the fellowship directors who had been on the call August 20th and about the alternative accreditation program that we're on. Or if you'd watched the recording about it and looked over things and see what kind of questions you have. We also, we can go through some of the numbers for the match later on first. I wanted to start out with the accreditation items first and see if anyone that's logged onto the call had specific questions. I think a couple of things that came up when we had our first meeting that I was gonna address first had to do with, there was some question about why we're doing this accreditation process, this alternative accreditation program. And I just wanted to kind of give some more details about that. So just in general, this is something, I think the members have been asking for for a long time. I had been on the board of counselors for AAOS for about six years until a couple of years ago. And this is where that kind of got started back in the early, I'd say probably 2013 or so. There was an outcry from the, not only Flint and Ankle, but the other subspecialties for an alternative accreditation process for fellowships in all the subspecialties. A lot of people felt the ACGME process was quite onerous, particularly for programs that were not tied to a university setting. I think that's where that got started. And now over time, every society, we'd mentioned this before, every society except for ours, every specialty except for ours now has an alternative accreditation process for their fellowships. So that's the whole reason for this going forward. There's a lot of benefits, I think, to having this alternative accreditation process. Our main competitor, the podiatrists, have had this for years. And I've even run into this sometimes in legal work and things like that, where they ask, well, your fellowships aren't accredited, or most of ours are not, whereas all the podiatry ones are. So I think this does give us some clout in the legal arena, as well as with the public, when the public is looking at, how are you guys differentiating yourselves of being qualified to work on Flint and Ankle compared to these other groups out there? So that's another reason for this. I think it does some of the other benefits we looked at. We kind of can have the training in a lot of the programs can be, differs from program to program. This can kind of give us everyone a framework for here's some things that we think are essential for training Flint and Ankle fellows. And so those are a lot of the reasons for going forward with this. I think it's important. It's very, it's been requested for a lot of our members across the board. And so that's the whole reason I'm about. And it's something that the board of directors has felt is a very important topic that we have worked on. It's a very important program to work on. Well, that was, and I know that was a question some people had. Some programs that already have our ACGME accredited, this may not seem as appealing to them, but majority of our fellowship programs are not ACGME accredited. And most of them, a lot of them are associated with private groups and not universities, which make it much more difficult to kind of fulfill those requirements to be an ACGME accredited program. So that's part of the reasoning for this whole, this whole task force and program that's gone forward. Now, I know specific questions, any of the directors are on the call here that have specific questions about the fellowship program that have come up that you can add? We wanted to talk about it. Aaron, I have a question just from the last meeting or lane two in Guadalupe. Do you, I mean, was there any feedback that you got in the form of email or other communications from the last meeting, one way or the other? Any outliers in terms of people that really felt like this was too onerous a process or they weren't interested or, you know, generalized support either way? I didn't get emails that were vehemently, you know, against starting this program. I had a few people say that they were very pleased that it was going forward and just were, you know, the devil were in the details. They wanted, you know, details of how it's gonna be rolled out and how we see it going forward. I did have a question about, from someone at an ACGME accredited fellowship of how are we going to, they basically didn't want to duplicate work. Like, and say, hey, we want to be AOFAS accredited also. Is there a way to kind of grandfather those people in that already have, and I think there's a handful, maybe six or eight programs, I think, that are ACGME accredited, if there's some way to grandfather them into this program. And that's something that we're gonna address at our fellowship committee meeting next week. We have that on the agenda. We're gonna discuss that as possibly there's a way to have some overlap there, so you don't have to duplicate work if you want to be accredited in both programs. But that was the main feedback I got. I don't know if Elaine or Bob had any other feedback from anybody. Overall, everybody seemed to be interested in this. Out of the 23 that responded to the survey, 21 said that they would be providing the case data for the coming year. So again, there's definitely interest. And overall, just from interested, most of everybody said that they were interested as well. So we got really good feedback on that. So did that mean that two said they were not interested in providing data, or just, okay. Yes. Okay. Erin, Townie, Manning, and Vale, I was just wondering if we could create the log system so that the fellows can use it then, because a lot of credentialing bodies ask, well, how many total articles have you done? How many X have you done? And it'd be nice. I think we're trying to keep this fairly proprietary, but if at least the individual could search or print out a log of what they've done at the end of the year, because most of us keep case logs. Anyway, if it could be a one-stop shop, that'd be great. Right. So we do have a case log system that will be going live next month. That's been created here at AOFAS. Next, let's see, on the 22nd, September 22nd at 8 p.m. Central, there's going to be a demo of that system. And the Zoom, there will be Zoom invites for that to go going out for that. So, but yes, there is that case log system is already created, well, being worked on at AOFAS. It is, I mentioned in our presentation, it's going to be CPT-based, but