Dean Huffman, MD

The American Board of Obstetrics and Gynecology's (ABOG) written maintenance of certification test appears to be necessary to anybody who is board certified in OB/GYN who was certified more than about 12 years ago, but who was not permanently board certified “grandfathered in.” That is to say, about half of ob/gyns will be required to take the written examination this year. 

For those who fail the test, you are allowed to retake the test up to four additional times. See the FAQ at the ABOG web site. The only constraint is that the exam must be passed before the end of the year and it takes about two weeks to arrange to take the test or the repeat test.

I would like to offer these suggestions based on my own experience. I took the MFM and the OB tests, so this might or might not apply the same to the other tests.

1) There are multiple tests available. General ob/gyns must select two tests from OB, GYN, Office Practice, and perhaps from one or more other categories. Subspecialists must take the test for their subspecialty plus one of the general tests. I took MFM and OB. The two tests I took were multiple guess, had 3 – 5 suggested answers (“distracters”) for each question, and were very straightforward. No “cutsie” questions, no trick questions, just straightforward questions on basic issues. 

2) I have been asked whether to study for the test or not. Since you have multiple opportunities to pass the test, I suggest you sign up for the test as soon as you can. If you fail the test, there are ample study guides or review courses available (just look at the advertisements in the back of any of the throw-away OB/GYN journals you get in the mail or by computer). My best suggestion for a study guide is ABOGs own PROLOGUE series. Remember, you get four additional chances to pass the test.

3) ABOG does not want you to fail. If on December 31, 20% of the OB/GYNs were no longer board certified; this would be a very uncomfortable situation, not only for the individuals, but also especially for the Board. How would they explain that all of a sudden 20% of their certified members are no longer certified? Hence they make the test so that any reasonable ob/gyn who has reasonably kept up to date can pass it. It is nothing like the original written exam you took just out of residency or fellowship.

4) In order to pass the test, however, you need to sign up and take the test. Look on the http://www.abog.org/ web site and you will find the telephone number to call in order to set up the test. If you cannot find the phone number, call ABOG at (214) 871-1619 and they will give you the number. They have hired an independent company to administer the examinations. 

5) When you sign up for the test, they will send you a confirmation by e-mail. Make sure that you receive it, that you spam filter has not eaten it. Print it out and read it. It tells you how to get to the testing center. I recommend that you also go to Mapquest or Google Maps and print out an enlarged map of the exact area where the testing site is. You might also ask the testing company what the GPS co-ordinates are for the testing center. Take your GPS device with you. Also ask them what phone number to call (presumably the phone number for the specific testing site) in case you get lost or have other problems on the way to the site. There was road construction where I took the test, making it more difficult to find the place. I am really happy that I gave myself an extra 90 minutes to get to the site because I needed 89 of them. 

6) You will be required to give the people at the testing site a government ID with your photograph, e.g., a driver’s license. They will ask for a second ID with your signature on it. I took my passport, but I suppose a credit card with a signature would do. You might ask them, ahead of time, about specifics as to what ID is acceptable, however. They will also take two palm prints, a photograph, and a signature sample. (If I had been fully aware of this ahead of time, I would have been tempted to print on my palm, “F*UC ABOG”). They made me feel like a black person trying to vote in a Republican state. 

7) If you go by something other than your first name, e.g., a middle name or a nickname or your first name has multiple spellings, you should check with the board (ABOG) ahead of time. Be sure that you have the proper ID. The last thing you want to do is to get to the testing center and find out that you cannot take the test because your legal name is Mary Rebecca Huffman but for some reason one of your IDs lists you as Becky Huffman, the name that you use. This will save you a lot of driving, a lot of hassle, and a wasted day with no income. This also applies to people who have changed their names because of marriage, divorce, or legal name changes. Make sure AHEAD OF TIME that ABOG and the testing company will not give you a hard time or refuse you entrance to the examination. Apparently they will accept either a middle initial or a middle name, as long as they agree with each other. 

