The ABS-VSB: Extolling the virtues of vascular surgery’s independent board

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Thomas Huber

The evolutionary process by which vascular surgery became a bona fide independent discipline has much to thank the American Board of Vascular Surgery (ABVS), but the specialty’s certification interests are now fully met by the American Board of Surgery Vascular Surgery Board (ABS-VSB), the annual meeting of the Florida Vascular Society (April 28–May 1) heard.

The message came during the gathering’s Presidential Address, entitled “The Vascular Surgery Board of the American Board of Surgery: Our independent board,” delivered by Thomas Huber, MD, also the current chairman of the ABS-VSB.

Huber took attendees on a history tour of the vascular surgical specialty’s development through the prism of evolving qualification and certification requirements; the evolution of the VSB inside the ABS into the status it occupies today; and the emergence of the ABVS in 1996 as it sought a fully separate board for vascular surgery. 

The purpose of the talk, Huber told Vascular Specialist in an interview shortly after his address, was to place the ABS-VSB in historical context and to elucidate its independent role in the certification of vascular surgeons. 

“Vascular surgery as a discipline really has evolved since the mid-1950s, and perhaps more so since the mid-70s,” he explains. “By the early-80s, it had come to the point where it was perceived, at least by the providers, as a separate discipline. The American Board of Surgery recognized that with additional qualifications in vascular surgery that morphed into added qualifications. The discipline continued to evolve into the 80s and the 90s.” 

By the mid-90s, a feeling had developed among the vascular surgery leadership of the time that their profession had evolved into “a truly separate discipline,” and that the ABS “was no longer meeting our needs,” Huber continues.

It was a divisive time for many, he says. But by 2006, a primary certificate for vascular surgery had emerged under the then sub-board VSB: “Despite the controversy and concerns, we were morphing in the right direction,” Huber says.

Meanwhile, the discipline itself was undergoing its “most dramatic change on top of all that” with the development of endovascular therapies, through the 90s and into the 2000s. “It was disruptive technology for vascular care so that the only people doing vascular surgery now in 2022 are truly vascular surgeons,” he adds.

At this juncture, Huber says the ABS-VSB has met vascular surgery’s needs for board certification, its primary responsibility. There are, of course, ongoing matters concerning the likes of predicted workforce shortages, appropriateness of care, and the training volume of open repairs, but the core purpose of the VSB is to certify candidates or maintain certification for practicing candidates, he points out.

In that vein, a “Blueprint” redesign is currently underway in order to eventually update what the VSB defines as “vascular surgery” in the wake of the discipline’s evolution.

The overarching message, Huber underscores, is that vascular surgery has evolved into a separate, independent discipline, “partly as a result of the leadership and effort of the ABVS,” he says. 

“For most vascular surgeons,” Huber reiterates, the issue of a separate board  has “come and gone,” adding: “My message is to be conciliatory: For the people who have brought this forward, all their goals, desires and wants have been met. We have moved on in a very positive light.” 

2 COMMENTS

  1. Dr. Huber. While I give congratulations to the great job the VSB has done in advancing the specialty of vascular surgery and testing and approving candidates for the primary certificate, we are still not an independent board. We do not have all of the same advantages of an independent board. One key factor all other independent boards have is in repect to the review and approval of training programs via the RRC. While we have tried twice to bring that under the SVS and the VSB it has been unsuccessful. As someone who promotes and supports the idea of an independent board a balanced view of the issue would have been appropriate or at least commentary to provide
    the opposite view.

    Sean Lyden

  2. Dr. Huber,

    The ABS-VSB has done an outstanding job of maintaining quality and high standards with regards to the credentialing of vascular surgeon. I believe that the ABS-VSB does hold the same values that many of us have who support an independent board for vascular surgery. Where we diverge is the belief that the ABS-VSB can fully realize its value and mission in its current state under the ABS.

    The value of an independent board goes far beyond what is written in the bylaws of the organization. There are countless examples of how certain offices, positions, and institutions are valued not only for their function, but also their symbolism. Take for instance, the Office of the Presidency of the United States. This office has several defined responsibilities and authorities as defined by the Constitution, however, the value of the office as a symbol and representation of the nation transcends written documents and becomes an intangible entity.

    It is this intangible value that drives the argument for securing an independent board for vascular surgery. The ABVS is satisfied that the ABS-VSB is fulfilling its duties in the training and credentialing of vascular surgeons. However, being an independent board member of the ABMS would add essential intangible values for our specialty.

    What are these intangibles? Allow me to answer by asking this question: “What do I perceive when I see that specialty XYZ has their own ABMS independent board?”

    I would see that the specialty XYZ –
    – Has developed itself far enough to have its own unique set of issues and thus best served with self-governance.
    – Has raised the issue of independence with its members and respected their various opinions.
    – Has distinguished itself enough to be seen as a distinct specialty before the American public and ethically obliged to provide the highest level of care for their patients.
    – Cares enough about patients with a certain pathology to allow for independent governance.
    – Does not feel that governance from another specialty would benefit patients cared for by XYZ.
    – Believes that the practice of XYZ is founded on unique training and should be practiced only by those completing the required training and demonstrating competence using rigorous methodology.
    – Has matured to the point of needing self-determination and equal recognition among peer specialties.
    – Believes that the public should be aware that for certain pathologies, an XYZ physician would be the best choice
    – Believes that XYZ should have its own department at the medical center level, since medical centers are modeled after the ABMS member boards.

    In summary, the intangible value of having an independent board is primarily the public perception of our specialty. The current member boards have all made this realization. We should also move to become an independent board for the benefit of the public at large. It is not enough to claim that a board is simply fulfilling the duties written in the bylaws. A board should understand its symbolic value to its members and the to the public. It is an ethical obligation for vascular surgery to be an independent board.

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