RRA Certification

What the RRA Certification Actually Is

The Reconstructive Rearfoot/Ankle Surgery (RRA) credential is awarded by the American Board of Foot and Ankle Surgery (ABFAS). It sits on top of the Foot pathway, so it is not an entry-level credential and it is not a standalone shortcut. It is aimed at podiatric surgeons who perform advanced reconstruction of the hindfoot and ankle and want a board credential that documents that scope of practice.

If you are new to the acronym and its many meanings elsewhere, start with our explainers on what RRA certification is and what RRA stands for. For this article, the identity is fixed: every fact below concerns ABFAS Reconstructive Rearfoot/Ankle Surgery and nothing else.

The Three Components of the Pathway

Candidates move through three distinct components, each with its own format, fee and scoring requirement. Understanding that they test different skills is the first step toward efficient preparation.

A separate $225 nonrefundable application fee applies once per examination calendar year. Prerequisite Foot examinations and their associated fees are additional, which is why a total budget is larger than the three line items above. Our RRA certification cost breakdown walks through how those layers stack up.

Inside the RRA Didactic Blueprint

The Didactic is built from five weighted Topics, each with an official target weight and an allowable range. Treat these as the spine of your preparation. The target weights and ranges are:

• Diagnostic Studies/Medical Imaging: 15% target (range 15-25%, so the stated range sets a floor that this target sits at)
• Surgical Principles: 20% target
• Surgical Procedures/Techniques: 25% target, the largest Topic
• Procedural Perioperative Management: 20% target
• Complications: 20% target

The official allowable ranges for these five Topics, in order, are 10-20%, 15-25%, 20-30%, 15-25% and 15-25%. Individual forms can drift within those ranges, so do not assume your exam will mirror the targets exactly.

For a deeper domain-by-domain treatment, see our complete guide to the RRA exam domains, and use the RRA practice test to check how each Topic feels under timed conditions.

NEW RRA CBPS and Its Case Management Areas

The NEW RRA CBPS is not a second multiple-choice exam. It is 12 clinical simulations at 15 minutes each, 180 minutes in total, and it tests how you manage a patient from presentation through treatment decisions. Its organization differs from the Didactic, and mixing the two up is a common source of confusion.

Four weighted Case Management Areas

Four CBPS areas carry official ranges:

Ten overlapping Content Areas

Layered over those are ten unweighted Content Areas that describe the clinical subject matter of the simulations: Complications/Revision, Congenital disorders (pediatrics), Congenital disorders (adult), Deformities, Perioperative management, Neoplastic disorders, Neurovascular disorders, Trauma, Wound/Infection, and Metabolic, rheumatologic, and inflammatory disorders.

A practical consequence: a single simulation might be a trauma case (Content Area) in which you are scored on your physical examination, imaging selection, diagnosis and treatment (Case Management Areas). Prepare for the overlap rather than studying each heading in isolation.

RRA Case Review and Surgical Logging

Part II is unlike anything in Part I. There is no timed sitting. Instead, ABFAS evaluates eight selected surgical cases through its PLS system, and the quality of your documentation and operative decision-making is what gets reviewed. The preparation begins years earlier, in how you log cases during and after residency.

2027 logging requirements

• At least 30 logged cases must contain an RRA-eligible procedure.
• Eight selectable RRA core-procedure cases must come from unique patients.
• Log all required post-residency surgeon-of-record cases, not just the minimum, so you have a full pool to choose your eight from.
• The issuer has an RRA-only logging exception for candidates who are already Foot-certified.

Case Review authority comes from the September 2026 document, Information and Requirements For Board Certification, for 2027 Case Review. Because older renderings of ABFAS documents conflict, always confirm eligibility against the current ABFAS eligibility and calendar pages. Our RRA exam dates guide covers timing and scheduling.

Eligibility, Fees and Registration Mechanics

Requirements are cumulative and strict. To qualify, you need a DPM from a CPME-accredited four-year podiatric college, at least three years of accredited residency with the required PMSR/RRA training and surgical documentation, unrestricted licensure and applicable surgical privileges.

The Foot linkage is the detail candidates most often underestimate:

• Foot qualification is required for RRA qualification.
• Foot certification is required for RRA certification.
• Certification is normally required within seven years of qualification, with exceptions for certain pre-2014 residency candidates.
• Eligible passed final-year in-training examination components may be converted for a fee, which does not change the RRA scope.

For the full eligibility walk-through, read our RRA requirements guide. One caution on documents: the currently linked Part I handbook is titled Board Qualification for Fall 2025 Examinations. It is not a verified 2026 calendar, so verify dates and windows with ABFAS directly.

Scoring and Historical Pass Rates

Each Part I component requires a scaled score of 500 on a 200-800 scale. This is not the same as 62.5% correct, and you should not try to reverse-engineer a raw-score target. Because the Didactic is computer-adaptive and may include unscored field-test items with no fixed scored/unscored split assigned, a simple percent-correct calculation will mislead you. See our RRA passing score explainer for more detail.

ABFAS publishes historical cumulative pass rates through Spring 2025:

Exam-Day Rules and Adaptive Testing Reality

Pearson VUE delivers Part I in test centers. You must present two valid matching IDs, and books or study materials are prohibited in the testing room. Plan your identification well before test day, because a mismatch between your registration name and your IDs can derail an otherwise perfect preparation.

The Didactic being computer-adaptive changes how you should behave in the room:

• Completed items cannot be revisited, so there is no flag-and-return strategy.
• Pacing matters: 80 questions in 120 minutes leaves time to think, but not to dwell indefinitely on one item.
• Some items may be unscored field-test questions, so a strange or unusually difficult item is not necessarily a sign you are failing.
• Commit to your best answer, then mentally reset before the next question.

Practice under these conditions in the RRA practice test, where the one-way navigation habit is worth building in advance.

Sequencing Your Preparation Around the Blueprint

Rather than a generic schedule, sequence your study by blueprint weight and by dependency. Surgical Procedures/Techniques is the largest Topic at a 25% target, and Surgical Principles supports it, so build principles first and then layer techniques on top. Complications and perioperative management are best studied alongside the procedures they follow, because the questions often link a technique to its failure modes.

For a fuller plan, see our RRA study guide, and keep the RRA cheat sheet handy for last-week review. The timeline above is a template; adjust the pacing to the weeks you actually have before your testing window.

Keeping the Credential After You Earn It

Initial certification lasts ten years, but holding it requires ongoing compliance. Maintenance includes:

• Annual fees ($205 for Board Qualified status, $440 for Board Certified status)
• Unrestricted licensure and applicable surgical privileges
• Recent-surgery attestation
• 100 Category 1 and/or CPME-approved CME hours per five-year period
• LEAD participation

New time-limited cohorts complete at least 12 LEAD quarters in each five-year period and meet the applicable performance standard. RRA requires its own MDT standard but no participation quarters beyond Foot. Older cohorts follow transition schedules, so check the LEAD requirements pages at ABFAS to see which applies to you.

If you are weighing whether the investment pays off, our analyses of whether RRA certification is worth it and the RRA salary guide take up the career side, and RRA jobs covers where this credential is valued. Orthopedic-podiatric group practices, hospital-based foot and ankle services and academic training programs are the settings where reconstructive rearfoot and ankle expertise is most relevant.

Frequently Asked Questions