Newly Published
Education  |   April 2017
Effectiveness of Written and Oral Specialty Certification Examinations to Predict Actions against the Medical Licenses of Anesthesiologists
Author Notes
  • From the American Board of Anesthesiology, Raleigh, North Carolina (Y.Z., H.S., D.J.C., A.E.H., D.O.W.); Department of Anesthesiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts (D.J.C.); Federation of State Medical Boards, Euless, Texas (A.Y.); and Department of Anesthesiology, Mayo Clinic, Rochester, Minnesota (D.O.W.).
  • Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).
    Supplemental Digital Content is available for this article. Direct URL citations appear in the printed text and are available in both the HTML and PDF versions of this article. Links to the digital files are provided in the HTML text of this article on the Journal’s Web site (www.anesthesiology.org).×
  • Submitted for publication September 7, 2016. Accepted for publication February 15, 2017.
    Submitted for publication September 7, 2016. Accepted for publication February 15, 2017.×
  • Acknowledgments: The authors thank Frann Holmes, M.S., former business intelligence specialist from the Federation of State Medical Boards, for matching American Board of Anesthesiology records with Federation of State Medical Boards records to provide the physician licensure and disciplinary actions data.
    Acknowledgments: The authors thank Frann Holmes, M.S., former business intelligence specialist from the Federation of State Medical Boards, for matching American Board of Anesthesiology records with Federation of State Medical Boards records to provide the physician licensure and disciplinary actions data.×
  • Research Support: Supported by the American Board of Anesthesiology, Raleigh, North Carolina.
    Research Support: Supported by the American Board of Anesthesiology, Raleigh, North Carolina.×
  • Competing Interests: Drs. Harman, Sun, and Zhou are staff members of the American Board of Anesthesiology (ABA); Dr. Young is a staff member of Federation of State Medical Boards; Drs. Culley and Warner are ABA Directors and receive a stipend for their participation in ABA activities.
    Competing Interests: Drs. Harman, Sun, and Zhou are staff members of the American Board of Anesthesiology (ABA); Dr. Young is a staff member of Federation of State Medical Boards; Drs. Culley and Warner are ABA Directors and receive a stipend for their participation in ABA activities.×
  • Correspondence: Address correspondence to Dr. Sun: American Board of Anesthesiology, 4208 Six Forks Road, Suite 1500, Raleigh, North Carolina 27609. huaping.sun@theABA.org. Information on purchasing reprints may be found at www.anesthesiology.org or on the masthead page at the beginning of this issue. Anesthesiology’s articles are made freely accessible to all readers, for personal use only, 6 months from the cover date of the issue.
Article Information
Education / Quality Improvement
Education   |   April 2017
Effectiveness of Written and Oral Specialty Certification Examinations to Predict Actions against the Medical Licenses of Anesthesiologists
Anesthesiology Newly Published on April 13, 2017. doi:10.1097/ALN.0000000000001623
Anesthesiology Newly Published on April 13, 2017. doi:10.1097/ALN.0000000000001623
Abstract

Background: The American Board of Anesthesiology administers written and oral examinations for its primary certification. This retrospective cohort study tested the hypothesis that the risk of a disciplinary action against a physician’s medical license is lower in those who pass both examinations than those who pass only the written examination.

Methods: Physicians who entered anesthesiology training from 1971 to 2011 were followed up to 2014. License actions were ascertained via the Disciplinary Action Notification Service of the Federation of State Medical Boards.

Results: The incidence rate of license actions was relatively stable over the study period, with approximately 2 to 3 new cases per 1,000 person-years. In multivariable models, the risk of license actions was higher in men (hazard ratio = 1.88 [95% CI, 1.66 to 2.13]) and lower in international medical graduates (hazard ratio = 0.73 [95% CI, 0.66 to 0.81]). Compared with those passing both examinations on the first attempt, those passing neither examination (hazard ratio = 3.60 [95% CI, 3.14 to 4.13]) and those passing only the written examination (hazard ratio = 3.51 [95% CI, 2.87 to 4.29]) had an increased risk of receiving an action from a state medical board. The risk was no different between the latter two groups (P = 0.81), showing that passing the oral but not the written primary certification examination is associated with a decreased risk of subsequent license actions. For those with residency performance information available, having at least one unsatisfactory training record independently increased the risk of license actions.

Conclusions: These findings support the concept that an oral examination assesses domains important to physician performance that are not fully captured in a written examination.