But once you pass, I assume the fail becomes a non-issue? It's not like failing a Step where people expect a score report and will see the previous failure.
That is accurate. They really only care about your active eligibility/certification status. Except insurances may stop reimbursing you if you're running out of eligibility status....
Kind of but most jobs (so I've heard) will give you at least a couple tries to pass it before they start showing you the door. The biggest problem seems to be when you're getting to the end of your "board eligibility".
And most fellowship seem like they'll just let you retake it again, presumably would be easiest during the 3rd year when you have less clinical time. Theres even some peds subspecialists who aren't even gen peds board certified anymore (I know a couple ID docs at our institution that were like that).
Most jobs will let you retake it. I know one person, though, who had a job as a general pediatrician, who had two failures and almost lost their job because they weren't certified within the first year of employment (after they had already failed once). They were able to convince the employer to give another chance and passed on the third attempt.
As far as the second point, you need to be board certified in general pediatrics before you can sit for your subspecialty boards. So fellowship directors have motivation to get you to pass your gen peds boards.
You have 7 years to be board eligible. I thought it used to be three tries, but maybe it’s indefinite in the allotted time. Fellowship can’t stop you from retaking it. You can let your general board expire if you only practice in your subspecialty, but that is institute dependent.
You can take it as many times as you want within those 7 years, but after 7 years, you have to have 6 months of residency-like time again, and then your clock is reset. We had someone do the mini-residency when I was a resident (BTW, super awkward to be a senior resident for someone who was a practicing general pediatrician 2 months before, especially when they make some questionable choices...), and then failed when he retook the boards for like the 5th time following re-eligibility status. He finally passed last year.
