Board Certification and Recertification

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Board Certification and Recertification

Randall V. Wong, M.D., is a board certified ophthalmologist requiring recertification every 10 years.Though a retina specialist, I’m in the midst of re-certifying to remain a board certified ophthalmologist.  Every 10 years, I’m required to re-certify, that is, I must pass a test to demonstrate competence based upon my knowledge, skill and experience.  Board certification means I practice a high standard of patient care.

Up until about 20 years ago, an ophthalmologist had to pass the exam once for life.  My generation of  Ophthalmologists must now re-certify every 10 years to remain board certified.

This summer I’m studying to sit for a 4 hour 150 question exam given in September.

What is Board Certification?

Board certification reflects a high standard of competency based upon the doctor’s knowledge and skills.

The American Board of Ophthalmology is the oldest medical specialty certifying board.  At present there are 24 medical specialty certifying boards recognized by the Board of Medical Specialties (ABMS).

There are various sub-specialties in ophthalmology.  1/3 of the exam, by requirement, will be on general ophthalmology covering topics felt to be “core” knowledge.  By choice, the rest of my exam will be covering diseases of the retina and vitreous…my sub-specialty.

Believe it or not, there is no pre-determined passing score.  There is some type of curve and I’ll be judged with all other applicants who sit for the exam for 2013.

Why Board Certification?

In general, board certification ensures some level of competency.  It is not required to obtain a medical license in most states, however, most hospitals, malpractice insurance companies (those that insure docs against malpractice) and insurance companies (those who insure patients) require their participating docs to be board certified.  So, practically speaking, in 2013, you must be board certified if you want hospital privileges, obtain malpractice insurance or participate in health plans as a providing doctor.

What Does this Mean?

Board certification for doctors is not new.  The American Board of Ophthalmology was created almost 100 years ago in 1916.  Re-certification, however, is indeed new.

Over the past 2 generations, medicine has become ultra sub-specialized.  For instance, I deal only with problems of the retina.

The exam requires me to study because there are sure to be topics which I simply do not see on a routine basis as a practicing retina specialist.  The test will require general knowledge of ophthalmology and not simply practical knowledge of retinal diseases.

The American Board of Ophthalmology does not offer sub-specialty certification, yet there are about 10 recognized sub-specialties in Ophthalmology (Cornea, Retina, Glaucoma, Oculoplastics, Neuro-Ophthalmology, Pediatrics, Uveitis, Ocular Oncology, Ocular Pathology).  The Board should consider sub-specialty certification to reflect our training and how we practice daily.  Perhaps this is why we are graded on a curve.

I am experienced and am professional.  I know what I know and I know what I don’t know.  If a situation presents where I am not comfortable, I am sure to refer to a specialist who will be able to make a diagnosis.

I object to practicing as a sub-specialist, being able to offer exemplary surgical and medical retinal care, but being subject to more generalized review.  We need sub-specialized certification if “board certified” is to be meaningful.

“Board Certification” should be based upon my clinical practice including patient care and surgical outcomes…and not, my ability to study.

Comments
  • Jonathan Brickman August 8, 2013 at 12:11 pm

    So true, I just want to know about your relevant knowledge…not your ability or lack of ability to do other things besides treating my retina.

  • Miguel Matias August 8, 2013 at 12:19 pm

    I wish you luck on your exam Randy… I’m sure you’ll ace it 🙂

    I also hope those that write the questions and evaluate the answers are at least in your league because you are a highly competent and professional ophthalmologist.

    All the best,

    Miguel Matias

  • Scott August 8, 2013 at 1:07 pm

    Ironically I think your practice is an example of why re-certification should exist. Many eye doctors, even retina specialists, refer to the dogmatic view that vitrectomies for eye floaters are too risky to consider and that the patient should simply learn to live with the condition. If the education of doctors starts to steer in a different direction, say that vitrectomies for eye floaters are a safe and effective option, then perhaps some of the more stubborn or entrenched doctors may at least be exposed to the information because they certainly won’t in their day to day practice. I saw we just discovered a new layer of the cornea. Would not the forced exposure via re-certification at least serve as a mile high view of some recent progress in the field?

    You won’t get any sympathy from me. I work in IT and my certifications expire every 3 years. 🙂

  • joseph vigliaturo August 8, 2013 at 1:41 pm

    I think recertification is great keeps every one alert to all the new and eexciting advances, therefore better quality care and results

  • Cecile Heatley August 8, 2013 at 1:45 pm

    Dear Dr. Wong,
    I am with you. There should be sub-specialized certification.

  • Debbie Mills August 8, 2013 at 8:44 pm

    It started with a tear in my retina, it was handled in the office but 6 weeks later, it happened again but worse so had to do it in a hospital. Not quite a year later, the retina actually detached, a gas was put in and I was told it would dissolve in about 6 wks. I had to stay on my side for 4 days, and wear a patch when sleeping, no other instructions were given as to things not to do, I work on a computer all day. About 6 months later, it detached again and I had to have a gel put in that would then be surgically removed 6 months later.I slept on my side for 1 wk. again, I wasn’t given any other speical insuructions (oh, I did have to wear a patch for 2 wks) After that, I’ve had double vision that seems to be getting worse (it will be another 4 months before it will be 1 year that the gel was removed). My per ferial vision is really off which is a pain for driving. Sometimes it even looks as though the road lines are coming through my car. My job is scanning official police reports into a computer and I do that all day. My doctor said I have to be patient but he doesn’t understand why I have double vision but that the retina is still attached. I’m so lost, I don’t know where to turn. My regular eye doctor said glasses won’t do any good (I had an implant prior to all this happening) I never had any problems with the right eye, only the left. Any suggestions as to whom I should see or what I should do or look into???? I live in Florida close to Orlando. I’ll also be retiring at the end of Sept. Just call me frustrated and lost

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