Continuing Board Certification: Seeing Our Way Forward

J Am Board Fam Med. Sep-Oct 2020;33(Supplement):S10-S14. doi: 10.3122/jabfm.2020.S1.190439.

Abstract

Background: Traditionally the role of certifying boards has been to hold physicians accountable for demonstrating standards of competence. In recent years, the authority of continuing board certification has been challenged, due to multiple factors that have shifted the dynamics. The breadth and depth of new information, combined with the pressures of system barriers and administrative burdens, can make it challenging for clinicians stay current and maintain their own competency. Absent feedback about their performance, physicians presume they're practicing effectively. The resulting gap between confidence and competence can also lead physicians to make errors of which they may be unaware. In this environment, assessment and accountability are more important than ever.

Four key areas: The authors present four key areas to address to move forward with a board certification system that is effective, relevant, and respected. First, boards should set and communicate the specific expectations of specialists. Second, boards should use technology to create practice-relevant assessments. Third, they should collaborate with educators, while maintaining their distinct role as assessors. Fourth, boards need to establish and meet standards for professionalism and ethics that reflect their position as regulatory bodies.

Conclusion: Boards have a critical role in professional self-regulation. They should not compromise on their primary responsibility to set and evolve standards for competence and to conduct rigorous assessments of physicians. The methods boards use for assessments should evolve to meet the changing needs of physicians. Collaboration between educators and assessors provides more educational choice, relieves burdens, and supports physicians' commitment to lifelong learning. By working together with physicians, educators and assessors advance their shared goal of supporting physicians to work at the top of their capability and ultimately, optimize patient care.

Keywords: Certification; Continuing Medical Education; Medical Errors; Physicians; Professional Autonomy; Social Responsibility; Specialization.