMUNICATION Table 2 American Osteopathic Association: Certification of Added Qualifications Awarded by Osteopathic Medical Specialty Boards, 2004-2008* Certifying Board/ Certification Awarded 䡲 ▫ ▫ 䡲 ▫ ▫ 䡲 ▫ ▫ ▫ 䡲 ▫ ▫ ▫ ▫ 䡲 ▫ ▫ ▫ ▫ ▫ ▫ 䡲䡲 ▫ ▫ 䡲䡲䡲 ▫ 䡲 ▫ 䡲 ▫ 䡲䡲 ▫ ▫

Anesthesiology Critical Care Medicine Pain Management Dermatology Dermatopathology Mohs Micrographic Surgery Emergency Medicine Emergency Medical Services Medical Toxicology Sports Medicine Family Physicians Addiction Medicine Adolescent and Young Adult Medicine Geriatrics Sports Medicine Internal Medicine Addiction Medicine Clinical Cardiac Electrophysiology Critical Care Medicine Geriatric Medicine Interventional Cardiology Sports Medicine Nuclear Medicine Neurology and Psychiatry Addiction Medicine Neurophysiology Neuromusculoskeletal Medicine Obstetrics and Gynecology Ophthalmology and Otolaryngology Otolaryngic Allergy Orthopedic Surgery Hand Surgery Pathology Dermatopathology Pediatrics Physical Medicine and Rehabilitation Sports Medicine Sports Medicine with Special Proficiency in OMM 䡲 Preventive Medicine ▫ Preventive Medicine (Occupational) ▫ Sports Medicine

2004

2005

Year 2006

2007

2008

0 1 (2)

0 0

0 2 (2)

0 0

0 3 (7)

0 0

0 0

1 (1) 0

0 0

1 (2) 2 (5)

1 (2) 0 0

0 0 0

1 (1) 0 0

0 4 (11) 0

0 0 1 (2)

0 0 2 (4) 13 (26)

0 0 6 (17) 1 (3)

0 0 6 (7) 16 (18)

0 0 5 (14) 7 (19)

0 0 5 (12) 9 (21)

0 1 (2) 0 4 (8) 12 (24) 0 NA

0 0 10 (29) 0 2 (6) 0 NA

0 4 (4) 7 (8) 4 (4) 36 (40) 0 NA

0 0 3 (8) 0 2 (6) 2 (6) NA

0 3 (7) 0 0 0 2 (5) NA

1 (2) 0 NA NA

0 0 NA NA

0 1 (1) NA NA

0 2 (6) NA NA

0 3 (7) NA NA

0

3 (9)

1 (1)

0

0

0

2 (6)

0

2 (6)

2 (5)

0 NA

0 NA

0 NA

0 NA

0 NA

0 0

1 (3) 0

0 0

0 0

0 0

6 (12) 0

3 (9) 0

2 (2) 0

4 (11) 0

3 (7) 0 (continued)

* Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2008). Abbreviations: NA, not applicable (ie, no Certification of Added Qualifications is offered through this certifying board); OMM, osteopathic manipulative medicine.

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Table 2 (continued) American Osteopathic Association: Certification of Added Qualifications Awarded by Osteopathic Medical Specialty Boards, 2004-2008* Certifying Board/ Certification Awarded 䡲䡲 ▫ ▫ ▫ ▫ ▫ 䡲 ▫

Proctology Radiology Body Imaging Neuroradiology Nuclear Radiology Pediatric Radiology Vascular and Interventional Radiology Surgery Surgical Critical Care

Total

2004

2005

Year 2006

2007

2008

NA

NA

NA

NA

NA

0 2 (4) 0 0 4 (8)

0 4 (11) 0 0 2 (6)

1 (1) 0 0 1 (1) 2 (2)

0 1 (3) 0 3 (8) 1 (3)

0 3 (7) 0 2 (5) 0

3 (6)

1 (3)

5 (6)

0

4 (9)

50

35

90

36

43

* Data are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2008). Abbreviations: NA, not applicable (ie, no Certification of Added Qualifications is offered through this certifying board); OMM, osteopathic manipulative medicine.

gibility process was established last July with BOT approval of Resolution 44 (A/2008), Amendment to Board Eligibility Requirement for AOA Board Certification (https://www.doonline.org/pdf/cal_hod08res44.pdf). Candidates currently in the certification process will not be affected by this policy revision. For more information, see http://www.doonline.org/index.cfm?PageID=crt_brdeligible.

