Review of certification processes in other specialties and professions
Appendix 7 — Environmental Scan
For the medical specialties, boards’ approaches vary substantially for part two (Lifelong Learning and Self-Assessment), with some boards requiring only continuing medical education (CME) credits and others also providing reading lists. Requirements for part four (Improvement in Medical Practice) also vary but will not be summarized here. This discussion focuses on part three (Assessment of Knowledge, Judgment and Skills) [1–40].
In review of a large swath of medical specialties, several trends can be noted [Table 2]. First, all specialties require a minimum number of CME credits over a specified time span. This can vary from 25 credits per year (e.g., the American Board of Dermatology [4]), to 100 credits over five years (e.g., the American Board of Internal Medicine [7]). Second, there has been a trend away from point-in-time examinations (either secure at testing centers or remote) and toward longitudinal assessments. The point-in-time examinations are at 10-year intervals in most cases. Longitudinal assessments come in many forms but typically have a multiple-choice question (MCQ) format. The frequency and number of questions varies substantially. For instance, the ABR offers two questions weekly, with 52 questions required to be completed every year, while the American Board of Family Medicine offers a quarterly assessment of 25 questions [6,22]. Although several boards still offer a point-in-time examination, some specialty boards, such as the American Board of Emergency Medicine (ABEM) offers a hybrid approach: four assessment examinations that must be completed every five years and a separate 10-year examination [5].
Although many medical specialties rely on MCQ tests for skills assessment, several boards outside of medicine utilize other assessment tools, such as case scenarios, including dental specialties and airline pilots [25–40]. To maintain a commercial pilot’s license, there is a flight review approximately every six months, including one hour of ground instruction and one hour of inflight (or simulator) evaluation. There are also periodic physical and mental health evaluations as well as mandatory retirement ages (e.g., Delta airlines at age 65). Individual airlines may also impose their own additional safety rules or requirements [39–40].
While a private pilot’s license can be revoked for cause, it does not expire. However, to be legally able to fly, on a two-year cycle, the pilot must have a current medical certificate attesting to overall fitness to fly and must be up to date on current regulations. Lastly, the pilot must undergo a test flight review with an instructor [41], involving maneuvers and simulated emergencies. The pilot can request that specific skills be part of the biennial test [39–40].
In review of a large swath of medical specialties, several trends can be noted [Table 2]. First, all specialties require a minimum number of CME credits over a specified time span. This can vary from 25 credits per year (e.g., the American Board of Dermatology [4]), to 100 credits over five years (e.g., the American Board of Internal Medicine [7]). Second, there has been a trend away from point-in-time examinations (either secure at testing centers or remote) and toward longitudinal assessments. The point-in-time examinations are at 10-year intervals in most cases. Longitudinal assessments come in many forms but typically have a multiple-choice question (MCQ) format. The frequency and number of questions varies substantially. For instance, the ABR offers two questions weekly, with 52 questions required to be completed every year, while the American Board of Family Medicine offers a quarterly assessment of 25 questions [6,22]. Although several boards still offer a point-in-time examination, some specialty boards, such as the American Board of Emergency Medicine (ABEM) offers a hybrid approach: four assessment examinations that must be completed every five years and a separate 10-year examination [5].
Although many medical specialties rely on MCQ tests for skills assessment, several boards outside of medicine utilize other assessment tools, such as case scenarios, including dental specialties and airline pilots [25–40]. To maintain a commercial pilot’s license, there is a flight review approximately every six months, including one hour of ground instruction and one hour of inflight (or simulator) evaluation. There are also periodic physical and mental health evaluations as well as mandatory retirement ages (e.g., Delta airlines at age 65). Individual airlines may also impose their own additional safety rules or requirements [39–40].
While a private pilot’s license can be revoked for cause, it does not expire. However, to be legally able to fly, on a two-year cycle, the pilot must have a current medical certificate attesting to overall fitness to fly and must be up to date on current regulations. Lastly, the pilot must undergo a test flight review with an instructor [41], involving maneuvers and simulated emergencies. The pilot can request that specific skills be part of the biennial test [39–40].