February 9, 1947. On that date, with the horrors of war on a global scale still fresh, the American Board of Physical Medicine was recognized by the American Medical Association Advisory Council for Medical Specialties. Our board—which ultimately became the American Board of Physical Medicine and Rehabilitation (ABPMR)—was born, and physiatry became a formally recognized medical specialty. Our greatest professional communal challenge in that era was to deal with the unprecedented number of soldiers returning with newly acquired disabilities. It is a challenge that changed our field. In the words of one of our pioneers, Dr Frederic “Fritz” Kottke, the war “broadened the focus of physical medicine from restoration of … ambulation and low energy activities to comprehensive restoration of an individual’s physical, mental, emotional, vocational and social capacities.”1 Throughout our 75-year history, this “broadening of focus”—the commitment to treat not only disease but to mitigate the functional impact of disease—has become our defining characteristic. It is the lens through which our colleagues in other specialties typically do not see; the lens that refocuses our efforts on the broad impact of conditions that produce disability. It is a philosophy that has guided and continues to guide our approach to a diverse array of conditions, from cerebral palsy to neurotrauma, from limb loss to musculoskeletal conditions, from organ transplantation to cancer, and from polio to COVID-19. It is a philosophy that will equip and prepare us to address whatever health challenges the future brings.
This special supplemental issue of the American Journal of Physical Medicine and Rehabilitation commemorates the 75th anniversary of the ABPMR—the accrediting body of our field. It is a collection of articles, which pauses briefly to look back, but primarily leans into the future.
Preparing for that future, the ABPMR recently refreshed its mission and vision statements (Table 1). This revision has recently been the subject of a comprehensive review in these pages.2 All of the words are important, and all were carefully chosen. However, to introduce this commemorative issue, I would like to focus on just a few of the words from our vision: that our certification process will be dynamic, reliable, and valid. Underlying the ABPMR’s journey to realize this vision is a commitment to objective, data-driven decision making.
TABLE 1 - The ABPMR mission and vision statements Mission: The mission of the ABPMR is to serve the public by improving the quality of patient care in physical medicine and rehabilitation. This is accomplished through a process of certification and maintenance of certification that fosters excellence and encourages continuous learning. Vision: The ABPMR will continue to provide—in partnership with diplomates—a dynamic, reliable, and valid certification process that: • Is transparent, valuable, and relevant throughout a physiatrist’s career • Facilitates lifelong learning and promotes professionalism • Supports improvements in quality of care and the functional outcomes of patientsAs physicians, developing expertise as life-long learners requires critical thinking skills and the ability to be reflective.3 Critical thinking helps us recognize when old solutions are not effective for new problems or are less effective than they could be. Reflection gives us the ability to pause and use available resources to create better solutions for the future. We improve through deliberate change in practice, informed by our experience, data, and new discoveries.
If we expect expert physicians to think, reflect, and become more effective over time, we should expect no less of our accrediting board. The ABPMR encourages life-long learning of our diplomates and must in turn commit the organization to the same principles. This supplemental edition contains partial evidence of that commitment. Approximately half of this edition is composed of peer-reviewed articles that pose fundamental questions about the process of board certification. It is part of our effort to pause, think, and reflect to develop solutions that will carry us into our next 75 yrs.
Anniversaries are a good time to reflect, but also to give thanks. We at the board are thankful for the physiatric visionaries and giants that came before us. We are grateful for dozens of board members over decades who gave of their time and expertise to contribute to our field (Figs. 1–4). We are grateful to our small, gritty, and highly effective professional staff, which always punches above its weight. From a physician perspective, we are a volunteer army and are grateful to the hundreds of volunteers that write and administer our examinations. The organization flat-out could not fulfill its mission without their enthusiastic engagement and commitment.
The ABPMR 1982–1983. From left to right: front row: Catherine Hinterbuchner, MD; Gordon Martin, MD (executive director); John Ditunno*, MD; B. Stanley Cohen*, MD; Clay Gerken (psychometrician); Barbara deLateur, MD. Back row: Murray Freed, MD; Victor Cummings, MD; John Melvin*, MD; Donald See, MD; John Redford, MD; Arthur Grant, MD; Donald Erickson (assistant to exec director). “*” indicates director has served as a board chair.
The ABPMR 1996–1997. From left to right: front row: Murray Brandstater, MD; Margaret Hammond, MD; Nicolas Walsh*, MD; Joel DeLisa*, MD; Robert Christopher, MD; Bruce Gans, MD; Margaret Turk*, MD. Back row: William Staas Jr, MD; James Swenson, MD; F. Patrick Maloney, MD; Joseph Honet, MD; Gerald Felsenthal, MD; Malcolm McPhee, MD; Stephen Noll, MD. “*” indicates director has served as a board chair.
The ABPMR 2007–2008. From left to right: Front row: Karen Kowalske*, MD; Teresa Massagli*, MD; Dennis Matthews*, MD; Margaret Turk*, MD; Steve Geiringer, MD; Carolyn Kinney, MD; Barry Smith, MD. Back row: Robert DePompolo, MD; Jay Subbarao, MD, MS; David Kilmer, MD; William Bockenek, MD; Stephen Noll, MD; Anthony Tarvestad, JD (executive director); William Micheo, MD; Gary Clark, MD. “*” indicates director has served as a board chair.
ABPMR 2021–2022. From left to right: Front row: Susan Garstang, MD; Diane Braza, MD; Mary McMahon, MD; Carolyn Kinney (executive director), MD; James McDeavitt*, MD; Sherilyn Driscoll*, MD; Keneshia Kirksey, MD; Carolyn Geis, MD. Back row: Christopher Garrison, MD, MBA; Sunil Sabharwal, MD; R Van Harrison, PhD (public member); Gerard Francisco, MD; Daniel Clinchot, MD; Jeffery Johns, MD; Vu Nguyen, MD; Kevin Murphy, MD. “*” indicates director has served as a board chair. Not pictured in figures: Anthony Chiodo*, MD; Larry Robinson, MD; Jim Sliwa, DO; Daniel Dumitru, MD; Mark Raymond, MD; Joachim Opitz, MD; Phala Helm, MD.
Lastly, we are grateful to our 14,253 diplomates. You are the American Board of Physical Medicine and Rehabilitation.
Happy anniversary!
1. Kottke FJ, Knapp ME: The development of physiatry before 1950. Arch Phys Med Rehabil 1988;69:4–14 2. Kinney CL, McDeavitt JT: Board certification in physical medicine and rehabilitation: a new approach for a new era. Am J Phys Med Rehabil 2021;100:718–20 3. Cutrer WB, Miller B, Pusic MV, et al.: Fostering the development of master adaptive learners: a conceptual model to guide skill acquisition in medical education. Acad Med 2017;92:70–5
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