Cardiac Board Certification

[Dr. Rude]

I was just looking at it the other day. Looks like I'll have a LOT of reading to do this next year.

Anyone have any idea on if they will grandfather people in who have been doing cardiac for a long time? Or expect everyone to take the test if they want the designation?

What ABA has traditionally done is to make the first year(s) of a new certification exam easy with a high pass rate. Usually drops off noticeably after that.

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[vector2]

I was just looking at it the other day. Looks like I'll have a LOT of reading to do this next year.

Anyone have any idea on if they will grandfather people in who have been doing cardiac for a long time? Or expect everyone to take the test if they want the designation?

What I posted indicates that the only people who can get boarded are those who pass the new exam plus being 1. fellowship trained + PTE certified, 2. Non-ACGME fellowship trained plus PTE certified or 3. PTE testamur + requisite cardiac anesthesia cases in the prior 3+ yrs

In any case sounds like everyone has to take the test

 

[nimbus]

I was just looking at it the other day. Looks like I'll have a LOT of reading to do this next year.

Anyone have any idea on if they will grandfather people in who have been doing cardiac for a long time? Or expect everyone to take the test if they want the designation?

It reads like you can be “grandfathered” into being eligible to take the exam based on NBE credentials and experience (with less than 12months of ACTA fellowship) but you still have to pass the exam.

 

[nimbus]

I don’t care if the exit test from fellowship is this or the NBE’s test. But it can’t be both.

And once you pass it, that should be it. No further “recertification.”

So says this NBPAS-certified guy who does not pay the MOCA extortion fee/practice tax.

I have a feeling it’s going to be both. And NBE is already time limited to 10 years.

 

[Beeftenderloin]

I have a feeling it’s going to be both. And NBE is already time limited to 10 years.

This is all assuming the institution you work at actually requires this as a pre-requisite to performing cardiac anesthesia. The place I’ll be going in the fall didn’t even have an aPTE requirement until a couple years ago, and even that is flexible if you can demonstrate you have adequate CV/echo experience as an attending elsewhere. The majority of hospitals in the US have no such requirement. You just have to be “comfortable” doing the cases. My guess is cardiac anesthesia board certification will be relegated to academics, at least for a while.

 

[vector2]

This is all assuming the institution you work at actually requires this as a pre-requisite to performing cardiac anesthesia. The place I’ll be going in the fall didn’t even have an aPTE requirement until a couple years ago, and even that is flexible if you can demonstrate you have adequate CV/echo experience as an attending elsewhere. The majority of hospitals in the US have no such requirement. You just have to be “comfortable” doing the cases. My guess is cardiac anesthesia board certification will be relegated to academics, at least for a while.

I wouldn't necessarily say "academics" but rather more tertiary centers. I've seen more and more jobs which are not academic but which have MCS and/or transplant, and these increasingly require fellowship + PTE certification.

But I do think the uptake of requiring cardiac board certification has the possibility of being more rapid than the historical uptake of requiring PTE certification in the community setting. The practice pathway for PTE cert closed a long time ago, so there are a number of testamurs who do a fair amount of TEE in the community who will never be eligible for cert, so hospitals or med exec committee haven't put forth a cert requirement for that reason.

OTOH, pretty much anyone who's been near a pump case in the last couple years will be eligible to take the cardiac board exam, so that might change the calculus for the powers that be.

 

[nimbus]

This is all assuming the institution you work at actually requires this as a pre-requisite to performing cardiac anesthesia. The place I’ll be going in the fall didn’t even have an aPTE requirement until a couple years ago, and even that is flexible if you can demonstrate you have adequate CV/echo experience as an attending elsewhere. The majority of hospitals in the US have no such requirement. You just have to be “comfortable” doing the cases. My guess is cardiac anesthesia board certification will be relegated to academics, at least for a while.

I agree that medical staff offices are generally clueless about the specifics of subspecialty credentialling. The only people who know are physicians within the specialty. I have no clue about ortho spine, ortho sports, or foot and ankle training. Neither do most physicians sitting on credentialling committees. I think most of the motivation to be ACTA certified will come from the practitioners themselves who want the highest possible credentials for themselves. Why go through all the effort to learn that material and not get the paper?

