American Board of Thoracic SurgerySpring Meeting

William A. Baumgartner, M.D.Executive Director, ABTS

(2009-2016)

October 2013

ABTS, Past and Present

ABTSMission Statement

The mission of the American Board of Thoracic Surgery is to protect the public by promoting effective, safe and ethical thoracic surgical practice by maintaining high standards for education, training and knowledge through examination, certification and maintenance of certification.

• In 1925, AATS met with National Board of Medical Examiners to discuss certificationConclusion:– No need for separate thoracic specialty certification

• In 1928, Dr. John Alexander at the University of Michigan began the first thoracic surgery training program

ABTSOrigin

• In 1936 questionnaire sent to AATS members– 94% response rateConclusion:– Thoracic surgery should be practiced as a part of

general surgery• At a 1937 AATS meeting a resolution was passed

stating that the ABS “was, and should remain, the parent organization of all matters dealing with training and certification of surgeons and surgical specialties.”

ABTSOrigin

• Special expertise was gained for handling thoracic trauma

• Several advances in the treatment of thoracic injuries emanated from the war experience

• Letter from Dr. Robert Shaw to Dr. John Alexander (1946)

• Dr. Claude Beck, President of the AATS in 1946, re-commissioned a committee

ABTSWWII: The Tipping Point

• AATS Committee performed second survey to its members– Thoracic surgery should be a specialty– Thoracic surgeons should be certified

• However, Thoracic Board would be an affiliate to ABS– Consist of members from:

• AATS (4)• ASA (3)• ACS (2)• AMA (2)

ABTSGreen Light from AATS Committee

Requirements for certification included:• ABS certification• Two years of training in ABTS approved residency

program• Successful completion of written, oral and practical

examinations

ABTSNew Board of Thoracic Surgery

• Founders Group– Carl Eggers, Chairman– Cameron Haight, Vice-Chairman– William Tuttle, Secretary-Treasurer– William Adams– Frank Berry– Brian Blades– Thomas Burford– Michael DeBakey– Emile Holman– George Humphreys– Richard Sweet

ABTSBoard of Thoracic Surgery

• 1948 – officially established• 1949 – first booklet of information• 1949 (August 1st) – first written exam

– Pass rate: 78% (22/28)• 1949 (October 15th) – first oral exam in Chicago

– Pass rate: 75% (15/20)

ABTSBoard of Thoracic Surgery

ABTSBoard of Thoracic Surgery

• First office was in Detroit, MI– Dr. Tuttle was a member of a group of surgeons in town

• Louise Sper was the former secretary of the group (resigned due to the birth of her son)

• Asked Louise Sper to be responsible for correspondence and record keeping

– Initially work was done in Louise’s kitchen• Established in Herman Kiefer Hospital in Detroit

ABTSLouise Sper

• First administrative assistant• During the 1950’s, she was given

authority to sign checks• Establishment of a $100 per

month annuity after the age 60• Bond of $5000 established

ABTSFounding Members

• Dr. Carl Eggers received certificate #1• Others received their certificates in order of their

election to membership in AATS– Notable exception: Dr. Edward Churchill

• Received #174, rather than #13 because he had delayed so long in applying

– Dr. Evarts Graham also had a high #• Held #1 certificate from ABS

ABTSTraditions

• Prominent and promising thoracic surgeons selected to be guest oral examiners

“This was also a testing ground for future board membership”

• Original Board members realized the Board would be a lasting organization, long after they departed

“Thus the custom of obtaining a photograph of each member as they came on the Board was established”

ABTSTraditions

• The practice of eating dinner together the evening before a Board meeting began early in the Board’s history– One custom was to remove a label from one of the wine bottles and have it

signed by each member, often with a message• Provided a fascinating history• Louise Sper collected and saved them

– Dr. Tuttle noted “flexed arm syndrome” in many of the photographs• Emeritus Dinner

– “invited all present and past Board members together with their wives or friends”

– Every five years– Black tie

ABTSTraditions

• Having each Board member sign each certificate became problematic– Decided to only include chair, vice-chair, and secretary

• Members would be reimbursed for travel and living expenses, whether or not the meetings were held in conjunction with another meeting

• Credentials committee established• AATS decided to require candidates for membership to be certified

by ABTS• In 1959, The Journal of Thoracic Surgery changed its name to

The Journal of Thoracic and Cardiovascular Surgery– The Board deliberated on whether it should change its name

