- What This Cheat Sheet Covers (and Doesn't)
- The RRA Pathway at a Glance
- RRA Didactic Blueprint: Five Weighted Topics
- NEW RRA CBPS: Case Management and Content Areas
- Format, Timing and Scoring Numbers
- Fees, Eligibility and Calendar Facts
- Case Review: Logging Rules for 2027
- Exam-Day Rules That Trip Candidates Up
- After Certification: Maintenance Basics
- Scheduling Review by Domain Weight
- Frequently Asked Questions
- RRA here means Reconstructive Rearfoot/Ankle Surgery, certified through the American Board of Foot and Ankle Surgery (ABFAS).
- Surgical Procedures/Techniques carries the largest didactic target weight at 25%.
- Each Part I component needs a scaled score of 500 on a 200-800 scale, not 62.5% correct.
- RRA Didactic is 80 adaptive questions in 120 minutes; completed items cannot be revisited.
What This Cheat Sheet Covers (and Doesn't)
This page condenses the must-know facts for the Reconstructive Rearfoot/Ankle Surgery (RRA) pathway into a single scannable review. It is built for candidates who have already started preparing and want a fast reference for the numbers, rules and content areas that show up repeatedly. If you are still orienting yourself, start with What Is RRA Certification? and then return here.
One clarification matters before anything else: the facts below describe only the ABFAS Reconstructive Rearfoot/Ankle Surgery credential. Other credentials abbreviate to the same letters, and their fees, dates and formats do not apply. Every figure on this sheet traces to ABFAS materials, and where the issuer has not published a number, this article says so rather than guessing.
The RRA Pathway at a Glance
The full RRA pathway has two parts. Part I covers qualification and itself has two exam components. Part II is Case Review, which leads to certification.
| Stage | Component | Format | Key Fact |
|---|---|---|---|
| Part I | RRA Didactic | 80 computer-adaptive multiple-choice questions, 120 minutes | Pearson VUE test center |
| Part I | NEW RRA CBPS | 12 clinical simulations, 15 minutes each, 180 minutes total | Scored separately from Didactic |
| Part II | RRA Case Review | Eight selected surgical cases evaluated through PLS | No timed examination sitting |
Two linkage rules are easy to forget. Foot qualification is required for RRA qualification, and Foot certification is required for RRA certification. Prerequisite Foot examinations carry their own fees on top of the RRA costs. For the full eligibility picture, see RRA Requirements 2026.
RRA Didactic Blueprint: Five Weighted Topics
The didactic exam is organized around five Topics, each with an official target weight and an allowable range. The target weights are the numbers to plan around; the ranges explain why your individual exam may lean heavier or lighter in a given area.
| Domain | Target Weight | Allowable Range |
|---|---|---|
| 1. Diagnostic Studies/Medical Imaging | 15% | 10-20% |
| 2. Surgical Principles | 20% | 15-25% |
| 3. Surgical Procedures/Techniques | 25% | 20-30% |
| 4. Procedural Perioperative Management | 20% | 15-25% |
| 5. Complications | 20% | 15-25% |
Domain 3: Surgical Procedures/Techniques (25%)
The heaviest Topic and the one where depth pays off most. Expect questions that ask you to select, sequence or troubleshoot an operative approach for rearfoot and ankle reconstruction.
- Know indications and contraindications for each reconstructive option, not just the steps.
- Be able to compare alternative techniques for the same deformity.
- Link technique choice to fixation, soft-tissue and perioperative consequences.
Domain 1: Diagnostic Studies/Medical Imaging (15%)
The lightest weighted Topic, but it feeds every other area because imaging interpretation drives surgical decisions.
- Practice reading rearfoot and ankle studies and naming what they change in the plan.
- Know which study answers which clinical question.
Domains 2, 4 and 5: The 20% Trio
Surgical Principles, Procedural Perioperative Management and Complications each carry a 20% target, and together they make up 60% of the didactic blueprint. Candidates who study only operative technique leave a large share of the exam under-prepared.
- Surgical Principles: the reasoning that sits beneath technique selection.
- Perioperative Management: preparation, intraoperative decisions and postoperative care tied to specific procedures.
- Complications: recognition, prevention and management, often presented as a scenario you must resolve.
For a deeper walkthrough of how these Topics are tested, read RRA Exam Domains 2026: Complete Guide to All 19 Content Areas.
NEW RRA CBPS: Case Management and Content Areas
The NEW RRA CBPS is a separate component built around clinical simulations. Its source headings fall into two different classifications, and mixing them up is a common mistake.
Case Management Areas (Domains 6-9)
These four areas have official ranges. They follow the logic of a clinical encounter:
| Case Management Area | Official Range |
|---|---|
| 6. Physical Examination | 20-40% |
| 7. Diagnostic procedures/labs/imaging | 15-35% |
| 8. Diagnosis | 10-30% |
| 9. Treatment | 15-35% |
Content Areas (Domains 10-19)
These ten areas are overlapping and unweighted. They describe the clinical subject matter the simulations draw from:
- Complications/Revision
- Congenital disorders (pediatrics)
- Congenital disorders (adult)
- Deformities
- Perioperative management
- Neoplastic disorders
- Neurovascular disorders
- Trauma
- Wound/Infection
- Metabolic, rheumatologic, and inflammatory disorders
Practically, this means a CBPS simulation might present a neurovascular or wound/infection problem (a Content Area) and ask you to work through examination, workup, diagnosis and treatment (the Case Management Areas). Prepare for both layers at once.