Osteopathic Continuous Certification Update To ensure that AOA board–certified physicians are current with the latest advances in medicine, AOA specialty certifying boards have long mandated that board-certified physicians meet continuing medical education (CME) requirements. Certificate holders have been required to complete at least 50 credit hours in their respective specialties for each 3-year CME cycle.5 In addition, last February, the BOT formally accepted the osteopathic continuous certification model (Figure) through Resolution 23 (M/2008), Implementation of Osteopathic Continuous Certification Process by 2012 (https://www.doonline.org/pdf/cal_midyr08res23.pdf). All certifying boards are required to submit their implementation plans for BOS approval by April 2010. As stated in the resolution’s name, pending BOS approval, full implementation of this model must be achieved by all osteopathic certifying boards by 2012.

to respond to the needs of the osteopathic medical profession and to support patient health and safety. Osteopathic board certification will undoubtedly continue to adapt to the changes of the healthcare environment while also providing a valuable mechanism to help assess ongoing physician competence.

References 1. American Osteopathic Association. Handbook of the Bureau of Osteopathic Specialists. Chicago, Ill: American Osteopathic Association; 2007. 2. About ABMS Maintenance of Certification (MOC) page. American Board of Medical Specialties Web site. Available at: http://www.abms.org/Maint enance_of_Certification/. Accessed March 4, 2009. 3. Ramirez AF, Bell EC. Osteopathic specialty board certification. J Am Osteopath Assoc. 2007;107:117-125. Available at: http://www.jaoa.org/cgi /content/full/107/3/117. Accessed March 4, 2009. 4. Ayres RE, Scheinthal S, Ramirez AF, Bell EC. Osteopathic certification evolving into a continuous certification model. J Am Osteopath Assoc. 2008;108:159-165. Available at: http://www.jaoa.org/cgi/content/full/108/3/159. Accessed March 4, 2009. 5. Rodgers DJ. AOA continuing medical education. J Am Osteopath Assoc. 2009;109:160-179. Available at: http://www.jaoa.org/cgi/content/full/109/3/160.

(continued)

Conclusion Just as the AOA’s certification program responded to the needs of osteopathic physicians in its early days, it continues Ayres et al • AOA Communication

JAOA • Vol 109 • No 3 • March 2009 • 185

AOA COMMUNICATION Table 3 American Osteopathic Association: Recertifications Awarded by Osteopathic Medical Specialty Boards, 2004-2008* Certifying Board/ Recertification Awarded 䡲 Anesthesiology ▫ Anesthesiology CAQ – Critical Care Medicine – Pain Management 䡲 Dermatology ▫ Dermatology CAQ – Dermatopathology – Mohs Micrographic Surgery 䡲 Emergency Medicine ▫ Emergency Medicine CAQ – Emergency Medical Services – Medical Toxicology – Sports Medicine 䡲 Family Physicians ▫ Family Practice and OMT ▫ Geriatric Medicine CAQ – Addiction Medicine – Adolescent and Young Adult Medicine – Geriatrics – Sports Medicine

2004

32 (11)

2005

Year 2006

2007

2008

0

3 (⬍1)

2 (⬍1)

0

NA NA

NA NA

NA NA

NA NA

NA NA

0

0

0

0

0

NA NA

NA NA

NA 4 (⬍1)

3 (⬍1) 0

0 0

21 (7)

29 (6)

NA NA NA

NA NA NA

41 (14) 0 NA 0 NA 0

63 (8)

59 (5)

183 (25)

3 (⬍1) NA NA

2 (⬍1) NA NA

1 (⬍1) NA 1 (⬍1)

229 (47) 2 (⬍1)

435 (53) 47 (6)

971 (77) 24 (2)

200 (27) 6 (1)

NA 0 NA 5 (1)

NA 0 NA 17 (2)

NA 1 (⬍1) NA 5 (⬍1)

0 0 NA 8 (1) (continued)