• Decided that it was not the appropriate time to change the name, due to a struggle in the surgical section of the AMA

ABTSAmenities

• Ben Roe designed the original Board tie in 1981• Pen Faber initiated the Board pin in 1992• John Ochsner designed the second Board tie in 1994• John Ochsner designed the third Board tie in 2001

ABTSInclusion of CV Surgery

• Operations for pulmonary tuberculosis were decreasing while number of CV cases was increasing

• Question of a separate certifying Board for CV surgery– Questionnaire showed most thoracic programs included CV surgery– No other group wished to assume responsibility

• BTS decided to examine candidates in CV surgery – Decision not to issue separate certificate

• Board felt that a candidate should be examined in the entire field of thoracic surgery, whatever their experience (1956)

ABTSEvaluation of Training Programs

• Board initially thought that it should not be involved in approving hospitals/programs– Commissioned a committee in 1949

• Sent a list of provisionally approved residencies to the Council on Medical Education and Hospitals of AMA in 1950

– Together they inspected these hospitals/programs until 1967, when the RRC was officially formed

ABTSResidency Review Committee

• Evolved from Board and AMA Council of Medical Education in collaboration with American College of Surgeons– Met for several years during the 1950’s and the 1960’s– Tripartite Committee approved in 1967

• Clarification of program requirements• Discussion of matching program for residents through

ABMS began by Dr. Beattie from 1964 – 1969– Became a reality in 1992 under the aegis of the TSDA and

leadership of Mark Orringer

ABTSFrom Affiliate to Independent

• Originally suggested in 1969 by ABMS, as it was the only affiliate Board and by protocol had no vote at the medical specialties forum.

• ABMS approved ABTS as a member Board in 1970• ABTS became an independent primary member of ABMS

in 1971– “American” added to the name of the Board of Thoracic Surgery– Certificate also changed

ABTSFinal Discussions of a “Cardiovascular Board”

• Board (by early 1970’s) had established its interest in CV surgery, and this had been accepted by the other bodies interested in cardiac and vascular problems.

• Inclusion of “Cardiovascular” in the Board’s name– Much difference of opinion

• Compromise reached: the text of the certificate was revised to state that the holder was qualified in Thoracic and Cardiac Surgery

ABTS3/3 Pilot Trial Program

• 5 centers approved• A few residents completed the program• “Died due to lack of interest”

– Did not received promised training in G.S.– Technical skill development was the responsibility of the

CT faculty– Rivalry between special residents and those involved in the

standard program– Residents changed their specialty and withdrew from the

program

ABTSRequirements for Recertification (1981)

• Valid ABTS certificate at time of application• Valid license to practice medicine• Evidence of accumulation of 100 hours of CME• Submit a practice review in the form of an operative

experience covering the most recent 100 consecutive major operations performed

• Cognitive exam (SESATS)• Diplomates who received certificates prior to 1975 were

“grandfathered” and were not required to recertify

ABTSEvolution of 125 Cases Per Year

• Originally adequate operative experience was defined as:

“Candidates had to have an operative case load that reached at least the 30th percentile marker of experience of all candidates applying for the examination.”– Reached a point where it was no longer important

• Evolved to 125 cases per year averaged and no fewer than 100 cases in any given year

ABTSThe Examinations

• Written exam was first developed with the help of The National Board of Medical Examiners (NBME)

• Written questions were submitted by ABTS diplomates and exam was collated in Philadelphia (Question pool book was limited)

• Mini-conference after every four candidates suggested by Dr. Roe in 1982

• 93% of all candidates who applied eventually passed• Only 79% of residents, who completed thoracic training

were finally certified, due to inability to pass ABS exams

ABTSManpower Studies

• Mid-1970’s – Manpower study from University of Michigan School of Public Health suggested that if 135 thoracic surgeons were certified each year, that would be adequate to take care of the population in 2013

• 1976 – Graduate Medical Education National Advisory Committee (GMENAC) was established– 1981: Final report recommended a 10% decrease in the number

of thoracic surgeons trained

ABTSLong Range Planning (1985)

• Size of Board• More orderly rotation of directors• Represent option from regional thoracic societies• Adding a member of the public

– Did not occur until 2013• Expanded use of computers in the Board office• New location for the Board office

ABTSNew Location for Board Office

• Philadelphia with ABS• Evanston with ABMS• Considerable disagreement

– Evanston was chosen for physical location of the Boardo Dr. Najafi was instrumental in moving the Board office to Evanston

