Friday, May 06, 2011

Will Doctors Have to Take Out Loans to Pay for (Re-)Certification?

I have recently realized that if I want to remain board certified in cardiovascular disease and cardiac electrophysiology, I must begin the lengthy process to re-certify now. No longer are doctors board certified for life; the process must be repeated very ten years. For me, it won't be long before I'm taking the tests for the third time and I carry two board certifications that are subject to this every-10-year requirement.

But while preparing for this gauntlet again, I was struck by the fees I must pay just for prep-courses and registration fees: well over $10,000.

CV Board Review Course$998.00
EP Board Review Course$1420.00
Maintenance of Certification (MOC) Fee - CV Disease$1810.00
MOC Fee - EP (with 2nd MOC discount)$760.00
Board Certification Fee - EP$2785.00
Board Certification Fee - CV Disease$2165.00
Test Center Fee - Board Cert$500.00
Test Center Fee - MOC$500.00

Realize these costs don't include transporation and housing costs that might be required, not to mention the costs incurred from time off from work.

I realize that it's expensive to prepare, review, monitor and regulate this testing, but these costs are growing at a ridiculous rate - I hate to think what new doctors saddled with significant educational loans must endure just to get started.

Hey, I think I have a new idea for a business: a loan company that funds doctors to help doctors pay for their certification fees!

Oh wait: it already exists.


Addendum 5/9/2011 08:45 AM CST - I received this follow-up e-mail from Lori B. Slass, VP for Communications at the ABIM, with the following clarification of their fees for dual-boarded individuals like myself:
"As the VP for Communications at ABIM I did want to clarify some of the fees you presented today.

As someone who is already board certified in CV and EP, your costs to recertify would be $1,810 + $760 for the 2nd (EP) exam. Total cost is $2,570 – good for ten years.

So it is about $250 a year to maintain certification for someone like yourself who is dual certified. I agree this is not an insignificant amount, and many physicians take review courses to prepare and that does add to the costs, but it is much less than you highlighted in your post. The test center fees you note are only for international candidates.

It is also worth noting that the fee includes all the modules you need for both certifications, and over the course of ten years, even after you complete the MOC requirements you can complete modules for CME credit at no extra cost.

The ABIM Board of Directors are very careful in establishing fees. We are a non profit and to a great extent, the key determinant of the fee for MOC is the direct cost of developing and administering the program. Costs associated with the examination have also risen with the introduction of Computer Testing Centers. We have found, and our candidates confirm, that computer based testing has important advantages over the older method of testing. Hope this is helpful."
I have provided links to the published ABIM fees in my post. It states clearly that the examination fee (alone) for EP is $2,795. I have asked for additional clarification.

Addendum #2 9 May 2011 09:43AM CST: Additional clarification is now provided:
"We will try to make it clearer on our website, but you do not have to repay certification fees once you are certified. Only the MOC fees – total cost for you $2570 for Card and EP (covering two exams) and you correctly noted that you do not have to maintain IM, only those certifications relevant to your practice.(emphasis mine) We also like to think the free CME for 10 years is a nice addition."


Keith said...

I honestly can't believe that we have been saddled with this idea we have to recertify every 10 years! What other profession is required to do this! Certainly if someone wants this to happen, then they should bear the cost of recertification. Enough is enough already!

PS. Where is the proof that any of this does anything to improve care? Seems like a good place where we can test comparitive effectiveness research to show whether recertification is indeed worth the expense!

Anonymous said...

Your employer should pay for all of this. They're the ones who want you to be board certified. This is ridiculous!!!

Anonymous said...

Time to start selling botox injections.

Dr Sam Girgis said...

At my hospital, our yearly CME allowance can be used for licensing fees, DEA registration, and board prep and board certification. The yearly allowance is $2000. This would not nearly be enough for your fees. It's a good thing that I'm a hospitalist and board certified in IM only.

Dr Sam Girgis

Anonymous said...

you forgot to include your internal medicine certification costs in that chart.
or looking at it from the other direction, you are not required to maintain your cardiovascular board certification (at least from the board perspective) so in a cost cutting move you could just maintain your EP certification. that should be something the hospital administration should understand.

DrWes said...

Folks board certified before 1 January 1990 are not required to recertify every 10 years. I am one of the lucky ones in that regard.

As you point out, to have to re-certify in three board certifications after being so removed from general internal medicine for long, it's probably a good thing that that's the way it is for all involved...There's plenty to know for two boards, let alone three.

Anonymous said...

From ABIM website:

Diplomates must hold current, valid ABIM certification in Cardiovascular Disease to be eligible for renewal of certification in:

Advanced Heart Failure and Transplant Cardiology
Clinical Cardiac Electrophysiology
Interventional Cardiology

You don't need to hold valid certification in Internal Medicine to recertify in Cardiovascular Disease.

Anonymous said...

i thought ep had been emancipated from cardiology? that it was not a caq anymore, but a separate subspecialty, the same way cardiology no longer has to maintain internal medicine?

Unknown said...

I was very bad (bad doctor! bad doctor! Back to your kennel!)and did not recertify (ABFM) for several years. The unrecompensed expense made no sense. This year an insurance company dropped me from their panel...the first time board certification made any financial difference. (If I was a physician's assistant I'd not have been dropped, PA>>>BE FP).

I'm scheduled for the test in July.