By using this site, you agree to the Privacy Policy and Terms of Use.
Accept
Health Works CollectiveHealth Works CollectiveHealth Works Collective
  • Health
    • Mental Health
  • Policy and Law
    • Global Healthcare
    • Medical Ethics
  • Medical Innovations
  • News
  • Wellness
  • Tech
Search
© 2023 HealthWorks Collective. All Rights Reserved.
Reading: How Stronger Residency Directors and Board Certification Can Work Together
Share
Notification Show More
Font ResizerAa
Health Works CollectiveHealth Works Collective
Font ResizerAa
Search
Follow US
  • About
  • Contact
  • Privacy
© 2023 HealthWorks Collective. All Rights Reserved.
Health Works Collective > Policy & Law > Medical Education > How Stronger Residency Directors and Board Certification Can Work Together
Medical Education

How Stronger Residency Directors and Board Certification Can Work Together

Thomas Pane
Thomas Pane
Share
5 Min Read
SHARE

Residency directors have a challenging job.  They are entrusted with selecting young doctors and training them over the course of several years.  Newly graduated medical students are thereby turned into internists, surgeons, radiologists, pathologists and the like.  Fellowship directors build upon this foundation with extra training, setting the stage for these graduates to become clinical experts in their respective fields.

Residency directors have a challenging job.  They are entrusted with selecting young doctors and training them over the course of several years.  Newly graduated medical students are thereby turned into internists, surgeons, radiologists, pathologists and the like.  Fellowship directors build upon this foundation with extra training, setting the stage for these graduates to become clinical experts in their respective fields.

The Maintenance of Certification (MOC) process adds an additional and continued requirement once doctors achieve their initial board certification, but the entire process has come under unified, multispecialty criticism.

Another article critical of the certification process noted that program directors already know plenty about the qualifications of their trainees, and seemed to suggest that program directors’ power to hold back or terminate trainees could reduce the need for the post-residency certification (and recertification) process.

More Read

medical test procedure
Medical Tests or Procedures That May Be Unnecessary
Collaborating with Patients in the Digital Information Age
How To Prepare For A Neurosurgical Operation
Medical Advances Aid Fight Against Pollution-Caused Skin Conditions
What Steps Can Doctors Take to Boost Patient Loyalty?

It can be said that the ability to pass tests does not equate with the ability to practice ethical, high-quality medicine.  People who are good at passing tests (i.e. the majority of people who get into medical school) can keep doing it right through board certification.  But is that a good use of time and resources?  Likely not, and this is one reason why MOC has been criticized as little more than a Trojan Horse to maintain certifying board revenue.

However, there is a question whether residency directors can effectively manage their trainees, as they once did.  In past decades, residency directors’ power was near absolute, and many programs (especially surgical fields) ran pyramid structures that only graduated a few of the trainees each year.  Residents knew they were under the microscope every day, and continued progress in the program was not assured.  The old pyramids have been eliminated, although that is not the key problem.  The evidence shows that few residents are ever actually dismissed from training.  Even problem residents – as many who have been in a residency can anecdotally support – are often nudged along and graduated.  This is easier than firing them, which is often a costly and difficult endeavor.

This is not an easy topic to get data on, but the 2009-10 annual report of the Accreditation Council for Graduate Medical Education (ACGME) suggests that firings are in fact rare.

Of 111,140 full-time residents, 261 (0.2%) were dismissed.  Even counting the 112 (0.1%) who Unsuccessfully Completed Program (seems an odd word choice), the 96 (0.09%) who went on Leave of Absence, and the 943 (0.8%) who Withdrew, only 1.3% of all residents were somehow taken out of programs every year.  That seems like a small number, and perhaps represents directors’ aversion to taking hard action against sub-par trainees.

Certifying boards may say this is why post-residency evaluation is essential.  But failure in (or noncompliance with) certifying exams cannot keep sub-par physicians from practicing, though it can reduce their options.

The MOC process is imperfect, and stands to be simplified, improved, and made less expensive. Concurrently, the discretion of program directors to remove sub-par trainees should be increased.   They should also be empowered to direct a simplified initial certification process culminating in the final month of residency.

This can ensure that well-qualified people complete residencies with their initial certification, and can later maintain their qualifications with a sensible and cost-effective MOC process.

 

TAGGED:medical residentsResidency directors
Share This Article
Facebook Copy Link Print
Share

Stay Connected

1.5kFollowersLike
4.5kFollowersFollow
2.8kFollowersPin
136kSubscribersSubscribe

Latest News

a woman walking on the hallway
6 Easy Healthcare Ways to Sit Less and Move More Every Day
Health
September 9, 2025
Clinical Expertise
Healthcare at a Crossroads: Why Leadership Matters More Than Ever
Global Healthcare
September 9, 2025
travel nurse in north carolina
Balancing Speed and Scope: Choosing the Nursing Degree That Fits Your Goals
Nursing
September 1, 2025
intimacy
How to Keep Intimacy Comfortable as You Age
Relationship and Lifestyle Senior Care
September 1, 2025

You Might also Like

sleep apnea
DiagnosticsMedical EducationWellness

Dentistry and Sleep Apnea

December 1, 2012
BHG Partner, Operation Smile
FinanceMedical EducationPublic HealthWellness

From Lake Placid: Doc Generously Donates Surgeries, Resources

October 20, 2015
bullying healthcare
Hospital AdministrationMedical EducationPolicy & Law

Culture of Disrespect in Medicine Affects Patient Safety

July 27, 2013
biopharma beat incremental change healthcare
Medical EducationMedical InnovationsPublic HealthTechnologyWellness

BioPharma Beat: Incremental Innovation Is Sometimes What the Doctor Needs

September 16, 2014
Subscribe
Subscribe to our newsletter to get our newest articles instantly!
Follow US
© 2008-2025 HealthWorks Collective. All Rights Reserved.
  • About
  • Contact
  • Privacy
Welcome Back!

Sign in to your account

Username or Email Address
Password

Lost your password?