– Exam preparation was to remain in Philadelphia

ABTSFiduciary Responsibilities

• Increase in work load for the Board and fixed income from exam fees of 130 candidates per year– Written exam in Dallas– Oral exam in Chicago– Recertification exam– Education of Board members in psychometric science– Participation in ABS exams, RRC, ABMS and Council of Board

Executives

ABTSFiduciary Responsibilities

• Annual donation of $25,000 from the AATS and STS• Committee of Drs. Roe, Hatcher and Urschel

– Diplomates asked for $300 donation to the ABTS Endowment Fund

– Voluntary dues of $50 per year• Solvency resulted from the generosity of the majority of

the diplomates

ABTSAdministrative Directors

• Louise Sper (1948-1986)– Recruited by Dr. William Tuttle

• Glennis Lundberg (1986-2002)– Recruited by Drs. Anjali and Maloney

• Patricia Watson (2002-present)– Recruited by Drs. Gay and Cleveland

ABTSCurrent Administrative Staff

Gloria Nance Stacy Wilhite Sarah Dunlap

ABTSExamination Chairs

• L. Penfield Faber – 1st chair (1991-1994)• Gordon Murray (1994-1998)• Richard Anderson (1998-2001)• Gordon Olinger (2001-2004)• Larry Cohn (2004-2007)• John Calhoon (2007-2009)• Mark Allen (2009-present)

ABTSCarolyn Reed

• First woman director (1997-2003)• First woman vice-chair (2003-2005)• First woman chair (2005-2007)

ABTSExamination Formats

• Originally, a norm-referenced written exam• 1994 – first criterion-referenced written exam

– Drs. Ben Wilcox, John Ochsner, Pen Faber, and Mary Lunz, PhD oversaw its development

• 1995 – Dr. Gordon Murray initiated efforts to restructure the oral exam to a criterion-referenced exam

ABTS – 1988Examination Restructure

• Examination pool of questions determined to be inadequate and statistical analysis revealed better questions needed

• Cardiac and general thoracic Board members rewrite entire written and oral examination questions during extra time at each and every Board function.

• Board consultants recruited to write questions. Full day of editing under direction of Pen Faber

ABTSRestructuring of the Board

• 1992 – position of Secretary/Treasurer would be elected by the Board for an initial period of five years with the possibility of reelection for an additional five years– Freed up one position for another Board nomination, rather than

have the secretary/treasurer be a representative from one of the parent organizations

ABTSRestructuring of the Board

• AATS (4)• STS (4)• ASA (2)• ACS (2)• TSDA (2)• AMA (1)• ABS (1)• Secretary/Treasurer

ABTS - 1998

• 50th year anniversary celebration• Discussion to change written exam (Westin,

O’Hare) to computer-based electronic exam• Representative to RRC for Surgery (General

Vascular Surgery) reported that ABTS would no longer be represented

ABTS - 1998

• Written exam pass rate: 85%• 142 candidates scheduled for oral exam, 1999• Finance committee recommended a “maintenance fee”

- $100 per Diplomate per year

ABTS - 1999

• Approval of ABTS to send an “observer” representative to CTSNet

• Development of the new examination database• Discussion of moving the In Training Exam to an

electronic format• Approval by ABMS of the 6 competencies

ABTS - 1999

• Dr. David Campbell elected President of CCCETS• Resolution stating:

“The American Board of Thoracic Surgery acknowledges that recertification/competency is a continuous process”

ABTS - 1999

• Electronic transfer of Op Log from CTSNet to ABTS• Resolution to change wording of “recertification to

maintenance of certification”• Resolution passed stating that the ABTS assumes

responsibility for the assessment of competency for thoracic surgeons

ABTS - 1999

• Motion passed:“The ad hoc Long Range Planning Committee recommends that the ABTS change its current policy regarding ABS certification so that at a point in the future, yet to be determined, ABS certification will become optional. The ABTS will meet with other organizations involved in thoracic surgery education (RRC, TSDA, AATS, STS, ACS) to discuss the significant implications of this decision.”

