Expanding the role of the Vascular Surgery Board-ABS

Despite increasing financial and regulatory pressures, mainstream vascular surgery must continue to uphold high standards and excellence in clinical care. Achieving this benchmark can only be done by providing rigorous postgraduate training followed by a comprehensive evaluation and certification process.

To receive accreditation, new training programs, working with the support of their local graduate medical education committee and Designated Institutional Official, need to complete the formal application process of the Accreditation Council for Graduate Medical Education (ACGME). Those completed applications, following screening by ACGME staff, are forwarded to the ACGME’s Review Committee for Surgery for evaluation and accreditation determination. For some programs, the application process may require a site visit by ACGME field staff.

Several cycles of evaluation and application revision may be required to ensure all the necessary components of training are in place before the status of “Initial Accreditation” can be achieved.

Vascular surgery residents and fellows who have successfully completed an ACGME-accredited program may then apply for board certification in vascular surgery, a process by which the individual applies to the Vascular Surgery Board of the American Board of Surgery (VSB-ABS) to take a written qualifying exam and then an oral certifying exam. It is only by maintaining this process that vascular surgery, the medical community, and the public at large can be assured that a board-certified vascular surgeon has met the rigorous requirements of both the ACGME and VSB-ABS for knowledge and training in vascular surgery.

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It has been shown time and again that patients value board certification. In fact, in a 2003 Gallup poll,95% of the respondents felt that physicians should be board certified and 95% felt that maintenance of this certification was important (JAMA. 2004;292:1038-43).

The VSB-ABS has undergone many changes since its inception. Initially, the American Board of Surgery issued a certificate of added qualifications to vascular surgeons who met its criteria and passed the proper exams. The first certificate was issued to E. Jack Wylie, MD, on June 30, 1982.

In the ensuing 35 years, the specialty and the requirements for certification have evolved. The VSB-ABS was formed in 1998 in recognition of the increasing independence of vascular surgery as a specialty. A primary certificate in vascular surgery was then introduced in 2006 to allow for certification in vascular surgery without the requirement of general surgery board certification. At this juncture, vascular surgery was no longer considered a “dependent specialty.” This change allowed for the creation of different training paradigms to include three different pathways: Independent (5+2), Integrated (0+5), and Early Specialization (ESP, 4+2). Initially, graduating trainees were required to pass the General Surgery Qualifying Examination or the Surgical Principles Examination prior to being able to take the vascular surgery exams.

In 2015, the VSB-ABS eliminated this requirement and incorporated core surgical management into the Vascular Surgery Qualifying Examination. This strategic change again affirmed the independence of vascular surgery as a specialty. The total number of board-certified vascular surgeons and number of training programs are summarized in Table 1.

The mission of the VSB-ABS is to serve the public and the specialty of surgery by providing leadership in surgical education and practice, by promoting excellence through rigorous evaluation and examination, and by promoting the highest standards for professionalism, lifelong learning, and the continuous certification of surgeons in practice. The VSB-ABS is responsible for setting the requirements for board certification in vascular surgery, including the creation and administration of the Vascular Surgery Qualifying (written) and Certifying (oral) Examinations. In addition, the VSB-ABS is responsible for the Vascular Surgery In-Training Examination and Maintenance of Certification (MOC) Examination. With the increasing number of graduates from vascular surgery training programs and the changing needs of our dynamic specialty, the VSB-ABS also is working on the following important initiatives.

Expansion of the VSB-ABS

The VSB-ABS currently consists of eight board members elected from the following four national vascular societies: the Society for Vascular Surgery, the Association of Program Directors in Vascular Surgery, the Society for Clinical Vascular Surgery, and the Vascular and Endovascular Surgery Society.

In addition, two other current VSB-ABS members have been elected from the American Surgical and the Southern Surgical Associations. They have both also been elected to serve on the Executive Committee of the American Board of Surgery. Based on the wide range of responsibilities of the VSB-ABS and the importance of ensuring the voice of the U.S. vascular surgery community is well represented, a decision was made to expand the VSB-ABS. As of July 2017, the VSB-ABS will be expanded to include an additional five members (to be elected), encompassing one representative from each of the major regional vascular societies: the Eastern Vascular Society, the Midwestern Vascular Surgical Society, the New England Society for Vascular Surgery, the Southern Association for Vascular Surgery, and the Western Vascular Society. We look forward to the contributions of these new members.