Posts Tagged board certification

Number 27: The Answer is C

(Or: Give Me The Right Answers, ABEM!)

courtesy Wikimedia Commons

Today we residents are post-inservice exam, put together by The American Board of Emergency Medicine, and I can say this about the test: I’m glad I’m not an intern anymore. I’ve obviously still got a lot to learn, but it’s nothing like the feeling of overwhelmth (yes, just made that up) you feel halfway through your internship thinking, “I’m supposed to know the answer to this?”

But today I’m not writing about those mushy-gushy feelings and experiences. No no. Today, I want answers.

I was always annoyed with standardized medical tests (primarily the USMLE) where you left the exam with a) no idea how you performed and b) no real feedback for several months. At this point, I don’t really care if I missed a question about cyclic GMP on USMLE Step I, but for the inservice exam, it’s a different story. This is stuff that I apparently need to know. And so, please, ABEM: I want to know the right answers.

If the point of the inservice and the boards is knowledge and learning and requiring a certain level of competency of emergency physicians, then why not give us feedback so we don’t actually screw something up with an actual patient? What, the answer wasn’t ceftriaxone? Why not? What is it that I’m not understanding about the case that you thought it so important a concept as to test it? If a resident answers that he or she wants to use an ABG to rule out a pulmonary embolism, or decide to get abdominal films as the test of choice for right lower quadrant pain, shouldn’t we be telling that resident (or his or her program) that there’s some serious educating that needs to happen?

ABEM: I want an email with feedback on the questions I missed, or wasn’t sure about. Have me optionally fill out my email address in bubble format, and when you scan through my answers and calculate my percentage, email me the answers. Or, if you don’t want to share the questions because you recycle them, email me the specific topic. Not just “management of status epilepticus,” but “second and third line agents for status epilepticus.” Not just “tick borne disease,” but “treatment of pediatric lyme disease.”

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ACEP Releases Statement on Texas Medical Board Action

ACEP President Angela Gardner, MD, FACEP, released the following statement on December 10, 2009 regarding the ruling by the Texas Medical Board that physicians certified by the American Board of Physician Specialties could advertise themselves as board certified.

ACEP, and the entire emergency medical community, was surprised to learn that on Oct. 20, the Texas Medical Board (TMB) ruled that physicians certified by the American Board of Physician Specialties (ABPS) could advertise themselves to the public as board certified. ABPS certifies physicians in 17 specialties. Its emergency medicine board is the Board of Certification in Emergency Medicine (BCEM).

After learning of the ruling, ACEP contacted the Texas Medical Board and requested under the Texas Open Records Act, copies of all materials pertaining to this ruling. We are expecting the documents in the next several days, and once they have been reviewed we will decide on a course of action. We may ask that the board hold public hearings, or that this action be overturned.

As outlined in ACEP’s policy statement “ACEP Recognized Certifying Bodies in Emergency Medicine,” ACEP recognizes ABEM and AOBEM as the only certifying bodies for emergency medicine. This has been ACEP’s position for many years and it has not changed. In recent years, ACEP and its chapters have actively defended this position in opposing similar ABPS initiatives in other states including Florida, Kentucky, New York and North Carolina.

ACEP’s opposition is based on concerns that BCEM allows and encourages new physicians to enter unsupervised practice without residency training in the specialty. ACEP has maintained a consistent position on the critical importance of residency training for physicians entering emergency medicine. The specialty has grown such that residency training is widely available and should be the pathway for new physicians entering the practice of emergency medicine. In fact, the first sentence in our policy statement, “The Role of the Legacy Emergency Physician in the 21st Century” states, “ACEP believes that physicians who begin the practice of emergency medicine in the 21st century must have completed an accredited emergency medicine residency training program and be eligible for certification by the American Board of Emergency Medicine (ABEM) or American Osteopathic Board of Emergency Medicine (AOBEM).” Unfortunately, BCEM does not share this commitment to the importance of residency training for new physicians and as a result, ACEP opposes efforts to allow those physicians to advertise themselves as board certified.

It is important to distinguish our position on board certification from our position on ACEP’s legacy physicians. ACEP was founded more than 40 year ago when residency training in emergency medicine was not available. The physicians who founded the specialty, and many who came after them, did not have the opportunity to attend a residency or become board certified. These “legacy” physicians remain a critical component of the emergency medicine workforce. They are also vital contributors to the success of America’s emergency care system and they will remain so for many more years.

Our position on BCEM pertains to the important role of residency training today. BCEM certification provides equivalent recognition to new physicians who simply choose not to seek residency training in emergency medicine. Allowing new physicians without emergency medicine residency training to advertise themselves as board certified in emergency medicine would dilute and deemphasize the critical importance of residency training. It also misrepresents to the public the level of training these new physicians have received. Therefore, ACEP continues to oppose efforts to allow BCEM-certified physicians to advertise themselves as board certified.

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