Do most people take the boards their first year out?

[Trismegistus4]

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In last year's graduating class, there were three people I knew of who took the boards last fall: two who had gone right into practice, one who's doing a fellowship.

Since I'm not doing a fellowship, I thought I'd follow the example of the two who went into practice, and tried registering for the boards, only to find that 1) I'm already past the Feb 2 deadline for this year and thus will have to pay a $500 late fee, and 2) my program hasn't certified my rotations since I haven't graduated yet, so I have to ask my program director to put in my PGY4 rotations as "expected."

I don't know why issue #2 didn't come up with those graduates who took the boards last year. However, looking at job ads, I'm noticing that many of them specify that one must pass the boards within, say, five years of starting, or some other multi-year length of time. So I'm wondering, is it important, recommended, a good idea, that I take the boards this fall? What do most people do?

 

[F0nzie]

Most of people in my class took the board exam first year out. I still have not taken it. No catastrophes to report.

 

[clusterF]

Yes. Although there's no benefit to doing so. If you are relatively confident you will pass them, it is almost better to wait. You will then have another year before you recert as well.

 

[notdeadyet]

Some employers offer a salary bump for board certification and sometimes it's pretty substantial (>$5k). That would be enough for me to pay the late fee...


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[F0nzie]

Some employers offer a salary bump for board certification and sometimes it's pretty substantial (>$5k). That would be enough for me to pay the late fee...


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Plus it will help with negotiations and promotions.

Don't follow in my footsteps. I'm looking for a way out of the system not in.

I will still take the boards despite how annoying MOC seems.

 

[Doctor Bagel]

All 7 of the people I graduated with took it right out (and passed). The one person who fast tracked hasn't taken it yet. I'd vote for taking it just to get it out of the way even with the extra $500. If you don't take it, though, it's not the end of the world. I think I hyped it up into a scarier test than it is, but it's nice to not have it hanging over my head.

This post also leaves my impressed with our program coordinator who took care of all our pre-cert stuff well in advance. Our program also did a good job of communicating to us what the registration deadline was. Might be some good feedback for your program.

 

[wolfvgang22]

I took my general psych board after the first year of fellowship, and I'm glad I did. It did give me an edge in job negotiations when I asked for more money. Now, after only 9 months as an attending I'm debating whether to take the child psych boards. Deadline is March 2nd. I'm inclined to let it pass and think about it for next year. I'm not treating children or adolescents, and I'm not sure if there would be much return on investment, and I've been stressed out enough this year. I'm kind of on the fence on whether to do it at all. I'm happy to entertain anyone's opinion on that.

 

[Shikima]

I took my general psych board after the first year of fellowship, and I'm glad I did. It did give me an edge in job negotiations when I asked for more money. Now, after only 9 months as an attending I'm debating whether to take the child psych boards. Deadline is March 2nd. I'm inclined to let it pass and think about it for next year. I'm not treating children or adolescents, and I'm not sure if there would be much return on investment, and I've been stressed out enough this year. I'm kind of on the fence on whether to do it at all. I'm happy to entertain anyone's opinion on that.

Plus the increased MOC requirements.

 

[st2205]

I took my general psych board after the first year of fellowship, and I'm glad I did. It did give me an edge in job negotiations when I asked for more money. Now, after only 9 months as an attending I'm debating whether to take the child psych boards. Deadline is March 2nd. I'm inclined to let it pass and think about it for next year. I'm not treating children or adolescents, and I'm not sure if there would be much return on investment, and I've been stressed out enough this year. I'm kind of on the fence on whether to do it at all. I'm happy to entertain anyone's opinion on that.

If I recall correctly, you're at the VA? Do you plan on doing C&A in the future?

 

[F0nzie]

I took my general psych board after the first year of fellowship, and I'm glad I did. It did give me an edge in job negotiations when I asked for more money. Now, after only 9 months as an attending I'm debating whether to take the child psych boards. Deadline is March 2nd. I'm inclined to let it pass and think about it for next year. I'm not treating children or adolescents, and I'm not sure if there would be much return on investment, and I've been stressed out enough this year. I'm kind of on the fence on whether to do it at all. I'm happy to entertain anyone's opinion on that.

