1 year training for ABIM eligibility

[kaycee18]

A few doctors have now lost their ABIM eligibility. Would be nice to have a tread with a list of programs where people can go to regain eligibility. I have been searching for programs but not found any so far.

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[DrMetal]

What a stupid profession we work in, that would forbid perfectly good doctors from working, because they lost some fictitious made up credential ('board certification').

Who's "board" is it anyways? It's not the board of a hospital, of a university, nor of a gov't entity. It's a board for the sake of a board. And we've allowed it to run a muck.

Meanwhile, some NP or ND who got their clinical degree online is practicing independently.

I hope you good physicians find a way to make it work, or leave this rat race and go do something smarter with your time!

(No I'm not drinking, this post is totally sober)

 

[chessknt]

If this exists it will not be advertised. I would reach out to your residency location first and ask them for a position vs. help. If that gets you nowhere time to start mass emailing every residency program in the country until you dig one up.

 

[paki20]

I'm no where near the end of my eligibility but we all really should lead a petition to have ABIM create a more plausible remedial action (forcing a candidate to take a ABIM-sanctioned refresher course to restart eligibility, heck they can even charge tuition for this and make more money off of us). I can imagine it being extremely difficult for a residency program to take an attending into their program as a resident for an entire year, no real incentive for a program to do that either. This exam is in no way a marker for how good a physician is and should not be used to ruin people's careers and livelihoods. Absolutely no reason why doctors who have passed 4 licensing exams be denied ability to take care of patients while APRNs with 500 clinical hours and online degree from degree mills are able to see patients independently. Makes zero sense.

 

[kaycee18]

I'm no where near the end of my eligibility but we all really should lead a petition to have ABIM create a more plausible remedial action (forcing a candidate to take a ABIM-sanctioned refresher course to restart eligibility, heck they can even charge tuition for this and make more money off of us). I can imagine it being extremely difficult for a residency program to take an attending into their program as a resident for an entire year, no real incentive for a program to do that either. This exam is in no way a marker for how good a physician is and should not be used to ruin people's careers and livelihoods. Absolutely no reason why doctors who have passed 4 licensing exams be denied ability to take care of patients while APRNs with 500 clinical hours and online degree from degree mills are able to see patients independently. Makes zero sense.

I still have eligibility years but I’m so worried about becoming ineligible. I’m totally for a petition

 

[darklabel]

The only reason this exists is to punish people who stayed "board eligible" indefinitely on purpose to skirt around the requirements of being board certified.

I agree, the requirement is unnecessarily arduous. I think they just wanted to punish physicians who took advantage of it. For new grads it isn't completely terrible. You get about 6 chances to pass the exam (after 3 failures they make you wait another year) and the pass rate after 3 years is 98%. I wouldn't be surprised if its close to 100% after 7 years if someone keeps trying.

This mostly punishes older docs, which I don't really agree with.

 

[DrMetal]

Or, we could get rid of Board Certification altogether.

Sounds crazy? So too is the notion of making someone who already has 10-15 years of higher education and training sit for another test. (If you want to test him/her, do it while they're still students or trainees)

 

[rokshana]

Or, we could get rid of Board Certification altogether.

Sounds crazy? So too is the notion of making someone who already has 10-15 years of higher education and training sit for another test. (If you want to test him/her, do it while they're still students or trainees)

Eh… it’s the old timers that haven’t picked up a journal and barely does cme that need testing the most.

 

[paki20]

Eh… it’s the old timers that haven’t picked up a journal and barely does cme that need testing the most.

I'd still take an older timer over APRN practicing independently any day. These exams barely test basic bread and better medicine (I had zero questions on diabetes, ACS, hypertension, asthma, COPD, etc.), they ask esoteric facts in esoteric ambiguous ways. Not at all a marker of a good physician. It's not that it's impossible to pass, it's just another hoop that physicians are made to jump through to make it more difficult for us while making it easier for APRNs/PA to practice that same medicine with much less strigency and oversight.

 

[DrMetal]

Eh… it’s the old timers that haven’t picked up a journal and barely does cme that need testing the most.

