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What is the American Board’s Certification
Process?What Does it Mean?
Conflict of Interest?
I am unaware of any!
Wish I Did!
My 401-K has become a 401-Y
Educational Objective #1
At the end of the presentation learners
should be familiar with the process of certification by
the American Board.
Educational Objective #2
At the end of the presentation learners should have a general idea about the
process of Maintenance of Certification.
Educational Objective #3
At the end of the presentation learners should understand the differences between the
American Board and the American College.
Present “Gold Standard” for Medical School Teaching
Evidence Based Medicine
I Tell Stories
More fun and entertaining
Recently Received a Summons
For Jury Duty
County Court
#135 Citizens
Goal
12 Jurors and 1 Alternate
First Degree Murder Trial!
Friends who are Lawyers reassured me
No way would I be selected!
Six Definite Disqualifications
• 75 years of age and forgetful• Insulin dependent diabetic with
frequent hypoglycemic attacks• Severe spinal stenosis requiring
multiple drugs including narcotics
Six Definite Disqualifications
• Appeared to be hard of hearing• Pulled nose hair resulting in active tears• Defense lawyer called computer nerds
and docs “techies” and announced in court these individuals are poor jurors
Charming and Brilliant Judge
However there was a candidate who
interrupted the judge on two different occasions
Key Phrase
“I Am Schizophrenic”
Do Not Be Timid - Be Loud!
One of my best friend’s during my 30’s was a young
Lawyer
One night I challenged him with the following:
“I am amazed how poorly laws are written.”
Colorado Good Samaritan Law
Wonderful law---- granted absolute immunity to a doctor who cared for an injured victim and the second clause was---
Second Clause:
The doctor must assume the responsibility to ride in the ambulance and transfer the patient to another physician of equal or greater medical ability.
Obviously, I would have to spend the rest
of my life with the injured patient.
Initial Board Certification
1. Multiple-choice computer exam
2. Three hour oral exam
Requirements for Written Exam
1. Doctor of Medicine or Osteopathy
2. Unrestricted State Medical License
3. Hospital Privileges
4. Completed 48 months of Residency Training
Program Director’s letter certifying candidate has:
1. Completed necessary training
2. Achieved knowledge, ability, and judgment3. Demonstrated technical skills4. Demonstrated good moral and ethical character
Blueprint of Written
Exam is Published
Written Bulletin orwww.abog.org
Content of Exam• 250 questions
30% obstetrics30% gynecology30% office practice and preventative medicine
10% cross content
Questions• Multiple choice questions with
single best answer• Questions developed to be thought
provoking and / or problem solving
Written Exam• When- Last Monday in June
• Where- Multiple Computer Testing Sites (Pearson-VUE)
Written Exam Results
Total
1611
Passed
1226
(76%)
Failed
385
(24%)
Total
1564
Passed
1164
(74%)
Failed
402
(26%)
2009
2008
Fees for 2009 Written Exam
• Application Fee $735.00
• Examination Fee $675.00
• Total Fees 1410.00
“Board Eligible” is slang (no meaning)
Past, present, future
ABMS has revisited this problem three times
Requirements for Oral Exam
• Passing grade on written exam
• Hospital inquiry– Moral and ethical character– Unrestricted license– Unsupervised practice
Case Lists (HIPPA de-identified)
• All patients in all hospitals for the past 12 months
• Alternative- cases from senior year of residency
• Affidavit from record room
Content of Oral Exam
• Obstetrics: one hour, two examiners
• Gynecology: one hour, two examiners
• Office practice: one hour, two examiners
Questions
• 50% from case lists• 50% from prepared cases by
committee of the Board• Emphasis- differential diagnosis,
evaluation, and management
Blueprint of Oral Exam
is Published
Oral Exam- When
• One week in November, December or January– 18-30 months after residency– 18 months- accelerated oral exam– 30 months- usual and customary
Oral Exam-Where
•OB-GYN Exam Center–Dallas, Texas–50 rooms–Sound proof with audio and TV monitoring
Oral Exam Results
Total
1266
Passed
1072
(85%)
Failed
194
(15%)
Total
1247
Passed
1056
(85%)
Failed
191
(15%)
2008
2007
Fees for 2009 Oral Exam
• Application Fee $805.00
• Examination Fee $935.00
• Total Fees 1740.00
Subspecialties• Gynecologic Oncology• Maternal-Fetal Medicine• Reproductive
Endocrinology and Infertility
Subspecialty Training
• Three years
•Written and Oral Exams
•Defense of Thesis
Maintenance of Certification
• Formal process began January 1, 2008
• Stimulus– ABMS- Pressure from above– IOM publication– Board does it or government will
Presently Four Parts
1. Professional Standing (Federation of State Medical Boards)
2. Lifetime Education (ABC)3. Cognitive Expertise (Computer
Exam, once in six years)4. Practice Performance and Self
Assessment (Continuous Quality Improvement)
Large Problems and Obstacles
• “Everyone wants to get into the act”
• Multiple add-ons• Recession blunting retirement
plans• MOC encouraging retirement
plans
Large Problems and Obstacles
• Expensive• Lack of enthusiasm• End points in CQI• Failure rate in computer exam
Comparisons
Home Dallas, Texas Washington DC
Territory USA USA and Central America
Emphasis Certification Process
Education and Politics
ABOG ACOG
Comparisons
Type of Organization
Small Board Large Membership
Size of Organization
20-25 Members
Thousands
Constituency Diplomates Fellows
ABOG ACOG
Comparisons
Initial Fees
Annual Fees
Sizable
Minimal
Minimal
Sizable
Voting by Constituency
Never Yes like Russia
Listens to Constituency
“Needs Hearing Aids”
Yes conducts frequent surveys
ABOG ACOG
ABOG and ACOG
• Great mutual respect
• Several cooperative projects
• “Switch Hitters” are common
Summary
Certification by The American Board of Obstetrics and Gynecology attests to the physician’s professional colleagues and to the public that the diplomate possesses special knowledge and capability.
Learn as if you were to live forever
Live as if you were to die tomorrow
John Wooden