Board Certification Examination Updates

May 6, 2021
Pass/Fail sign

ABO recently completed the first administration of its revamped Board Certification Examination. The exam was administered during the month of March at Scantron Testing Centers, ABO’s new test-delivery partner. Despite reduced capacity at some centers due to Covid restrictions, 98% of candidates were pleased with their scheduling options and all candidates who responded to the survey question agreed or strongly agreed that they received good customer service from Scantron.

ABO’s Board Certification Examination is overhauled every 5 years, based on the results of the Job Task Analysis (JTA). This year, the examination underwent additional revision in order to comply with the National Commission for Certifying Agencies (NCCA) standards that were updated in 2016. The major change for 2021 was the elimination of the Areas of Emphasis. All candidates now take the same examination comprised of 160 questions (140 scored questions, 20 unscored pilot questions) encompassing 9 topical areas (domains). The time allotted for the exam is now 4 hours, reduced from 6.5 hours, making it more convenient for candidate scheduling. The testing windows have also been expanded; future test windows will run for 2 months (July/August and February/March), further increasing convenience for candidates.

Each time a certification examination undergoes significant revision, a new pass/fail cut score must be determined. A formal process known as a standard setting is used to make this determination. A committee of 9 ABO Diplomates were guided through the standard setting process by Vincent Lima, Director of Test Development for Authentic Testing Corporation, ABO’s psychometric partner. The cut score was determined to be 111/140 (79.3%). This sets the standard for all exams over the next 5 years. Subsequent exams with different test questions will be equated to this standard, and the cut score will be raised or lowered depending on the relative difficulty of the future exams.

Since the Areas of Emphasis have been eliminated, all candidates are now tested on identical material, ensuring that all ABO Diplomates have a standard knowledge base. After NCCA revised its standards in 2016, ABO was advised that the use of Areas of Emphasis implies separate sub-specialty certification programs. This was not the original intent of ABO’s board certification and a decision was made to eliminate the Areas of Emphasis and maintain a single certificate program. NCCA standards do allow  maintenance of certification (MOC) paths to focus on sub-specialty areas, and ABO recently formed a committee to conduct a preliminary exploration of specialty MOC paths.



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