- What "RRA Jobs" Actually Means
- Who Hires Reconstructive Rearfoot/Ankle Surgeons
- What the Work Looks Like Day to Day
- Clinical Domains That Shape Job Readiness
- The Credential Pathway Employers Look For
- Fees and Status Costs to Plan Around
- Case Logging: The Career Habit Behind the Credential
- Sequencing Exam Prep Around a Job Search
- Keeping the Credential Active After You're Hired
- Frequently Asked Questions
- RRA here means Reconstructive Rearfoot/Ankle Surgery, certified through the American Board of Foot and Ankle Surgery (ABFAS).
- Foot qualification is required for RRA qualification; Foot certification is required for RRA certification.
- Part I is 80 adaptive didactic questions plus 12 CBPS simulations; Part II is a Case Review of eight surgical cases.
- Initial certification lasts ten years, with annual fees of $205 Board Qualified or $440 Board Certified.
What "RRA Jobs" Actually Means
Searching for "RRA jobs" can be confusing, because the phrase is not a job title. Reconstructive Rearfoot/Ankle Surgery (RRA) is a credential, administered by the American Board of Foot and Ankle Surgery (ABFAS), that signals a podiatric surgeon has demonstrated competence in complex surgery of the hindfoot, ankle, and related structures. Employers do not usually post a vacancy for an "RRA"; they post for foot and ankle surgeons, and the RRA credential is one of the qualifications that separates candidates.
If you are new to the terminology, our explainers on what RRA is and what RRA certification is cover the basics. This article focuses on the career side: where the credential matters, what hiring managers and credentialing committees tend to look for, and how to sequence your certification milestones so they support rather than delay your first job.
Who Hires Reconstructive Rearfoot/Ankle Surgeons
Podiatric surgeons with rearfoot and ankle training work across several practice settings. The credential travels with you into any of them, but the way it is valued differs.
| Practice Setting | How RRA Status Tends to Matter |
|---|---|
| Hospital-employed surgical groups | Medical staff bylaws and privileging committees often reference board status; reconstructive privileges may be easier to document with qualification or certification in hand. |
| Multispecialty orthopedic or sports medicine groups | Board standing helps establish credibility with physician colleagues who may be less familiar with podiatric surgical training. |
| Private podiatric practices | Partners and buy-in discussions often weigh certification progress as evidence of long-term commitment to surgical practice. |
| Academic centers and residency programs | Faculty roles frequently expect or encourage board certification, and the credential supports teaching and mentorship of residents. |
| Trauma and limb-preservation programs | Surgeons who handle complications, infection, and complex deformity benefit from documented reconstructive competence. |
Specific requirements vary by employer, payer panel, and hospital. Treat the table above as a pattern, not a rule, and always ask directly what a given employer requires and by when.
What the Work Looks Like Day to Day
Reconstructive rearfoot and ankle surgeons spend their time on a blend of clinic evaluation and operative care. A realistic week often includes new-patient consultations, postoperative follow-up, imaging review, pre-operative planning, and operating room time. The reconstructive emphasis means a larger share of cases involve deformity correction, post-traumatic problems, revision work, and the management of complications than in a purely forefoot or routine practice.
That reality is the reason the examination is built the way it is. The RRA Didactic is not a test of isolated facts; it asks you to reason through diagnosis, surgical choice, perioperative management, and what to do when things go wrong. The same reasoning is what a medical director or surgical colleague will expect from you in your first year of practice.
Clinical Domains That Shape Job Readiness
The ABFAS Part I objectives are organized into several classifications, and the structure is worth understanding because it mirrors how a working surgeon thinks. The RRA Didactic uses five topics with target weights and allowable ranges; the separate CBPS simulations use Case Management Areas and Content Areas. These are different classifications, so percentages should never be added across them.
RRA Didactic Topics (Domains 1-5)
These five areas make up the weighted didactic blueprint, with allowable ranges of 10-20%, 15-25%, 20-30%, 15-25%, and 15-25% respectively.
- Diagnostic Studies/Medical Imaging (15% target): interpreting radiographs, CT, MRI, and other studies that drive reconstructive planning.
- Surgical Principles (20%): fixation concepts, soft-tissue handling, and the reasoning behind operative choices.
- Surgical Procedures/Techniques (25%, the largest target): the procedures a reconstructive rearfoot/ankle surgeon is expected to perform and justify.
- Procedural Perioperative Management (20%): preparation, anesthesia considerations, and postoperative protocols.
- Complications (20%): recognizing, preventing, and managing what goes wrong.
CBPS Case Management Areas (Domains 6-9)
The clinical simulations are scored through four management areas with official ranges.
- Physical Examination (20-40%)
- Diagnostic procedures/labs/imaging (15-35%)
- Diagnosis (10-30%)
- Treatment (15-35%)
CBPS Content Areas (Domains 10-19)
These overlapping, unweighted content areas describe the clinical territory the simulations can draw from.
- Complications/Revision and Perioperative management
- Congenital disorders (pediatrics) and Congenital disorders (adult)
- Deformities, Neoplastic disorders, and Neurovascular disorders
- Trauma, Wound/Infection, and Metabolic, rheumatologic, and inflammatory disorders
The "19" figure is simply the count of serialized source headings, not a single 19-domain blueprint. For a full walkthrough, see our guide to all 19 RRA content areas. From a job-readiness standpoint, notice how heavily the content areas lean toward the problems that hospital and trauma-oriented practices see constantly: deformity, trauma, infection, revision, and complications.