* Recertification data for General Certification and Certification of Added Qualifications (CAQ) are presented as No. (%). Some percentages do not total 100 because of rounding. Totals are calculated by date of final approval by the American Osteopathic Association Bureau of Osteopathic Specialists (December 31, 2008). As of January 1, 2004, all 18 member boards had a time-limited certificate in place (ie, all new certificates are issued with an expiration date).2 Certificates issued before the time-limit requirement was instituted, however, are valid for the life of the physician. † Reports published in previous editions of THE JOURNAL’s Osteopathic Medical Education issue3 combined Anatomic Pathology and Laboratory Medicine under a single heading for recertification statistics. They have been separated here. Likewise, previous reports combined Ophthalmology and Otolaryngology as well as Neurology and Psychiatry under single headings. Beginning with the data reported for 2005 and 2006, respectively, these numbers were likewise separated. Abbreviations: NA, not applicable (ie, recertification not offered in year indicated) or not available (ie, see †); OMM, osteopathic manipulative medicine; OMT, osteopathic manipulative treatment.

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Table 3 (continued) American Osteopathic Association: Recertifications Awarded by Osteopathic Medical Specialty Boards, 2004-2008* Certifying Board/ Recertification Awarded 䡲 Internal Medicine ▫ Allergy and Immunology ▫ Cardiology ▫ Endocrinology ▫ Gastroenterology ▫ Hematology ▫ Infectious Diseases ▫ Internal Medicine ▫ Nephrology ▫ Oncology ▫ Pulmonary Diseases ▫ Rheumatology CAQ – Addiction Medicine – Clinical Cardiac Electrophysiology – Critical Care Medicine – Geriatric Medicine – Interventional Cardiology – Sports Medicine 䡲 Nuclear Medicine ▫ Nuclear Medicine 䡲 Neurology and Psychiatry ▫ Child Neurology ▫ Child Psychiatry ▫ Neurology† ▫ Neurology and Psychiatry† ▫ Psychiatry† CAQ – Addiction Medicine – Neurophysiology

2004

2005

Year 2006

2007

2008

2 (1) 8 (3) 3 (1) 8 (3) 1 (⬍1) 3 (1) 83 (29) 0 0 9 (3) 3 (1)

0 23 (5) 3 (1) 12 (2) 0 1 (⬍1) 71 (14) 4 (1) 5 (1) 5 (1) 2 (⬍1)

0 12 (1) 2 (⬍1) 10 (1) 1 (⬍1) 2 (⬍1) 84 (10) 3 (⬍1) 1 (⬍1) 6 (1) 4 (⬍1)

1 (⬍1) 19 (1) 0 9 (1) 1 (⬍1) 2 (⬍1) 17 (1) 3 (⬍1) 0 8 (1) 0

0 0 0 0 0 0 174 (24) 3 (⬍1) 0 0 0

NA 0 3 (1) 7 (2) NA 0

NA 3 (1) 12 (2) 6 (1) NA 0

NA 5 (1) 12 (1) 11 (1) NA 1 (⬍1)

NA 3 (⬍1) 8 (1) 3 (⬍1) NA 0

NA 0 0 0 NA 1 (⬍1)

0

1 (⬍1)

0

0

0

NA NA NA 0 NA

NA NA NA 0 NA

NA NA 2 (⬍1) NA 4 (⬍1)

NA NA

NA NA

NA NA

19 (4)

13 (2)

14 (1)

NA

NA

NA

䡲 Neuromusculoskeletal Medicine ▫ Neuromusculoskeletal Medicine and OMM 3 (1) CAQ – Sports Medicine NA

NA NA 6 (⬍1) NA 13 (1)

NA 1 (⬍1) 5 (1) NA 0

3 (⬍1) NA

1 (⬍1) NA

6 (1) NA (continued)



JAOA • Vol 109 • No 3 • March 2009 • 187

AOA COMMUNICATION Table 3 (continued) American Osteopathic Association: Recertifications Awarded by Osteopathic Medical Specialty Boards, 2004-2008* Certifying Board/ Recertification Awarded 䡲 ▫ ▫ ▫ ▫

Obstetrics and Gynecology Gynecologic Oncology Maternal and Fetal Medicine Obstetrics and Gynecology Reproductive Endocrinology