Get it and ask for a pay bump for the added qualifications.

 

[MadRadLad]

Can someone real quickly go over how the board eligible/certified system works? I gather that you're allowed to practice in your specialty even if you don't take the board exams? In that case, what's the point of them?

 

[st2205]

Can someone real quickly go over how the board eligible/certified system works? I gather that you're allowed to practice in your specialty even if you don't take the board exams? In that case, what's the point of them?

Being able to advertise that you are board certified (as opposed to just board eligible -- via completing residency).

 

[F0nzie]

Can someone real quickly go over how the board eligible/certified system works? I gather that you're allowed to practice in your specialty even if you don't take the board exams? In that case, what's the point of them?

Pay to learn and pay to win.

Keeps you current with knowledge and makes insurers and hospitals happy.

Graduate from residency = BE
Pass board exam = BC

Although the boards are redefining board eligibility now as the first 7 years post residency graduation. After that you are no longer "eligible" to take the board exam.

 

[MadRadLad]

Pay to learn and pay to win.

Keeps you current with knowledge and makes insurers and hospitals happy.

Graduate from residency = BE
Pass board exam = BC

Although the boards are redefining board eligibility now as the first 7 years post residency graduation. After that you are no longer "eligible" to take the board exam.

So if you don't take your board exams in those 7 years....you can no longer take them ever again? Or can you regain eligibility? I guess my real question is, why isn't it a requirement to pass them to practice? It just seems weird to me that it's optional, especially from a liability standpoint.

 

[F0nzie]

So if you don't take your board exams in those 7 years....you can no longer take them ever again? Or can you regain eligibility? I guess my real question is, why isn't it a requirement to pass them to practice? It just seems weird to me that it's optional, especially from a liability standpoint.

You have to shamefully go back to your residency program and pass your mock interviews all over again to regain eligibility.

 

[wolfvgang22]

If I recall correctly, you're at the VA? Do you plan on doing C&A in the future?

Yes.
I don't know. ¯\_(ツ)_/¯
Seeing youngsters would be an easy-ish way to make some side cash in my area.

 

[keifernny2]

Everyone I graduated with last year took them first year out (and passed), my job didn't give me a salary bump for passing them, but I would've (supposedly) been let go if I hadn't.

 

[Doctor Bagel]

Everyone I graduated with last year took them first year out (and passed), my job didn't give me a salary bump for passing them, but I would've (supposedly) been let go if I hadn't.

Wow, that doesn't sound like a supportive employer.

 

[MacDonaldTriad]

A lot of systems have BC as the only quality assurance measure for their docs coming in as a provider. The ABPN is no longer using the term “board eligible”. You are either certified or you are not.

It is true that you are qualified to take the boards for 7 years after graduation. Otherwise you have to retake your clinical skills examinations. This can be difficult because it isn’t clear to programs what passing a psychiatrist means in terms of future liability. Most will test their previous graduates, but not psychiatrists that they didn’t train.

Some have seen this as a money making process. The conflicts of interests are very large in my opinion. “Pay me $1K and I’ll tell you if you pass”.

 

[peppy]

Get it and ask for a pay bump for the added qualifications.

Can you give a rough idea of how much more money you think it is "worth" to be board certified? For example, if you're looking at a job that offers a salary of say 250K, do you think most employers would consider it reasonable to ask for another 5K on top of that because of the extra qualification?

 

[F0nzie]

Can you give a rough idea of how much more money you think it is "worth" to be board certified? For example, if you're looking at a job that offers a salary of say 250K, do you think most employers would consider it reasonable to ask for another 5K on top of that because of the extra qualification?

5-10k per cert

 

[notdeadyet]

For example, if you're looking at a job that offers a salary of say 250K, do you think most employers would consider it reasonable to ask for another 5K on top of that because of the extra qualification?

Id request $8-10k and settle for $5k. This assumes you don't already have the job, obviously.


