A survey recently went out to Society for Vascular Surgery (SVS) members asking them to contribute their voice to an opinion poll over whether the Vascular Surgery Board (VSB) should remain a constituent board of the American Board of Surgery (ABS)—or become free-standing.
It’s a question that has come into and out of view in the vascular surgery community for the better part of three decades: should vascular surgery break away and form a fully independent board to certify vascular surgeons, or continue under the auspices of its current, federated structure as a component of the ABS?
On the one hand, advocates of a fully independent board advocate the strengthened voice the specialty would have with its own seat at the table of key decision-making bodies like the American Board of Medical Specialties (ABMS), or on the American Medical Association (AMA) RVS Update Committee (RUC) when recommendations are made over Medicare reimbursement. On the other, proponents of the status quo VSB-ABS structure argue that vascular surgery’s voice is more powerful under the much larger ABS umbrella, and can call upon a far greater pool of resources as a result.
Both sides were articulated during a recent focused session at the 2025 Society for Clinical Vascular Surgery (SCVS) Annual Symposium in Austin, Texas (March 29–April 2), which came in the wake of a recently disseminated Society for Vascular Surgery (SVS) survey which puts the question directly to the SVS membership.
In Austin, Alan Dietzek, MD, a vascular surgeon at Hackensack Meridian Health in Edison, New Jersey, put the case forward for a free-standing board, saying that the current VSB has done “an outstanding job” in the role it currently performs but is limited owing to the need for approval of its work in conjunction with the ABS. “There have been no issues to date, but who can predict tomorrow,” he said.
“A desire for an independent board is not a vote against the current VSB. It is a vote to change where the VSB sits.” That would include “a permanent seat on the ABMS” and “a critical seat” on the AMA RUC, he noted. In addition, Dietzek called out the need for such an independent board to have its own Accreditation Council for Graduate Medical Education (ACGME) Residency Review Committee (RRC), as do the 44 current boards of the ABMS. This would enable sub-specialization, the creation of new programs, the recruitment of more medical students and trainees, and possibly increase the number of diplomates,
he said.
As a currently serving director of the VSB, Rabih Chaer, MD, chief of vascular surgery at the University of Pittsburgh, laid out the role of the board as it currently operates. “The VSB essentially defines and oversees all the requirements and processes required for vascular surgery certification—all of it,” he said. “By being affiliated with the ABS, vascular surgery has a larger voice; we speak with the ABS voice in terms of ACGME and ABMS affairs. In addition, we clearly take advantage of their resources.” The VSB only requires ABS approval when the issue at hand involves “a large financial situation,” Chaer continued. The VSB plays no part in issues such as the Match, reimbursements, hospital credentialing and turf wars, he added. Of current representation on the ACGME Surgery RRC, Chaer said three vascular surgeons serve on the committee “and this hasn’t really hampered our ability to get things done.”
For some, at odds is the question of what the present VSB does, or can do. Kellie Brown, MD, a session moderator, chair of the VSB and a professor of surgery at the Medical College of Wisconsin in Milwaukee, argued during discussion that many of the perceived benefits of a free-standing board are conflated with the responsibilities of other vascular surgical bodies. Malachi Sheahan III, MD, the current VSB vice chair and chair of surgery at Louisiana State University in New Orleans, outlined the VSB’s function in the session introduction. “What does the Board actually do?” he posed. “It’s dull and boring, but we define and oversee certification.” He explained: “When you think about what we need as a specialty—more training programs—that’s probably going to come from the ACGME. Addressing burnout? That’s probably coming from the SVS. Increasing our workforce? That’s complicated—multiple institutions would need to be involved. Our public profile? That’s probably the SVS. Government advocacy, that’s the SVS and the ACS [American College of Surgeons]. None of these things is really what a board does, and it gets conflated a lot in what we would gain.”
It was left to Keith Calligaro, MD, SVS president-elect and chief of vascular surgery at Pennsylvania Hospital in Philadelphia, to explain the context behind the findings of the SVS Task Force on Free-Standing or Federated Board Certification, which were recently disseminated to SVS members along with the survey that seeks their input. An eight-month process yielded a report that summarizes equivocal findings, among which it is stated that the ACGME “is not in a financial position to grant a separate RRC to any group”; findings that favor the current VSB structure, including financial costs associated with creating an independent board structure; and findings that favor a free-standing board, such as the standalone votes such an entity would cast at the ABMS and the fact it would have its own seat at the AMA RUC.
The specter of cardiology’s recent American Board of Cardiovascular Medicine (ABCVM) application for independent board status to the ABMS, subsequently rejected, also consumed considerable task force deliberation, explained Calligaro. “This one factor we have now moved away from the list of things favoring a free-standing board [to being an equivocal factor] because, on the one hand it got turned down, but, on the other hand, if they re-apply in two years, and they get it, will all SVS members be saying, ‘What the heck are you guys doing? How can cardiology have their own board, but vascular surgery does not?’”
The results garnered from the survey sent to SVS members will form part of the process by which the SVS Executive Board will come to a final decision on whether to recommend to the VSB that the status quo continue or a free-standing board should be sought,
Calligaro added.
All board-certified and board-eligible SVS members have been sent numerous reminder emails to complete the five-minute survey, the SVS announced as it revealed more than 800 members have already submitted responses. The emails come from Avenue M, the survey company retained by the SVS to field the survey. Any questions should be directed to [email protected]. The survey will close at 5 p.m. on Thursday, April 17.