I understand the concept of keeping people in check, but there's better ways to do it.

All BC means is that you were able to study for and pass a test. We're all smart and hard working. You could pass your state bar if you put the time in. Doesn't mean you'll be a good lawyer.

 

[paki20]

Or, we could get rid of Board Certification altogether.

Sounds crazy? So too is the notion of making someone who already has 10-15 years of higher education and training sit for another test. (If you want to test him/her, do it while they're still students or trainees)

Yes can't imagine 10 years from now with several children studying for this again like I'm studying for USMLE while working full time and having to worry that if i don't pass I'll lose my certification and job.

 

[DrMetal]

If there was a movement (a petition, whatever have you) to eliminate BC as a strict requirement for employment, credentialing, insurance, reimbursement...would you support it?

(It could still be a highly desired thing, but not strictly required).

What about a movement to eliminate the term, ''board eligible"? Replace it with, "residency trained" (or something to that effect)

 

[rokshana]

I'd still take an older timer over APRN practicing independently any day. These exams barely test basic bread and better medicine (I had zero questions on diabetes, ACS, hypertension, asthma, COPD, etc.), they ask esoteric facts in esoteric ambiguous ways. Not at all a marker of a good physician. It's not that it's impossible to pass, it's just another hoop that physicians are made to jump through to make it more difficult for us while making it easier for APRNs/PA to practice that same medicine with much less strigency and oversight.

So if not all that hard to pass… what does that say about someone who isn’t capable of passing it in7 years.

I don’t disagree that the testing is not a good way of keeping utd or judging the quality of a physician… but just because you have an MD/DO doesnt mean you are automatically qualified to practice medicine…

 

[rokshana]

I understand the concept of keeping people in check, but there's better ways to do it.

All BC means is that you were able to study for and pass a test. We're all smart and hard working. You could pass your state bar if you put the time in. Doesn't mean you'll be a good lawyer.

Agree…BC doesn’t make you a good or even better physician…appropriate CME is a better way to stay utd… that really should be what is utilized to maintain lifelong learning

 

[ultipouri]

Unfortunately I’m the one who lost initial Abim eligibility after 7 years. Any of you know programs which offer one year of retraining. It’s frustrating but seems like no other choice. Also if you are in the same boat as I’m let’s connect.

To OP can you share any resources you found.

Thanks

 

[aafisahar]

Eh… it’s the old timers that haven’t picked up a journal and barely does cme that need testing the most.

Back in my day we transfused to 10 and they did fine

 

[DrMetal]

Unfortunately I’m the one who lost initial Abim eligibility after 7 years. Any of you know programs which offer one year of retraining. It’s frustrating but seems like no other choice. Also if you are in the same boat as I’m let’s connect.

To OP can you share any resources you found.

Thanks

look into NBPAS. They're certify you if you were iBC (initially board certified) and keeping up on your CME. More hospitals are accepting NBPAS as well.

NBPAS - Providing a Pathway for Continuous Certification

NBPAS is a physician-led organization providing another pathway for continuous board certification that is clinically relevant, specialty-specific, and reducing burdens.

nbpas.org

 

[ultipouri]

look into NBPAS. They're certify you if you were iBC (initially board certified) and keeping up on your CME. More hospitals are accepting NBPAS as well.

NBPAS - Providing a Pathway for Continuous Certification

NBPAS is a physician-led organization providing another pathway for continuous board certification that is clinically relevant, specialty-specific, and reducing burdens.

nbpas.org

Unfortunately that’s not the option for me. NBPAS has requirement that you should have initial certification from ABIM.

ABIM devised this poorly thought policy. On one hand we have NP/PA with half knowledge treating patients and on other hand ABIM bringing crazy policies in the name of patient safety kicking so many docs out of jobs/practice.

I’m in practice since 2008 and luckily lack of board has not affected me but since I learnt of it, it stresses me out. I’m a subspecialist with published articles in leading journals and keeping upto date in my field with tons of CME and major conferences. But I’m dumb in eyes of ABIM and needs to go thr retraining in IM which I’m not even practicing.