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[Trismegistus4]

Have they changed the way they do registration since last year? As I mentioned, several graduates from my program took the boards last fall. Yet this year, my program director seemed surprised that she had to enter info about my rotations before I graduate in order for me to register.

 

[Doctor Bagel]

Have they changed the way they do registration since last year? As I mentioned, several graduates from my program took the boards last fall. Yet this year, my program director seemed surprised that she had to enter info about my rotations before I graduate in order for me to register.

Mine had to do all that last year, too.

 

[whopper]

I'd recommend taking it right after 4th year, or something equivalent such as fellowship.

The only reason I can think of as to not take it would be if you haven't passed USMLE Step III yet. The focus needs to be on that exam until it's passed, then you can focus on the psych board exam.

Reasons why-Several already mentioned here.
1-You have the feather in the cap when applying for jobs.
2-While at work as an attending you can focus on work and getting used to the new job. Any new job I've seen (and I've had lots of jobs-state psyche hospital, court doctor, U of Cincinnati, community psych center, St. Louis U., Lindner Center of Hope, private forensic cases, private practice) will have you go through a 1-3 month period where you don't know WTF is going on and you need to focus on learning how to handle the new job. Forget studying for the board exam while this happens.
3-While a resident you can focus on studying for the board exam while in a learning environment with several attendings that hopefully are experts in their own fields. You can ask questions on several psych-related issues and you'll have lost this connection after graduating (or it'll be greatly weakened).
4. PGY III and IV is relatively easy in most places, while as an attending you are making a lot more money for the time you put in. Cost-effectively it's more of a payback to study as a resident for this exam vs being an attending and studying for it.
5. Several insurance panels will not take you unless you are BE and attempt the board exam. Get this headache out of the way before you become an attending.

Reasons against:
1-Already mentioned-you might not have passed USMLE Step III, in which case you're in a very different world of priorities. Get that monkey off your back and pass it.
2-depending on your residency, you might have a tough PGY IV year with little time to study.


Hmm can't think of any other reasons.

If you don't take the board exam close to PGY IV so be it. It's not the end of the world. Lots of people did that and they're fine. For me, my first job was as an attending in a state hospital and the workload there was incredibly non-existent. I had little to do, and needed to occupy about 6 hours of my 8 hour day with something so in that case studying and taking the board exam in that job setting was very compatible.

 

[Trismegistus4]

Whopper, I'm at a loss to understand how your listed advantages are advantages given the timeline on which most people graduate from residency/fellowship and start their first job (July/August,) and when the boards are offered (September.)

1-You have the feather in the cap when applying for jobs.

In order to start working within a reasonable amount of time after residency, you have to apply for jobs while still a PGY-4. So I won't be board certified by the time I'm applying for jobs.

2-While at work as an attending you can focus on work and getting used to the new job. Any new job I've seen (and I've had lots of jobs-state psyche hospital, court doctor, U of Cincinnati, community psych center, St. Louis U., Lindner Center of Hope, private forensic cases, private practice) will have you go through a 1-3 month period where you don't know WTF is going on and you need to focus on learning how to handle the new job. Forget studying for the board exam while this happens.

If you start your job in July/August as most people do, and the exam is offered in September, that 1-3 month period coincides with what should be your board study time.

3-While a resident you can focus on studying for the board exam while in a learning environment with several attendings that hopefully are experts in their own fields. You can ask questions on several psych-related issues and you'll have lost this connection after graduating (or it'll be greatly weakened).

If you start studying way in advance. Otherwise, you're talking about starting to study at the very end of PGY-4 year, at which point you won't have that access for long.

5. Several insurance panels will not take you unless you are BE and attempt the board exam. Get this headache out of the way before you become an attending.

Again, unless you're independently wealthy, you're going to have to start working before September, so there's no way to take the exam before becoming an attending.

Am I missing something?

 

[TexasPhysician]

50% of my class did not do boards 1st year out. I'm sure they will within 7 years, but it hasn't made a difference salary wise. It may have to do with the jobs they chose though.