• Motion passed:“to change the term of office for the secretary/treasurer to 7 years, not subject to renewal”

ABTS - 2000

• ABTS officially joins CTSNet with link on its website• Search committee formed for successor to

Dr. Richard Cleveland– Fred Crawford – Chair– Peter Pairolero – Vice-Chair– Richard Cleveland – Secretary-Treasurer– Marvin Pomerantz – Past Chair

ABTS - 2000

• Report of ABMS Maintenance of Certification (MOC) Committee

“The Member Boards of the ABMS are committed to evolve their current or planned programs of recertification into programs of MOC as currently defined by the ABMS. It is understood that for some boards, this transition will require time, flexibility and assistance from the ABMS and other member boards.”

ABTS - 2000

• Two motions pass regarding written exam– Number of items reduced from 300 to 250– Distractors reduced from 5 to 4

• First administration of electronic in-training exam(CTSNet)

• CME added to re-certification process

ABTS – 2000

• Joint Council proposed a 6 year “ideal” residency program consisting of:– 3year core (prerequisite)– 3 year (requisite)

• ABTS starts MOC planning• CME established for SESATS• Dr. William A. Gay nominated and elected to succeed

Dr. Cleveland

ABTS – 2001

• First discussion of use of ACGME CPT codes for the operative log

• Joint Council endorsed the ABTS recommendation to make ABS certification optional and that it should be done as quickly as possible

• Further discussion of an integrative 6 year program

ABTS – 2001

• Exam candidates signed an attestation to the security of the exam

• 9-point rating scale for the oral exam was reduced to a 4-point scale

• Dr. David Nahrwold spoke to the Board regarding MOC

ABTS – 2001

• Ms. Pat Watson attended the Fall Board Meeting at The Boulders as the administrative director designate

• Sarah Dunlap also attended as the associate administrative director

• A letter from Dick Cleveland was read as his last report, following which Dr. Gay assumed the secretary-treasurer position

ABTS – 2001

• Joint Council forwarded 10 recommendations pertinent to residency programs– Outlined the pathways to ABTS certification– Endorsed by RRC– Approval by the Board at the Fall Meeting

ABTS – 2002

• First discussion of 4/3 pathway• ABMS develops 4 major elements of MOC• First discussion on “inactive” status of MOC• ITE administered only in an electronic format• Discussion of resident work hour limitation

ABTS – 2002

• First discussion regarding financial difficulties being experience by CTSNet

• 9-point scale re-adopted for oral exam• Consultant engaged to evaluated criterion – referenced

oral exam

ABTS – 2003

• ABS Committee formed to study the issue of early specialization in thoracic surgery

• Secretary-Treasurer title changed to Executive Director– More accurately reflects the duties of the position

• ABMS dues increased to $5000 per year $10,000 by 2009

ABTS – 2004

• Initiation of the electronic written (qualifying) exam was Pearson Testing Centers– In collaboration with the ABS

• ABMS changes Bylaws to create a Board of Directors• Passage of a motion creating 2 primary paths to

certification, CT Surgery track and GT Surgery track

ABTS – 2005

• SESATS IX – only in electronic format• Qualifying exam pass rate: 82%• First discussion congenital cardiac surgery

certification• Although 2 paths were approved for certification,

a single certificate would be issued

ABTS – 2005

• Certifying exam pass rate: 86%• Discussion of “recent security breach” of the oral

examination – RRC sends warning letter to all programs if they engage

in unethical activities• Change in psychometrians from Mary Lunz to

Everett Smith

ABTS – 2005

• Final approval of 2 pathways and increase in the operative case requirements

• Approval to establish a certificate of added qualifications in congenital heart surgery beginning in 2007

ABTS – 2006

• First residency programs approved for the 4/3 pathway• Qualifying examination pass rate: 85%• First report of the Ad Hoc Oral Exam Committee• Discussion of the secured exam component of MOC

ABTS – 2006

• Motion passed to incorporate CCCETS, pending approval of the founding organizations, into the ABTS structure and take over its responsibilities

• Motion to fund the creation of a portfolio within CTSNet

• The Board’s application for MOC was approved by both COCERT and the ABMS Assembly

ABTS – 2006

• Stacy Wilhite recruited to the office staff to assist in meeting MOC requirements

• Motion passed: “ABTS require that in order to maintain a current and valid certificate, all valid certificate holders, including those with non-time- limited certifications, will participate fully in MOC for 2008

• Motion approving an ABTS policy on mock oral examinations

ABTS – 2006

• Detailed description of new oral examination process and grading system

• Plan to create a new instructional video for examiners on oral exam techniques– Previous videos had been produced by Ben Roe and Pen

