Board reviews: A closer look at various certifications for graduating fellows

Endocrine Today Fellows' Board member discusses how to best prepare for the large number of upcoming exams.

See the mugshot? It’s my driver license photo taken on July 13, 2004—a day I remember in excruciating detail. It was the day I was scheduled to take the USMLE Step 3.

Earlier that morning, I had dutifully packed my lunch with all the essentials. I also remembered to bring a vest, just in case the testing center was too cold, and I brought a form of identification, ie, my driver’s license. I arrived on time and everything was proceeding as expected until the lady sifting through my paperwork asked, “Do you have another form of ID … one that isn’t expired?”

Susan Peng

Apparently my driver’s license renewal had been sent to my parents’ previous address and I never bothered to look since past renewals had always magically appeared in the mail. So I rushed over to the nearest Department of Motor Vehicles to obtain a new, valid driver’s license. By the time I returned to the testing site, however, it was already too late to take the exam. I had to reschedule … and pay a fee of somewhere between $150 and $200.

So why am I recounting all this, other than the fact that I remember it every time I pull out my driver’s license? Well, the sad reality is that the exam fee—not to mention the rescheduling fee—is insignificant compared with the various exams many of us will be registering for in the next several years.

Surviving the gauntlet of upcoming exams requires that you be prepared, and you might as well check your driver’s license while you’re at it.

Exams at a glance

Let’s start with the most important of all—the board examination in endocrinology, diabetes and metabolism.

Registration started March 1 and ends May 1 for this year’s examination on October 24, which will cost $1,665 or $2,065 if you register late, between May 2 and June 1. Thankfully, 87% to 90% of first-time takers from 2002 to 2007 passed the boards.

So how does one prepare?

I attended the Cleveland Clinic Endocrinology and Metabolism Board Review, co-sponsored by the American Association of Clinical Endocrinologists and the American College of Endocrinology. This is a three-day course usually held in October of every year. I thought it was a very worthwhile program. The lecturers covered all the major topics, including a great review of pediatric endocrinology. The keypad Q&A format with instant feedback for comparison with your peers was helpful and quite fun.

Overall, I would recommend the course given the learning experience and very reasonable fellow registration rate of $325, which included meals. Moreover, the registration fee is waived and hotel stay is provided for the first 50 fellows nominated by their program directors. Note that you must be in your third year of training to qualify.

The Endocrine Society has its own board review, which will take place from Sept. 23-24, 2008 in Boston. This will precede the Clinical Endocrinology Update from Sept. 25-28, 2008. This past year the rate was $540 for the board review alone and $345 if taken in conjunction with the update, which is $440 for fellows for a combined cost of $785. Registration is slated to open next month.

To complement the course or for self-study, the Endocrine Self-Assessment Program (ESAP) can be purchased for $99 if attending the board review or $199 at the fellow rate. It is a manual consisting of 160 multiple choice questions with answers. I know of many fellows who used this resource alone, and they passed the boards.

The American College of Endocrinology has its own self-assessment program known as the ASAP. The latest version is still in the works, according to its Web site, and I have not had the opportunity to peruse prior edition(s). It will cost $220 for members, and fellows can obtain membership for free by contacting Arlene Nau, assistant director of membership services, at anau@aace.com.

Endocrine University is only open to fellows in their final year of training, but by all reports, it is not to be missed. It usually takes place in the spring and was recently held March 8-13 in Rochester, Minn. The registration fee was $250, but fellows were reimbursed $450 to help defray travel expenses and most meals were fully subsidized. The week-long course included: thyroid ultrasound and FNA biopsy accreditation, bone density measurement certification, and metabolic laboratory (CLIA) certification. There are also “Meet the Experts” sessions on various topics among other learning activities.

For fellows with a special interest in lipidology, you may want to consider certification by the American Board of Clinical Lipidology. But it certainly is not cheap, with a non-refundable application and credentialing fee of $300, in addition to the examination fee of $900, for a grand total of $1,200. The certification is valid for 10 years. Exam dates in 2008 are May 30 or May 31 in Seattle, and Sept. 27 in Chicago. The National Lipid Association has a self-assessment program (NLA-SAP) available for $300 per volume, or $900 for the three-volume set, but fellows may be able to obtain this for free by having your program director contact Nicole Woodsmall at (904) 998-0854. You can also attend the NLA Masters in Lipidology Advanced Training and Board Review course for $850 if you are a member ($35 for fellows to obtain membership), which includes the three-volume NLA-SAP. As opposed to the examination, there are locations across the country and courses throughout the year for the board review.

For those interested in women’s health, you can become a Menopause Practitioner through the North American Menopause Society. Registration is $200 for members, $400 for nonmembers if you apply early and an additional $75 by the April 11 deadline. The examination will take place on May 17 at a dozen locations across the country. There is also one held later in the year, on Sept. 24, offered only in Orlando. Drawbacks are the certification is valid for three years and to become a member of NAMS, fellows pay $155 for six months. This, however, will allow you to purchase the recently revised third edition of the textbook Menopause Practice for $85 as opposed to $125 for nonmembers. If you become a member and then register for the exam and buy the book, it will cost you $440 vs. $525 for nonmembers.

Last, but not least, is to obtain credentialing by the American Board of Physician Nutrition Specialists. The examination costs $800, but is good for 10 years. It is a one-day exam taken during a pre-specified two-week period at LaserGrade testing centers. It was administered between Nov. 3-17, 2007. There is no word yet on exams for this year.

For those interested in the field, but not necessarily ready to become a certified Physician Nutrition Specialist, take a glance at their curriculum guide. It is a good resource for references to book chapters, papers, links to relevant topics such as diabetes, obesity, dietary supplements and nutraceuticals.

The above is certainly not an exhaustive list, but it does illustrate the many options beyond board certification in endocrinology, diabetes and metabolism for those with a specific interest within the field … so happy studying!

Susan Peng, MD, is the Chief Endocrinology Fellow at the University of California, San Diego, and is a member of the Endocrine Today Fellows Advisory Board.