I admire Paul Tierstein, MD's honest attempt to create a greatly simplified alternative to the  ABMS's Maintenance of Certification (MOC) program called the National Board of Physicians and Surgeons (NBPAS).  I hope he's successful, but I sense there will be large headwinds for the effort ahead. Here's why. The Affordable Care Act (ACA) modified Sections 1848 (k) and 1848 (m) of the Social Security Act, which defines how CMS pays physicians for their services.  ...

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It's that time of year again. Bright-eyed fourth years have begun wandering our hospital in uncomfortable shoes and fancy suits. They look equal parts nervous and excited, ready to embark on the insane adventure that is being an intern. But first, they have to survive interview season and Match Day:  a stressful, expensive, hoop-jumping endeavor that culminates with an envelope containing the result of eight years of hard work. Wouldn't ...

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In respectful memories of Benson, Rose, and Sandy. I want to thank each one of them for helping me become a better physician. I stepped into the intensive care unit with a feeling of apprehension. I knew deep down, the patients I was going to care for were sick patients. Their status could change at any time. This was my first week on the ICU as a resident physician. Benson needed emergent ...

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We recently had a session hosted by the medical education staff at our school where we were encouraged to share any difficult situations encountered in clerkship (submitted anonymously beforehand if that was preferred) and discussed them as a class. Issues regarding ageism, sexism and racism were brought up and addressed with the group. While I have not encountered any of the above three, I was baffled to hear some of ...

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We have met the enemy, and he is us. -Pogo (a comic strip character of Walt Kelly) I doubt that physicians would have supported the creation of the American Board of Medical Specialties (ABMS) in the early 1900s if they had known that eventual maintenance of certification (MOC) might be used as requirements for re-licensure. In my state of Connecticut, we already have continuing medical education requirements (CME) which consists of 50 hours ...

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As a faculty member, I’ve encountered many medical students excelling inside and outside of the classroom. Students can be recognized for their contributions through scholarships, awards, and grants. Whenever I can, I try to direct students to these opportunities. It’s been a great joy for me to help students win scholarships, and here’s what I’ve learned from award recipients. 1. Your ability to develop strong relationships with faculty mentors is crucial ...

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During the MOC debate that JAMA sponsored, I was asked what I would do if “I were king” of MOC. As an internist, I believe in first making a diagnosis, then prescribing a treatment. So I have spent time diagnosing my needs as an internist. When I passed my boards I showed knowledge competency. But medicine changes over time. We have major advances and changes since I took my boards. Some examples follow:

When my husband started medical school, we immediately got hooked on getting student loans. After spending years of being broke all through undergrad, we felt like we were getting “magic” checks in the mail. Life was good. We could go out to dinner, buy our son the toys we wanted him to have, go shopping. We were enjoying all the luxuries we had gone without for so long. We didn’t ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. How many of you have heard a flight attendant or pilot announce, “We know you have a choice of airlines when you fly, and we want to thank you for flying with us”? Over the years, many other industries have adopted similar statements.  Continuing medical education (CME) ...

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Do physicians in training take better care of patients or perform better on their exams when their work hours are restricted?  Two recent studies in the Journal of the American Medical Association suggest that the answer is no.  In one, patients of surgery residents showed no difference in morality or postoperative outcomes after duty hour restrictions were implemented.  Their test scores did not improve either.  In the other, hospitalized Medicare ...

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