President's Perspective

The Many Facets of "Fellowship"
Michael Cornelison, DPM, FACFAS
ACFAS President

It’s been only a short time since I returned to my office after a truly memorable experience at the 2022 ACFAS Annual Scientific Conference in Austin. I imagine a lot of you feel as recharged as I do after an ASC, but that’s been especially true this year, following the most attended ASC to date. No doubt, so many of us were ready to get back together again.

Through the pandemic, we’ve found easier ways to access our continuing education virtually. In place of exhibit halls, we’ve had to find alternative methods to engage with our industry partners on whom we depend in our daily practices. As sure as necessity is the mother of invention, the technology world stepped up to our needs, and we will continue to benefit from optimized virtual platforms. Nevertheless, when the opportunity finally presented itself, more of us got together in Austin than at any previous ASC. Throughout the meeting and since, I’ve done some earnest thinking as to why this has been the case.

One of the things I think we’ve been longing for is the sense of fellowship we experience when we are able to congregate in large numbers, with those we’ve known since we started down our shared pathways, with others we’ve since met along the way, and with whom we want to share what we’ve been doing since we last met and what we expect we’ll be doing until we meet again. For foot and ankle surgeons, there’s no better place to do it than the ASC.

“Fellowship” is a term we encounter frequently within the realm of what we do as foot and ankle surgeons. In this particular case, it refers to “friendly association, especially with people who share one's interests.” Most recently, if you were to ask our professional community what the first thing that comes to mind when we hear the word “fellowship,” many would likely associate it with post-residency advanced training. Indeed, as the knowledge base of foot and ankle surgery expands and as new technologies continue to develop, it is quite practical to address this with additional training in subspecialty areas. The growth in the number of fellowship training programs has been substantial, and back in 2010 the ACFAS anticipated the potential ramifications of this with the creation of its Fellowship Recognition Initiative. The intent was and remains to foster high-quality programs by establishing specific criteria that must be met to become an ACFAS Recognized Fellowship. Today, the college recognizes over fifty such fellowship programs. For more information, please visit the Fellowship Center at acfas.org.

Fellowship might mean something different to some of our newest members. In Austin, I had the distinct honor of assisting ACFAS Immediate Past President Dr. Thanh Dinh in presenting Fellow pins to those foot and ankle surgeons who this year achieved Fellowship member status in ACFAS. Fellowship in ACFAS, as is typical of medical specialty colleges, represents considerably more than just being a member. Another specialty college, the American College of Surgeons, describes being a fellow thusly:

The letters FACS (Fellow, American College of Surgeons) after a surgeon’s name mean that the surgeon’s education and training, professional qualifications, surgical competence, and ethical conduct have passed a rigorous evaluation, and have been found to be consistent with the high standards established and demanded by the College

Likewise, the post-nominal letters FACFAS indicate that the foot and ankle surgeon has met the threshold of high standards demanded by our own College; in our case, these include board certification specifically by the American Board of Foot and Ankle Surgery (ABFAS), the only board recognized by the Joint Committee on the Recognition of Specialty Boards certifying Doctors of Podiatric Medicine in foot and ankle surgery. Fellowship, in this sense, represents a brand that the public and referring health care professionals can depend upon when seeking surgical care of the foot and ankle.

Returning to the notion of fellowship defining a cordial group of people sharing common interests, perhaps we should consider ourselves to be in “fellowship” in a more general sense with other organizations or specialties outside of our own. Over the duration of my 25 years as a Doctor of Podiatric Medicine, I have frequently heard about real or presumed differences and conflicts between professional organizations, many with other medical specialties but also others within our own. More recently, there has been an earnest recognition that in many cases, those that have differences with us oftentimes share much more in common with us. There is no better illustration of this than the collaboration that has been fostered by the Joint Task Force of Podiatric and Orthopaedic Surgeons, composed of the ACFAS, the APMA, the American Academy of Orthopaedic Surgeons (AAOS), and the American Orthopaedic Foot and Ankle Society (AOFAS). Representatives within the Task Force will continue to convene to work on mutually-experienced challenges surrounding issues such as reimbursement, CPT code valuation, pre-authorization practices, and unilateral exclusions of specific procedures, modalities and surgical devices by payors, to name a few. Significant progress has already been made in these endeavors which never would have been possible without the collaborative efforts of the Task Force.

So “fellowship” means a number of things to the College, all of which it constantly takes quite seriously. As I enter into my term as President, to me it reflects firstly the common bond all ACFAS members have of being Proven Leaders and Lifelong Learners who are positively impacting the lives of our patients. Per the College’s stated mission, I look forward to doing my part to help empower you as a member of the College.