Education And Debate

Continuing medical education: Recertification and the maintenance of competence

BMJ 1998; 316 doi: (Published 14 February 1998) Cite this as: BMJ 1998;316:545
  1. Philip G Bashook, director of evaluation and education (pgb{at},
  2. John Parboosingh, associate director, office of fellowship affairsb
  1. a American Board of Medical Specialties, Evanston, IL 60201-5913, USA
  2. b Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada K1S 5N8
  1. Correspondence to: Dr Bashook


    This is the fourth in a series of seven articles looking at international trends and forces in doctors' continuing professional development

    Completion of postgraduate specialist training is a landmark event for most doctors. The award of a certificate is acknowledgment that a doctor has undergone a recognised training programme and been assessed as competent to practise as a specialist in his or her field. Specialists begin practice with a common knowledge base and similar clinical skills but go on to develop different areas of expertise in response to patients' needs. In time, the knowledge and skills of doctors within a specialty will vary appreciably.

    Summary points

    Summary points Recertification should assess real performance in practice and competence to continue to learn

    Recertification programmes in the United States use examinations and performance assessments as “snapshots” of competence taken every 7–10 years

    In other countries most programmes evaluate documented participation in continuing education as evidence of continuing competence as a specialist

    The proposed continuous recertification programme uses computer technology to document self directed learning from practice and to monitor performance

    Poor performers could be recognised early, given focused assistance and additional periodic examinations at testing centres, and if necessary their certificates could be rescinded

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