Format, Timing and Scoring Numbers
- RRA Didactic: 80 computer-adaptive multiple-choice questions in 120 minutes. Some items may be unscored field-test questions, but no fixed scored/unscored split is assigned, so treat every question as if it counts.
- NEW RRA CBPS: 12 clinical simulations at 15 minutes each, 180 minutes total.
- Case Review: eight selected surgical cases evaluated through PLS, with no timed sitting.
- Passing standard: a scaled score of 500 on a 200-800 scale for each Part I component.
Key Takeaway
The 500 scaled score is not a percentage. Because the didactic exam is computer-adaptive, a score of 500 cannot be converted into "62.5% correct." Stop doing raw-percentage math and focus on consistent accuracy across all five Topics. The details are in RRA Passing Score 2026.
For context on difficulty, ABFAS publishes historical cumulative pass rates through Spring 2025: 54% (211/394) for 2025-residency-class RRA Didactic, 89% (353/398) for that class's CBPS, and 79% (19/24) for 2023-residency-class RRA Case Review. These are cumulative figures for specific residency classes. They are not first-attempt rates and they are not 2026 rates. The gap between Didactic and CBPS is worth noting, and RRA Pass Rate 2026 and How Hard Is the RRA Exam? unpack what it may and may not mean.
Fees, Eligibility and Calendar Facts
Fee Table
| Item | Amount | Note |
|---|---|---|
| Application | $225 | Nonrefundable; once per examination calendar year |
| RRA Didactic | $475 | Part I component |
| NEW RRA CBPS | $475 | Part I component |
| RRA Case Review | $550 | Part II |
| Annual status: Board Qualified | $205 | Per year |
| Annual status: Board Certified | $440 | Per year |
Prerequisite Foot examinations and their fees are additional. A full budget therefore exceeds the RRA line items alone. See RRA Certification Cost 2026 for a planning breakdown.
Eligibility Checklist
- DPM from a CPME-accredited four-year podiatric college.
- At least three years of accredited residency, with required PMSR/RRA training and surgical documentation.
- Unrestricted licensure and applicable surgical privileges.
- Foot qualification for RRA qualification; Foot certification for RRA certification.
Certification is normally required within seven years of qualification, with exceptions for pre-2014 residency. Eligible passed final-year in-training examination components may be converted for a fee, which does not change the RRA scope. Details on timing sit in RRA Exam Dates 2026, and the eligibility narrative is in RRA Requirements 2026.
Case Review: Logging Rules for 2027
Part II rewards candidates who log carefully from the start of practice. The 2027 rules, drawn from the September 2026 document, are specific:
- At least 30 logged cases must contain an RRA-eligible procedure.
- Within those, 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 deeper pool to select from.
- The issuer has an RRA-only logging exception for candidates already Foot-certified.
Because case selection happens after logging, a thin log limits your options. Treat logging as ongoing documentation rather than a pre-exam project.
Exam-Day Rules That Trip Candidates Up
- Two valid matching IDs are required for Part I.
- No books or study materials are allowed in the testing room.
- Pearson VUE test centers deliver Part I; it is not a remote experience.
- No going back: completed computer-adaptive items cannot be revisited, so a flagged-and-return strategy does not exist on the didactic exam.
Key Takeaway
Because you cannot revisit answered items, practice committing to an answer within a fixed time budget. With 80 questions in 120 minutes, you have roughly a minute and a half per item on average, so rehearse making a decision and moving on.
Official practice material is login-gated, and paid or gated questions were not reviewed for this article. For independent, domain-organized practice, use the RRA practice test platform.
After Certification: Maintenance Basics
Initial certification lasts ten years. Maintenance includes:
- Annual status fees.
- Unrestricted licensure and privileges.
- A 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 published on the ABFAS LEAD requirement pages. If you are weighing whether the investment is worthwhile, Is the RRA Certification Worth It? and the RRA Salary Guide cover the career side, and RRA Jobs looks at where the credential matters in hiring.
Scheduling Review by Domain Weight
Rather than a generic weekly template, tie your calendar to the blueprint. The sequence below front-loads the heaviest Topic and saves integration for the end. For a fuller plan, see the RRA Study Guide.
Domain 3: Surgical Procedures/Techniques
- Largest target weight at 25%, so it gets the longest block.
- Build comparison tables of techniques, indications and pitfalls.
Domains 2 and 4: Principles and Perioperative Management
- Two 20% Topics that explain why technique choices are made.
Domain 5: Complications
- Study after technique so complications attach to specific procedures.
Domain 1: Imaging, then CBPS simulation practice
- Pair imaging review with timed 15-minute case walk-throughs across the Content Areas.
Finish with timed, mixed-domain practice. The main practice test site is built for exactly this kind of cumulative review.
Frequently Asked Questions
It stands for Reconstructive Rearfoot/Ankle Surgery, certified through the American Board of Foot and Ankle Surgery (ABFAS). See What Does RRA Stand For? for background.
Surgical Procedures/Techniques, with a 25% target weight and an allowable range of 20-30%.
No. Each Part I component requires a scaled score of 500 on a 200-800 scale, and that does not convert to a raw percentage correct.
No. The didactic exam is computer-adaptive, and completed items cannot be revisited.
At least 30 logged cases must contain an RRA-eligible procedure, including eight selectable RRA core-procedure cases from unique patients. Logging all required post-residency surgeon-of-record cases is recommended rather than stopping at the minimum.