End of an era for board certification - deadline is now

[Gonio5]

The American Board of Ophthalmology, in conjunction or pressure from the ABMS, now has a 7 year board certification requirement. If you do not become board certified within 7 years of residency, you are banned forever. There is a minor exception in the case of health problems, but that might only extend it a year or so. The grandfather period ends with this fall's written exam (WQE).

If you are not board certified within 7 years of finishing residency, the last time to take the WQE is this fall. The registration deadline is July 1 but it seems that late applications are being taken. Maybe it might be for 30 days. If so, the deadline to register is tomorrow.

For those unsure, I would register and you can always change your mind later but would not be eligible for a partial refund.

The deadline for passing the oral exam is in May 2025 (for those beyond 7 years after finishing residency).

Good luck to those approaching their 7 year deadline. Let us, the ophthalmology community, help you in any way. Study hints, stories of how we passed, how we studied, etc. I am open to help as probably others are.

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[eyeeye_captain]

Pretty sure that went into effect 1/1/23, so you’re a little behind the times but I guess trying to rally the troops. Here’s the thread from last year:

ABO 7 year limit

If you can’t/don’t want to get certified by 7 years, it ain’t ever gonna happen. This is a nothingburger. You play the game just like medical school/residency/fellowship.

I have my bones to pick with ABO, but at least it’s cheap and quick CME. If you’re non-surgical or have an ASC willing to sign you up, you’ll be ok I guess, but almost any reputable facility that will let you operate is going to ask about board certification to CTA. Heck, it’s even to CYA on the whole. If you have a complication or a missed diagnosis and the plaintiff’s attorney brings up that you aren’t certified (even if you’re perfectly competent), jurors will pay attention.

 

[Gonio5]

It's true that the policy technically came into effect in 2023 but there was a grandfathering provision that if you were beyond 7 years, you had until 2025 to become board certified. In other words, the 7 year policy will not really come into effect until 2025. Those who finished after 2023 will have 7 years. Those who finished in 2018 will have 7 years. Those who finished residency before 2018 will have until 2025.

 

[eyeeye_captain]

While I commend you for trying to remind some of our colleagues about this (who for better or likely worse are at this point), I think it will fall on deaf ears to be that far out and not have handled this already. 7+ years is a pretty long time to sit on something that, while flawed, is generally considered a basic requirement for practice. You don’t see anybody advertising online as “not board certified.”

 

[RetinaDude]

Such a good deal. Now, the ABO can sucker us into paying for a worthless recertification throughout a 7 year process instead of a 10 year process. The entire recertification process is such a waste of time and is basically a fundraising tool for each of the specialty boards. They make millions off of these recertifications and imply (lie) to the public claiming it increases patient safety.

 

[Gonio5]

Such a good deal. Now, the ABO can sucker us into paying for a worthless recertification throughout a 7 year process instead of a 10 year process. The entire recertification process is such a waste of time and is basically a fundraising tool for each of the specialty boards. They make millions off of these recertifications and imply (lie) to the public claiming it increases patient safety.

It is true that the ABO has considered a shorter period that 10 years, possibly from ABMS pressure. However, some in the ABO support maintaining 10 years, which is good.

The 7 year figure is that now graduating residents must become board certified within 7 years of finishing training or they will have a lifetime ban to becoming board certified. The exception is foreign trained ophthalmologists. They have 7 years from the date of their initial application so they can study first then apply.

Nurse practitioners find it very easy to become board certified. They can easily become board certified in multiple specialties. It's quackery.

 

[RetinaDude]

It’s all a money grab and ridiculous. Yeah, the ability of NPs to be a FNP one week and then a cardiology NP the next is scary

 

[Slide]

Money grab yes, but after going through the process it does weed out a few ophthalmologists that don't need to be practicing. Not the most efficient way to do it though.

But looking back it at it now, I made it out to be a bigger deal than it should've been. With any sort of decent training and preparation, it's passable, and much more accommodating now since it's virtual.

Also the NP house of cards I think is going to fall sooner than later. Already receiving scrutiny in the press and even many NPs themselves are complaining about how horrible the standards are.

