Should ABIM “Grandfathers” Voluntarily Recertify?

Posted by Karen Buckley • March 15th, 2010

The latest Clinical Decisions asks about a 55-year-old physician who practices internal medicine with a strong subspecialty in endocrinology. He holds time-unlimited certificates from the American Board of Internal Medicine (ABIM) in both internal medicine and endocrinology, known as “grandfather” status because recertification is not required as it is for younger physicians. Should he voluntarily recertify, or is it not relevant to his practice? We asked you to read the argument presented for each side and comment about your choice. View those comments now. Earlier Clinical Decisions on the management of incidental hepatitis C virus infection, skin and soft-tissue infection, Type 2 diabetes, stable coronary disease, and the treatment of mild persistent asthma are also available at NEJM.org.

5 Responses to “Should ABIM “Grandfathers” Voluntarily Recertify?”

  1. Henry Ivey, MD says:

    As a physician in Family Practice which has always required recertification, I was surprised to learn that IM did not have a program whereby all physicians were required to demonstrate that they have maintained their skills. I would encourage ALL physicians to become involved in some form of maintenance of certification.

  2. Stuart Willson says:

    I have ABIM “grandfathers” but I also spent two years in a big “county” MICU and took the critical care board which expired in 1998. I recently spent five years studying clinical lipidology and in 2007 took the clinical lipid boards–the hardest of all the exams that I have taken. How many exams am I supposed to take before those of you that do not actually practice medicine but generate all this socialist NEJM crap, are going to get off our back? You all have already stated that we do not need internists but can do just as well with NP’s. I take care of NP’s and I am sorry but NP’s are not Doctors. You folks have done so much to destroy internal medicine and now you want those of us that actually practice to buy all your crap–Give Me a Break. Medicine is dead folks thanks to NEJM.

  3. I certainly agree that every practicing physician should have re-certification in the field of his or her practice. This helps to build confidence in himself or herself about the current knowledge and patients also feel comfortable about the medical knowledge and competence of their medical care provider

  4. pm chaturveddula says:

    i have been reading the comments on re-certification with amusement, i think the pendulum has swung to the right, self regulation and monitoring of our proficiency is all good, but at what cost. Does a physician who practiced all his life becomes obsolete once he moves to the wrong side of 60, or even 70, Are we going to penalize age and insist on these so called monitors that were meant to keep us all up to date? Could we develop other measures to ensure that everyone is with it? What help CME? I guess you need lot more documentation for surgeons for them to even be eligible to take the re-certification exams! Prevention of incompetence is a noble motive, but individualization of monitoring after certain age, say 60ys, is essential. Experience in this day and age is a disqualification! Must find ways to engage these experienced physicians in a profitable way to the society without hurting anyone. Ivory tower manipulations just may lead to hurting ourselves, cause all of us will get there sooner or later,

  5. N Sharm says:

    I recently took my ABIM recertification exam. While the ABIM’s goal to “prevent incompetence” is admirable (!), I cannot understand how my response to a clinical scenario in less than two minutes is accurate reflection of my competence. There are very few situations in Internal Medicine where I have to make even a critical decision within 2 minutes. And even in those rare situations, I have much more information available to me than what is written in a question. For one major difference, the patient is in front of me! And my differential diagnoses are narrowed down by RE-taking the history or going back to pt for some more info OR relooking at the labs OR asking a collegue for opinion OR looking at e-resources. In 10 yrs of practice, I never had to make a final irreversible decision within 2 minutes of seeing a pt. Neither did I ever make a decision about whether to send a cancer pt to chemo or radiation within 2 minutes and the list goes on and on. But the ABIM does not take this into account at all and I did not feel that the board were a fair assessment of my competence at all. I think its all a money making scheme…..

    If for the sake of discussion, I agree with MOC exam, then why are some people “grandfathered”? Does ABIM think that people who graduated before 1990 are superdocs and they need no demonstration of their “competence”? If at all, those are the people who need to demonstrate “competence” more than the younger docs. Or is it that the people who made these rules about MOC graduated before 1990 and thus wanted to make sure THEY got out of this nonsense…..I suspect the later. I am surprised that there has not been a class action lawsuit re discrimination regarding this matter.

    If ABIM is so concerned obout us continuing to prove our competence after yrs of medical school exams, residency and certification, let them get us to do modules every year if we must and learn from them rather than take all these exams which don’t prove a thing!

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