ABOS Allows Surgeons to Take Subspecialty Examinations Earlier

The American Board of Orthopaedic Surgery (ABOS) recently announced a new initiative to allow orthopaedic surgeons to take the Orthopaedic Sports Medicine and Surgery of the Hand Subspecialty Certification Examinations earlier in their careers, making the process of obtaining Subspecialty Certification less burdensome. The changes will be in effect for the 2025 Examinations, offered on Aug. 5, 2025.

Previously, orthopaedic surgeons had to be ABOS Board Certified before they were eligible to apply for a Subspecialty Certification Examination. With the new initiative, Candidates will be eligible to take a Subspecialty Examination after successfully completing an Accreditation Council for Graduate Medical Education (ACGME)-accredited fellowship. This change allows them to be assessed when their knowledge is at its peak and their practice demands are at their lowest. Candidates will be able to register for the Examination as early as the year they begin fellowship. Registration opens in September for an Examination the following August.

Passing the Examination is just one step in the process of obtaining Subspecialty Certification. The requirements for earning Subspecialty Certification will not change, just the order. Candidates must achieve primary Board Certification from ABOS (pass the ABOS Part I and Part II Examinations) before they can submit an application, case list, and letters of recommendation as part of the Subspecialty Certification process. Subspecialty Certification in Orthopaedic Sports Medicine or Surgery of the Hand is earned once all the requirements are met.

Surgery of the Hand Subspecialty Certification was established in 1989. Subspecialty Certification is available for surgeons who have successfully completed an ACGME-accredited hand surgery fellowship, made significant contributions to their field as shown through their letters of recommendation, and met the requirements for volume and diversity of surgical cases in hand surgery. Candidates need to submit a 1-year case list that includes at least 125 cases fulfilling at least five of the following categories: Bone and Joint (20 cases), Nerve (20 cases), Tendon and Muscle (20 cases), Skin and Wound Problems (14 cases), Contracture and Joint Stiffness (10 cases), Tumor (10 cases), Congenital (three cases), Microvascular (three cases), and Nonoperative (four cases).

Orthopaedic Sports Medicine Subspecialty Certification began in 2007. Surgeons must successfully complete an ACGME-accredited orthopaedic sports medicine fellowship. The certification process also requires contributions to the field of sports medicine and peer review, which is also evaluated through letters of recommendation. Once in practice, surgeons must submit a case list that demonstrates sufficient diversity and volume of cases. Candidates need to submit a 1-year sports medicine case list that includes at least 115 operative cases and 10 nonoperative cases. Seventy-five of the 115 operative cases must involve arthroscopy as a component of the procedure.

The end date of the Subspecialty Certification Certificate is the same end date as a Diplomate’s General ABOS Board Certification Certificate. Diplomates can recertify both their General Certificate and Subspecialty Certificate together, through the ABOS Web-Based Longitudinal Assessment Pathway (ABOS WLA), the Combined Computer-Based (Written) Examination, or the Combined Oral Examination. With the ABOS WLA Pathway, the only requirement in addition to earning 5 Quality Years is selecting at least five Knowledge Sources each year in the subspecialty. The Combined Written Examinations include only items related to the subspecialty; there are no general orthopaedic surgery questions. The Oral Examination is similar to the ABOS Part II Examination, in which Diplomates are assessed on their own cases.

There are approximately 2,700 Diplomates who hold an Orthopaedic Sports Medicine Subspecialty Certificate and 2,300 who hold the Surgery of the Hand Subspecialty Certificate. Thirty-six Diplomates hold both.

The ABOS believes there are many surgeons who want to earn Subspecialty Certification but find it too difficult to achieve with the current schedule. However, orthopaedic surgeons can still wait until they become Board Certified and do the traditional order of submitting the application and case list and then taking the examination.

The Examinations are 175 questions on only hand or sports and are administered over the course of 4 hours, plus 15 minutes each of tutorial and break time. The Examination Overview as well as the Examination Blueprints, which show the breakdown in types of questions, can be found on abos.org.

The ABOS has several ways in which those who earn Subspecialty Certification can let their patients know what it means, including brochures, online widgets, lapel pins, and window clings.

The changes have the full support of the relevant societies, including the American Association for Hand Surgery, American Orthopaedic Society for Sports Medicine, and American Society for Surgery of the Hand. These organizations believe that earning Subspecialty Certification is important to the profession and allows surgeons to distinguish themselves in these important subspecialties.

Those who are interested in taking a 2025 Subspecialty Certification Examination should log in to their ABOS Dashboard to register. The deadline is Feb. 1, 2025.

ABOS Subspecialty Certification requirements can be found at abos.org/subspecialties. Please send any questions to an ABOS Certification Specialist via abos.org/contact.

David F. Martin, MD, is executive director of the ABOS. He is ABOS Board Certified and holds Orthopaedic Sports Medicine Subspecialty Certification.

Michael S. Bednar, MD, is associate executive director of the ABOS. He is ABOS Board Certified and holds Surgery of the Hand Subspecialty Certification.