Objectives of recertification

Recertification of physician competency is a major topic of discussion and debate in the U.S.A. today. Nearly all graduates of U.S. medical schools are eventually certified by an approved American Medical Specialty Board. Since the mid-1970's all of these Specialty Boards have endorsed the concept of recertification. This paper defines what is meant by periodic assessment of physician competence, why such an assessment is becoming a reality, and the principles which should be followed in implementing a system for the periodic assessment of physician competency. The evaluation of physician competency is a task of enormous proportions when one recognizes the difficulty of reliably and validly measuring all aspects of the skill and abilities of the practicing physician. The evaluation of intellectual capabilities is feasible, but somewhat limited with regard to the spectrum of abilities expected of the physician. In the U.S.A., both the public and the medical profession have placed pressure on physicians to implement programs of recertification. Unlike most of the other professions, medicine has taken upon itself to develop and implement programs for recertification of the medical specialist. To develop recertification programs of value, they should meet certain standards. These include: the need for clear specification of the criteria by which qualification for recertification will be judged or measured; the need to attempt to coordinate programs of recertification with programs of continuing medical education; the need to design evaluation tools that accurately reflect the skills and abilities needed by the physician in the practice of the medical specialties; and the need to be certain that all who participate in such a program have the opportunity to successfully complete the program (that standards for passing tests be absolute rather than normative).