 

[dantt]

I know plenty of docs that are not board certified or will ever be. They seem to have booming practices.

 

[Slide]

I know plenty of docs that are not board certified or will ever be. They seem to have booming practices.

Are these older docs or recent graduates? The few that I know that are not board certified are older and either work at the VA or have been grandfathered into insurance contracts.

 

[MstaKing10]

Does board certification help protect us from scope expansion?

 

[Gonio5]

The spring ABO oral exam results are out. 68 people are hurting. It sounds painful. The failure rate is about the same, a tad higher at 21%. 61.4% of retakers passed. That means that 38.6% of those have to take it for the 3rd time (or more). 18% of first time takers failed.

I believe the oral exam is still hard but a little more predictable than half a generation or more ago. In those days, there were rumors of harassment and hazing as well as questions that were odd and difficult to answer.

With the 7 year rule, if one takes the exam at every possible setting, they could take it 7 times. That might be the written 3 times and the oral 4 times. Or the written 5 times and the oral 2 times. This is because the oral exam is going to change to a once a year schedule. Had the twice a year oral schedule been kept, that could mean 6 written + 2 oral attempts or 4 written + 8 oral attempts or various combinations. The stakes for board certification are really high so giving 4 chances or more is not unreasonable. With the written, the pass rate for retakers is really low, like 28-59%.

 

[dantt]

Are these older docs or recent graduates? The few that I know that are not board certified are older and either work at the VA or have been grandfathered into insurance contracts.

1 is 39 years old. "Published numerous research papers," latest surgical techniques, etc etc.
Other is 49 years old. "Published numerous research papers,", latest surgical techniques, KOL, etc etc.

 

[Gonio5]

1 is 39 years old. "Published numerous research papers," latest surgical techniques, etc etc.
Other is 49 years old. "Published numerous research papers,", latest surgical techniques, KOL, etc etc.

I know of 20 non-board certified ophthalmologists by reputation, not necessarily personal friends.
5 of them had criminal problems and lost board certification.
4 did not do MOC/Continuing Certification.
Of the 11 who never became board certified, two finished in 2018, two finished in the mid to late 1990's, and the remaining 8 finished between the early 2000's and early 2010's. In other words, half are 5-15 years out of residency and are under 45 years old. Some are hurting. Others do not seem to be hurting but may be hurting on the inside.

 

[kevlar22]

Figured it would be worth posting here:

Just found out yesterday that I failed the oral - which hurts - but I guess doesn't hurt as much as not matching the first time.

I realized that maybe I should've postponed my test date as fellowship got busy with one of my co-fellows leaving essentially doubling my clinical and surgical duties, apartment hunting, job hunting (with an employer pulling a contract and trying to scramble for another job), research presentation, other life factors...I did devote 6-8 weeks of studying but in retrospect this may have been insufficient with the background noise I was experiencing and probably limited bandwidth I had for studying, as I would end up passing out in front of my computer

The resources I used were Pemberton and Luviano. I did some oral presentations with my significant other, who is a board certified ophthalmologist, and they were as shocked as I was when we found out I failed given my previous history of doing fine with OKAPs and passing the written exam with no issue.

I subscribed for ophthogenie, and will be using the Loma Linda PDF, Wills manual and using pemberton/luviano closer to the exam date. Decided to do November test date, as I do not want to have this looming over my head until May 2025.

Any updates on what people did differently their second time around? Trying to decide between the Denver course vs Osler. I just really do not want to fail a second time...

Finding out during your vacation is oh so fun! So we currently have 99 days until November 8th, and the material is (relatively) fresh in my head, so I was planning on doing some warm up studying going through the cases above as I will be traveling until September 8th. With some 2 months of hardcore studying from September to November. I will be moving states and starting a new job on October 14th, but I will have nothing on my plate September 8th through October 13th, other than moving and getting settled in. Any advice as to my current situation?

 

[Slide]

Figured it would be worth posting here:

Just found out yesterday that I failed the oral - which hurts - but I guess doesn't hurt as much as not matching the first time.

