ABFAS Statement on ABPM Certificate of Added Qualification in Podiatric Surgery

Note: It is important for patients, providers and the podiatric community to understand the differences between ABFAS Board Certification and ABPM’s unrecognized CAQ in podiatric surgery. The two are not comparable credentials. Learn more now.

August 5, 2022

The American Board of Foot and Ankle Surgery (ABFAS) is the only recognized certifying board for foot and ankle surgery in the United States. We are deeply concerned about the announcement by the American Board of Podiatric Medicine (ABPM) that it plans to issue a new, unrecognized certification in podiatric surgery. The Council on Podiatric Medical Education (CPME) recognizes only ABFAS certification for podiatric surgery. By offering its new surgical certification, which is without recognition by any accrediting body, ABPM risks injecting confusion into the US healthcare market about podiatrists’ qualifications to perform surgery, harming public health, and sullying the reputation of currently surgical-certified podiatrists throughout the country. ABPM’s marketing communications about its new certification program are already causing health care providers to misunderstand the serious and substantial importance of a surgeon’s certification in podiatric surgery. 
 
The ABPM’s new certification is intended to be perceived as similar to certification by ABFAS. It is not. In addition to not being recognized by an accrediting body—which hospital privileging boards and patients must be made aware of and are likely not to understand without a detailed explanation—the ABPM surgical certification program lacks any review of newer podiatrists' actual surgical experience, sometimes referred to as case review. Case Review is a hallmark of surgical certification by ABFAS. 
 
Our concern about health care providers’ and the public’s confusion is fomented by ABPM’s already confusing marketing communications, which reflect at least three misleading statements. 

• First, ABPM asserts that surgery is a “subspecialty” of podiatry. This is incorrect. Surgery is a specialty area of podiatric practice, and ABFAS is the only recognized board for the surgical specialty area of practice.  
• Second, ABPM asserts that there is only one residency track for podiatrists, and therefore podiatrists’ experience should be considered equally. There are in fact two residency tracks for podiatrists, Podiatric Medicine and Surgery Residency (PMSR) and Podiatric Medicine and Surgery Residency/Reconstructive Rearfoot/Ankle (PMSR/RRA). While the PMSR/RRA residency program trains podiatrists in reconstructive/rearfoot and ankle surgery, PMSR does not.  
• Third, ABPM compares its new certification to the American Board of Medical Specialties (ABMS) Certificate of Added Qualification (CAQ) programs, to which ABMS now refers as subspecialty certification. However, the ABMS subspecialty certification must be approved by the applicable accrediting body (the ABMS Committee on Certification (COCERT)), and ABMS’ non-surgical boards do not offer surgical subspecialties, as ABPM implies.  

These concerns are not new. We submitted a complaint earlier this year to the CPME, asking it to review ABPM’s proposed new certification program rules for its obvious attempt to blur the lines of surgical certification. The CPME, however, determined at the time that this certification was not within CPME’s jurisdiction. We disagree, and we are submitting another complaint because we believe ABPM is failing to comply with at least two CPME requirements:

1. ABPM is not making only truthful and accurate statements in its communications, in violation of CPME 220 § 11.5. 
2. ABPM is offering certifications in an area not recognized by CPME’s standards. ABPM’s “Certifications of Additional Qualifications” are in fact “certifications.” The standards prohibit ABPM from offering “certifications” beyond those authorized by CPME because this may foster fragmentation and confusion in the health care market (CPME 220 §§ 1.4, 4.6, 12.2). ABPM’s new certification for surgery plainly represents the “fragmentation and duplication” prohibited by CPME 220 § 1.4, and represents a substantive and significant departure from the scope of ABPM’s approved certifications in violation of CPME 220 §§ 4.6 and 12.2. 

ABFAS contends that CPME failed to comply with its own standards when it determined not to address ABFAS’s complaint filed earlier this year, and we strongly urge CPME to consider this complaint more seriously. CPME’s bylaws (see Ch. 19) require it to take action to address complaints that a standard or requirement is not being followed. CPME 230 requires that CPME seriously evaluate a specialty board’s change in scope. ABPM’s new certificate represents a “distinct and significant philosophical change in the definition and scope of the specialty area [and] the original intent of the specialty board,” and thus must “require that the specialty board seek recognition as a new applicant in accord with the expectations for specialty boards seeking initial recognition.” This new complaint, like ABFAS’s January 3, 2022 complaint, identifies critical issues that are squarely “relevant and related to substantive issues pertaining to CPME standards, requirements, criteria, or procedures” (CPME 925).  
 
We thus call upon CPME to undertake a thorough investigation of ABPM’s new certification program, requiring that ABPM immediately cease in the interim to launch the program until CPME is satisfied that the health care community and the public will not be harmed, and that ABPM is in compliance with CPME’s requirements.  
 
We also ask you, the podiatric community, to contact CPME, the APMA Board of Trustees, and the Specialty Board Recognition Committee to express your concerns.