also total number of case-based. There's going to be a couple of ways to log cases, and they'll go over that at the demo. So that's going to be, you'll see that September 22nd is when that's scheduled for, and you'll be getting some info on that. This is Ken Hunt from Denver. Is that case log system, will reports for cases for an individual via program be available to the program so that we can use that as our source of truth on tracking our own cases? I believe so, yeah. I believe you're going to have, you'll have each program have access to their own data to see how many cases they've done, how many, what types of cases they've done, how many of each, say, CPT code you've done. That should be all available to the programs, but I don't know the absolute details of it yet, but they'll, the 22nd, they should be able to go over some of that with you. I can add just a little bit of detail. I know that we're basically modeling it off the OTA case log collection system. OTA shared with us what theirs looks like, and it's going to be housed in the platform that AOFAS uses to do that. It's going to be housed in the platform that AOFAS uses for abstracts. And so people who already interact with that will already be logged in, and it's just going to be another bucket, if you will, in that platform. We haven't seen it come back yet built out, and when that comes next week, Alina and our staff will be sharing it with Aaron and a few other people on the committee just to make sure it looks the way we want, but it's something we can certainly adapt if it's missing something or we hear from people that there's some field that doesn't work well, but the fellows will enter the data and be able to export the data. So I don't know that we thought through the program director having access to it, but I would have to defer to Alina on that for permissions, but I know it would be entered by the fellows. Aaron, to digress two seconds on the ACGME thing, in terms of pre-work, it might be helpful if someone who is currently in an ACGME certified accredited program could sit down and sort of look at the Venn diagram to see where the overlap is. I agree. We should be nice not to have them duplicate the work. And maybe, again, in terms of pre-work, we could look at that and see what additional things they need or not need. I suspect it's a pretty short list. And I don't know if anybody on the call is in an ACGME program, but I think the requirements to some degree are more stringent. And what AOFAS is proposing is a little bit different, but probably not much more work. But anyway, we're thinking about that now if someone's interested in volunteering. I think it is important to, just as a general comment, I think it's really important to not make it seem like we are, maybe penalizing isn't the right word, but certainly overburdening the programs that have already elected to be accredited through the ACGME. I think we need to really welcome them, because they've already really done the work, and it may not be exactly what we had in mind, but they've obviously demonstrated interest and necessity for their program. Some university programs will require that their fellowships become ACGME accredited, and so they will not be able to actually divert from one to the other. But I think it's appropriate that just for uniformity and, what's the word I'm looking for, not cohesiveness, but just a united front as a society that I think we be inclusive of all fellowship programs and really encourage them to be part of this and make it less onerous for those who are already doing work to be accredited through the ACGME to run at least in parallel. Because there are optics involved in this, I think, that are really important as well. Part of the reason to do this is because we are in a competitive market with podiatry. And because we are being challenged for our quality and qualifications of our fellows who have graduated. So I don't think that can be overstated enough, but if we don't have buy-in from our own fellowships into our own societal accreditation system, it's also going to call that into question when it comes up. So I just think it's really important to encourage, as best we can, 100% inclusion. Yeah, I also think that it's important to message that the intentions behind doing this are good and in the best interests of all the fellowship programs and the society as a whole. And that this really will be a living, fluid, breathing document that will likely evolve over time as we learn. We're trying to shoot for a median, a benchmark standard that I'm sure will change a little bit to meet everyone's needs over time. And that's very important. So. Right, this is a fluid system we're coming up with. There's several things that have come up that we're going to be discussing at our fellowship committee meeting next week. And this being one of them, of how to, for those ACGME programs, how to have them have that crossover to the AOFAS alternative accreditation fellowship and make sure they don't have to duplicate work getting both of those. So the details, yeah, we'll be working on that. Any other questions for anyone on the call here? I do have a question. Sorry, Cesar from Iowa. We're starting the process. We were already starting the process for ACGME accreditation. So what would you recommend to us right now? Should we still keep moving with the ACGME or the recommendation from AOFAS would be just wait for it and just go with the AOFAS accreditation and might not be needed to be double accredited? Or I don't really understand what would be the legal cross-section between the accreditations. Do we have to have both? Or should we wait, stop the ACGME, and do the AOFAS? I'm a little bit confused what you would recommend for that. I think it's up to you. I mean, again, this is a alternative accreditation that we're trying to put forth to all the fellowships that they could have instead of ACGME, just because we have seen over the years that getting that ACGME accreditation is quite onerous for a lot of programs. I'm sure that if you're in that process of looking at ACGME accreditation, you'll probably see it's a lot more involved than what we're setting forth for that. I think legally, I mean, it doesn't really matter. It's just we're trying to make sure that fellowships have a way of having an accreditation of some sort. And this is what other societies have done. They're doing it, again, as an alternative to doing the ACGME. If