䡲 Ophthalmology and Otolaryngology ▫ Facial Plastic Surgery ▫ Ophthalmology† ▫ Ophthalmology and Otolaryngology† ▫ Otolaryngology† ▫ Otolaryngology and Facial Plastic Surgery ▫ Otolaryngology – Head and Neck Surgery CAQ – Otolaryngic Allergy 䡲 Orthopedic Surgery ▫ Orthopedic Surgery CAQ – Hand Surgery 䡲 ▫ ▫ ▫

Pathology Allergy and Immunology Anatomic Pathology† Anatomic Pathology and Laboratory Medicine† ▫ Forensic Pathology ▫ Laboratory Medicine† ▫ Pathology CAQ – Dermatopathology 䡲 ▫ ▫ ▫ ▫ ▫

Pediatrics Neonatology Pediatric Allergy Immunology Pediatric Endocrinology Pediatric Pulmonology Pediatrics

䡲 Physical Medicine and Rehabilitation ▫ Physical Medicine and Rehabilitation Medicine CAQ – Sports Medicine

Year 2006

2004

2005

NA NA 0 NA

NA NA 0 NA

NA NA 2 (⬍1) NA

NA NA 0 NA

NA NA 30 (4) NA

NA NA 0 NA NA NA

NA 1 (⬍1) NA 0 NA NA

NA 0 NA 0 NA NA

NA 0 NA 0 NA NA

NA 0 NA 0 NA 0

NA

NA

NA

NA

NA

29 (4)

38 (3)

34 (12)

47 (10)

2007

2008

0

NA

NA

7 (1)

0

3 (⬍1)

NA NA NA

NA NA NA

NA NA 1 (⬍1)

NA 2 (⬍1) NA

NA 0 NA

NA NA 0

NA NA 0

NA NA 0

NA 2 (⬍1) 0

NA 0 0

NA

NA

NA

1 (⬍1)

0

2 (1) NA NA NA 9 (3)

0 NA NA NA 1 (⬍1)

0 1 (⬍1) 2 (⬍1) NA 10 (1)

0

1 (⬍1)

6 (1)

0

NA

NA

NA

NA

0 0 0 NA 14 (1)

0 0 0 NA 0

0

NA (continued)


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Table 3 (continued) American Osteopathic Association: Recertifications Awarded by Osteopathic Medical Specialty Boards, 2004-2008* Certifying Board/ Recertification Awarded 䡲 Preventive Medicine ▫ Preventive Medicine and Aerospace Medicine ▫ Preventive Medicine and Public Health ▫ Preventive Medicine and OccupationalEnvironmental Medicine ▫ Preventive Medicine and Occupational Medicine CAQ – Occupational Medicine – Sports Medicine 䡲 Proctology ▫ Proctology 䡲 Radiology ▫ Diagnostic Radiology ▫ Diagnostic Roentgenology ▫ Radiation Oncology ▫ Radiology CAQ – Neuroradiology – Nuclear Radiology – Pediatric Radiology – Vascular and Interventional Radiology 䡲 Surgery ▫ General Vascular Surgery ▫ Neurological Surgery ▫ Plastic and Reconstructive Surgery ▫ Surgery (General) ▫ Thoracic and Cardiovascular Surgery ▫ Urological Surgery CAQ – Surgical Critical Care Total

2004

2005

Year 2006

2007

2008

0

0

0

0

0

0 0

0 0

0 0

0 0

0 1 (⬍1)

0

1 (⬍1)

0

0

0

4 (1) NA

0 NA

0 NA

6 (⬍1) NA

1 (⬍1) NA

2 (1)

1 (⬍1)

0

1 (⬍1)

0

7 (2) NA NA NA

3 (1) NA NA NA

10 (1) NA NA NA

5 (⬍1) NA NA NA

4 (1) 0 NA NA

2 (1) NA NA NA

0 NA NA NA

0 NA NA NA

0 NA NA NA

0 NA NA NA

NA NA NA 0 NA 0

NA NA NA 0 NA 0

NA NA NA 1 (⬍1) NA 0

NA NA NA 0 1 (⬍1) 0

1 (⬍1) NA NA 0 0 0

NA

NA

NA

1 (⬍1)

0

288

491

823

1267

731



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AOA COMMUNICATION Part 1 – Professional Standing

Part 3 – Cognitive Expertise

Requires that physicians who are board certified by the American Osteopathic Association (AOA) hold a valid unrestricted license to practice medicine in one of the 50 states. In addition, these physicians are required to adhere to the AOA’s Code of Ethics (see http://www.osteopathic.org/index.cfm?PageID=aoa_ethics).