This happened with PTE certification long before it became a requirement at most places. AFAIK, PTE certification is still not required where I work and yet I’m the only testamur and everybody else is certified. It is not required yet everybody did it anyway. I stopped doing cardiac at the end of last year, but I’m willing to bet all my partners who continue to practice cardiac anesthesia will become ACTA certified. They are just the kind of people who go beyond the minimum requirements. It won’t be relegated to just academics.

 

[Beeftenderloin]

I agree that medical staff offices are generally clueless about the specifics of subspecialty credentialling. The only people who know are physicians within the specialty. I have no clue about ortho spine, ortho sports, or foot and ankle training. Neither do most physicians sitting on credentialling committees. I think most of the motivation to be ACTA certified will come from the practitioners themselves who want the highest possible credentials for themselves. Why go through all the effort to learn that material and not get the paper?

This happened with PTE certification long before it became a requirement at most places. AFAIK, PTE certification is still not required where I work and yet I’m the only testamur and everybody else is certified. It is not required yet everybody did it anyway. I stopped doing cardiac at the end of last year, but I’m willing to bet all my partners who continue to practice cardiac anesthesia will become ACTA certified. They are just the kind of people who go beyond the minimum requirements. It won’t be relegated to just academics.

Maybe I’m just a little burnt out as I’m nearing the end of training, but as I’m staring down oral boards and the NBE exam, both in the next few months, the thought of having to study and sit for ANOTHER exam just seems nauseating. Unless someone tells me I can’t sit a pump case without it, I’ll happily pass.

 

[pgg]

What ABA has traditionally done is to make the first year(s) of a new certification exam easy with a high pass rate. Usually drops off noticeably after that.

I bet most of that effect, if it's even real, is due to self-selection.

I would imagine the first people to sign up for any new certification exam are the people who have the highest confidence that they'll pass it.

 

[nimbus]

Maybe I’m just a little burnt out as I’m nearing the end of training, but as I’m staring down oral boards and the NBE exam, both in the next few months, the thought of having to study and sit for ANOTHER exam just seems nauseating. Unless someone tells me I can’t sit a pump case without it, I’ll happily pass.

That’s totally understandable and nobody will tell you that you can’t sit pump cases without an ACTA certification that just came out. But maybe you’ll change your mind in a couple years after recovering from test fatigue. A lot of people willingly jump through hoops that are not required.

 

[Robotic Wis-Hipple]

Reason #32 why the name of the game is getting out of the game as quickly as you can.

I feel bad for fellows. Take oral boards during fellowship and then a year later have both the PTE and this new Cardiac board to study for while in their first year out on their own.

Professional fees, licensing, CME, endless extortionary tests and recertifications really shouldn’t ever hit the point where they are a leading reason of quitting but they are.

 

[Iso4ane]

Just looked over the outline. Oof. It's a nightmare. The amount of info is large, but the formatting is most concerning. They want it to more recognized, but they can't put the effort in to have a nice looking content outline.

 

[Hork Bajir]

It’s somewhat frustrating that there are no great resources from which to study. Content outline covers a vast amount of material, without much direction as to how much detail (or which details) might be tested on each topic. Whoever writes the first good review book will probably make bank… until then, what are people planning on using? Reading through up-to-date on each topic? Personally I never found the Kaplan CT anesthesia books that useful…

 

[sevoflurane]

It’s somewhat frustrating that there are no great resources from which to study. Content outline covers a vast amount of material, without much direction as to how much detail (or which details) might be tested on each topic. Whoever writes the first good review book will probably make bank… until then, what are people planning on using? Reading through up-to-date on each topic? Personally I never found the Kaplan CT anesthesia books that useful…

Agree. Thought I was done w/exams.
Now I have to recert NBE and this test as well.

😫

 

[sevoflurane]

What is probably best is to take the outline they provided and go to town on it.

 

[Dr. Rude]

Who says it can't be both. It can if they say it can.