Faber• Approval of categories of certification

– Certified, active– Certified, inactive– Retired and/or disabled– Not certified

ABTS – 2007

• Stacy Wilhite introduced at 2007 Spring Board Meeting

• RRC-TS approves one year residency in congenital cardiac surgery

ABTS – 2007

• New Oral Examination format– All oral exam protocols were revised into new abbreviated

and flexible format– New taxonomies were created– New oral exam matrix– Duration: 1.5 hours– 12 protocols evenly divided between cardiac and general

thoracic topics– 2 examiners per room; one split room– Grading scale of pass, marginal, fail and critical fail

ABTS – 2007

• TSDA took over In Training Exam Administration• Motion to approve to accept a primary certificate in

vascular surgery for entrance into an ACGME Thoracic Surgery Residency

ABTS – 2007

• Doris Stull retires as Executive Director of RRC-TS• Peggy Simpson appointed as Executive Director of

RRC-TS• Financial support of TSDA via gift• SESATS X initiated with Dr. David Campbell as

Editor-in-Chief• CTSNet experiences a decrease in financial support

from corporate sponsors

ABTS – 2007

• Oral exam pass rate: 71%• Motion approved to support the development of a

thoracic education director to head up the newly consummated Joint Council of Thoracic Surgical Education

• Election of William A Baumgartner as next Executive Director, upon completion of Dr. Gay’s term in 2008

ABTS – 2008

• Motion approved to support ABMS’ CEO, Kevin Weiss’ 11-point public trust initiative

• First boot camp at Chapel Hill, July 31st – August 2nd

• CTSNet provides E-Commerce for the Board’s services

ABTS – 2008

• Motion approved to fund the newly re-organized Joint Council for Thoracic Surgical Education (JCTSE) with $250,000 per year for 4 years

• Revision of the Bylaws– Recertification references changed to MOC – Included subspecialty certification language– Training Committee renamed Education Committee – Re-wording of Revocation and Appeals policies

ABTS – 2008

• Initial report of ABS developing a uniform curriculum, called the Surgical Curriculum on Resident Education (SCORE)

• Resolution passed “to seek an alternative parent organization for surgical specialty Boards” in response to changes within ABMS

• RRC stresses importance of experience and seniority for program directors

ABTS – 2008

• CTSNet elects to create a new CEO and Editor-in-Chief as Dr. Peter Greene stepped down due to increased responsibilities at his parent institution

• CTSNet plans to search for a new Senior Editor, with Dr. Tom Ferguson retiring

• JCTSE selects Dr. Ed Verrier as first surgical director (50% commitment)

• Oral pass rate: 72%

ABTS – 2008

• Motion approved “that the ABTS create a pathway for certification in critical care”

• Motion approved “to increase the importance of critical care within cardiothoracic surgery as described in Dr. Rusch’s resolution”

• ABMS approves congenital cardiac surgery subspecialty certification

ABTS – 2008

• Dr. Feins’ motion was approved “that comprehensive integrated cardiothoracic surgery training beginning after medical school be the sole pathway leading to ABTS certification, beginning in 2020.”

• Dr. Gay was recognized for his service to the Board – Black tie dinner in his house at 2009 Spring Board Meeting

ABTS – 2009

• RRC votes against the Integrated-6 residency program mandate

• CTSNet selection of Dr. Andrew Wechsler to succeed Dr. Greene and Dr. Marko Turina to succeed Dr. Thomas Ferguson

• MOC Committee proposed recommendation that if a diplomate failed the 10 year secure exam, he/she would be required to take Parts I and II exams

ABTS – 2009

• Credentials Committee recommended to the Board to develop a policy for diplomates who want to resume practice after being considered retired or inactive

• Executive Committee recommended the constitution of an Ad Hoc Committee with representation from the ABTS, RRC and TSDA to develop recommendations for residency requirements and operative case criteria in 6-year integrated thoracic surgery residencies

ABTS – 2009

• Critical Care Committee (CCC) reported that 4 additional consultants (cardiac-2, general thoracic-2) have been appointed to assist in the development of critical care questions

• CCC also recommended working with ABS to define the curriculum for a CT surgery focused fellowship year leading to ABS certification– Determined there was not a critical number of ABTS certified

academic surgeons who were also certified in critical care

ABTS – 2009

• Dr. Doug Wood was elected to succeed Dr. Irv Kron as chair of RRC-TS

• TSDA representative, Dr. Mark Allen, reported on the June 2009 Match:– 72% of positions were filled– 28% of positions remained unfilled– 93 certified applicants

