What is the American Board

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What is the American Boards Certification
Process?What Does it Mean?
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Conflict of Interest?

• I am unaware of any!

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Wish I Did!

• My 401-K has become a 401-Y

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Educational Objective 1

• At the end of the presentation learners should be
  familiar with the process of certification by the
  American Board.

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Educational Objective 2

• At the end of the presentation learners should
  have a general idea about the process of
  Maintenance of Certification.

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Educational Objective 3

• At the end of the presentation learners should
  understand the differences between the American
  Board and the American College.

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Present Gold Standard for Medical School
Teaching

• Evidence Based Medicine

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I Tell Stories

• More fun and entertaining

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Recently Received a Summons

• For Jury Duty
• County Court

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135 Citizens

• Goal
• 12 Jurors and 1 Alternate

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First Degree Murder Trial!

• Friends who are Lawyers reassured me
• No way would I be selected!

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Six Definite Disqualifications

• 75 years of age and forgetful
• Insulin dependent diabetic with frequent
  hypoglycemic attacks
• Severe spinal stenosis requiring multiple drugs
  including narcotics

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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

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Charming and Brilliant Judge

• However there was a candidate who interrupted the
  judge on two different occasions

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Key Phrase

• I Am Schizophrenic
• Do Not Be Timid - Be Loud!

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One of my best friends during my 30s was a
young Lawyer
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One night I challenged him with the
followingI am amazed how poorly laws are
written.
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Colorado Good Samaritan LawWonderful law----
granted absolute immunity to a doctor who cared
for an injured victim and the second clause was---
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Second ClauseThe doctor must assume the
responsibility to ride in the ambulance and
transfer the patient to another physician of
equal or greater medical ability.
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Obviously, I would have to spend the rest of my
life with the injured patient.
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Initial Board Certification

• Multiple-choice computer exam
• Three hour oral exam

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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

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Program Directors letter certifying candidate
has1. Completed necessary training
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2. Achieved knowledge, ability, and judgment3.
Demonstrated technical skills4. Demonstrated
good moral and ethical character
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Blueprint of Written Exam is PublishedWritten
Bulletin orwww.abog.org
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Content of Exam

• 250 questions
• 30 obstetrics
• 30 gynecology
• 30 office practice and preventative medicine
• 10 cross content

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Questions

• Multiple choice questions with single best answer
• Questions developed to be thought provoking and /
  or problem solving

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Written Exam

• When- Last Monday in June
• Where- Multiple Computer Testing Sites
  (Pearson-VUE)

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Written Exam Results
Total 1611 Passed 1226 (76) Failed 385 (24)
Total 1564 Passed 1164 (74) Failed 402 (26)
2008
2009
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Fees for 2009 Written Exam

• Application Fee 735.00
• Examination Fee 675.00
• Total Fees 1410.00

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Board Eligible is slang (no meaning)

• Past, present, future
• ABMS has revisited this problem three times

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Requirements for Oral Exam

• Passing grade on written exam
• Hospital inquiry
• Moral and ethical character
• Unrestricted license
• Unsupervised practice

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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

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Content of Oral Exam

• Obstetrics one hour, two examiners
• Gynecology one hour, two examiners
• Office practice one hour, two examiners

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Questions

• 50 from case lists
• 50 from prepared cases by committee of the Board
• Emphasis- differential diagnosis, evaluation, and
  management

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Blueprint of Oral Exam is Published
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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

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Oral Exam-Where

• OB-GYN Exam Center
• Dallas, Texas
• 50 rooms
• Sound proof with audio and TV monitoring

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Oral Exam Results
Total 1266 Passed 1072 (85) Failed 194 (15)
Total 1247 Passed 1056 (85) Failed 191 (15)
2007
2008
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Fees for 2009 Oral Exam

• Application Fee 805.00
• Examination Fee 935.00
• Total Fees 1740.00

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Subspecialties

• Gynecologic Oncology
• Maternal-Fetal Medicine
• Reproductive Endocrinology and Infertility

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Subspecialty Training

• Three years
• Written and Oral Exams
• Defense of Thesis

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Maintenance of Certification

• Formal process began January 1, 2008
• Stimulus
• ABMS- Pressure from above
• IOM publication
• Board does it or government will

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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)

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Large Problems and Obstacles

• Everyone wants to get into the act
• Multiple add-ons
• Recession blunting retirement plans
• MOC encouraging retirement plans

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Large Problems and Obstacles

• Expensive
• Lack of enthusiasm
• End points in CQI
• Failure rate in computer exam

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Comparisons
ABOG
ACOG
Home Dallas, Texas Washington DC
Territory USA USA and Central America
Emphasis Certification Process Education and Politics
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Comparisons
ABOG
ACOG
Type of Organization Small Board Large Membership
Size of Organization 20-25 Members Thousands
Constituency Diplomates Fellows
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Comparisons
ABOG
ACOG
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
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ABOG and ACOG

• Great mutual respect
• Several cooperative projects
• Switch Hitters are common

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Summary

• Certification by The American Board of Obstetrics
  and Gynecology attests to the physicians
  professional colleagues and to the public that
  the diplomate possesses special knowledge and
  capability.

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Learn as if you were to live foreverLive as if
you were to die tomorrow

• John Wooden