Navigating the ABU certification journey: The value of recertification and upcoming changes

J. Stuart Wolf Jr, MD, FACS

Board certification by the American Board of Urology (ABU) is a defining chapter in a urologist’s professional journey. The rigorous process ensures the highest standards of competence and expertise, ultimately benefiting both practitioners and patients. However, the journey does not end with initial certification; recertification is beneficial in fostering continuous learning and safeguarding patient well-being. Herein, we review the process of ABU certification, explore the value of recertification, and peek at the exciting improvements in continuing certification on the horizon.

The first step in certification is completing a residency program accredited by the Accreditation Council for Graduate Medical Education or the Royal College of Physicians and Surgeons of Canada, although on the ABU website, there are details about an alternative pathway for urologists without this training. To sit for the Qualifying Examination (Part 1), candidates must have completed at least 6 months of chief residency by June 30 of the examination year. This computer-based test, held at Pearson test centers, assesses the candidate’s minimum level of knowledge for safe urological practice. It comprises two 3-hour sessions on a single day, encompassing 300 multiple-choice questions with a standardized subject matter breakdown.

Passing Part 1 grants eligibility for the Certifying Examination (Part 2). To sit for this final step in the certification process, candidates must possess an unrestricted medical license, provide a 6-month practice log with complication narratives, have acceptable peer review references, and complete 16 months of practice in a single community. Currently, this in-person oral examination is held at the testing center of the American Board of Anesthesiology in Raleigh, North Carolina. Recent modifications include 2 examiners per candidate, which enhances reliability of the assessment, and completion of the examination in a half-day. In addition, the 4 standard oral protocols are supplemented by 2 objective structured clinical examinations involving standardized patients, which assess application of knowledge in real-world scenarios.

Continuing certification is not merely a bureaucratic process; it is a commitment to staying abreast of advancements in urology and maintaining competencies. There are some compelling reasons why urologists should participate in ABU continuing certification. Medical knowledge continuously advances beyond formal training, making continuous learning essential. Unless reinforced, medical knowledge and skills naturally diminish over time. Accurately gauging one’s own skill set can be challenging. Recertification activities facilitate keeping up with the latest advancements and maintaining competence because they provide structured self-assessments that highlight areas for improvement and foster deeper learning. Finally, patients and credentialing bodies expect urologists to demonstrate a commitment to ongoing learning and professional development. Survey results have revealed that board certification and maintaining certification are some of the most important factors to patients in selecting a physician.^1-4 ABU continuing certification marks competence, reassuring patients and upholding the trust bestowed upon urologists. Most hospital credentialing committees and insurance networks prioritize board-certified and actively recertifying physicians.

We are often asked why CME alone is not sufficient to maintain certification. The ABU feels that a robust system of continuing certification should include comprehensive formation and summation beyond that achieved with CME. It should incorporate specialty-specific standards to serve as tailored assessments that ensure adherence to urology-specific best practices. Knowledge assessments are required to gauge knowledge retention and mastery of evolving concepts. Confirming engagement in initiatives aimed at improving patient care and outcomes is a key component. Finally, we need to assess professional conduct and the maintenance of ethical and professional standards.

Findings from studies across various specialties have shown a significant correlation between a lower rate of state medical board disciplinary actions with both initial board certification and participation in recertification programs.^5-8 Unpublished ABU data suggest a similar trend for urologists, where initial certification on the first attempt is associated with fewer state medical board disciplinary actions.

Recognizing the evolving landscape of medical education, the ABU is planning a new iteration of continuing certification called Continuing Urologic Certification. The ABU anticipates that the American Board of Medical Specialties (ABMS) will approve this program, which appears to have several distinct advantages over the existing Lifelong Learning program. We will bring this forward to Urology Times readership once ABMS approval occurs.

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