new American Board of Ophthalmology policy to ban ophthalmologists from being board certified if they didn't do it by year 7 after residency

[Doc320]

The American Board of Ophthalmology has a new policy that one is "board eligible" for 7 years. After that 7 years, you can NEVER become board certified. This is a change from the recent past where the term "board eligible" was a common term used but having no official definition. It must have been the ABMS not liking it so the ABO did finally sanction the term "board eligible" for 7 years after residency. After that, one is no longer has the status "board eligible" but could become board certified by passing the written and oral exams, as well as having a unrestricted medical license (so no convicted rapists or terrorists) and completing an ophthalmology residency.

Effective 1/1/2023, the new policy is after 7 years, you are prohibited from ever becoming board certified if you aren't already. You can ask for a medical exemption if you were sick and maybe they'll give you an extra year. To lessen the shock, there's a grandfathering provision so non-certified ophthalmologists can have 2 more years to get board certified. After 2025, iron fist takes over.

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[solitude]

The American Board of Ophthalmology has a new policy that one is "board eligible" for 7 years. After that 7 years, you can NEVER become board certified. This is a change from the recent past where the term "board eligible" was a common term used but having no official definition. It must have been the ABMS not liking it so the ABO did finally sanction the term "board eligible" for 7 years after residency. After that, one is no longer has the status "board eligible" but could become board certified by passing the written and oral exams, as well as having a unrestricted medical license (so no convicted rapists or terrorists) and completing an ophthalmology residency.

Effective 1/1/2023, the new policy is after 7 years, you are prohibited from ever becoming board certified if you aren't already. You can ask for a medical exemption if you were sick and maybe they'll give you an extra year. To lessen the shock, there's a grandfathering provision so non-certified ophthalmologists can have 2 more years to get board certified. After 2025, iron fist takes over.

I know lots of doctors who never got board certified. One became a Senator. If you aren't going to jump through those hoops by 7 years, you probably never will.

 

[itsjusteyeballs]

is there a number of limits you can take oral boards in general? i.e. like after 3-4 failures, you have to do the written again or something like that?

 

[Etorphine]

I wonder how many ophthalmologist's careers will be over. I am surprised when there is a nationwide shortage and many senior ophthalmologists retiring...especially with shortages in some states leading to turf wars with surgical privileges for optometrists

 

[PLA2]

What is the point of becoming board certified? You don't need to be board certified to be bill insurance? I'm confused, how this would end careers @Etorphine

 

[Doc320]

I know lots of doctors who never got board certified. One became a Senator. If you aren't going to jump through those hoops by 7 years, you probably never will.

I wonder which Senator is that? It's not Senator Rand Paul. He is an ophthalmologist. He was board certified but opposed the 10 year duration imposed on younger board certified ophthalmologists but not older ophthalmologists with lifetime board certification so he refused to do MOC. His board certification ended in 2005. When he was board certified in 1995, he was one of the first with a time limited certificate. I think 1992 was the first year of time limited certificates but I am not certain.

I wonder how many ophthalmologist's careers will be over. I am surprised when there is a nationwide shortage and many senior ophthalmologists retiring...especially with shortages in some states leading to turf wars with surgical privileges for optometrists

In major cities, it is impossible to get hospital privileges if one is not board certified or board eligible. So in those cities, your career is ended or you have to move to a smaller city in a rural state.

In contrast to ophthalmology, urology has a written exam pass rate of 99% and an oral pass rate of 97%. That compares with a flunk rate of about 20% for ophthalmology, which has a tougher exam. On the other hand, ophthalmology is a bit easier in recent years because the written no longer has really off the wall questions and the orals are no longer a huge mystery because the ABO is more transparent to what they want in the orals.

 

[Etorphine]

What is the point of becoming board certified? You don't need to be board certified to be bill insurance? I'm confused, how this would end careers @Etorphine

Even though certification is sometimes described as an “optional” step, it is necessary to be credentialed with many insurance plans (or at least board eligible). If you cannot get paid, it is difficult to remain employed

 

[Dusn]

I wonder how many ophthalmologist's careers will be over. I am surprised when there is a nationwide shortage and many senior ophthalmologists retiring...especially with shortages in some states leading to turf wars with surgical privileges for optometrists

Why would the ABO care about these issues? They’re a private company just looking for their paycheck.

 

[mjohnsonets]

Why would the ABO care about these issues? They’re a private company just looking for their paycheck.

I had no idea the ABO was a private company.

 

[PLA2]

I wonder which Senator is that? It's not Senator Rand Paul. He is an ophthalmologist. He was board certified but opposed the 10 year duration imposed on younger board certified ophthalmologists but not older ophthalmologists with lifetime board certification so he refused to do MOC. His board certification ended in 2005. When he was board certified in 1995, he was one of the first with a time limited certificate. I think 1992 was the first year of time limited certificates but I am not certain.