you're already ACGME accredited, well, then you can choose to stay with that or not and go with this accreditation. If you're looking at one or the other, I think you're probably going to see that this alternative accreditation process is probably going to be simpler than ACGME. So that's up to you. You may, I can't really say, give you an answer one way or the other. It's up to you. But you may see this as a simpler process. Cesar, and I'm happy to talk to you about this offline, because it's a complicated situation, depending on where you are in the application process for ACGME accreditation. I mean, that can be not only onerous, but it can take some significant time to go through the process to have your program evaluated. I don't know if it still requires a site visit, but I think it does. And it's a fairly significant chunk, but we're still not in the process of offering accreditation at this point either. We're just accumulating data. At this point, our process is in the fledgling stage. So part of what we're doing is trying to build an appropriate accreditation process that is easier. But in doing so, we are asking that we gather data and establish some minimums and do some things. So we won't have an accreditation offering, I would say, for at least 10 months, I think. And that's even being potentially generous. But I would say maybe this time next year would be nice to be able to offer that. But we really need a year lead time data or close to it to see if we're looking at case minimums, for instance. We can't just base that off a month or even three months because, as you know, seasons have different effects on case volumes and regions. So we need to accumulate it. We need to analyze it. We need to regurgitate it and make a formal process. So if your fellowship or your institution feels the need to have accreditation, I would say I would advise you to move forward with what you're doing. And then once the AOFAS has its accreditation process, then we can hopefully move you in seamlessly and have that ready for you. So like I say, it depends. And like I say, I'm happy to talk to you offline about it. If you'd like, just give me a call, and we can chat about it. But I would say if you're pretty far down that road, just go ahead. OK. Great. Thanks for the inputs. I appreciate it. I think if you remember, part of the initial program here is all the programs that had participated in SFMATCH through AOFAS, our plan is to have initial accreditation while we're still working out the details of reaccreditation and case logs and things like that for all the programs. In here. Any other questions that people thought of on the accreditation process? I see some other people have joined in on the call. Or any other questions about what's going on in the Fellowship Committee? All right. Well, if we don't have any other questions, then I'll let you Let me just make a quick comment. I think, first of all, thank you, and Jim and the whole committee, for getting us to this point. And I think it's really an important step. I know there's some folks that are meeting with this with some angst and maybe some friction. I think it's really important that we move forward with very positive messaging, that this is really not to create extra work, but it's really to be in an effort to promote maybe solidarity is not really the right word. But certainly, that's kind of the message, is that we want to do this together as a united front to really support all of our graduating fellows to really try and validate them in the public eye. And the other thing that you mentioned, which you went through, was our meeting with San Francisco Match the other day. I just think that that's going to be an important part of the Fellowship Committee to just kind of make sure. Because I felt like we left that meeting with a good feel, a reasonably good feel, but a lot of unanswered questions because they just hadn't completed their thought process yet. The Academy is infusing itself in many areas that I'm not really sure it belongs in or should have oversight in the way that it thinks it does. But I think that it's going to be important for the committee to survey that and supervise just all the things we talked about, the data, how the match is being run. We still need to have a strong say-so in how that runs. I know you were there, and I think we're all on board with that. But just for the whole group, the last little part of Aaron's presentation, we spent some time with San Francisco Match, and there seems to be some evolution. But I think it is in an effort to try and make it a more uniform process across fellowship specialties so that everything happens similarly and at the same time. Yeah, I agree. I have the same thoughts you did after that meeting we had with them last week. Actually, I do have that on our committee's agenda for next week when we meet to talk about the changes at SF Match, and we're going to have to follow that closely. Again, they don't have all their ducks in a row yet. They still have the concept, but they haven't worked out the details. And I don't think we'll know those details until they work those out going forward. So one good thing I did see, I did get out of that meeting, is it doesn't sound like there's going to be much change in kind of the structure of how we run our portion of the match, such as determining, OK, what programs can be in the match, or if there's something that they don't fulfill our criteria, the data, our access to the data. I don't think there's going to be a lot of change in terms of access to the data. I don't think they're changing any of that. It didn't seem like they are. It seemed to be more of just trying to unify certain things, such as the whole matching process timeline, and then, of course, the agreements, the legal agreement they have with AOS, rather than differing agreements that they have with every subspecialty, which is the way it is now. They're trying to kind of uniform thing, make things more uniform. So that's going to be a little bit of a wait and see that we'll just have to keep a close eye on. All right, well, thank you. Any other questions? If not, I'll thank you all for joining in on the call here today. And we'll look forward to a good meeting here. Thanks, Aaron. Thank you. Thank you. Great job.

alternative accreditation program

fellowship programs

American Orthopedic Foot & Ankle Society

AOFAS

accreditation process

ACGME accreditation