Adult Complex Thyroid and Parathyroid Surgery Focused Practice Designation
The first ACTPS FPD Examination will be administered April 7-9, 2025, with applications for the exam opening up in the fall.
An Update from the Education Readiness Taskforce
What is the Adult Complex Thyroid and Parathyroid Surgery Focused Practice Designation (FPD)?
The American Board of Surgery (ABS) and the American Board of Otolaryngology – Head and Neck Surgery (ABO-HNS) will soon begin offering a joint Focused Practice Designation in Adult Complex Thyroid and Parathyroid Surgery.
The FPD was approved by the American Board of Medical Specialties (ABMS) in 2017 and “recognizes areas of practice within existing specialties that either evolve over a career or emerge with new medical knowledge”.
The FPD can be obtained after primary surgery certification.
This new professional designation will highlight diplomates of the ABS (general surgery) or the ABO-HNS who have focused their practice in complex thyroid and parathyroid surgery, developed the infrastructure to support a comprehensive program, passed a written examination, and completed an application for the FPD.
What is the History of the Adult Complex Thyroid and Parathyroid Surgery FPD?
In 2019, a joint task force of representatives from the ABS, ABO-HNS, AAES, and American Head and Neck Society (AHNS) met to discuss creation of a FPD in thyroid and parathyroid surgery. After an initial draft and period of public comment, the FPD was approved by the ABMS in June 2022.
In the fall of 2022, there was an open call for applications to participate in the Steering Committee, comprised of 10 members (5 ABS members and 5 ABO-HNS members).
In the Spring of 2023, ABS and ABO-HNS members were invited to apply to participate in the FPD Exam Committee. The joint Steering Committee selected 20 members (10 ABS and 10 ABO-HNS members).
Throughout the process, the ABS has worked closely with representatives from the AAES to define standards of practice, participation, and knowledge required to be identified as a surgeon with a FPD in Adult Complex Thyroid and Parathyroid Surgery.
Why Should I Obtain a FPD in Adult Complex Thyroid/Parathyroid Surgery?
The primary benefit of the FPD is for patients. Numerous studies have shown the beneficial effects of high-volume expertise for patients requiring thyroid or parathyroid surgery.
Many patients seek surgeons with a practice that is focused on their health care needs, yet most patients with thyroid and parathyroid surgical diseases still receive care from low-volume thyroid/parathyroid surgeons.
In other surgical specialties such as Metabolic and Bariatric Surgery, a FPD designation is already available. It is expected to foster best outcomes and promote quality improvement and transparency.
FPD designation is intended to help patients and referring clinicians identify those surgeons who devote a significant portion of their practice to complex thyroid and parathyroid surgical disease management.
FPD designation demonstrates a surgeon’s commitment to excellence and shows that they have taken the extra steps needed to achieve the distinction.
How May the FPD be Achieved? The FPD in Adult Complex Thyroid and Parathyroid Surgery may be achieved by pursuing one of two pathways as specified below:
Practice Pathway:
ABS or ABO-HNS surgery certification in good standing
No prior fellowship training required (e.g. Comprehensive Endocrine Surgery or Complex General Surgical Oncology)
120 index cases (24 complex) within three consecutive years prior to application submission
Qualifying Cases for the Practice Pathway:
Core cases: thyroidectomy, parathyroidectomy, neck dissection for thyroid cancer
Complex cases: substernal goiter, reoperative thyroid or parathyroid surgery, tracheal resection for thyroid malignancy, management of anaplastic or medullary thyroid cancer
Provide evidence of participation in a multidisciplinary care model (e.g., tumor board or other documentation)
Take and pass a written examination
Complete the above requirements within three years of initial application
Training Pathway:
ABS or ABO-HNS surgery certification in good standing
Complete an accredited fellowship in Comprehensive Endocrine Surgery (AAES accreditation) or Complex General Surgical Oncology (ABS accreditation; CGSO subspecialty certification not required)
Complete an accredited Head and Neck Surgical Fellowship
80 index cases (16 complex) within two years prior to application submission
Provide evidence of participation in a multidisciplinary care model (e.g., tumor board or other documentation)
Take and pass a written examination
Apply within five years of completion of fellowship training
Thyroid and Parathyroid FPD Exam Content
Tables 1 and 2 include the major content categories and secondary classifications in the exam blueprint. Weights are also provided for each. Concretely, the weights indicate the approximate percentage of questions to be included on the FPD exam; actual percentages may vary slightly from year to year.
Content Categories
Table 1 includes the major content categories for the exam, which are separated into four sections: Anatomy and Physiology, Thyroid Diseases, Parathyroid Diseases, and Surgical Concepts.
Secondary Classifications
Table 2 includes the secondary classifications for exam items. All items will reflect both a content category and a secondary classification (e.g., a question about the pathology of follicular carcinoma).
Additional details regarding the application process will be forthcoming.
