The American Board of Anesthesiology changed its rules for passing the Maintenance of Certification in Anesthesiology examination this year and I think that is total BS. The ABA stopped issuing lifetime anesthesiology board certificates after the year 2000. Now all recently graduated anesthesiologists have to recertify for their boards every ten years with a series of CME credits and this MOCA exam. Since this process went into effect older anesthesiologist could voluntarily recertify their lifetime certificates by taking the exam. Their rationale is that anesthesiology board certification rules for employment may change in the future and every anesthesiologist should have recent evidence of anesthesia competency. Frankly I thought that was a pretty convolulated way to encourage people to pay for an exam they didn't really have to take. In my group I know of maybe one or two people who took the test even though they had lifetime certificates. None of the older partners are particularly concerned about not being able to work in the future.
Now ten years after MOCA was begun, the ABA has changed the rules for passing the exam. Previously, the exam taker could select 150 questions out of 200 that he wanted to answer and be graded only on those. The other fifty questions, the ones he didn't know the answers to, were simply discarded. How convenient for the examinee. I bet the ABA received a lot of exams with 100% correct answers. When I took my exam in January I had to answer every single one of those 200 questions. Yes there were some questions that I had no clue the answer to but I couldn't just simply skip them; I had to answer them to the best of my abilities. Thankfully I was one of the 346 out of 373 examinees who passed the test. But this change in standards is aggravating and smacks of a double standard against younger anesthesiologists.
It was bad enough that they removed the lifetime certificates two years before I finished residency. When I started anesthesiology training I didn't know about an impending change in board certification. Now ten years later they changed the rules on me again! I wonder why they altered the MOCA rules. Could it be that after ten years of MOCA exams anybody with a lifetime certificate who wanted to take the test have already done so? Would their pass rate have been lower if the ABA hadn't allowed them to disregard 25% of the exam questions? Are the new anesthesiologists being held to a higher standard than older anesthesiologists? What does this say about the competency of older anesthesiologists if they need help from the ABA to cheat their way into a new board certification? Yes I said cheat. The ABA's data clearly demonstrates this dichotomy. Anesthesiologists like me who recertified in their seventh or eighth year after residency had a pass rate of 97% while those who took the test in their ninth or tenth year only passed at an 88% rate. I wonder what the pass rate would have been for anesthesiologists who were taking the recertification in their fifteenth or eighteenth year of practice if they had to answer all 200 questions?
Think how many tests you have taken in your lifetime. If you could throw away 25% of the questions in your SAT or MCAT or USMLE don't you think your scores would be higher too? By allowing the lifetimers to answer only the questions they want to this gives the illusion that these older guys are smarter than they really are and that anesthesiologists around the country are more knowledgeable than they appear. I know plenty of anesthesiologists who could bulls*** their way through a case but who are stuck on pancuronium and isoflurance because that is all they know. In the meantime we younger guys have to keep jumping through hoops that the older generation created for us just to prove we are worthy of our profession.