My Path for Board Recertification
June 28, 2023
Fresh out of fellowship, I was understandably quite proud of being quadruple board certified. It was after all the culmination of years of training and a demonstrable badge of expertise. The shine had worn off by my first 10-year recertification cycle, and now, as a seasoned clinician, the prospect of undergoing yet another round of recertification weighs heavily. Fortunately, alternatives to the 1-day exam are now available in the form of the American Board of Internal Medicine (ABIM) Longitudinal Knowledge Assessment (LKA) option. Soon, I will need to commit to one of these options. As many of us may be faced with a similar situation, I thought I would share my process in selecting a recertification pathway.
The benefits of a single-day exam center around 8 hours of testing, hopefully resulting in a 10-year reprieve (aside from maintenance of certification). Of course, this doesn’t count the weeks to months of preparation for the test. Luckily, well-developed resources are available and have served me well in preparing for my initial round of certifications. These resources range from web-based (Medical Knowledge Self-Assessment Program [MKSAP®] MedStudy; CHEST SEEK™ learning resources, American Academy of Sleep Medicine Board Review online modules) to live courses (CHEST Critical Care, Pulmonary, and Sleep Medicine Board Review). My board preparation has also included reviewing landmark trials in high-impact journals over the past 3 to 5 years, as well as reviewing articles in journals associated with our respective professional societies.
The idea of the LKA is appealing and offers flexibility that integrates into your schedule. As of 2023, it is available for both sleep and critical care medicine, with more subspecialties on the way. The charm of the LKA revolves around small boluses of questions on a quarterly basis, with a focus on knowledge assessment, and access to resources during the test. It is intended to mirror how most of us practice by looking up information as needed throughout the day. Like the single-day examination, UpToDate® would be a well-suited resource for the LKA as well; however, limitations may exist based on the subject matter.
The structure of the LKA, however, results in a more protracted time frame for testing, assessment, and learning, and results of whether one is performing well enough to pass the LKA is typically not available until several 3-month cycles of testing have passed. In case one does not pass, the individual is then eligible to take the traditional 1-day test. Further, at this time, there does not appear to be an option for combining the LKA for different boards, thus resulting in a large number of questions each quarter and significant amount of time required for those who will recertify in multiple specialties. Hopefully, as we navigate this process together, the ABIM will consider consolidating the LKA in overlapping areas to truly streamline the pathway for those with multiple certifications.
As things stand, my current inclination is toward taking the 1-day exam for my primary specialties. However, for subject areas more remote to my daily practice (internal medicine), I may consider the LKA. Clearly, this is a highly personal decision based on my preferences and values, and everyone needs to make their decision based on their unique circumstances.
Saadia A. Faiz, MD, FCCP
Saadia A. Faiz, MD, FCCP, currently practices in Houston, Texas. She has board certifications in internal medicine and pulmonary, critical care, and sleep medicine. Her roles with CHEST include Chair of the Pleural Disease Section of the Thoracic Oncology and Chest Procedures Network, member of the Educator Development Subcommittee and Domain Bronchoscopy Task Force, member of the CHEST Scientific Program Committee, and faculty for the CHEST Pulmonary Medicine Board Review. Her research interests include pulmonary manifestations of cancer, pleural disease in hematologic malignancies, pulmonary hypertension in cancer, sleep and cancer, and medical education.