Education and training and boards, oh my! How residency and fellowship coordinators can better understand board exams

Mandi Smith, C-TAGME, GME Coordinator II, shares tips for residency and fellowship program coordinators on understanding the board certification exams their trainees will take.

How familiar are program coordinators with the board certification examinations that their trainees are required to take after or during their residency and/or fellowship program? In a recent survey of Penn State Health Milton S. Hershey Medical Center residency and fellowship program coordinators conducted by the Office of Graduate Medical Education, nearly 32 percent of respondents indicated that they do not feel competent at all or the feel only somewhat competent in knowing and interpreting their specialty’s board requirements. Another 9 percent said they did not feel this to be part of their job.

It is important for program coordinators to understand their specialty’s board requirements. This article is designed to help coordinators identify what board examinations their trainees will or may be taking and establish requirements and determine the coordinators’ roles in assisting their trainees with this process.

Additionally, examples of the certifications for cardiology fellows will be shown to demonstrate what kind of information coordinators should be seeking.

Determining what board certification examinations are required

There are multiple ways coordinators can determine what board certifications their trainees will or may take.

Coordinators can start by asking themselves these questions:

• Do trainees in this program have prerequisite board requirements?
• Are these trainees residents/interns or fellows?

If residents/interns, it is likely they do not have any prerequisite board requirements.

If fellows, it is likely that they do have pre-requisite board requirements.

For example, a cardiology fellow must complete a three-year Internal Medicine Residency prior to fellowship. Therefore, a first-year cardiology fellow will be taking their Internal Medicine boards within their first few months of fellowship. And, in order to sit for the Cardiovascular Disease boards after their cardiology training, they must have first passed the Internal Medicine boards. This is why it’s important for the coordinator to know their trainees are taking these exams.

Most coordinators are hopefully familiar with the ACGME requirements and expectations for their graduates to pass their boards. This means that each program’s outcomes are directly affected by their trainees passing their boards. It is the job of the coordinator to keep tabs on each trainee’s passing of these prerequisite boards.

• Are these trainees educated in multiple subspecialties within their specialty?

If yes, it is likely that they have additional board examinations in which they may choose to get certification.

Any subspecialty that requires a deeper knowledge of its content area is likely to have its own further certification. This may not be required, but may be desired by the trainee or their future employer. These certifications often have strict requirements for time spent training in the content area, procedures performed or patients seen/treated. Although the ultimate responsibility for verifying this information to the board typically belongs to the program director, it is important for the coordinator to know these requirements as the director likely relies on the coordinator for tracking the information and ensuring its accuracy.

Where to find this information

Determining who the certifying board is for a specialty is the first step in ascertaining board requirements. The American Board of Medical Specialties is the first place to look for this. Once determined, coordinators should visit their certifying board’s website to obtain requirements.

Other people or groups that can assist in obtaining this information are the current chief residents/fellows, the program director(s), any specialty coordinator group, the GME office or the ACGME.

What to know about each board certification

Information that coordinators should know about each examination includes:

• Who is the certifying board?
• What are the requirements or prerequisites?
• When is the registration period?
• When is the exam administered?
• How much does the exam cost?
• Does the program cover the cost, or may the trainee be reimbursed from their Educational Support Funds?
• When will the results be released?

Again, while the responsibility for knowing this information ultimately lies on someone else (the trainee), in reality, part of the coordinator’s job is to make the trainees’ jobs (administratively) easier. Helping them navigate this, especially in a subspecialty with many board certifications, will be appreciated.

Testamur and diplomate defined

• Testamur: A certificate that an examination held, especially by a university, has been passed.
• Diplomate: A person who holds a diploma, especially a physician qualified to practice in a medical specialty by advanced training and experience in the specialty followed by passing an intensive examination by a national board of senior specialists.

This may or may not apply to any of the certifications that individual trainees take. However, if it does, it is important to know. Many trainees do not know about this or understand it.

In short, a trainee who holds testamur status for a particular certification exam, then obtains the prerequisite licensing and certification and converts their status successfully with the certifying board, is then regarded as a diplomate. Typically, if a testamur does not have their certification converted to diplomate within a certain timeframe, the certification becomes invalid.

Summary

In summary, it is important for the program coordinator to be knowledgeable about board certifications. A training program’s curriculum and outcomes rely on or are directly affected by these certifications. Coordinators who are unsure or having trouble finding the information should ask their trainees or program directors for guidance.

An example chart of the information each coordinator should gather about their specialty’s certification exams can be found in the GMENetwork shared folder at \gradmeded\GMENetworkShared\ResidencyProgramCoordinators\GMEN Newsletter Files (internal access only).

With questions, email Mandi Smith, C-TAGME, at asmith5@pennstatehealth.psu.edu.

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