Symposium. Subspecialty certification: current status of orthopaedic subspecialty certification.

Symposium: Subspecialty certification: Current status of orthopaedic subspecialty certification. During the last twenty years, an increasing number of orthopaedic surgeons have chosen to subspecialize. As such, there has been an increased interest in subspecialty certification. In 1990, 44% of orthopaedic surgeons viewed themselves as general or-thopaedists and 21%, as specialists. Currently, those numbers are largely reversed , with 31% who consider themselves general orthopaedists and 35% who view themselves as specialists (Fig. 1). The average age of orthopaedic subspecialists is forty-nine years, and the average age of general orthopaedic surgeons is fifty-four years (Fig. 2). Therein, the anticipated trend is that, with time, an even higher percentage of orthopaedic surgeons will be subspe-cialists, and the number practicing general orthopaedic surgery will shrink to the point at which general orthopaedic surgeons will be a dramatically smaller percentage of the specialty than those who either exclusively practice a sub-specialty or have a strong interest in a subspecialty. There are advantages and disadvantages to subspecialty certification. The process of accomplishing acceptance of the subspecialty certification by the American Board of Orthopaedic Surgery (ABOS) and the American Board of Medical Specialties (ABMS) is a long, time-consuming one, as documented by the certification processes for hand surgery and sports medicine. The preparation of the examination is very time-consuming and expensive. The main purpose of subspe-cialty certification is to establish a body of knowledge within that field and, ultimately, to improve the quality of medicine being practiced within that subspecialty. The concerns about subspecialty certification include the time and effort involved with the process, both by those who lead the process to accomplish subspecialty certification and by those who take the examination. Most ortho-paedic surgeons do not want to take more examinations. Furthermore, sub-specialty certification can be perceived as a threat to those who have not finished an accredited fellowship and who do not practice that particular subspe-cialty in a substantial quantity. Hand subspecialty certification has existed for many years now. Sports-medicine certification has just arrived, and the first examination is about to be administered. Spine-spinal deformity subspe-cialty certification is currently being investigated and is in its early stages. Accomplishing agreement across societies and disciplines outside ortho-paedic surgery is also an obstacle. The purpose of this article is to provide an informative review. However , we are not able to provide answers with regard to the overall effect of sub-specialty certification on the whole of practicing …