I realized that maybe I should've postponed my test date as fellowship got busy with one of my co-fellows leaving essentially doubling my clinical and surgical duties, apartment hunting, job hunting (with an employer pulling a contract and trying to scramble for another job), research presentation, other life factors...I did devote 6-8 weeks of studying but in retrospect this may have been insufficient with the background noise I was experiencing and probably limited bandwidth I had for studying, as I would end up passing out in front of my computer

The resources I used were Pemberton and Luviano. I did some oral presentations with my significant other, who is a board certified ophthalmologist, and they were as shocked as I was when we found out I failed given my previous history of doing fine with OKAPs and passing the written exam with no issue.

I subscribed for ophthogenie, and will be using the Loma Linda PDF, Wills manual and using pemberton/luviano closer to the exam date. Decided to do November test date, as I do not want to have this looming over my head until May 2025.

Any updates on what people did differently their second time around? Trying to decide between the Denver course vs Osler. I just really do not want to fail a second time...

Finding out during your vacation is oh so fun! So we currently have 99 days until November 8th, and the material is (relatively) fresh in my head, so I was planning on doing some warm up studying going through the cases above as I will be traveling until September 8th. With some 2 months of hardcore studying from September to November. I will be moving states and starting a new job on October 14th, but I will have nothing on my plate September 8th through October 13th, other than moving and getting settled in. Any advice as to my current situation?

Chin up, it'll all be ok. My situation was the exact same as yours; was way too busy during fellowship to prepare properly. I too should have pushed it off several months until I had proper time to prepare.

IMO you can't get by with just Pemberton and Luviano, it'll prep you for some of the presentations but you need to re-review most of the major topics in each field. During fellowship it's remarkable how fast how stupid you become with the other subspecialties. I used Wills and the Loma Linda PDFs in additio to supplement my knowledge.

If you can take the Denver course (if still offered), do it. Also prep with a friend if you can, it takes repetition to get it downpat. I crushed it the second time and didn't realized how unprepared I truly was until I took it the second time. Even though the material is fresh, be honest with yourself and determine if you need more time or not between testing sessions.

 

[kevlar22]

Chin up, it'll all be ok. My situation was the exact same as yours; was way too busy during fellowship to prepare properly. I too should have pushed it off several months until I had proper time to prepare.

IMO you can't get by with just Pemberton and Luviano, it'll prep you for some of the presentations but you need to re-review most of the major topics in each field. During fellowship it's remarkable how fast how stupid you become with the other subspecialties. I used Wills and the Loma Linda PDFs in additio to supplement my knowledge.

If you can take the Denver course (if still offered), do it. Also prep with a friend if you can, it takes repetition to get it downpat. I crushed it the second time and didn't realized how unprepared I truly was until I took it the second time. Even though the material is fresh, be honest with yourself and determine if you need more time or not between testing sessions.

Thank you. I do have the loma linda PDF as well, so will be using that, Wills and ophtho genie (end of August). Overall, the test seemed fair, and I didn't walk out thinking I crushed it, nor did I think I failed.

The material is relatively fresh in my head, so at this point, I'm just trying to spend the rest of August reviewing cases and Wills (maybe my Pt Education needs some brushing up on), and I'll be able to sit down all of September and most of October to study for it, since I do not start my job October 14th. I will have to move to a different state, so that may cut my time by a little bit, but I will be using a moving company. From what I was told, my clinic schedule in the first few weeks are lighter to allow for the transition

Just the thought of taking it in May distresses me as this would mean this would loom over my head for another 9 months, so I want to give it my all to pass this time in November. Thought I could enjoy my vacation, but I'll just read a few hours in the morning and evening before a day of activities and practice my 2 minute timing. My significant other timed me and noted that my timing wasn't an issue

Also would you recommend the UC Denver course or Osler course? I want to make sure I am doing it right this time.

 

[Slide]

Thank you. I do have the loma linda PDF as well, so will be using that, Wills and ophtho genie (end of August). Overall, the test seemed fair, and I didn't walk out thinking I crushed it, nor did I think I failed.