 

[MacDonaldTriad]

I’m all for civil disobedience and all of that, but let me frame this in another way. After 12 years of post-high school education and some fairly substantial hurdles like getting into medical school, would you really let $2K and a day of examination get in the way of finishing just because of the principle of the thing? Yes it is a monopoly, yes it doesn’t mean that much in terms of quality standards, but you should be able to pass it if you trained yourself well and there is nothing wrong with demonstrating your abilities with one more test. If anything, do it just to “be true to your school” because board pass rates for training programs is a serious measure of success. I will grant you the MOC stuff is irritating. I really don’t mind the money or the tests, but this is getting annoying.

It would be interesting to do a poll on attitudes towards taking the boards and look at board certification as an independent variable. Like me, a lot of people have to be board certified for their jobs. I wonder what proportion of those who suggest not taking boards have not taken them.

 

[psychattending]

The vast majority (>90%) of my residents take in what would have been their PGY5 year, even those that are doing a fellowship. Lots of advantages as enumerated by others. From my perspective when a resident has chosen not to immediately take it, he/she almost invariably complains that he/she should have taken it earlier and that it was much harder to find the time to study for it because he/she was busy with their job.

The Boards did make a change recently. Previously a program could certify residents either via PreCert or by sending in a letter. I believe this year (but it could have been last year) was the first year that they went to requiring all programs to go through PreCert.

 

[F0nzie]

I’m all for civil disobedience and all of that, but let me frame this in another way. After 12 years of post-high school education and some fairly substantial hurdles like getting into medical school, would you really let $2K and a day of examination get in the way of finishing just because of the principle of the thing? Yes it is a monopoly, yes it doesn’t mean that much in terms of quality standards, but you should be able to pass it if you trained yourself well and there is nothing wrong with demonstrating your abilities with one more test. If anything, do it just to “be true to your school” because board pass rates for training programs is a serious measure of success. I will grant you the MOC stuff is irritating. I really don’t mind the money or the tests, but this is getting annoying.

It would be interesting to do a poll on attitudes towards taking the boards and look at board certification as an independent variable. Like me, a lot of people have to be board certified for their jobs. I wonder what proportion of those who suggest not taking boards have not taken them.

In my region psych Nps are running inpatient and outpatient so just being a doctor is a big deal. I am sure this affects attitudes for getting certified.

If money is what the boards want I would rather they cut out the BS and just pay them 10k for a lifetime cert to leave me the #%^* alone.

 

[Shikima]

In my region psych Nps are running inpatient and outpatient so just being a doctor is a big deal. I am sure this affects attitudes for getting certified.

If money is what the boards want I would rather they cut out the BS and just pay them 10k for a lifetime cert to leave me the #%^* alone.

I think we all pretty much feel the same way.

 

[whopper]

No problem not fully understanding me. A lot of the problem here is me!
I've been past applying for quite some time and the mental cobwebs are there.
Some residents don't work immediately after residency. Some take some time off, some only work part-time, others do fellowship.

You're not missing anything. My post was rather excessively too broad in some areas and too specific for others.

 

[Trismegistus4]

No problem not fully understanding me. A lot of the problem here is me!
I've been past applying for quite some time and the mental cobwebs are there.
Some residents don't work immediately after residency. Some take some time off, some only work part-time, others do fellowship.

You're not missing anything. My post was rather excessively too broad in some areas and too specific for others.

One situation in which your post would definitely make sense is if someone took the general boards while in fellowship. Then they could be general-board certified when applying for jobs, and take their time more to prepare for their subspecialty boards.

 

[PikminOC]

Everyone I graduated with last year took them first year out (and passed), my job didn't give me a salary bump for passing them, but I would've (supposedly) been let go if I hadn't.

Correct. This is what I've seen in employed positions.
At least they paid for it as they gave a lot of CME money.

 

[Trismegistus4]

Correct. This is what I've seen in employed positions.
At least they paid for it as they gave a lot of CME money.

Would they reimburse you with CME money if you paid for the exam before you started working there?

 

[keifernny2]

Depends on the job. In my case, yes, I made it part of my negotiation. I didn't get the reimbursement until I started in July, but I had to make final payment in Feb, so the cost was on me for the months in between.


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