 

[DrMetal]

Unfortunately that’s not the option for me. NBPAS has requirement that you should have initial certification from ABIM.

ABIM devised this poorly thought policy. On one hand we have NP/PA with half knowledge treating patients and on other hand ABIM bringing crazy policies in the name of patient safety kicking so many docs out of jobs/practice.

I’m in practice since 2008 and luckily lack of board has not affected me but since I learnt of it, it stresses me out. I’m a subspecialist with published articles in leading journals and keeping upto date in my field with tons of CME and major conferences. But I’m dumb in eyes of ABIM and needs to go thr retraining in IM which I’m not even practicing.

I agree with you in principle, see rant above. The way I look at it, BC is a private product, many (or at least a few) of its kind should be entertained and recognized.

Why didn't you get iBC?

 

[ultipouri]

I tried but failed once and then got extremely busy with practice and still is. Never thought that this could be an issue. When I learnt about it, tried to take it but with practice it’s difficult and also been practicing my subspecialty since 2008 so while I know IM it was difficult to read and memorize everything from exam perspective which I’m not going to use anyways. Also taking standardized test has always been tough but still managed step 1-2-3 with glowing scores. I think it was more of busy practice which really didn’t allow dedicated prep like I did for MLEs.

 

[DrMetal]

I tried but failed once and then got extremely busy with practice and still is. Never thought that this could be an issue. When I learnt about it, tried to take it but with practice it’s difficult and also been practicing my subspecialty since 2008 so while I know IM it was difficult to read and memorize everything from exam perspective which I’m not going to use anyways. Also taking standardized test has always been tough but still managed step 1-2-3 with glowing scores. I think it was more of busy practice which really didn’t allow dedicated prep like I did for MLEs.

Is anyone pressuring you to get BC? Your employer? Why now?

 

[ultipouri]

No one so far. But I read about it online and worried that at some point it may become an issue. Most not aware, I’m not telling anyone proactively. On privilege application I clearly mentioned that I’m not bc and they never raised questions. I also wonder that why I’m so worried but somehow when I’m free doing nothing it starts bothering me.

 

[DrMetal]

No one so far. But I read about it online and worried that at some point it may become an issue. Most not aware, I’m not telling anyone proactively. On privilege application I clearly mentioned that I’m not bc and they never raised questions. I also wonder that why I’m so worried but somehow when I’m free doing nothing it starts bothering me.

Well if no one's pressuring you for it, you might as well forge ahead without it. What's the alternative? You're going to ask your employer for (and they would allow for) a 1-year sabbatical, to go do an IM year of training? Probably not feasible. I'd just continue working. If you've been honest about it on your privileging/credentialling paperwork, they can't fire you for it (at least I don't think).

 

[gutonc]

Well if no one's pressuring you for it, you might as well forge ahead without it. What's the alternative? You're going to ask your employer for (and they would allow for) a 1-year sabbatical, to go do an IM year of training? Probably not feasible. I'd just continue working. If you've been honest about it on your privileging/credentialling paperwork, they can't fire you for it (at least I don't think).

One thing that can happen is that the hospital(s) where you have privileges could change their rules to require BC and not grandfather anyone else in. they'd have to have a 1-2 year grace period to allow people to get caught up of course, but it happens.

 

[DrMetal]

One thing that can happen is that the hospital(s) where you have privileges could change their rules to require BC and not grandfather anyone else in. they'd have to have a 1-2 year grace period to allow people to get caught up of course, but it happens.

That certainly could happen. What ridiculousness.

 

[indest]

I totally agree with you. I wish we as physicians would stand united.

 

[DrMetal]

I don't have a problem with iBC. In fact, I would require it to finish residency, and have it run by the ACGME. That would make more sense, and would avoid situations like the OP.

I do have a problem with re-cert. It's unnecessary and exorbitant.

