Recertification Exam Performance in General Surgery is Associated With Subsequent Loss of License Actions

Area of Science:

• Medical Licensure
• Surgical Recertification
• Professional Accountability

Background:

• Board certification is time-limited, facing criticism for necessity.
• Limited research exists on recertification exam performance and subsequent professional outcomes.

Purpose of the Study:

• To investigate the association between initial performance on the American Board of Surgery (ABS) recertification exam and subsequent disciplinary actions by state medical boards.
• To determine if failing the recertification exam predicts future license actions.

Main Methods:

• Retrospective analysis of general surgeons initially certified by the ABS between 1976 and 2005.
• Examined loss-of-license actions from 1976 to 2016 using the Disciplinary Action Notification System.
• Employed Cox proportional-hazards regression to analyze risk factors for disciplinary actions.

Main Results:

• A total of 14,169 general surgeons were included in the analysis.
• Surgeons failing their first recertification exam had a significantly higher incidence rate of loss-of-license actions (3.41) compared to those who passed (0.01).
• Cox regression revealed a significantly higher adjusted hazard rate (2.98) for loss-of-license actions in surgeons who failed their first attempt, even after adjusting for other characteristics.

Conclusions:

• Failing the initial American Board of Surgery recertification exam is a significant predictor of increased subsequent loss-of-license actions.
• Demonstrating adequate surgical knowledge through recertification exams appears crucial for maintaining medical licensure and preventing disciplinary actions.