Board Certification requirements in a time of crisis

This is a letter to the Editor regarding a medscape Article topic "Board Certification"... Issue was whether BC and re-certification really are meaningful, who is profiting from this "certificate" and how does it impact quality of care.

-----Original Message-----
From: JP Saleeby, MD jpsaleeby@aol.com
To: glundberg@medscape.net
Sent: Mon, 9 Feb 2009 3:55 pm
Subject: Who should be allowed to take the board exam?

Re: To the Editor
From Medscape General Medicine
Letters
Readers Respond to "Board Certification -- A Hot Topic for Patients and Physicians"
Posted 05/19/2006Jeffrey A. Marmelzat, MD; Name Withheld on Request; Carla S. Fore, RN, PA-C; J. Michael Miller, PhD, (D)ABMM; Ajoy Chhabra, MD----------------

Board certification is so overrated. I have practiced medicine for over 16 years in Emergency Medicine, I did not complete a residency and therefore am not eligible for taking any board exams, despite the fact that I am very competent, have a stellar track record as a physician and ascended to leadership roles in EM (6 years as assistant medical director and the past 2+ years as director of a department). My record will show that while I am not board-certified in any specialty, my performance as an ER physician outshines some of my associates who are EM-residency trained and BC (and even a few who are double boarded).

I find the board certification process to be faulted in that "any" MD or DO who has completed a PGY-1 year and obtained medical license in any state should be able to sit for any board... should he or she pass.. then give them the certification. What truly is the difference between a physician who is taking his re-certification exam for the 4th time being so far from residence (and in fact what was taught back then may be obsolete or even wrong by today's standards) and a physician who is current in his practice (participates in CMEs) but to did not complete residency? It appears that the boards are in fact profiting (by collecting fees) from requiring re-examination and the training programs profiting from a cheap source of labor.

Because of the desire by some hospitals to staff their EDs with EM-trained BC physicians (who look good on paper) by-laws are excluding good experienced ED physicians (even those BC in Primary Care specialties) and this is making it increasingly difficult for doctors to find work, especially in a time when our nation is facing physician shortages.

JP Saleeby, MD
www.saleeby.net