 

[NotAProgDirector]

I agree. Some sort of test at or just after graduation makes sense. I think the recert process is also rather poor. I'd get rid of the 10 year exam. I can't speak to other specialties, but Hosp Med and GIM have a medical knowledge test every year on the ABIM site, worth 10-20 MOC points, 40 questions, with answers based on references in the literature. Focuses on new findings / treatments / practices. It's self study, you can take it as many times as you want. Requiring something like that would be reasonable (and I find it helpful).

 

[AlbinoHawk DO]

Unfortunately I’m the one who lost initial Abim eligibility after 7 years. Any of you know programs which offer one year of retraining. It’s frustrating but seems like no other choice. Also if you are in the same boat as I’m let’s connect.

To OP can you share any resources you found.

Thanks

As far as I know there are a lot of programs that have a "4th year" chief resident spot that they recruit outside candidates. Typically people trying to go into competitive fellowships from lackluster programs apply to these, but I think many spots go unfilled. I have no idea how to find a list of places offering this though

 

[AlbinoHawk DO]

Have you guys tried to see if you can qualify for the AOBIM test? I think MDs can apply to it now

 

[NotAProgDirector]

It's an interesting option for @ultipouri. The ABOIM also has a 6 year window. But their appeal process for extension is much more nebulous and doesn't automatically require additional testing. Would need to also study OMM or just decide to get all those questions wrong.

 

[dozitgetchahi]

I'd still take an older timer over APRN practicing independently any day. These exams barely test basic bread and better medicine (I had zero questions on diabetes, ACS, hypertension, asthma, COPD, etc.), they ask esoteric facts in esoteric ambiguous ways. Not at all a marker of a good physician. It's not that it's impossible to pass, it's just another hoop that physicians are made to jump through to make it more difficult for us while making it easier for APRNs/PA to practice that same medicine with much less strigency and oversight.

Funny story:

When I was a rheumatology fellow, there was an attending in my department who was recertifying with the IM exam (apparently she hadn’t done MOC). She passed, but somehow rheumatology was scored as her *lowest* percentage score of any section. She said there were a lot of goofy questions that didn’t square with how medicine is actually practiced.

 

[dozitgetchahi]

Well if no one's pressuring you for it, you might as well forge ahead without it. What's the alternative? You're going to ask your employer for (and they would allow for) a 1-year sabbatical, to go do an IM year of training? Probably not feasible. I'd just continue working. If you've been honest about it on your privileging/credentialling paperwork, they can't fire you for it (at least I don't think).

A lot of insurance companies make you become BC within 5-7 years, or they won’t credential you.

 

[rokshana]

A lot of insurance companies make you become BC within 5-7 years, or they won’t credential you.

Some states like Oklahoma and Massachusetts prohibit this… they don’t allow for requirement for BC for anything

 

[dozitgetchahi]

Some states like Oklahoma and Massachusetts prohibit this… they don’t allow for requirement for BC for anything

Wow, interesting. I didn’t know this.

 

[michaelrack]

Funny story:

When I was a rheumatology fellow, there was an attending in my department who was recertifying with the IM exam (apparently she hadn’t done MOC). She passed, but somehow rheumatology was scored as her *lowest* percentage score of any section. She said there were a lot of goofy questions that didn’t square with how medicine is actually practiced.

I can identify with that. In addition to ABIM certification, I am also certified in Psychiatry (and relevant to the question below, also in the consult psychiatry subspecialty). Recently at a TN ACP chapter meeting I was doing MOC modules on Updates in outpatient and hospital medicine.
I missed the question on what agent to give IM to an agitated geriatric patient. Sometimes knowing too much about a topic can be a hindrance.

 

[DrMetal]

I missed the question on what agent to give IM to an agitated geriatric patient. Sometimes knowing too much about a topic can be a hindrance.

No, it's not a hindrance. The true hindrance is the test and that we have to participate in any form of re-certification. Plus everyone knows the answer to that question is IM Haldol, give lots and lots of IM Haldol.