Right now the NBE is sufficient. If I planned to be practicing cardiac anesthesia for 10+ years I would suck it up and do the damn thing. Especially if I lived in or planned to relocate to a desirable area at some point in the future.

 

[vector2]

It’s somewhat frustrating that there are no great resources from which to study. Content outline covers a vast amount of material, without much direction as to how much detail (or which details) might be tested on each topic. Whoever writes the first good review book will probably make bank… until then, what are people planning on using? Reading through up-to-date on each topic? Personally I never found the Kaplan CT anesthesia books that useful…

I would bet that some combination of Hensley, Kaplan (for the more basic science/pathophys topics), and UTDOL will be more than sufficient.

 

[Twiggidy]

I agree that medical staff offices are generally clueless about the specifics of subspecialty credentialling. The only people who know are physicians within the specialty. I have no clue about ortho spine, ortho sports, or foot and ankle training. Neither do most physicians sitting on credentialling committees. I think most of the motivation to be ACTA certified will come from the practitioners themselves who want the highest possible credentials for themselves. Why go through all the effort to learn that material and not get the paper?

This happened with PTE certification long before it became a requirement at most places. AFAIK, PTE certification is still not required where I work and yet I’m the only testamur and everybody else is certified. It is not required yet everybody did it anyway. I stopped doing cardiac at the end of last year, but I’m willing to bet all my partners who continue to practice cardiac anesthesia will become ACTA certified. They are just the kind of people who go beyond the minimum requirements. It won’t be relegated to just academics.

A lot of those reason comes into play when I’m looking at jobs. Why the hell should I even be considering generalist jobs when i just went through all the trouble to recertification my TEE unless it’s a drastic improvement in lifestyle or salary

 

[OB1🤙]

Not gonna recert ABA, NBE, or take and maintain whatever useless nonsense is being talked about here.

I’ll keep my money in my pocket, away from these greedy thieves, and continue to stay current on my own volition and practicing good medicine.

All these people want a cut of your salary. These are all practice taxes. Everyone keeps letting these entities impose them. It won’t stop until enough people say no.

 

[OTCAwesome]

100% right there with you brother. It's another Ivory tower money grab that I refuse to partake in. In the unlikely situation where I switch jobs, I might have to bite the bullet though

 

[OTCAwesome]

Not gonna recert ABA, NBE, or take and maintain whatever useless nonsense is being talked about here.

I’ll keep my money in my pocket, away from these greedy thieves, and continue to stay current on my own volition and practicing good medicine.

All these people want a cut of your salary. These are all practice taxes. Everyone keeps letting these entities impose them. It won’t stop until enough people say no.

100% right there with you brother. It's another Ivory tower money grab that I refuse to partake in. In the unlikely situation where I switch jobs, I might have to bite the bullet though

 

[pgg]

100% right there with you brother. It's another Ivory tower money grab that I refuse to partake in. In the unlikely situation where I switch jobs, I might have to bite the bullet though

The problem is, in our line of work, no matter how secure you think your position is, there's a nonzero chance you could be abruptly finding yourself looking for a new one. Not having these stupid practice taxes paid in full can impact your search for months.

But there's always locums, I guess.

 

[OptionOffense]

It may effect the fellowship numbers significantly. Im not sure if I was a graduating senior I would opt for a 1 year fellowship so at the end i can take Four pretty comprehensive exams that you really have to study for MONTHS as hard as you study for a medical school exam. And the pay is not significantly better.

 

[Twiggidy]

It may effect the fellowship numbers significantly. Im not sure if I was a graduating senior I would opt for a 1 year fellowship so at the end i can take Four pretty comprehensive exams that you really have to study for MONTHS as hard as you study for a medical school exam. And the pay is not significantly better.

Valid response

 

[pgg]

It may effect the fellowship numbers significantly. Im not sure if I was a graduating senior I would opt for a 1 year fellowship so at the end i can take Four pretty comprehensive exams that you really have to study for MONTHS as hard as you study for a medical school exam. And the pay is not significantly better.

Yeah when you put it in those terms, wow, what an ordeal ...