I honestly don't think there is anything wrong with the ABFAS exams... the "written" is tough but fair. The CBPS can be tricky if you aren't familiar with the format, but that takes all of one day to learn and understand the choices/workup in computer format.
The case review is the insaaaaaaaaaaaaane part. They want records in far more detail and more patient records than any other surgical specialty board. It is such a chore and gives them a million ways to fail you for "missing X note or report," "inadequate pre-op H&P on that patient you brought straight from ER to OR" even if the case was done perfect and turned out perfect. Nearly all other surgical specialties just make you get a certain number of cases (verified simply by hospital logs), and then they give you an oral exam with cases (now maybe most do CBPS for social distance and more standardization?).
This ABFAS thing of case review meaning candidates need to ask past jobs for all notes, dozens of xray screenshots, labs, path, etc etc is tedious and way over the top. That stuff is hard enough to collect if you still work there at that hospital/office and have full EMR access (feels kinda like doing research), but it's basically impossible if you do not work there anymore. You are talking days and days of phone calls and mailed or emailed requests, etc. It is probably much easier for insurance to do their audits. That case review makes plenty of smart, good, busy DPM surgeons fail on case review or have to try the next year. Hospital case logs are quick and easy, and even op reports aren't too tough... but there is just nothing in it for a past employer to spend hours fishing through old records for every last detail, and you obviously can't do it yourself once you have left the place.
And now, we even need consultant reports too... the vast majority of those MDs are employed in a different place and different EMR than you unless maybe you work in large MSG or hospital. So basically, if my TMA went to vascular before/after my surgery, I need that vascular group and doc to give their notes also. If I called ID for antibiotics opinion, I need that note. As if they have time for that... they don't understand why you want/need it years later (esp if you don't work in that area anymore), they don't have time to go find it, it is a HIPAA concern for them, they have to find how to send it securely, etc. It is foreign to them since their boards process doesn't care about the podiatry surgery before the BKA... they just wanted hospital log of BKA and that's all. I don't understand why reasonable approach of hospital case logs and then passing a tough but fair exam is good enough for nearly every other type of surgeon. As it stands, we can be an awesome surgeon who passes tests and does many cases well... yet if we fail in terms of paralegal and auditor skills to subpoena records and quell HIPAA fears from locations X,Y, and Z that we worked at years ago, we fail?