• 90% matched

ABTS – 2009

• First certificate in congenital cardiac surgery awarded to Dr. Ed Bove

• Founders group included:– John H. Calhoon– Constantine Mavroudis– Ross M. Ungerleider– Winfield J. Wells– Scott M. Bradley– J. William Gaynor– John E. Mayer, Jr.– Michael R. Mill

ABTS – 2009

• Inaugural Congenital Heart Surgery written exam was administered on November 30, 2009 at Pearson Vue Centers– 80 applicants

• 77 grandfathers• 3 graduates from recently approved congenital heart surgery fellowship

programs

ABTS – 2009

• 2009 oral exam pass rate: 73%– Psychometrician report revealed no statistical difference in

any parameters– Exam Committee recommended creation of a video for

applicants illustrating the (oral) exam process– Finance Committee recommended continuing the Board’s

relationship with Mr. Richard Krentz as its financial advisor

ABTS – 2009

• MOC Committee recommends actions for diplomates who do complete the 5 year milestone

• Board accepts successful completion of a Canadian cardiac surgery residency for entrance into an ACGME-accredited surgical residency program

• Board approves conflict of interest guidelines for ABTS officer candidates and their involvement in other thoracic organizations

ABTS – 2010

• The RRC-TS Five Year review by ACGME recommended the Board adopt the ACGME case log system rather than the current CTSNet Op Log system

• Dr. Mayer, representative to ABMS, reported that the Boards remained concerned with “mission creep” of the ABMS

• SESATS X was released on May 3, 2010

ABTS – 2010

• The Board plans to migrate all diplomate and resident applications to the Board’s website from CTSNet site

• JCTSE reports that the first “educate the educator” course will be conducted at the 2010 Boot Camp

• 2009 written exam pass rate: 77%• First written congenital heart surgery exam pass

rate: 79%

ABTS – 2010

• Board approves RFP for the development of a new website and relational database

• MOC Committee opines on alternatives for database participation

• MOC Committee discusses a comprehensive versus a focused specialty exam

ABTS – 2010

• Education Committee reported on its activities in simulation and the new technology course held in Cincinnati, Ohio

• Report of the Ad Hoc I-6 Committee– Discussed potential case requirements– Identified need for a robust electronic curriculum– Discussed need for a case log– Discussed need for a simulation in curriculum

ABTS – 2010

• Selection of Web Data Solutions as vendor for a new web site and database

• Motion approved “to adopt the current RRC-TS I-6 case requirements” beginning June 2011

• 2010 oral exam pass rate: 67.4%• Development of taxonomy for the Congenital Heart

exam, allowing feedback to candidates who were unsuccessful in passing the exam

ABTS – 2010

• First MOC exam administered during a 2 week period in September 2010– Pass rate: 96%

• New committee, led by Dr. Carolyn Reed, formed to convert and map ACGME CDT codes to ABTS index cases

• CTSNet was reported to be having financial difficulties

ABTS – 2010

• The Board strengthens its nomination process for directors– Letter to thoracic organizations with specific requests for

consideration of diversity– Board requests nominations for both consultants and oral

examines from chiefs or divisions/departments• Decision to have Spring Board Meeting in Chicago

ABTS – 2011

• ABMS report regarding allowing MOC to meet maintenance of licensure (MOC) requirements

• ABMS report also indicated that the CEO’s performance is under review

ABTS – 2011

• 2011 Boot Camp will address simulation with faculty and residents– This would allow faculty to bring back to their institutions

this resource• 2010 written pass rate: 81%• Congenital Cardiac Surgery Committee motion approved to

extend “the eligibility for Pathway II candidates by 2 years, ending in 2014”

ABTS – 2011

• Development of a core curriculum for all thoracic surgery residency programs– Traditional 5/2, 5/3 programs– 4/3 programs– Integrated (I-6) programs

• State of the Board article published in Annals of Thoracic Surgery and Journal of Thoracic and Cardiovascular Surgery

ABTS – 2011

• Motion approved to incorporate in the booklet of information for certification the following text to recognize the expanding faculty involved in the training and education of our residents: “Thoracic surgery faculty is interpreted to be any faculty member with ABMS certification at a participating institution of a program and is not limited to an ABTS certified thoracic surgeon”

ABTS – 2011

• Dr. John Mayer, representative to the ABMS, reported that the ABMS Board of Directors voted not to renew the contract of the current CEO and President, Dr. Kevin Weiss

• Board deliberates on future financial commitment to JCTSE

• 2011 oral exam pass rate: 66%• Executive Director speaks to residents at STS meeting

regarding the oral exam

ABTS – 2011

• Credentials Committee reaffirmed the guidelines for diplomates who hold an inactive or retired certificate and wish to return to active status.

