Value of recertification (I).

Abstract

To The Editor: I am writing in regard to the Commentary entitled "The Value of Recertification to Orthopaedic Surgery and to the Public" (81-A: 292-294, Feb. 1999), by Simon and DeRosa. Although I disagree with the thrust of the entire article, I will restrict my discussion to four points. 1. Dr. Simon and Dr. DeRosa state, "Through periodic evaluation, the recertification process demonstrates to the profession and to the public that the orthopaedic surgeon has maintained an acceptable level of continuing qualifications, knowledge, and skills in his or her area of practice." This is refuted by a statement by Dr. James Urbaniak, President of the American Board of Orthopaedic Surgery in 1990, who stated that any test that the American Academy of Orthopaedic Surgeons and the American Board of Orthopaedic Surgery can devise "says nothing about competency" of the surgeon being tested1. 2. Dr. Simon and Dr. DeRosa state, "The process of recertification improves the overall quality of orthopaedic care of patients, establishes higher standards of clinical competence, and promotes continuing scholarship." This is refuted by a statement by Dr. Frank Wilson, President of the American Board of Orthopaedic Surgery in 1989, who, when asked, "What is the correlation between performance on an examination and performance in practice?" answered, "We don't know."2 3. Dr. Simon and Dr. DeRosa state that "the philosophy of the American Board of Orthopaedic Surgery's recertification process is to evaluate diplomates in the area of what they are currently doing." This may be their philosophy, but it is not what they are doing. One of my partners who does spine surgery almost exclusively (95 percent) recently took his recertification examination, and 40 percent of his questioning was on general orthopaedics - much of it on infections of the hand, which he does not …