Board chairs break down the new ABS and AOBS metabolic and bariatric surgery exam

The American Osteopathic Board of Surgery (AOBS) and the American Board of Surgery (ABS) have started a collaboration on the ABS Metabolic and Bariatric Surgery (MBS) Focused Practice Designation (FPD) examination. While the exam has been available for three previous testing opportunities, this year, eligible osteopathic surgeons will also have the opportunity to test. After passing the exam, AOBS-certified surgeons will be recognized by the AOBS with a certificate of added qualification (CAQ).

The DO talked with David Dellinger, DO, FACOS, AOBS board chair, and Adam Smith, DO, DFACOS, FASMBS, newly appointed MBS board chair, to learn more about the inspiration behind this collaboration and the benefits of taking this exam.

How did this collaboration between the AOBS and the ABS get started? What challenges or gaps do you see it addressing for physicians, particularly for DOs?

David Dellinger, DO: Well, I have to say that the lion’s share of the credit for making this thing go forward is really Dr. Smith. He contacted me around 18 months ago and filled me in on some difficulties people were having with being able to take the exam. After a few meetings, we decided to create our own system. We went through the AOA and the exam was approved and we were in the early stages of creating our first examination.

Then we ended up having some conversations with ABS, which ultimately resulted in an invitation to have a discussion about doing something jointly. ABS was extremely open to having us participate in some sort of joint process that would be beneficial for both of us.

Adam Smith, DO: We were all actually quite surprised. I mean, it goes back all the way to the beginning—before the last couple years, all bariatric surgeons were certified in general surgery, and most of us in private practice were quite happy with that, but the people in leadership at the bariatric society decided somewhere along the line that they wanted a specialty designation for bariatrics. About three years ago, I was at a Texas Association of Bariatric Surgeons meeting, and they started talking about this exam that they were going to offer, and they put it out for comment. One of the prerequisites was you had to be certified by the ABS.

That did not sit well with me at all, as it would leave many DOs out. I talked to my friends on the board of the bariatric specialty organization. They said “Well, we understand and we’re supportive, but there’s not really anything we can do.”

We had some more discussions, and now the first exam opportunity is taking place in late March/early April. The board agreed that our shared goal is to have high standards for the patient care in the country. And they didn’t think it made sense for us to have competing examinations. We would like to have the same standard.

Dr. Dellinger: We said to ABS, “We need to have some representation on this, on the examining group, as well as representation on the examination development and psychometric evaluation. They said OK to basically everything and we found them to be very reasonable and negotiations went very smoothly. There was some back and forth between the attorney groups, but I think the physicians and leadership involved have all been very positive in wanting to make this go forward. To my knowledge, there has never been a collaborative group such as this, when our MD and DO colleagues were basically maintaining their separate organizations, but having a joint group to do the examining process. So, people who are osteopathic bariatric surgeons, they’ll send their logs into the AOBS, and we’ll review the logs and make sure that they meet the criteria for the exam. We’ll forward that back to ABS, just like ABS will vet their people and send them to MBS.

Dr. Smith: Everybody will take the same exam at the same place. It’ll be reviewed by one group. And the people who pass will get a certificate from AOBS. It allows us to maintain our own individuality.

This definitely shows the significance of the partnership for the broader medical community, especially those surgeons who specialize in metabolic and bariatric surgery. You touched on the significance of it being the first time a collaboration like this has ever happened. Do you see this collaboration opening doors for other specialties and other partnerships between allopathic and osteopathic physicians?

Dr. Dellinger: Hopefully both sides are looking at this very closely. There are a lot of people who are watching to see how this goes. I think it does open the doors to perhaps having more collaborative efforts between allopathic and osteopathic groups. This way we can just give one test, with one certification. You’re both equally certified, so equally qualified.

Dr. Smith: I’m cautiously optimistic. However, rather than looking at other group collaborations, I think the next step is going forward with the longitudinal assessment after passing the test. That’s our next goal to collaborate on once we have passed this examination, which AOBS has been working really hard on.

Dr. Dellinger: Neither side has established the ground rules for their own maintenance of certification or osteopathic continuous certification. I’m sure we’ll have something that’s somewhat similar, and both sides have a tendency to mirror each other, no matter what surgical specialty you’re in. I would imagine it’ll be about the same with this.

Dr. Smith: We all have the same shared goals. We have subtly different ideas of how to get to that goal. But in this case, we’re all steering the boat in the same direction.

How do you see this new designation benefiting patients who are seeking this type of surgery?

Dr. Smith: I think it assures them, because in order to qualify for the exam, you have to meet a certain standard. That means you can’t just be a dabbler or part-time. You have to be all in in this profession, even to sit for the exam. And so by passing that exam, it not only reassures the patient that this particular surgeon has met a certain standard of being able to pass a test, but they’ve also set a standard of participating in a national database, having acceptable outcomes.

Have you received any feedback from other DOs or organizations about this new designation?

Dr. Dellinger: I can tell you that at the last ACOS annual meeting, Dr. Smith gave a couple of different talks on this topic, as well as some other things having to do with the bariatric society. And it was standing room only, and he talked to a packed house.

Dr. Smith: I’ve had pretty positive interest and feedback.

Dr. Dellinger: We’re very excited about this. It’s completely unprecedented. I want to congratulate Dr. Smith and recognize all his hard work on this. I’m the facilitator, but he’s the driving force behind this.

Dr. Smith: I’ve been around this profession a long time, and I was pleased. I’m very happy with the leadership right now. I have gotten a lot of support from membership and from the leadership.

Sue Murray, AOBS Certification Director: A live marketing webinar is targeted for April and will also be recorded for viewing. The webinar will be presented by Dr. Smith to provide potential candidates with an overview of the eligibility requirements, importance of obtaining the CAQ for their practice, and he will also talk about his recent exam experience personally.

Learn more

The ABS Metabolic and Bariatric Surgery (MBS) Focused Practice Designation (FPD) exam is taking place from March 24 through April 14, 2025, and annually thereafter.  The AOBS will share details about the 2026 exam opportunity shortly.

For more information or to register for an upcoming informational webinar, please contact Sue Murray, AOBS Certification Director at [email protected].

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