2010 SSO Presidential Address: Subspecialty Certificate in Advanced Surgical Oncology

Abstract

To put things in perspective, let me briefly summarize the history of the American Board of Surgery (ABS). It was exactly 100 years ago, in 1910, that Dr. Abraham Flexner, supported by funds from the Carnegie Foundation, recorded the state of affairs of medical training in the USA at the beginning of the century: the quality of medical schools was extremely variable, with some of them based on scientific principles and others completely devoid of proper training, resulting in practitioners of vastly different education and quality. By the same token, there were no standards for training in medicine and surgery or any standards to verify and validate the quality of the individual trainee at the end of specialty training. The field of medicine was in disarray and needed standardization of educational quality and certification of individual competence. The idea of certification by a specialty board was first adopted by the ophthalmology organizations, which formed a specialty board, the American Board for Ophthalmic Examinations, which was incorporated in 1917. By 1933, the name was changed to the American Board of Ophthalmology. The otolaryngologists formed the American Board of Otolaryngology, which was incorporated in 1924. The American Board of Surgery, a private, nonprofit, autonomous organization, was incorporated in 1937. Today the American Board of Surgery is 1 of the 24 boards of the American Board of Medical Specialties (ABMS), and its principal objective is to evaluate the education, training, and knowledge of broadly qualified and responsible surgeons and to issue certificates to all candidates meeting the board’s requirements and satisfactorily completing its prescribed examinations. The ABS considers certification to be voluntary and limits its responsibilities to fulfilling the purposes stated above and not to designate privileges, credentialing or special recognition in the practice of surgery or its subspecialties. In doing so, the ABS serves the public, by guaranteeing that certified surgeons are highly qualified, and it serves the diplomates, by conferring on them recognition of their special skills, training, and knowledge. The founding organizations of the American Board of Surgery were the American College of Surgeons (ACS), the Surgical Section of the American Medical Association (AMA), and the American Surgical Association (ASA), each providing three representatives, plus four regional surgical societies, the New England Surgical Society, the Pacific Coast Surgical Association, the Southern Surgical Association, and the Western Surgical Association, each providing one representative. With the increase in workload created by the growing number of surgeons seeking certification and the process of recertification started in the early 1980s, the ABS has added to the number of directors over the years by inviting representation from other surgical societies: currently 22 national and regional surgical organizations and 3 surgical boards provide 32 directors Society of Surgical Oncology 2010