How Many Boards Do We Really Need ?

by Jarrod Shapiro, DPM
PRESENT Resident Editor
Botsford General Hospital
Farmington Hills, MI

Recently, my co-residents and I have increased our studies for the ABPS board exams.  With the boards ever present and looming in the near future I’ve been thinking about the different boards now available to us.  Currently, the two best known and recognized boards are the American Board of Podiatric Surgery (ABPS) and the American Board of Podiatric Orthopedics and Primary Podiatric Medicine (ABPOPPM).  Other less well known boards include the American Board of Multiple Specialties in Podiatry (which certifies in wound care, podiatric medicine, and podiatric surgery separately ) and the American Academy of Wound Management.  Currently, the ABPS and ABPOPPM are the only boards certified by the Council on Podiatric Medical Education (CPME) to test for advanced qualifications of its examinees. 

With four boards that I know of (and probably more in existence or on the way) I have to ask, how many boards do we really need? One, two…none?  In my opinion the podiatric community should have one board that certifies us in medicine and surgery.  I know this is probably a controversial opinion, but here’s my take on it. 

Having multiple boards presents a disorganized and unclear picture of podiatry to our medical colleagues in other fields.   The general medical community needs to understand exactly what a board certified podiatrist is. How can they understand this if they are presented with multiple boards that require different exams that cover different topics?  Board certification, then, has less of an impact.  We need to show that board certified podiatrists undergo a rigorous and standardized examination process.

Our leaders of residency education have spent a lot of time and effort trying to make residencies more standardized.  We’ve managed to convert from RPRs, PPMRs, PSRs, and PORs to a PM&S 24 and 36 model.  The methods to evaluate residents are now more standard and consistent.  The alphabet soup of residency training has been converted to a clear and more understandable pattern.  If residency is more standard, why shouldn’t the testing follow suit?  Again, we need to present a unified and organized appearance to the medical community.

I’m sure that I’m not the only poor resident in the country, and it isn’t easy to afford all of these different exams.  Let’s decrease the cost for both the examinees as well as the profession by streamlining the process with one exam.  A decrease in administrative costs (location, staff, and supply costs, for example) will allow for a decrease in exam costs for the examinees. 

I’ve been told the smaller boards are for those doctors who are unable to pass the ABPS or ABPOPPM exam.  If they can't pass the exam, maybe they shouldn’t be certified.  How legitimate is the process if anyone can become certified?  Those folks who don’t pass should pursue extra training.  Perhaps the APMA could create a special training seminar for doctors in this category. 

I know what you’re thinking: “Hospital privileges and insurance plans often require certification.”  We have to consider, though, that patient protection is our first responsibility.  If you can’t pass a test that shows you have a certain level of competency or mastery of your field, you shouldn’t be allowed to advertise so.  Yes, they’ll loose money or privileges.  Maybe this would motivate these practitioners to gain that necessary education. 

I’m sure those of us coming out of residency now would adapt well to a new system.  Our training is better now than it ever has been, and we are well prepared to pass the boards.  What do you think?  Am I unrealistic?  Which boards should be dissolved if any?  To those of you taking the boards in June, best of luck!

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