A Perspective on an Asian Pacific Orthodontic Society Board: A SWOT Analysis and Proceedings of Deliberations at the APOS Boards Forum Held at the 9th APOC, Bali, on September 2, 2016
There has been an optimistic sentiment of the Asian Pacific Orthodontic Society (APOS) executive committee members (ECMs) toward the formation of an Asian Pacific Board of Orthodontics (APBO). However, the question has evolved into whether an APOB should be formed or should a subcommittee be selected to assist members planning to form their own national boards. The current subcommittee decided to set up a forum, as this appeared to be more transparent and inclusive than a report derived by the opinions of 3–4 appointed ECMs.
It has become apparent to all involved with the concept of developing an APBO that there are many different interpretations of an orthodontic board or a board of orthodontics. Of greatest concern are the discrete differences in the countries within the members of the APOS that have an orthodontic board. For instance, the Australasian Orthodontic Board is a voluntary process of continuing education and peer review. In contrast, the Thai Board of Orthodontics is a mandatory process of written examination, case presentations, and oral examination for all registrable orthodontists. The APOS subcommittee is sensitive to the need to avoid misinterpretation of the intent of the APBO. It is probable that even the terminology when referring to APBO would need to be modified so that it does not resemble the title of a registrable qualification. The terminology may need to be so different that it only resembles some other continuing education qualifications. As an example: Certified member of the Asian Pacific Orthodontic College.
It is becoming increasingly more likely that the APOS will develop a mentoring process where APOS member societies or associations that already have an orthodontic board or similar assist other APOS members to develop a dental board or similar that satisfies their particular country’s, society’s or association’s requirements.
To this end, the following SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis was undertaken and comments regarding the process of the development of an APBO are included [Table 1].
|Promote excellence in orthodontics in the region
Open professional development opportunities in orthodontics
Continue to raise the profile of the APOS
Differentiation of orthodontists from nonspecialist practitioners
Continued development of a positive public perception of orthodontists
Ability to utilize the breadth of knowledge within APOS membership in development of a board
Promotion of the prestigious status of obtaining board certifcation or similar
|Limited workforce of smaller countries to manage a board
Logistics to manage a board examination process for smaller associations/societies
An extensive amount of time is required to create the board examination - written if required
Necessity to develop criteria and a system for calibrating examiners
The relevance of a regional board
|Promotion of the excellence in orthodontics would raise the profile of APOS
Establishing a board could create collegial opportunities
|Conflict of interest with current boards in member associations or societies|
APOS – Asian Pacific Orthodontic Society; APBO – Asian Pacific Board of Orthodontics
Strengths, Weaknesses, Opportunities, Threats Strengths
There are numerous strengths for the APBO, and one of them is to promote excellence in orthodontics within the region. It will also provide professional development opportunities for the orthodontists, as some of the associations within the region do not have enough members and workforce to establish their own board of orthodontics or similar.
Furthermore, the APBO can continue to raise the profile of APOS and to differentiate orthodontic specialists from nonspecialist practitioners. The general public will also develop a positive perception on orthodontists.
As the APOS members possess a variety of orthodontic knowledge, the establishment of APBO will allow all members to utilize and share the breadth of knowledge among us.
The APOS has, from its inception, strived to put professional development at the pinnacle of its objectives. The completion of an orthodontic board certification process is one of the ultimate professional development experiences. Completion of an orthodontic board certification process by a large percentage of the orthodontists within the region will highlight the endeavor of orthodontists within the region to achieve excellence in orthodontics.
Once the APOB is established, it will inevitably have financial commitments related to its maintenance and administration. There will be limited workforce of the APOS to manage an APOB since many of the APOS committees are also APOS ECMs. The logistics of each board examination will be complicated as many of the APOS members are from different countries and from different educational backgrounds. There is an extensive amount of time required to create the APBO examination, and a written examination may be required.
As some of the APOS member countries already have a board structure, we will need to discuss and agree upon about the APBO structure. There are unclear or unestablished qualifications to take the APBO; these criteria can be set, but currently, there is disagreement within the ECMs on what is acceptable.
Another point that is to be sorted out is unclear or unestablished criteria to constitute the APBO examination, whether it will be written, case presentation, and/or oral examination. These can be set and agreed upon later, but there is currently disagreement within the ECMs on what is acceptable.
As for the APBO examiners, there are unclear or unestablished selection criteria for their selection, and we also need to develop criteria and a system for calibrating APBO examiners.
Finally, we all need to be clear about the need to have an APBO. The APOS has limited funds and workforce to set the APBO process in motion. An inordinate amount of time is required to select examiners, prepare and administer the examinations.
The APBO will promote the excellence in orthodontics around the region and would raise the profile of APOS. Establishing a board could also create collegial opportunities. And by having board examinations at the time of the APOC, we could potentially increase attendance to the APOC and its profile. With an increasing need for workforce for APBO, it could be seen as an opportunity to involve more members of the APOS.
There are many opportunities that could come about with the establishment of an APBO, most of which would revolve around increased participation within the APOS and attendance to the APOC.
There could be possible governmental restrictions placed on APOS member societies or associations regarding the establishment of an APBO within the country. There are also potential conflicts of interest with the current established boards in member associations or societies and we need to discuss about compromising terms and conditions.
The APBO will need to determine how difficult the APBO examinations should be. If it is too tough and unrealistic, it will be deterrence for orthodontists to submit for the APBO examination.
The APBO will have to encounter the difficulties with continuation or maintaining viability of the examination once we have established the system. And, we have to maintain the relevance of the APBO to APOS membership.
One of the largest impasses that the APBO would anticipate encountering is the governmental policies and established requirement for the existing registrable board qualifications. With this particular issue, it may be more prudent to change the title of the process to “Certified Member” of the Asian Pacific Orthodontic College or similar. It is critical that a balance between a rigorous examination to make the process meaningful with not too onerous as to deter APOS members to undergo the process. A significant amount of resources in workforce and financial backing will be required to maintain the APBO application, examination, and certification process.
Other Issues Discussed
There should be a standard for reviewing the structure of the examinations to ensure that the APBO is up to date and to determine who will review the application, examinations, and the certification process and if there is a recertification process. Will the recertification process mirror the certification process or will it include case presentations and oral examination? How often should recertification be required?
Within the APOS ECMs, there was agreement that the process of developing a board within the auspices of the APOS will be a very complex task.
Suggestions from the APOS ECMs were to focus attention to start by developing guidelines for an orthodontic board. Establishing guidelines for an orthodontic board will assist countries that currently aspire to develop a board but need assistance in the process. The recommendation from the EC was that the APOB subcommittee should continue to investigate and explore the possibility of developing an APOB with deliberation and thought given to the potential conflicts within some member associations/countries.
To this end, the SWOT analysis was undertaken regarding the process of developing guidelines for an APBO or additional orthodontic boards in the region.