The Credential Pathway Employers Look For
Hiring conversations usually reference where you are on the pathway rather than only whether you are finished. Understanding the stages lets you speak precisely about your status.
Eligibility foundations
ABFAS requires 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. Foot qualification is required for RRA qualification, and Foot certification is required for RRA certification. Our RRA requirements guide goes through eligibility in more detail.
Part I: qualification
Part I is delivered in Pearson VUE test centers and has two components:
- RRA Didactic: 80 computer-adaptive multiple-choice questions in 120 minutes. Some items may be unscored field-test questions, but there is no fixed scored/unscored split. Completed adaptive items cannot be revisited.
- NEW RRA CBPS: 12 clinical simulations at 15 minutes each, for 180 minutes total.
Each component requires a scaled score of 500 on a 200-800 scale. That is not the same as 62.5% correct, so avoid translating it into a raw percentage; see our explanation of the RRA passing score. Two valid matching IDs are required, and books or study materials are prohibited in the testing room.
Part II: Case Review
Case Review evaluates eight selected surgical cases through the PLS logging system. There is no timed examination sitting; the evidence is your documented surgical work. Certification is normally required within seven years of qualification, with exceptions for certain pre-2014 residency graduates.
Fees and Status Costs to Plan Around
Negotiating an offer without knowing your credentialing costs is a common blind spot. Some employers reimburse board fees, CME, or exam travel, and it helps to ask with exact figures in hand.
| Item | Amount |
|---|---|
| Application (nonrefundable, once per examination calendar year) | $225 |
| RRA Didactic | $475 |
| NEW RRA CBPS | $475 |
| RRA Case Review | $550 |
| Annual status fee, Board Qualified | $205 |
| Annual status fee, Board Certified | $440 |
Prerequisite Foot examinations and their fees are additional, so the all-in cost of reaching RRA certification is higher than the RRA line items alone. Our RRA certification cost breakdown lays out the full picture, and the RRA salary guide and ROI analysis help you weigh those costs against earnings potential.
Case Logging: The Career Habit Behind the Credential
The single most career-relevant habit in this entire pathway is consistent case logging. Case Review is built on your own surgical record, so the quality of that record shapes both your certification timeline and, indirectly, how smoothly you move through hospital credentialing.
For 2027 RRA Case Review, at least 30 logged cases must contain an RRA-eligible procedure, including eight selectable RRA core-procedure cases from unique patients. The practical advice is to log all required post-residency surgeon-of-record cases rather than stopping at the minimum, because a larger pool gives you better choices when selecting your eight. There is an issuer exception allowing RRA-only logging for candidates who are already Foot-certified. Do not assume the 2027 changes applied to Spring 2026, as they should not be backdated.
Key Takeaway
When you accept a position, ask about case volume and your role as surgeon of record. A job that gives you early reconstructive cases with real responsibility speeds your logging; a job that keeps you as assistant can quietly stall your Case Review timeline.
Sequencing Exam Prep Around a Job Search
Most candidates are balancing new-practice demands with exam preparation, so timing matters. This is the one place a short scheduling framework earns its keep, and it should follow the exam's own weighting rather than a generic calendar. Our RRA study guide covers methodology in depth; here is how to map preparation to the actual blueprint.
Build the heavy domains first
- Start with Surgical Procedures/Techniques, the 25% target and largest didactic topic.
- Pair it with Surgical Principles so technique choices are tied to underlying reasoning.
Layer in management and failure modes
- Cover Procedural Perioperative Management and Complications together, since each is a 20% target.
- Add Diagnostic Studies/Medical Imaging for pattern recognition on films.
Shift to simulation-style reasoning
- Rehearse the examination, diagnosis, and treatment flow that the CBPS case management areas test.
- Review deformity, trauma, wound/infection, and revision scenarios.
Check current RRA exam dates and scheduling windows before committing to a start date, and use a one-page review sheet for final consolidation. If you want a realistic sense of difficulty before you plan around a job start, read how hard the RRA exam is. When you are ready to test yourself, our RRA practice test lets you work through questions in a format built for this exam.
Keeping the Credential Active After You're Hired
Initial certification lasts ten years, but maintenance begins immediately. Employers and credentialing committees generally expect you to stay in good standing, and the requirements are concrete:
- Annual fees and unrestricted licensure
- Applicable surgical privileges and 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, which you can confirm on the ABFAS LEAD requirements page. If an employer offers CME funds, this is the obligation they are helping you meet.
Frequently Asked Questions
No. RRA is a credential, not a title. Search for foot and ankle surgeon, podiatric surgeon, or reconstructive foot and ankle roles, then look for postings that mention board qualification or certification. Reading about what RRA means helps you interpret postings correctly.
Not always. Many employers hire new graduates who are working toward qualification or certification, but requirements differ by employer, hospital, and payer. Ask each employer what they require and by what date.
No. Foot qualification is required for RRA qualification, and Foot certification is required for RRA certification. Plan both tracks together and budget for the additional prerequisite Foot examinations.
ABFAS reports cumulative rates through Spring 2025 of 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 not first-attempt or 2026 rates, but they suggest building buffer time for the didactic. See our RRA pass rate analysis for context.
Start with our overview of RRA training and the broader RRA certification page, then confirm current rules directly with ABFAS, since handbooks and calendars are updated periodically.