 

[michaelrack]

x

 

[ultipouri]

Thanks for all replies. I never looked into ABOIM. However it is just mind boggling and upsetting that folks with highest amount of intelligence come out with policies in the name of patient care and safety which has nothing to do with any of it. I’m practicing my sub specialty while successfully taking care of ICU, Pulm floors, clinic and ltac. Proficient with procedures which include bronch, central and arterial lines, intubations, thoracentesis, chest tubes, Right heart cath, complex vent Mx, bed side critical care Echo for last 14 years but somehow if I don’t go back to IM residency for 1 year it’s absolutely useless. All along pretty much I go either to ACCP Chest conference or ATS conference yearly with consistently lot more CMEs than required by my states licensing boards. Never had a single patient complaint or lawsuit. All PMDs in hospital and community still refer to me but I am bad physician according to ABIM.

 

[dozitgetchahi]

I don't have a problem with iBC. In fact, I would require it to finish residency, and have it run by the ACGME. That would make more sense, and would avoid situations like the OP.

I do have a problem with re-cert. It's unnecessary and exorbitant.

Agree with this. I mean, is a residency/fellowship certificate adequate to practice medicine in that specialty - or not? If it is, then we probably don’t need a test, but if we insist on testing then it should be administered by the ACGME at the end of training. Period, done. If it isn’t, then this whole “board certification” thing should be chucked in the trash.

I’m really bothered by the idea that you can graduate GME training with flying colors - with your attendings certifying that you can practice in that specialty - and then have your entire career derailed by an exam given by a completely separate “board” that has nothing to do with GME training and basically exists to collect extortionate fees from doctors. When this “board cert” crap started in the 80s and 90s, it was an optional thing that some doctors did just to put a feather in their cap - and then some admin geniuses had the idea that everyone should do it. What gives? Why did we go along with this?

 

[DrMetal]

What gives? Why did we go along with this?

B/c we (physicians) are stupid. Seriously, I never realized how dumb (practically speaking) most doctors are, until I became one.

 

[dozitgetchahi]

B/c we (physicians) are stupid. Seriously, I never realized how dumb (practically speaking) most doctors are, until I became one.

Well, obviously most docs are “intelligent” - but more so in a “book smart” way. Common sense, street smarts, and knowing when someone is ripping you off unfortunately aren’t stressed much in our training process.

The biggest problem, I think, is that we go through 10+ years of training that largely teaches us to be docile and to accept whatever authority figures drop on us without question. Once we are out from under all the training that forces us to accommodate whatever gets thrown out way, the old habits persist. What you end up with is a cadre of highly educated, highly intelligent people who fail to stand up for themselves and don’t realize how much power they actually hold. It’s tragic, really.

 

[imblue100]

Abim is very vague about what retraining program entails. If anyone undergone this kind of program does anyone know if a chief residency kind of structure where you supervise lower residents and help with residency duties such as call schedule/lectures etc count? Please PM me if more comfortable.Thank you.

 

[NotAProgDirector]

Depends on how it's structured. To "count", you need to be supervised. You can't be supervising other people, unless you are also supervised in some way. So it would be possible if someone else was looking at your work. Most 4th year CMR positions don't include this type of studture - you're expected to practice independently.

 

[welcome1234]

Thanks for all replies. I never looked into ABOIM. However it is just mind boggling and upsetting that folks with highest amount of intelligence come out with policies in the name of patient care and safety which has nothing to do with any of it. I’m practicing my sub specialty while successfully taking care of ICU, Pulm floors, clinic and ltac. Proficient with procedures which include bronch, central and arterial lines, intubations, thoracentesis, chest tubes, Right heart cath, complex vent Mx, bed side critical care Echo for last 14 years but somehow if I don’t go back to IM residency for 1 year it’s absolutely useless. All along pretty much I go either to ACCP Chest conference or ATS conference yearly with consistently lot more CMEs than required by my states licensing boards. Never had a single patient complaint or lawsuit. All PMDs in hospital and community still refer to me but I am bad physician according to ABIM.

What was the outcome of your problem above? Did you ever find a one year IM program to regain your abim board eligibility ? How did you apply? What is the process? This is so frustrating for so many doctors for no good reason