Medical Professionalism Is Like Pornography: You Know it When You See it

Addressing professionalism is a key role of Certification Boards, but how best to do this is not clear. This article describes a 360° approach to monitoring and enhancing professionalism taken by the American Board of Urology (ABU). In addition to monitoring full and active medical licenses, ABU has identified ethical issues specific to Urology, includes a position article on ethics in Urology on its Web site, and requires a completion of modules on ethics. As a part of its 10-year cycle, the Board requires peer evaluations from other urologists in the community. Finally, and most importantly, ABU uses a portfolio practice log to evaluate the candidates' use of procedures appropriate to their stated subspecialty area of expertise, evaluation of potential overuse or inappropriate use of procedures and a narrative that details any major complications associated with their procedures.