RRA Requirements 2026: Eligibility, Prerequisites & How to Qualify

Who Issues RRA and What the Pathway Includes

Reconstructive Rearfoot/Ankle Surgery (RRA) is issued by the American Board of Foot and Ankle Surgery (ABFAS). It is a surgeon-level credential, so the requirements described below are about your training, licensure, surgical documentation, and examination record. If you are still sorting out what the credential is, our primer on what RRA certification is covers the basics before you dive into eligibility.

The RRA pathway has two stages. Part I is the board qualification stage, delivered in Pearson VUE test centers. It has an RRA Didactic component (80 computer-adaptive multiple-choice questions in 120 minutes) and a NEW RRA CBPS component (12 clinical simulations at 15 minutes each, 180 minutes total). Part II is the Case Review, in which eight selected surgical cases are evaluated through the Prospective Logging System (PLS). Candidates do not attend a timed examination sitting for Case Review; the evaluation is of your documented surgical work.

That structure matters for eligibility because each stage has its own gate. You cannot simply sit for an exam; you must first be qualified to apply, and later you must have the logged surgical volume to be reviewed.

Core Eligibility: Degree, Residency, Licensure

The foundational requirements are straightforward but strictly documented:

• Degree: a DPM from a CPME-accredited four-year podiatric college.
• Residency: at least three years of accredited residency that includes the required PMSR/RRA training and surgical documentation.
• Licensure: an unrestricted license to practice.
• Privileges: applicable surgical privileges.

Note the word unrestricted. A restricted or conditional license can stall an application, so resolve any licensure issues before you submit rather than after.

Why Foot Qualification Comes First

RRA is not a standalone starting point. The rule is sequential: Foot qualification is required for RRA qualification, and Foot certification is required for RRA certification. In practice, you build the Foot credential first and then layer the rearfoot/ankle reconstruction credential on top.

This has several practical consequences:

• Prerequisite Foot examinations and their associated fees are additional to the RRA costs, so your total budget is larger than the RRA line items alone. See the RRA certification cost breakdown for how the pieces add up.
• Your timeline for RRA certification is partly governed by how quickly you complete Foot certification.
• The issuer has an RRA-only logging exception for candidates who are already Foot-certified, which can change what you need to log for Case Review. Verify your status against the current logging-procedures page before assuming you are covered.

Part I Requirements and Exam-Day Rules

Once you are eligible, Part I tests you in two separate components, each scored independently. Each requires a scaled score of 500 on a 200-800 scale. That is a scaled threshold, not a raw 62.5% correct, so do not translate your practice percentages into a pass prediction. Our guide to the RRA passing score explains how to interpret scaled scoring.

RRA Didactic: What You Are Tested On

The Didactic exam maps to five topic domains, each with an official target weight and allowable range:

Surgical Procedures/Techniques carries the largest target weight at 25%. Because the exam is computer-adaptive, completed items cannot be revisited, so you must commit to an answer and move on. 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: A Separate Component

The CBPS is its own exam of 12 clinical simulations. It is organized differently from the Didactic: Domains 6-9 are Case Management Areas with official ranges (Physical Examination 20-40%, Diagnostic procedures/labs/imaging 15-35%, Diagnosis 10-30%, Treatment 15-35%), while Domains 10-19 are overlapping, unweighted Content Areas such as trauma, deformities, wound/infection, neurovascular disorders, and metabolic, rheumatologic, and inflammatory disorders. The nineteen figure is a count of serialized source headings, not a single 19-domain blueprint, and percentages should not be added across these classifications. For a deeper walkthrough, see the RRA exam domains guide.

Exam-Day Identification and Materials

• Bring two valid matching IDs.
• Books and study materials are prohibited in the testing room.
• Exams are delivered at Pearson VUE test centers, so factor in travel and scheduling.

Fee Mechanics You Should Plan For

Eligibility is not only about credentials; it is also about funding each step. The published fee structure is:

Two points deserve emphasis. First, the $225 application fee is nonrefundable and applies once per examination calendar year, so a poorly timed application can cost you. Second, prerequisite Foot examinations and their fees are separate and additional. Eligible passed final-year in-training examination components may be converted for a fee, which can reduce redundant testing but does not alter the RRA scope. Always confirm current figures on the issuer's annual fees page before budgeting. For the full financial picture, including how it compares to earnings, see the RRA certification ROI analysis.

Case Review: Logging and Selection Rules for 2027

Case Review is where many candidates underestimate the eligibility burden, because it depends on surgical volume you must have documented, not on test-taking.

The instruction to log everything required is deliberate. Logging only the minimum can leave you with too little to choose from if some cases prove unsuitable for selection. A deeper pool gives you better options when choosing the eight cases that best represent your work.

Also note that the 2027 changes should not be backdated to the Spring 2026 cycle. If you are planning around a specific window, check the current calendar on the case review exam dates and registration page, and compare it with the RRA exam dates guide.

Which Official Documents to Trust in 2026

Candidates frequently get tripped up by outdated or conflicting source documents, so it helps to know what is current:

• The Part I handbook currently linked is titled Board Qualification for Fall 2025 Examinations. It is the linked handbook, but it is not a verified 2026 calendar. Do not treat its dates as 2026 dates.
• The current Case Review authority is Information and Requirements For Board Certification, September 2026, for 2027 Case Review. Use the versioned link, which renders the September 2026 cover.
• The unversioned link to the same document has produced conflicting content, with extracted September 2026 text alongside a rendered October 2025 v1.2 version. Avoid relying on it.
• Older summaries may contain self-referential prerequisite typos, so cross-check them against the current eligibility and calendar pages.

After Certification: Maintenance Requirements

Qualifying is the start, not the finish. Initial certification lasts ten years, and maintaining it requires ongoing compliance:

• Annual status fees ($205 Board Qualified or $440 Board Certified).
• Unrestricted licensure and applicable surgical 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, which are published on the LEAD requirements pages. Because this affects long-term career planning, it pairs naturally with research on RRA earnings and the types of roles described in our RRA jobs overview.

A Sequencing Plan Built Around Your Residency Years

Rather than a generic study calendar, think of eligibility as a sequence tied to specific milestones. This is the one place where timing matters more than technique.

For Didactic preparation, anchor your schedule to the weights: spend the most time on Surgical Procedures/Techniques, then divide the remainder among Surgical Principles, Perioperative Management, and Complications. Our RRA study guide lays out a full plan, and the RRA cheat sheet is useful for last-pass review. To gauge where you stand, try questions on the main practice test site, and review the difficulty guide and pass rate data to set realistic expectations. Historical cumulative figures through Spring 2025 show 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.

Frequently Asked Questions