The psychiatric certification examination in Canada and the United States: views of two recent candidates.

Abstract

The psychiatry certification process in both Canada and the United States is compared. Three important and interrelated areas are delineated: 1) the role of mandatory certification in Canada versus voluntary certification in the United States; 2) the differing emphasis of neurology and the medical model in the two exam procedures; and 3) the effect of the speciality exam on professional development. Compulsory certification in Canada has the potential to steer candidates in a direction that may not be immediately consonant with career plans and population needs. On the other hand, the American Board examination by its optional character does not seem to reach a large percentage of psychiatrists, an issue that has implications for the education of medical professionals. The ambiguity of the American Board's quasi-public position is portrayed. Competence in neurology appears as a distinct area for evaluation in the American Board of Psychiatry and Neurology examination. The emphasis on neurology in the Canadian Royal College exam is less marked. These issues lead to a discussion of psychiatry in Canada as a discipline in its own right as contrasted to the mixed loyalties to neurology and psychotherapy perceived in the American system. Finally, this paper sheds light on how the certification examination of both countries plays an important role in the passage to full professional status.