The material is relatively fresh in my head, so at this point, I'm just trying to spend the rest of August reviewing cases and Wills (maybe my Pt Education needs some brushing up on), and I'll be able to sit down all of September and most of October to study for it, since I do not start my job October 14th. I will have to move to a different state, so that may cut my time by a little bit, but I will be using a moving company. From what I was told, my clinic schedule in the first few weeks are lighter to allow for the transition

Just the thought of taking it in May distresses me as this would mean this would loom over my head for another 9 months, so I want to give it my all to pass this time in November. Thought I could enjoy my vacation, but I'll just read a few hours in the morning and evening before a day of activities and practice my 2 minute timing. My significant other timed me and noted that my timing wasn't an issue

Also would you recommend the UC Denver course or Osler course? I want to make sure I am doing it right this time.

It’s been 7 years since I went through it, but UC Denver all the way. The osler course is a waste of time and money. You spent most of the time watching others go through the simulations. The Denver course is a fully simulated exam, which is what it sounds like you need the most.

 

[Gonio5]

It’s been 7 years since I went through it, but UC Denver all the way. The osler course is a waste of time and money. You spent most of the time watching others go through the simulations. The Denver course is a fully simulated exam, which is what it sounds like you need the most.

It's changed in those 7 years. Denver is better to simulate the stress of the oral exam. You start and cannot stop until it's done. You have to hold back your tears! (just kidding) Then they go over answers. Osler covers far more material. With it now being online, you can stop other people's simulation then answer it on your own then turn back on the simulation. There is also the option to be grilled by instructors in real time, resulting in more contact hours and questions/cases than Denver.

 

[vkcakc23]

Thank you. I do have the loma linda PDF as well, so will be using that, Wills and ophtho genie (end of August). Overall, the test seemed fair, and I didn't walk out thinking I crushed it, nor did I think I failed.

The material is relatively fresh in my head, so at this point, I'm just trying to spend the rest of August reviewing cases and Wills (maybe my Pt Education needs some brushing up on), and I'll be able to sit down all of September and most of October to study for it, since I do not start my job October 14th. I will have to move to a different state, so that may cut my time by a little bit, but I will be using a moving company. From what I was told, my clinic schedule in the first few weeks are lighter to allow for the transition

Just the thought of taking it in May distresses me as this would mean this would loom over my head for another 9 months, so I want to give it my all to pass this time in November. Thought I could enjoy my vacation, but I'll just read a few hours in the morning and evening before a day of activities and practice my 2 minute timing. My significant other timed me and noted that my timing wasn't an issue

Also would you recommend the UC Denver course or Osler course? I want to make sure I am doing it right this time.

I used Pemberton and Loma Linda. Assuming you have the actual correct knowledge, the important part of orals is to say things efficiently. This is why many people advocate for practicing with a study partner because it forces you to talk out loud. In whatever studying you do, you need to practice speaking your answers out loud and keeping it under 3 mins. I would practice with a goal of a shorter time per case since test day always brings out the anxiety and your answers get longer.

I also think the Candidate Manual/Handbook that ABO has is helpful to give you an idea of what to expect. I know you’ve already taken it once so you have an idea but it’ll be good to read through it and watch some of the videos.

Here’s the link for that

 

[Gonio5]

Assuming you have the actual correct knowledge, the important part of orals is to say things efficiently. This is why many people advocate for practicing with a study partner because it forces you to talk out loud.

Saying things efficiently is excellent advice. I found that writing out a script for a few cases to be a helpful start, then edit the script many times to make it more efficient. Obviously, you cannot do that (write scripts) for all your studying or you would become an author. Just doing at least 3-10 helps you start thinking and talking efficiently.

Though the ABO would never listen to me, I believe that converting the oral exam to a written essay exam would be more fair but would be a longer, all day exam because writing is slower. The first ABO exams had essay questions.

As far as a study partner, pros and cons. The con if both are taking the exam is that it slows you down. One thing I did was to carry the Pemberton book in the car. I would then randomly open a page while driving or at a stop light and then start answering the question by talking to myself.