Requires provision of one (or more) psychometrically valid and proctored examinations that assess a physician’s specialty medical knowledge as well as core competencies in the provision of healthcare.

Part 4 – Practice Performance Assessment

Part 2 – Lifelong Learning/Self-Assessment Consistent with current commitment to lifelong learning, this component requires that all recertifying diplomates fulfill 120 hours of continuing medical education (CME) credit during each 3-year CME cycle—though some certifying boards have higher requirements.5 Of these 120+ CME credit hours, 50 credit hours must be in the specialty area of certification. Self-assessment activities will be designated by each of the AOA’s 18 approved specialty certifying boards.

Requires that diplomates engage in continuous improvement through comparison of personal practice performance measured against national standards for his or her medical specialty. This component, being the most complex to create, is in process and will be further detailed as it is developed and as each specialty certifying board decides which method its diplomates will use to fulfill this requirement.

Figure. The four components of the osteopathic continuous certification model4 approved last year by the American Osteopathic Association Board of Trustees through Resolution 23 (M/2008), Implementation of Osteopathic Continuous Certification Process by 2012 (https://www.doonline.org/pdf/cal_midyr08res23.pdf).

Appendix The American Osteopathic Association’s 18 approved certifying specialty boards by year founded. *From 1940 through 1996, the American Osteopathic Boards of Ophthalmology and Otolaryngology were known as the American Osteopathic Board of Ophthalmology and Otorhinolaryngology. †The American Osteopathic Board of Physical Medicine and Rehabilitation was known as the American Osteopathic Board of Rehabilitation Medicine from 1954 through to 2001. ‡The American Osteopathic Board of Anesthesiology was formerly under the American Osteopathic Board of Surgery, as was the American Osteopathic Board of Orthopedic Surgery. §The American Osteopathic Board of Family Physi䡲 1939 ▫ American Osteopathic Board of Radiology

cians was known as the American Osteopathic Board of General Practice from 1972 through 1993. //The American Osteopathic Board of Neuromusculoskeletal Medicine was originally known as the American Osteopathic Board on Fellowship of the American Academy of Osteopathy from 1977 through 1990. Then, from 1990 to 1999, they were known as the American Osteopathic Board of Special Proficiency in Osteopathic Manipulative Medicine. ¶In 1982 and 1983, the American Osteopathic Board of Preventive Medicine was known as the American Osteopathic Board of Public Health and Preventive Medicine.

䡲 1954 ▫ American Osteopathic Board of Physical Medicine and Rehabilitation†

䡲 1940 ▫ American Osteopathic Board of Surgery ▫ American Osteopathic Boards of Ophthalmology and Otolaryngology* ▫ American Osteopathic Board of Pediatrics

䡲 1956 ▫ American Osteopathic Board of Anesthesiology‡

䡲 1941 ▫ American Osteopathic Board of Proctology ▫ American Osteopathic Board of Neurology and Psychiatry

䡲 1974 ▫ American Osteopathic Board of Nuclear Medicine

䡲 1942 ▫ American Osteopathic Board of Internal Medicine ▫ American Osteopathic Board of Obstetrics and Gynecology 䡲 1943 ▫ American Osteopathic Board of Pathology 䡲 1945 ▫ American Osteopathic Board of Dermatology

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䡲 1972 ▫ American Osteopathic Board of Family Physicians§

䡲 1977 ▫ American Osteopathic Board of Neuromusculoskeletal Medicine// 䡲 1978 ▫ American Osteopathic Board of Orthopedic Surgery‡ 䡲 1980 ▫ American Osteopathic Board of Emergency Medicine 䡲 1982 ▫ American Osteopathic Board of Preventive Medicine¶