8) They will not let you take anything into the actual testing site. No watches, pagers, cell phones, pens, pencils, credit cards, billfolds, purses, tissue papers, handkerchiefs, medications, asthma inhalers (presumably if you had an asthma attack or angina, they would supervise you while you took your medications so that you would not die, but I am not absolutely certain of this), calculators, or anything else. Thank God they let me keep my glasses. I do not know what they would do with a hearing aid. They make you empty out your pockets and then give you a grease pencil and a clipboard that you can use if necessary. (I did not need it). The test is by computer. If you can operate a mouse, that is all the skill you need to take and pass the test (other than being able to answer the questions correctly). My suggestion is that you do not take any pockets into the testing center, i.e., when you enter the testing center you wear only shoes / socks and undershorts. (I suppose a brassier would also be acceptable for females taking the test). In all honesty, I would love to see somebody do just that. 

9) Within a few days after taking the test, you should be able to log on to the ABOG web site and find your test results. They have a “congratulations” letter in PDF format that you can download. I do not know what they do if you failed the test. They do not give you your score, although they might give it to you if you called the board and asked, but I doubt it. 

10) If you think you do not need to take the test this year, call ABOG on the phone to confirm. ABOG is notoriously bad at keeping candidates up to date on their requirements. They sent me an e-mail saying that I needed to take the written test, but e-mails are easily lost, missed, or discarded by spam filters. They did not send anything by the postal service, something that I would be more likely to read. (My suggestion to ABOG: Require a response to e-mails so that it is certain that they have been received an opened). By the way, make sure that your e-mail filter accepts any e-mails from an “@abog, org” address. Likewise for “@acog.org”. It would be a shame to lose board certification because of you e-mail spam filter. 

11) Good luck with the test. It should be a piece of cake. The sooner you sign up and take the test, the better. 



 

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Half of US ob/gyns need to take the American Board of Obstetrics and Gynecology's (ABOG) written maintenance of certification test this year. Here are tips from a physician who has already done it.

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 Our hospital is installing an electronic medical record system (EMR). It has added a minimum of 15 minutes to the time it takes to process each patient, without a perceptible increase in quality of care.

One benefit of the EMR, however, is it is showing me now inadequate ICD-9 is. For example, if I code “congenital heart block," ICD-9 does not allow me to specify whether it is the mother or fetus that has the condition! Nine tries and they still haven't figured that out. And if a patient has an abnormal screen for Down's, ICD-9 does not let me specify whether the fetus has a known or suspected chromosome abnormality. I hope 

 is better, but I am not holding my breath.
 

Here is the kicker. Today I saw a patient report that our system prints out. Problem was, the left 1

 inches of the report is missing, and the right 1

 inches of the report is just blank. In other words, they are left-shifting the image on the report 1

So I tell the EMR guy that this is a piece of crap. He says that this is OK since the report is shredded as soon as it is printed, so nobody has to worry about the error. Anyway, they are working to fix it.

I ask the EMR guy, "If we are printing the report then why we then shredding it immediately after printing? Can't we just skip printing the report and save a tree?"

He says this is impossible. "We MUST print the report."

," and it has to be printed within 72 hours of seeing the patient. Otherwise the EMR is NOT being meaningfully used, and the government will penalize us.

I say, "But we shred the report. We destroy it."

"My point is, if we shred the report as soon as it is printed, why not just SAY that we printed the report and that we then shredded it and that way we will NOT kill a tree?"

"Because that would not be meaningful use. We have to print it."

But do not fret. They are working on a way to print the report to a PDF file that will then be erased. Printed and erased, but no killing of trees, just one mild and temporary abuse of the surface of the hard drive.

Back to my original problem. The report is still missing the left-most 1

 inches. Not to worry, however. They will fix that printing glitch so that the PDF file that is deleted is, at least, correct before it is deleted.

Our hospital is installing an electronic medical record system (EMR). It has added a minimum of 15 minutes to the time it takes to process each patient, without a perceptible increase in quality of care. And trying to make sense of meaingful use? It's like "Catch 22."

Dean Huffman, MD

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