• ABS approves critical care fellowship with CT surgery focus

ABTS – 2011

• Critical Care Committee proposes new text to be included in the ABTS Booklet of Information

“The ABTS considers it inappropriate to exclude its Diplomates

from Credentialing for care of thoracic surgical patients in a

critical care setting based on a Diplomate's training or

certification. Our Diplomates have been trained with critical

care management of thoracic surgical patients and successfully

completed both written and oral exams which cover critical care

with thoracic surgery education.”

ABTS – 2011

• Board approves new index case requirements for residents entering programs in July 2012– These cases were revised due to the changing practices of

CT Surgery• Discussion as to a proposed change in the Bylaws to include a

Public Member

ABTS – 2011

• Launch of new web site and limited database in February 2012

• RRC report from their recent meeting:– 18 approved I-6 programs– 12 approved 4/3 programs– 10 approved congenital programs

• Representative to ABMS, Dr. John Mayer, reported that Dr. Lois Nora was selected as the new President and CEO of ABMS

ABTS – 2011

• Dr. Ed Verrier’s contract, as Surgical Director of the JCTSE, was renewed

• Motion approved “It is our intent to fund the Joint Council at $250,000 per year through 2016, assuming that metrics and effective collaboration with the TSDA are developed”.

• 2011 qualifying exam pass rate: 86.8%• 2011 MOC exam pass rate: 98.2%

ABTS – 2012

• Congenital Cardiac Surgery Subcommittee reported that of the 10 available program slots, 8 were filled

• 2011 written pass rate: 80%• MOC Committee reported they are looking at ways to

streamline the method of collection of peer and patient reviews, required by MOC process beginning in 2015

ABTS – 2012

• Migration of all “apps”, except E-Commerce for SESATS, from CTSNet to ABTS will be completed by end of 2012

• Motion passed to join ABS in their proposal to modify current duty hour regulations for trainees in surgical specialties

• RRC-TS reports that July 2013 is the date on which entering residents will use ACGME CPT codes to log in their index cases

ABTS – 2012

• RRC-TS reported on the Milestone Project progress– This new method of evaluating residents was a collaborative

effort of the RRC-TS and ABTS– The New Milestone requirements will be implemented in

2014 for all programs

ABTS – 2012

• RRC-TS reported the following:– 67 independent programs– 21 integrated programs– 12 4/3 programs– 11 congenital cardiac programs

• Representative from ABMS reported that:– Dues structure was undergoing re-evaluation– Need for a data sharing agreement between each member

board and ABMS– Patient Safety Module requirements became more flexible

ABTS – 2012

• Representative to the Joint Council reported that the online curriculum, based on the ABTS defined curriculum, was nearing completion

• Funding of Joint Council was primarily by the STS and ABTS. The AATS stopped funding after their initial commitment was completed

• 2012 oral exam pass rate: 70%

ABTS – 2012

• Oral exam report indicated there was no difference in the pass rate between specific cardiac or general thoracic rooms and mixed rooms.

• Congenital Cardiac Committee reported that to date 123 subspecialty certification have been granted

• MOC Committee reported that they were not going to seek a modular exam at this time– A motion was approved to “mandate Diplomate participation

in a suitable database to facilitate Part IV of MOC, and the deadline for the initial participation will be July 1, 2014”

• MOC Committee will also opine on the other pending MOC Part IV requirements

ABTS – 2012

• With the approval of the ABS Critical Care Fellowship with a focus in CT Surgery, the ABTS Critical Care Committee was dissolved

• A motion was passed “to approve the written statement regarding the appointment of a public member to the American Board of Thoracic Surgery”

ABTS – 2012

• To comply with an ABMS standard, motion approved “to accept the written statement of guidelines for beginning the ABTS examination sequence within one year of completion of residency training, with three chances to pass each of the qualifying and certifying examinations, and if additional training is required, to no longer use the term “eligible”, but rather “in training”