Sunday, October 10, 2010

Board Recertification in Gastroenterology: More Fun than Colonoscopy

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This coming Thursday, I will have the joy and pleasure of taking the gastroenterology (GI) board recertification exam.   There will be many entertaining elements to the experience, as other board certified physicians already know.  Although there will be many fun delights, some will clearly be more amusing than others.
Which of the following features of the GI board examination will be most fun?  While more than one answer may be correct, choose the best answer.
(1)    A 490 minute all day exam is a thrill, by definition
(2)    Losing a day of income
(3)    Paying the American  Board of Internal Medicine (ABIM) $1200
(4)    Pleasing my partners who will cover my practice
(5)    Having my palm vein recognition scan to verify my identity every time I reenter the room
During this exam, each giddy examinee will be provided with a computer station.  I am nostalgic already for the proctor of yore announcing, ‘pencils down!’, as there will be no pencils permitted in the examination room.  In fact, many items are forbidden in the sancta sanctorum, the examination chamber. For example, portable phones, wallets and watches are classified as contraband by the ABIM Security Police.  While I understand that my phone could be a secret repository of important facts on the life cycle of the hookworm, a likely exam topic on a parasite that no American gastroenterologist ever sees, what’s the fear about wearing a timepiece?   Are they worried that my watch might be an upgraded version of Maxwell Smart’s shoe phone, allowing me to quietly ‘phone a friend’ whom is poised to Google my urgent request?   
At the present time, the ABIM is still permitting test takers to take the exam fully clothed, although this policy is under review.   Security professionals are concerned that examinees might have secret wires and antennae woven into their underclothing, which could transmit stealth information on hemorrhoids and flatulence –key board topics – to the GI board certified wannabee.   Perhaps, the ABIM intel pros fear that a ‘wristwatch’ might actually be a monitor where such improper information could be displayed.  This would explain the wristwatch prohibition.  The solution, of course, is to require that all examinees take their recertification exams naked.  While this appears to violate established social mores, this is outweighed by ABIM’s desire and obligation to secure the exam.  This should be acceptable to medical professionals who confront nakedness every day.  After all, we are doctors.  The proctor, however, who does not have a medical degree, would have to be blindfolded throughout the exam.
I now mention a specific ABIM board examination restriction in its own paragraph to set it apart.  I, MDWhistleblower, solemnly affirm that the following sentence is true and is paraphrased from the ABIM web site.  Examinees are not permitted to bring suitcases in the exam room.  I wish I were funny enough to make stuff like this up.
Of course, we will be warned that any ‘irregular behavior’ will be reported to the authorities, which can result in severe professional sanctions.   We gastroenterologists know more about irregularity than any other physician, and we should have been consulted on this issue.   We would have suggested that any first offenders be subjected to a rigid sigmoidoscopy performed by a first year surgical resident.   I suspect this would serve as an adequate deterrent against temptation, and would guarantee very regular behavior.
Before the examination begins, I will have to agree to a Pledge of Honesty.  I’d like the ABIM to agree to a Pledge also.  Do they pledge that this examination, and the 5 required home study modules that preceded it, will make me a better gastroenterologist?    I have already opined on this issue.
Do any other physicians believe that board recertification is ‘irregular’.  If so, I propose a rigid response to the ABIM.


8 comments:

Elaine Schattner, M.D. said...

Michael,
I think it's great that you're taking the exam (sorry!) and PC that you're required to do so. What's wrong is that you have to pay for it.

It would scare me if an oncologist were practicing without having re-certified in >10 years - there are so many new diagnostic tests and drugs, side effects, reasons to treat, reasons not to treat...As for GI, I assume it's similarly complicated.

Good luck!

A. Bailey said...

I'm "grandfathered", so I don't have to take the exam no matter how senile and out of touch I become.

Does that make sense or what?

Anonymous said...

Most patients don't seem to care about the board certification. Insurance plans pay the same with or without board certifcation. I recertified in primary care last year and realized that the exam is out of touch with most primary care docs. It did feel like break from the office, as I was less tired after an all day exam than a single day in the office with patietns/phone calls/prior auths etc. One frustrating aspect is that nonboard certified primary care docs in my community who belong to one of the two hospital owned groups getting higher fees than I do for knowing less.

Chrysalis Angel said...

Some watches can have tiny cameras in them today. There have been known cases of cheaters using them to take photos of the exam questions, and then they work on the answers, and sell the answers to upcoming test takers.

"The proctor, however, who does not have a medical degree" Don't be so sure...some represent the affliation for which you are there to test for. Remember...you just never know who the people are that are watching you.

Just remember not to pick your nose or scratch yourself as you are on film. (joking with you here,but tis true none the less.)

Good luck to you on your exam.

Anonymous said...

took the gi boards also yesterday.

anyway i can talk to you privately?

Anonymous said...

awaiting reply

any email link to contact you?

can't find one on site

thank you in advance

Anonymous said...

I just discovered this blog after taking the recert GI exam last week. I was mainly concerned about the palm scans. I had to be scanned 10 times during the exam day! I felt like in a jail, scanned every time I passed through a door. I wonder if they do the same to other professionals: lawyers, politicians. I actually e-mailed to ABIM about it:

Q: For years two forms of ID were enough, what justifies such a radical change (introduction of biometrics)? Since you seem to like statistics: did ABIM have a lot of experience with fraudulent identity of physicians taking board examinations prior to your implementation of these intrusive procedures, or did you just decide to use palm scans because they were available at Pearson? What I mean is to find out if this change was an actual response to a problem or just "go with the flow" of intrusion to privacy, seen all around us these days?

A: ABIM has always employed a reasonably rigorous security/identity verification processes for admission to a test center and delivery of an exam.

Now, that is a thorough and informative answer!

And I have an idea for a prospective, randomized double-blind study to compare ABIM certified and non-certified doctors' clinical outcomes. How about that? Maybe ABIM could sponsor such a study, they have the money for sure!

Michael Kirsch, M.D. said...

Regarding the required palm vein scans, I invite you to peruse this Sunday's Whistleblower posting. To the anonymous commenter who desires to contact me, it should be an easy matter to find my office contact info. You know where I do colonoscopies. I'm sure you could find me in 3 clicks.

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