Endurance test: Quest for quality leads to a never-ending road to board recertification

Internists hope their specialty board can reduce some of the curves along the way. Other groups will likely follow its lead.

By Jay Greene, AMNews staff. March 11, 2002.

Theodore Li, MD, a general internist in Washington, D.C., is getting an early start on the circuitous road toward board recertification. Like thousands of other internists, Dr. Li wants to pace himself over the next few years to avoid having to cram all required recertification tasks into the last year or two. Internal medicine now requires five mini-tests or assessments and a final general knowledge examination that most likely contains medical problems he won't have faced in practice.

"I have completed [four of five] modules" of the American Board of Internal Medicine's new recertification system, Dr. Li said. "The questions were challenging -- none of them were the type you could answer cold. They all required some research into texts or review articles. Although the topics were often niche areas and somewhat esoteric, the point was not for me to acquire medical minutiae. Rather, the questions propelled me to examine my methods of information retrieval. I wasn't so much picking up clinical pearls; I was learning how better to pearl dive."

Nearly 12,000 internists like Dr. Li are in ABIM's recertification process -- now called "continuous professional development," or CPD. Thousands of other physicians face recertification in their specialties. But even for competent physicians, general medical knowledge tests are a challenge. Failure rates vary, depending on the year and specialty. For example, 8% of family physicians failed on their first attempt in 1999, and 13% of internists initially failed in 2000. [...]