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SPECIAL ARTICLES: Recertification for neurologists Neurology 2001; 57: 175-176 [Full text] [PDF]

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Recertification for neurologists

Jeffrey A Loeb   (19 February 2002)

Recertification for neurologists

Stephanie Carinci   (19 February 2002)

Reply to Jeffrey O Berman

Rosalie A Burns, Stephen C Scheiber   (19 September 2001)

Recertification for neurologists

Jeffrey O Berman   (19 September 2001)

Recertification for neurologists 19 February 2002
Jeffrey A Loeb Wayne State University School of Medicine Detroit MI Send Correspondence to journal: Re: Recertification for neurologists jloeb{at}med.wayne.edu Jeffrey A Loeb	After my first experience with the ABPN in 1993-1994, I thought I wanted to repress my feelings about the extreme hypocrisy of the new rules for recertification. The recent Special Article appearing in Neurology (2001;57:175-176) unfortunately rekindled them, now forcing me to speak out. There should be a mechanism to guarantee to the public that a board- certified neurologist remains at the cutting edge of new diagnostic and treatment options. Of course a recertification exam should focus on "clinically oriented"..."questions of unequivocal clarity and focus"..."relevant to clinical practice." I think this should be the focus of the initial certification process rather than “esoterica” that the board so proudly touts. What disturbs me the most is the double standard. We are asked to be up-to-date neurologists who have unequivocal clarity in our diagnostic and therapeutic skills only if we were initially certified after October 1994. Practicing neurologists who were certified prior to this time are "grandfathered" out of staying current and possessing the clear thinking skills needed to be recertified. Should this travesty of logic and clear contradiction of the Hippocratic oath go into effect? I think then we must contact our third party payers and recommend reimbursements only for recertified neurologists or those that have been certified within the past 10 years and recommend an early retirement for all of the "grandfathers" out there. It is interesting that in this Special Article, those who make these rules feel that the cost—the $1,150 exam together with required travel expenses and hotel accommodations--that are required for recertification would be sought out voluntarily by diplomats certified before October 1994. I think not. Given the exciting new advances in our field, to enact a “politically acceptable” policy of recertification that excludes those who need it most will guarantee that a majority of patients with diseases of the nervous system will not receive the latest treatments for at least 20-30 years. "Do as I say, not as I do" should not be the watchword in our field.
Recertification for neurologists 19 February 2002
Stephanie Carinci Lewiston MA Send Correspondence to journal: Re: Recertification for neurologists scarinci{at}sochs.com Stephanie Carinci	Dr. Berman's letter to the Editor raises issues of fairness regarding board recertification that are shared by many young neurologists but have gone largely unspoken. As someone who was also boarded in 1996,I, too, take exception to the cost, as well as the inherent unfairness in requiring neurologists boarded after a certain year to retest to maintain certification. Drs' Burns and Scheiber's comment that this is a “voluntary” certification is a poor response to a valid complaint. I practice in a rural, underserved area, and all hospitals in the region require the entire medical staff to be boarded in their specialty to maintain active status, and it strikes me that if board certification is not voluntary here, then surely this must be the case in other parts of the country. In addition, most health care plans require there participants to be board certified, so in practicality it is not an elective but required credential.
Reply to Jeffrey O Berman 19 September 2001
Rosalie A Burns American Board of Psychiatry and Neurology Inc Deerfield IL, Stephen C Scheiber Send Correspondence to journal: Re: Reply to Jeffrey O Berman burnsros{at}cs.com Rosalie A Burns, et al.	Dr. Berman requests certification of the term “cost” in regard to the American Board of Psychiatry and Neurology (ABPN) recertification examination for neurologists. In the context of the article, cost does mean the fee charged to candidates, and includes both application and examination fees. These fees reflect the costs sustained by the ABPN in developing, producing, and administrating, and scoring the examination. There are costs involved in the review of applicant credentials. There are expenditures for the committee responsible for writing questions, and for the staff who proof, administer and score the examination. In addition, there are costs involved in issuing certificates. The ABPN is not for profit organization. It is not a membership society, and therefore does not have members among whom costs can be spread. Instead, examinations pay for themselves. The recertification examination in neurology is voluntary, as is certification itself. Neither the examination for initial certification, nor the recertification examination is required. It should be pointed out that the recertification examination is open to all board-certified neurologists, including those who have lifetime certificates. We would also like to clarify a point regarding time-limited certificates that may have been confusing in the article. Those neurologists and child neurologists (and psychiatrists) who passed the November 1994 Part II Examination received ten-year, time- limited certificates. This was the first cohort to receive them as that Part II Examination marked the beginning of a new examination cycle. The certificates awarded earlier that year were lifetime certificates, and all those issued since have been time-limited.
Recertification for neurologists 19 September 2001
Jeffrey O Berman Neurology Group of Westchester PC White Plains NY Send Correspondence to journal: Re: Recertification for neurologists sandi_moriarity{at}urmc.rochester.edu Jeffrey O Berman	I was certified as a Diplomate of the ABPN in 1996, and read with interest the Special Article concerning recertification for neurologists. [1] I was relieved to learn that the counter of the examination will focus on clinically relevant items. However, I must take exception to the exorbitant anticipated cost ($1150). The term “cost” should be elaborated upon. Does this refer to the total fee to be charged to candidates and, if so, does this reflect solely administrative expenses? Regardless of whether this is the true cost of administering the test or whether there is a profit factor built-in, an itemized list of specific costs should be published to clarify the issue. Additionally, is it fair to ask that the youngest practicing neurologists-many of whom are still burdened with debt-shoulder the entire financial load? Moreover, the anticipated “cost” of the test does not include the additional costs of test preparation and travel expenses. I propose that any administrative fee requirement for candidates be substantially reduced and that the remainder of costs be spread evenly among the thousands of members of the ABPN. The test is, after all, a required examination instituted by senior colleagues who are not themselves subject to a similar financial burden. Reference: 1) Directors for Neurology, American Board of Psychiatry and Neurology. Recertification for neurologists. Neurology 2001;57:175-176.