In major cities, it is impossible to get hospital privileges if one is not board certified or board eligible. So in those cities, your career is ended or you have to move to a smaller city in a rural state.

In contrast to ophthalmology, urology has a written exam pass rate of 99% and an oral pass rate of 97%. That compares with a flunk rate of about 20% for ophthalmology, which has a tougher exam. On the other hand, ophthalmology is a bit easier in recent years because the written no longer has really off the wall questions and the orals are no longer a huge mystery because the ABO is more transparent to what they want in the orals.

If I'm an ophthalmologist doing premium lens cataracts, why do I need hospital privileges?! We're doing ASC at most, in office cataract surgery is also taking off.

 

[Slide]

I know lots of doctors who never got board certified. One became a Senator. If you aren't going to jump through those hoops by 7 years, you probably never will.

Sounds reasonable to me. **** or get off the pot. I don't necessarily like how opaque the written and oral exams are but I do think it's needed to uphold our profession in the eyes of others. I used to think the boards were a waste of time but after seeing what happens in the real world in terms of patient management and outcomes, I do think it's very much needed. Studying for the boards has made me a better attending.

I wonder which Senator is that? It's not Senator Rand Paul. He is an ophthalmologist. He was board certified but opposed the 10 year duration imposed on younger board certified ophthalmologists but not older ophthalmologists with lifetime board certification so he refused to do MOC. His board certification ended in 2005. When he was board certified in 1995, he was one of the first with a time limited certificate. I think 1992 was the first year of time limited certificates but I am not certain.

In my eyes he's as good as not being board-certified. I do agree with him that lifetime board certification (grandfathering) is ethically wrong but he started in the good ol boys generation of ophthalmologists. Creating your own board certification program, with your family and relatives in charge, and being de factor in charge, is not the way to address the issue and is just as bad.

I wonder how many ophthalmologist's careers will be over. I am surprised when there is a nationwide shortage and many senior ophthalmologists retiring...especially with shortages in some states leading to turf wars with surgical privileges for optometrists

I doubt it'll be that bad. At least on my end program directors want to make sure their graduates pass the boards because it'll affect their program accreditation if the failure/non-passage rate increases and are thus pushing them to do it. Also, in my humble opinion, there's not a shortage of ophthalmologists in general, there's a shortage of WILLING ophthalmologists to practice in less urban areas. It's still hard to find a good comp job in larger metropolitan areas

 

[PLA2]

I'm still confused why being board certified is so important? Our specialty doesn't need hospital privileges, and insurances and medicare/medicaid doesn't care if you are board certified or not.

 

[Slide]

I'm still confused why being board certified is so important? Our specialty doesn't need hospital privileges, and insurances and medicare/medicaid doesn't care if you are board certified or not.

May be state/job dependent. If you want to work at an institution in general, you need it unless you can get some sort of special exception. Of course, many of us are in private practice and are in ASCs, and most of us aren't dying to join the hospital call rotation, so it's kinda moot.

Some insurances in some states will not pay you if you're not board certified, though in poor access areas they may turn a blind eye. Also, if you're ever deposed or involved in a lawsuit, not being board certified isn't going to look good.

EDIT: last thing, my tinfoil hat theory is that board certification legally protects the ABOP and the profession in general. A lot of the test questions are things that are life or vision threatening, and more importantly, have come up in lawsuits. This is the ABOP's way of saying "hey we screen for the graduates who miss these things" and also puts new graduates on notice, saying "you better know what this is/not miss this".

 

[Doc320]

Why would the ABO care about these issues? They’re a private company just looking for their paycheck.

That is commonly said but there are really just two very highly paid individuals at the ABO. The rest of the ABO are not paid extremely high salaries. The ABO directors pay is low, like a few thousand dollars, not even $10k.

The 2 highly paid individuals are the CEO (~$800k) and the administrator (~$250k). The CEO tries to be responsive, or at least seems so. The administrator has been rumored to be very rude. That administrator gets a high salary and is not a doctor or someone with very advanced degrees.

I'm still confused why being board certified is so important? Our specialty doesn't need hospital privileges, and insurances and medicare/medicaid doesn't care if you are board certified or not.

Some private insurance requires it. Hospitals usually require it unless the hospital is rural. ASC's often require hospital privileges.

When I was board eligible, I was reminded by organizations more than once that I needed to be board certified by 5 years. It seemed like a blanket warning, not directed specifically at me.

Board certification is also important because nurse practitioners can claim to be board certified so if one is not, they are inferior to NP's. Some NP's have a DNP degree and call themselves "doctor". Optometrists can also be board certified. Optometrists claim to be physicians, namely optometric physicians.
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I have heard of a few ophthalmologists that had a delay before becoming board certified so some of them might have been affected if there was a 7 year ban. I am aware of 2 faculty members that are not board certified. One is a US medical school graduate and US trained. The other is an IMG and US residency trained. They are in different medical schools.