ABU: HISTORY AND ORGANIZATION

1. ABU: HISTORY AND ORGANIZATION • THE AMERICAN BOARD OF UROLOGY WAS ORGANIZED IN CHICAGO SEPT. 24, 1934 • IT WAS INCORPORATED AS A NONPROFIT ORGANIZATION MAY 10, 1935 • THERE ARE 12 TRUSTEES WHO SERVE 6 YEAR STAGGERED TERMS • THE TRUSTEES ARE NOT PAID • THE TRUSTEES ARE NOMINATED BY THE AUA, AAGUS, AACU, ACS, SSU, AND THE AAP SECTION ON UROLOGY • THE ABU & 23 OTHER MEDICAL SPECIALTY BOARDS ARE MEMBERS OF THE ABMS

2. American Board of UrologyTrustees 2008-2009 • President: W. Bedford Waters, M.D. • Vice-President: David A. Bloom, M.D. • President-Elect: Michael O. Koch, M.D. • Secretary-Treasurer: William D. Steers, M.D. • Robert R. Bahnson, M.D. • Timothy B. Boone, M.D. • Ralph V. Clayman, M.D. • John B. Forrest, M.D. • Gerald H. Jordan, M.D. • Barry A. Kogan, M.D. • Paul H. Lange, M.D. • Margaret S. Pearle, M.D.

3. ABU PURPOSE OF CERTIFICATION • THE ABU IS ORGANIZED TO ENCOURAGE STUDY, IMPROVE STANDARDS, AND PROMOTE COMPETENCY IN THE PRACTICE OF UROLOGY • THE ABU IDENTIFIES FOR THE PUBLIC’S KNOWLEDGE THOSE PHYSICIANS WHO HAVE SATISFIED THE ABU’S CRITERIA FOR CERTIFICATION, RECERTIFICATION & MOC IN UROLOGY • CERTIFICATION BY THE ABU DOES NOT GUARANTEE COMPETENCE IN PRACTICE

4. FUNCTIONS OF THE ABU • Evaluates candidates who are duly licensed to practice medicine, & arranges & conducts examinations for the purpose of certification, subspecialty certification, recertification, and ongoing maintenance of certification. • Certificates are conferred to candidates who successfully complete all requirements for a given certificate. • All certificates are the property of the Board, and the Board holds the power to revoke such certificates.

5. ABU PURPOSE AND FUNCTIONS • Is not a part of the AUA • Is not involved in the evaluation of urologic training programs (RRC) • Makes no attempt to control the practice of urology by licensed or legal proceedings • Does not interfere with or limit the practice of professional activities by licensed physicians

6. RECERTIFICATION: HISTORY • SINCE 1985 ALL CERTIFICATES ISSUED BY THE ABU HAVE BEEN LIMITED TIME CERTIFICATES WHICH EXPIRE IN 10 YEARS • THE ABU HAD NO LEGITIMATE BASIS TO RETROACTIVELY LIMIT THE CERTIFICATES OF UROLOGISTS WHO HAD BEEN PREVIOUSLY CERTIFIED

7. RECERTIFICATION: HISTORY • THEREFORE ALL DIPLOMATES WHO HAD PASSED THE PROCESS PRIOR TO 1985 ARE “GRANDFATHERED” • THE 2003 RECERTIFICATION PROCESS INVOLVED THE FIRST GROUP OF UROLOGISTS TO UNDERGO A SECOND RECERTIFICATION EVALUATION

8. CURRENT STATUS OF GRANDFATHERED UROLOGISTS • THERE ARE 10,178 CERTIFIED UROLOGISTS • THERE ARE 1857 (18% OF TOTAL) CERTIFIED UROLOGISTS LESS THAN 66 YEARS OLD WITH TIME LIMITED CERTIFICATE. AN UNKNOWN NUMBER OF THESE DIPLOMATES ARE RETIRED OR DECEASED. • BY THE TIME MOC IS FULLY IMPLEMENTED 2017 THERE WILL BE 7 (.01% OF TOTAL) CERTIFIED UROLOGISTS WITHOUT TIME-LIMITED CERTIFICATE UNDER 66 YEARS OLD.

9. RECERTIFICATION: REQUIREMENTS • A VALID UNRESTRICTED MEDICAL LICENSE IN THE GEOGRAPHIC AREA OF CLINICAL ACTIVITY • STATEMENT REGARDING ADVERSE ACTIONS IN LICENSURE, MALPRACTICE EXPERIENCE , ADVERSE ACTIONS ON HOSPITAL PRIVILEGES, SUBSTANCE ABUSE/DEPENDENCY PROBLEMS • CONFIDENTIAL PEER REVIEW

10. RECERTIFICATION: REQUIREMENTS • A 6 MONTH ELECTRONIC LOG SIMILAR TO THE LOG FOR CERTIFICATION • 90 HOURS OF CME IN THE PAST 3 YEARS • TAKE AND PASS A COMPUTER-BASED MODULAR, CLOSED BOOK EXAMINATION WITH CLINICAL QUESTIONS AT COMPUTER TEST CENTERS • THE EXAM CONSISTS OF 30 QUESTIONS FROM EACH OF 3 AREAS OF CLINICAL UROLOGY. THE CANDIDATE MAY CHOOSE THESE 3 AREAS FROM 5.

