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Physicians who do not certify more likely to receive disciplinary actions

An analysis of data sets found that 95% of internal medicine residents achieve certification through the American Board of Internal Medicine, according to findings published in Academic Medicine.

Rebecca S. Lipner, PhD, senior vice president of assessment and research for the ABIM, and colleagues reported that the remaining 5% of physicians were more likely to receive disciplinary actions from state medical board.

"The ABIM confers board certification status when the physician passes its certification examination," Lipner and colleagues wrote. "Although voluntary, certification is often used by health plans to select physicians, and by hospitals to issue practice privileges. Board certification has also been linked with better processes and outcomes of care. Disciplinary action by state medical boards — such as a reprimand or licensure restriction, suspension, or revocation — against ABIM-certified internists correlates with performance during IM residency training."

The researchers analyzed three data sets of 66,881 residents in Accreditation Council for Graduate Medical Education-accredited internal medicine residency programs between 1995 and 2004. They compared performance, demographics, practice type and other characteristics between three groups: physicians certified by ABIM, physicians certified by American Board of Medical Specialties and physicians who were not certified.

Results showed that 95% of residents were certified by ABIM, 1.6% obtained ABMS certification in another specialty and 3.4% did not receive ABMS specialty certification.

Lipner and colleagues reported that physicians who obtained ABIM certification performed better during residency than those who did not. In addition, fewer disciplinary actions were identified in physicians who obtained ABIM certification (1.2%) and physicians who obtained ABMS certification (2.4%) compared with physicians who did not receive certification (6%).

“While previous studies have found that general internists leave the practice of internal medicine more often than subspecialists, little research has been done on the attrition of physicians during training in internal medicine,” Lipner said in a press release. “Our findings indicate that initial certification does not cause much physician attrition among internal medicine physicians in training. Our findings also show that physicians who do not achieve certification are more likely to have disciplinary actions later in their careers.”

Richard J. Baron, MD, president and CEO of ABIM, addressed the study results in the press release.

“Achieving initial certification is a proud moment in a physician's career, and it indicates that they are ready to go — ready to practice medicine," Baron said. "The results of this research reinforce that the large majority of physicians who complete internal medicine training have the knowledge and skills necessary to practice internal medicine. The research also cautions that those who don't achieve certification may be less equipped to deal with the challenges faced by internists every day.” – by Chelsea Frajerman Pardes

Disclosures: Financial and material support for the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript were provided by the ABIM and FSMB. The authors report no relevant financial disclosures.