Less Is More: Advancements in Thyroid Surgery

by Jennifer Fink •

New Focused Practice Designation: Adult Complex Thyroid and Parathyroid Surgery

Otolaryngologists who would like to achieve formal recognition of their proficiency in the surgical management of thyroid disease can now choose to pursue a Focused Practice Designation (FPD) in Adult Complex Thyroid and Parathyroid Surgery (ACTPS).

Developed jointly by the American Board of Surgery and the American Board of Otolaryngology-Head and Neck Surgery, the new FPD (The American Board of Surgery. https://tinyurl.com/mkrk9sre) reflects the continuing move toward hyper-specialization and is intended to recognize physicians who devote a significant part of their practice to thyroid surgery.

“It’s an opportunity to designate that a given surgeon has a focus in this area that is backed up by certain volume numbers that have quality implications,” said Gregory W. Randolph, MD, professor of otolaryngology–head and neck surgery and the Claire and John Bertucci Endowed Chair in Thyroid Surgical Oncology at Harvard Medical School in Boston.

Eligible, non-fellowship-trained candidates must have performed a total of 120 or more (including 24 complex) thyroid/parathyroid cases over three consecutive years. Candidates who have completed a fellowship providing thyroid/parathyroid case experience must provide evidence of at least 80 cases (including 16 complex) within their first two years of practice following fellowship completion (The American Board of Surgery. https://tinyurl.com/mw9tt3m8).

I think it remains to be seen what ultimate value it will have, particularly for patients.” —Amanda L. Silver Karcioglu, MD

The benefits of ACTPS FPD are yet to be demonstrated. “One would think that perhaps patients, referring doctors, and even hospitals may, at some point, consider the focus practice designation as a badge of added quality due to focus and volume,” Dr. Randoph said.

“I think it remains to be seen what ultimate value it will have, particularly for patients,” said Amanda L. Silver Karcioglu, MD, clinical assistant professor at the University of Chicago Pritzker School of Medicine.

Applications for the first ACTPS FPD examination—an approximately 150-question multiple-choice computerized test—are currently open. The exam will be administered at secure testing centers from April 7-9, 2025.