Training Matters:

Abstract

Currently, the majority of medical boards require only one year of post-graduate training (PGT) for full and unrestricted licensure. This study analyzes the association between years of PGT, board certification and the risk of being disciplined by the Louisiana State Board of Medical Examiners (LSBME) to assess whether training requirements for physician licensure in Louisiana should be revised. 624 physicians who were sanctioned between 1990 and 2010 were compared to a random sample of 6,552 physicians who were not disciplined during the study period. Statistical methods included chi-squared tests of independence and logistic regression analysis. After controlling for demographics, specialty, years of training, board certification status and changing training requirements over time, physicians who had completed more than one year but less than three years of PGT were more than twice as likely to be disciplined (O.R. 2.24, p<.005), while non board-certified physicians were more than four times as likely to be disciplined (O.R. 4.64, p<.0001). Of all physicians sanctioned for findings of substandard practices/medical incompetency, 21% had fewer than three years PGT, and 46% of physicians with less than three years training were sanctioned for this reason. Our study indicates that physicians who do not complete a minimum of three years post-graduate training are more likely to be the subject of a disciplinary action, and that these physicians are more likely to be sanctioned for competency/standards-related issues. Because medical knowledge and training expectations have increased over time, licensing authorities may want to delay full licensure status until applicants have had a minimum of three years PGT in an ACGME or AOA-accredited training program.