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