11. RECERTIFICATION:PROCESS • THREE YEARS PRIOR TO THE EXPIRATION OF HIS (HER) TIME LIMITED CERTIFICATE THE DIPLOMATE WILL BE NOTIFIED BY THE BOARD OFFICE THAT HE (SHE) MAY ENTER THE RECERTIFICATION PROCESS • THEREFORE HE (SHE) CAN HAVE 3 CHANCES TO BE RECERTIFIED • UPON SUCCESSFUL COMPLETION OF THE PROCESS THE DIPLOMATE IS ISSUED A CERTIFICATE VALID FOR 10 ADDITIONAL YEARS FROM THE DATE OF EXPIRATION OF THE ORIGINAL CERTIFICATE OR THEIR PRIOR RECERTIFICATION

12. RECERTIFICATION RESULTS • APPROXIMATELY 96% OF THE CANDIDATES COMPLETE THE PROCESS ON THEIR FIRST ATTEMPT • APPROXIMATELY 98 % OF THE CANDIDATES COMPLETE THE PROCESS IN THE ALLOTTED TIME • IN 2007, 426 (96%) OF 446 CANDIDATES PASSED THE WRITTEN COMPONENT OF THE RECERTIFICATION PROCESS

13. MAINTENANCE OF CERTIFICATION • THE AMERICAN BOARD OF MEDICAL SPECIALTIES (ABMS) VOTED IN MARCH 2002 TO COMMIT MEMBER BOARDS TO MAINTENANCE OF CERTIFICATION FOR DIPLOMATS WITH TIME LIMITED CERTIFICATES • THE ABU HAD NO CHOICE BUT TO COMPLY WITH THIS MANDATE • THIS WILL INVOLVE SIX GENERAL AREAS OF COMPETENCY

14. GENERAL COMPETENCIES • MEDICAL KNOWLEDGE • PATIENT CARE • INTERPERSONAL AND COMMUNICATIONS SKILLS • PROFESSIONALISM • PRACTICE BASED LEARNING AND IMPROVEMENT • SYSTEM BASED MEDICINE

15. MAINTENANCE OF CERTIFICATION PROCESS • THE INDIVIDUAL BOARDS WILL EVALUATE THEIR DIPLOMATES IN THE FOLLOWING AREAS • PROFESSIONAL STANDING (LICENSE) • LIFELONG LEARNING AND SELF-ASSESSMENT (CME) • COGNITIVE EXPERTISE (EXAMINATIONS) • PRACTICE PERFORMANCE (OUTCOMES) • THIS IS TO BE AN ON GOING PROCESS WITH COMPONENTS EVALUATED AT 2 YEAR INTERVALS

16. MOC • Unfortunately there has been a fair amount of erroneous information disseminated about the MOC process • All ABMS boards (which are the only legitimate boards generally recognized by hospitals and third parties) currently have or are developing an MOC process • The Maintenance of Certification (MOC) plan which has been developed by the American Board of Urology is similar to many of the other specialty Boards, and is significantly less onerous than most.

17. MOC • The Trustees have made the MOC process as simple as possible while conforming to the ABMS mandates • The Trustees spent a significant amount of time over the last three years to insure that MOC process was meaningful, yet as inexpensive and unobtrusive as possible • Ultimately the process will be completed almost entirely online • The MOC process began with diplomates who were certified or recertified in 2007

19. Current PAP’s • Management of Stage Ta, T1, Tis Bladder Cancer • Prostate Specific Antigen Screening • Antibiotic Prophylaxis for Urological Procedures • Evaluation & Management of Ureteral Calculi • Evaluation & Management of Vesicoureteral Reflux • Evaluation & Management of Clinically Localized Prostate Cancer • Deep Venous Thrombosis Prophylaxis • Evaluation & Management of Erectile Dysfunction • Evaluation & Management of Varicocele

21. AMERICAN BOARD OF UROLOGY FINANCES THE TRUSTEES OF THE AMERICAN BOARD OF UROLOGY SPEND AN AVERAGE OF THREE WEEKS PER YEAR FOR 6 YEARS WORKING FOR THE BOARD WITH NO COMPENSATION. THE ABU HAD AN OPERATING BUDGET DEFICIT OF $119,000 IN 2005, $107,000 IN 2006, AND $49,979 IN 2007. DURING THE PREVIOUS 8 YEARS THE OPERATING BUDGET WAS CLOSE TO BREAKING EVEN. WITHOUT VOLUNTARY DUES THERE WOULD HAVE BEEN A DEFICIT ALMOST EVERY YEAR. THE ABU LIKE ANY OTHER INDIVIDUAL OR ORGANIZATION (EXCEPT THE U.S. GOVERNMENT) CANNOT PERMANENTLY HAVE AN OPERATING DEFICIT. THE ENDOWMENT OF THE ABU ON 12/31/07 WAS $2,535,691. IT NEEDS THE ENDOWMENT IN CASE OF EXPENSIVE LAW SUITS, UNEXPECTED EXPENSES, OR OPERATING DEFICITS AS IT HAS HAD FOR THE LAST THREE YEARS. THE CHARGE FOR RECERTIFICATION IS $1300 OR A TAX DEDUCTABLE $130 PER YEAR.

22. MOC Benefits • Easy re-licensure by state medical boards • Easy re-credentialing by hospitals •  malpractice premiums • Benchmarks for improving patient care • Dovetail with P4P

23. ABU WEB SITE • www.abu.org • REVIEW OF THE CERTIFICATION PROCESS • REVIEW OF THE RECERTIFICATION PROCESS • ALL APPLICATION FORMS (CAN DOWNLOAD) • HANDBOOKS FOR CERTIFICATION AND RECERTIFICATION • NEWSLETTERS • LIST OF TRUSTEES AND OFFICERS • CONTACT INFORMATION • LINKS TO THE ABMS