MINDFUL EM: Isn't It Time to Abandon the Recertification Exam? : Emergency Medicine News

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Isn't It Time to Abandon the Recertification Exam?

Hazan, Alberto MD; Haber, Jordana MD

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Emergency Medicine News 38(6):p 7, June 2016. | DOI: 10.1097/01.EEM.0000484517.56240.67

    If you like parasites, you will love TWiP (This Week in Parasitism), a podcast about all the noxious critters that wreak havoc in the human body, like Plasmodium (which causes malaria), Trypanosoma brucei (which causes sleeping sickness), Wuchereria bancrofti (which causes lymphatic filariasis or elephantiasis), Necator americanus (the bloodsucking roundworm that causes hookworm disease), and Taenia solium (the pig tapeworm that causes neurocysticercosis). If you're into viruses or bacteria, you can listen to TWiV (This Week in Virology) or TWiM (This Week in Microbiology).

    Physicians need to keep up with the latest in medicine, and podcasts are a great way of staying current and being exposed to just about any field of study our inquisitive heart desires.

    If microbiology isn't your thing, a plethora of emergency medicine podcasts are available to choose from, including Mel Herbert's EMRAP, Scott Weingart's EMCrit, Amal Mattu's EMCast, and Anton Helman's Emergency Medicine Cases. Many journals have podcasts, too, including Emergency Medicine News' Everyday Medicine with Ryan Stanton, MD, Annals of Emergency Medicine, the New England Journal of Medicine, and Emergency Medicine Clinics.

    Many high-quality medical blogs are also available, including R.E.B.E.L. EM (http://rebelem.com), Academic Life in Emergency Medicine (www.aliem.com), Life in the Fast Lane (http://lifeinthefastlane.com), Strip Tease (www.electricant.net/ekg), Resus.Me (http://resus.me), and The Poison Review (www.thepoisonreview.com). An exhaustive list of more than 300 emergency medicine and critical care blogs and podcasts are available on Life in the Fast Lane.

    Twitter also gives you minute-by-minute updates on the latest tidbits of interesting medical news and is arguably the best source for FOAMed (Free Open Access Medical Education), a collection of resources meant to assist physicians in keeping up with the latest in medicine.

    Beyond these modern methods for keeping up with the medical literature are still the old-fashioned approaches, such as reading medical journals, browsing medical textbooks, or attending one of dozens of medical conferences offered at various popular destinations throughout the world.

    More Effective Approach

    The one thing that is unlikely to help you keep up with the latest medical innovations or retain the knowledge you have gained since medical school, however, is the 10-year recertification examination, a mandatory requirement by the American Board of Emergency Medicine. It doesn't make sense to spend a couple of weeks every 10 years cramming for a test that does little to ensure that we stay up to date on our medical education. This is, in many ways, an obsolete exam that doesn't benefit our overall education.

    Our anesthesiologist colleagues have found a more effective approach than the recertification exam. The American Board of Anesthesiology this year became the first medical board to do away with the 10-year recertification exam. Instead, anesthesiologists will be offered a “more relevant and personalized approach ... to assess their knowledge and address knowledge gaps” through online quizzes and other educational material. (http://bit.ly/1S1Y5HJ.)

    Much of the criticism of the anesthesia recertification exam, which also applies to the emergency medicine 10-year test, argued that it was an expensive pass/fail assessment that did not provide feedback on performance or demonstrate that it was an effective way to keep anesthesiologists current in their field. Addressing these concerns, the regular online quizzes that are part of the MOCA 2.0 (Maintenance of Certification in Anesthesiology) program will give immediate comments, assist the practitioner in identifying any knowledge gaps, and provide better patient care.

    Our current technology allows for any of us with a computer or smartphone to have the entire breadth of medical knowledge at our fingertips. We are not naïve enough to think that every single practicing emergency physician will take advantage of the myriad podcasts, blogs, and other FOAMed resources, but cramming for a costly exam once a decade is not the most effective way to ensure we stay up to date with medical knowledge. The current Lifelong Learning and Self-Assessment program, through its yearly requirement of 10 to 15 journal articles and attached examination, is certainly a much more effective way to promote continuous learning, and does a much better job at encouraging us to stay current.

    Most emergency physicians agree that we should reform maintenance of board certification by abolishing the 10-year exam. Opposition continues to grow not only in our field but also throughout the medical community. If the 10-year recertification has been abandoned by one branch of medicine, shouldn't all of the others, including emergency medicine, follow suit?

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