Licensure and Professional StandingAll Member Boards require diplomats to hold a valid, unrestricted medical license in at least one state or jurisdiction in the United States, a U.S. territory, or Canada. Additionally, some boards require physicians to show documentation of hospital privileges and describe the nature and scope of their practice. Some Member Boards also require completed surveys or letters from medical hospital staff, including supervisors such as department chairs or chiefs, or board-certified peers attesting to their professionalism and clinical competence. Refer to the Overview of Member Board Requirements for more information.
Lifelong Learning and Self-Assessment
Physicians seeking to maintain their certification must participate in life-long learning and self-assessment programs that meet specialty-specific standards that are set by their specific Member Board. Individual Member Boards have different requirements in the following general areas. Note that not all Member Boards have a specified requirement for each of these:
- Proof of Continuing Medical Education (CME) credit over the period of certification. This ranges from an average of 15-50 credits per year.
- Self-assessment or learning modules which focus on various aspects of clinical care. Some Member Boards require completion of one or more specialty-specific modules. Additionally, many Member Boards require diplomats to complete Communication and Patient Safety Modules. Timeframe for completion of these modules vary as well, with many Member Boards requiring completion of a module at specified intervals during the certification period.
- Literature review of specialty-specific articles that provide evidence-based, up-to-date data germane to current clinical practice. Typically, post-review self-assessment tests or other attestation of completion must be completed with a required minimum performance on post-review activities such as post-tests.
Physicians seeking to maintain their certification must demonstrate, through formalized examinations at designated testing centers, that they have the fundamental clinical knowledge to provide quality care in their specialty. Most specialties offer a multiple-choice computerized examination that is completed over one or two days that can be taken during the last years of a recertification cycle. Some specialty boards require an additional oral examination or allow members to take an oral examination in place of the written examination.
Practice Performance Assessment
Physicians seeking to maintain their certification must evaluate their clinical practice according to specialty-specific standards for patient care. They are asked to demonstrate that they can assess the quality of care they provide compared to peers or national benchmarks and then utilize quality improvement methods and evidence-based practice standards to improve that care.
Physicians are asked to participate in various activities that document quality patient care and participation in practice improvement based on personal practice characteristics or data. Based on specialty requirements, physicians may be required to complete one or more of the following activities:
- Verification of clinical activity (e.g., surgical cases) by logging in data into a secure portal accessed from the Member Board website.
- Verification of activity working in quality improvement or quality assurance. A physician may be required by their Member Board to provide documentation regarding their work in this area as proof of their ongoing efforts to improve the quality of their laboratory, division or department.
- Peer attestations of performance, including interpersonal and communication skills, professionalism, ethics, and effectiveness in practice.
- Practice assessment and improvement activity in which practice data is gathered on a small number of patients, the data is reviewed and compared to standards, and feedback is given by the Member Board on performance. Other Member Boards require this review and comparison but the physician is required to design and implement a change to improve practice and data is again gathered and reviewed. These changes can include implementing clinical reminders, improvements in clinical knowledge, or making changes to a clinical or system process. Some boards require self-designed activities while others offer activities supported by interactive websites that explain each step of the process. Some boards allow these activities to be completed in groups rather than individually. Many Member Boards offer modules designed for physicians who practice in a variety of clinical situations and who may be interested in specific areas of clinical work. Additionally, many Member Boards allow reciprocal credit for a practice improvement module offered by another Member Board.
- Patient safety and clinical communication web-based modules that focus on improvement of knowledge in these specific content areas. Some Member Boards require completion of patient and/or peer communication surveys. Non-clinical web-based modules for physicians who no longer have a clinical practice or see a very limited number of patients on their own (i.e., researchers, teaching faculty who do not see patients on their own, etc.) Patient surveys regarding various aspects of clinical practice from the patient perspective. These surveys have been implemented by some Member Boards and are under development by others.
- Though all boards are moving toward some type of practice assessment and improvement activity, not every board requires completion at this time. Some boards do not require participation in Part IV activities for those physicians who no longer see patients, while others provide alternate activities for these physicians.
- Refer to the Overview of Member Board Requirements for more information.