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Focused Practice Designations
Adult Complex Thyroid and Parathyroid Surgery Focused Practice Designation
The Adult Complex Thyroid and Parathyroid Surgery Focused Practice Designation recognizes surgeons who dedicate a significant percentage of their practice to the care of patients with benign or malignant and functional or non-functional tumors of the thyroid and parathyroid glands.
Intro
Surgeons with an FPD in adult complex thyroid/parathyroid surgery have focused a significant portion of their time in the practice of this surgery
Focused Practice Designation (FPD) is a designation of ABMS member boards that recognizes diplomates who have focused their practice on one particular aspect of a given field of medicine or surgery that is not already recognized by specialty or subspecialty certification.
Adult complex thyroid and parathyroid surgery (ACTPS) involves the care of a distinct and definable patient population that includes those with benign or malignant and functional or non-functional tumors of the thyroid and parathyroid glands. It also encompasses the management of patients with locally advanced thyroid cancer, aggressive histologic subtypes, and inherited endocrine syndromes.
The ABS has worked in conjunction with the American Board of Otolaryngology-Head and Neck Surgery (ABOHNS) to define the standards of practice, participation, and knowledge that are required to be identified as a surgeon who focuses their practice in complex thyroid/parathyroid surgery. This new FPD can be achieved through a combination of fellowship training and/or clinical practice that is dedicated to the treatment of the patient population defined above.
Eligibility & Requirements
Requirements must be met at the time of application to the exam
Eligible candidates are expected to have successfully completed an ACGME-accredited general surgery residency and/or complex general surgical oncology fellowship training program, and be currently certified by the ABS.
To be eligible for this exam, applicants must meet the following requirements:
Participation in Multidisciplinary Care
Must demonstrate participation in multidisciplinary care for patients with thyroid/parathyroid diseases.
ACTPS Experience
Surgeons must be in practice and have case logs with the following clinical practice requirements during a consecutive period of time proximate to the application year.
The time in practice and case number requirements vary as defined by presence or absence of fellowship training as described below. Note that candidates participating in the training pathway have up to five (5) years following fellowship completion to apply for the examination.
The time in practice and case number requirements vary as defined by presence or absence of fellowship training as described below. Note that candidates participating in the training pathway have up to five (5) years following fellowship completion to apply for the examination.
A total of 120 or more thyroid/parathyroid cases are required over 3 consecutive years.
This total includes core cases and a minimum of 24 complex cases as defined below:
- Core Cases:
- Thyroidectomy
- Hemithyroidectomy
- Total thyroidectomy
- Completion thyroidectomy
- Parathyroidectomy
- Neck dissections for thyroid cancer
- Central neck dissection
- Lateral neck dissection
- Thyroidectomy
- Complex Cases
- Substernal goiter
- Reoperative thyroid/parathyroid surgery for recurrent/persistent disease
- Thyroid surgery with a preoperative vocal fold paralysis
- Thyroid/parathyroid surgery when there is a history of prior neck external beam radiation
- Thyroid/parathyroid surgery when there has been any surgery on the neck in the past that impacts the surgical approach
- Thyroid surgery when there is visceral involvement (such as larynx, trachea or esophagus), or vascular/recurrent laryngeal nerve/cranial nerve involvement (by the primary tumor or nodal disease)
- Node dissection that includes the parapharyngeal space, retropharyngeal space, or mediastinum
- Surgical management of medullary thyroid cancer
- Any management of anaplastic thyroid cancer
If surgeons have completed a fellowship providing a thyroid/parathyroid case experience as defined below, they will be able to shorten the Clinical Practice Requirements noted above from 120 cases over 3 years to 80 cases (16 complex) within the first two years of practice following fellowship completion. Fellowships must be accredited by the American Association of Endocrine Surgeons (AAES), Accreditation Council for Graduate Medical Education (ACGME), or American Head and Neck Society (AHNS). Candidates participating in the training pathway have up to five (5) years following fellowship completion to apply for the examination.
- Core Cases:
- Thyroidectomy
- Hemithyroidectomy
- Total thyroidectomy
- Completion thyroidectomy
- Parathyroidectomy
- Neck dissections for thyroid cancer
- Central neck dissection
- Lateral neck dissection
- Thyroidectomy
- Complex Cases: Of the 80 total cases, 16 cases must be complex cases, including:
- Substernal goiter
- Reoperative thyroid/parathyroid surgery for recurrent/persistent disease
- Thyroid surgery with a preoperative vocal fold paralysis
- Thyroid/parathyroid surgery when there is a history of prior neck external beam radiation
- Thyroid/parathyroid surgery when there has been any surgery on the neck in the past that impacts the surgical approach
- Thyroid surgery when there is visceral involvement (such as larynx, trachea or esophagus), or vascular/recurrent laryngeal nerve/cranial nerve involvement (by the primary tumor or nodal disease)
- Node dissection that includes the parapharyngeal space, retropharyngeal space, or mediastinum
- Surgical management of medullary thyroid cancer
- Any management of anaplastic thyroid cancer
Professional Activity
Be actively engaged in the practice of ACTPS.
In addition to the above requirements, one must be capable of performing independently the entire scope of ACTPS practice without accommodation or with reasonable accommodation.
How to Apply
Apply through the ABS surgeon portal
If a diplomate meets the requirements for this designation as defined above, they may access the application through the Apply & Register page in their ABS surgeon portal.
Items Required
- Application form, completed and submitted through the ABS portal
- Application fee, submitted online (credit card only)
The steps above must be completed by the application deadline to be considered for the examination in ACTPS, to be administered at Pearson VUE centers.
Following approval of their application, applicants may move to the registration section to complete registration, submit payment for the examination (credit card only), and schedule a testing center location
4/7 - 4/9
2025
Adult Complex Thyroid & Parathyroid Surgery Focused Practice Designation Examination
Location: Pearson VUE testing centers
Fee: $750
Application Deadline: 12/6/2024
Fee: $550
Examination Details
Exams are completed at a secure testing center
The ACTPS FPD exam consists of about 150 multiple-choice questions designed to evaluate a surgeon’s knowledge of adult complex thyroid and parathyroid principles and applied science.
It is a one-day exam lasting approximately 4.5 hours and is held at computer testing facilities across the U.S. The exam is administered in two 120-minute sessions, with an optional 10-minute break after the first session. Once a session has concluded, examinees will not be able to revisit those questions.
Results are posted approximately 4-8 weeks after the exam; surgeons will be notified by email when they are available. The exam’s contents are copyrighted and may not be reproduced or disclosed in any manner.
Maintaining Designation
Certification must be maintained
All diplomates with an ACTPS FPD must actively maintain their general surgery and/or complex general surgical oncology certification through participation in the ABS Continuous Certification Program, including completion of the applicable Continuous Certification Assessment every other year. Additional requirements directly related to maintenance of the FPD will apply, with additional information on this process forthcoming.
Contact
Our exam managers are here to help
Most questions can be answered with the information available on our website. For specific inquiries, please contact the FPD coordinator.
CME Credit
Diplomates may apply to the AMA to receive credit for successfully completing an FPD examination
Diplomates who pass an ABS Focused Practice Designation examination may apply to the AMA to receive 50 AMA PRA Category 1 Credits™. The AMA will also grant credit for teaching at a live CME activity, being first author on a published article, and obtaining a medically related advanced degree. Please see the AMA website and the direct CME application for details.