Emergency physicians maintain performance on the American Board of Emergency Medicine Continuous Certification (ConCert) examination.
OBJECTIVE
The American Board of Emergency Medicine (ABEM) Maintenance of Certification (MOC) program is a four-step process that includes the Continuous Certification (ConCert) examination. The ConCert examination is a validated, summative examination that assesses medical knowledge and clinical reasoning. ABEM began administering the ConCert examination in 1989. The ConCert examination must be passed at least every 10 years to maintain certification. This study was undertaken to determine longitudinal physician performance on the ConCert examination.


METHODS
In this longitudinal review, ConCert examination performance was compared among residency-trained emergency physicians (EPs) over multiple examination cycles. Longitudinal analysis was performed using a growth curve model for unbalanced data to determine the growth trajectories of EP performance over time to see if medical knowledge changed. Using initial certification qualifying examination scores, the longitudinal analysis corrected for intrinsic variances in physician ability.


RESULTS
There were 15,085 first-time testing episodes from 1989 to 2012 involving three examination cycles. The mean adjusted examination scores for all physicians taking the ConCert examination for a first cycle was 85.9 (95% confidence interval [CI] = 85.8 to 85.9), the second cycle mean score was 86.2 (95% CI = 86.0 to 86.3), and the third cycle was 85.4 (95% CI = 85.0 to 85.8). Using the first examination cycle as a reference score, the growth curve model analysis resulted in a coefficient of +0.3 for the second cycle (p < 0.001) and -0.5 for the third cycle (p = 0.02). Initial qualifying (written) examination scores were significant predictors for ConCert examination scores.


CONCLUSIONS
Over time, EP performance on the ConCert examination was maintained. These results suggest that EPs maintain medical knowledge over the course of their careers as measured by a validated, summative medical knowledge assessment.
The Department of Emergency Medicine, University of Toledo College of Medicine, Toledo, OH; The American Board of Emergency Medicine, East Lansing, MI.
Catherine A
CA
Marco
Francis L
FL
Counselman
Robert C
RC
Korte
Chad M
CM
Russ
Cameron T
CT
Whitley
Earl J
EJ
Reisdorff
D000328:Adult; D002568:Certification / Q000592:standards* / Q000706:statistics & numerical data; D002983:Clinical Competence / Q000592:standards*; D016001:Confidence Intervals; D004635:Emergency Medicine / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D014481:United States