Board Certification Research Articles

It is time for reform: Results from a questionnaire survey on the current status of next generation HBP surgeons in Japan.

A questionnaire survey was designed and performed to assess the current status of "next generation" hepatobiliary and pancreatic (HBP) surgeons regarding surgical training, career, recruiting, and work-life balance in Japan. Using a valid email address, a questionnaire was sent to members of the Japanese Society of Hepato-Biliary-Pancreatic Surgeons (JSHBPS) who were under 45 years old. The questionnaire comprised 50 questions across the following four sections: (i) board certification of JSHBPS, (ii) research activity and overseas study, (iii) recruiting, and (iv) work-life balance. A questionnaire survey was sent to 1735 HBP surgeons and responses were received from 303 members (17.5%). In a survey with 303 respondents, over 45.9% were above 41 years old, 93.7% were male, and 91.0% were affiliated with university surgery departments. About 25.1% were JSHBPS board-certified, while 72.7% of uncertified doctors aspired for the certification. Research activity was deemed crucial by 74.9%. Recruitment targeting postgraduate years 1-5 was recommended, with the technical difficulty of surgery being the main reason for choosing HBP. Regarding work-life balance, excessive work and classical work style were regarded as a hindrance to the sustainability of working practices. This survey highlighted that next generation HBP surgeons are highly motivated to acquire advanced surgical skills and recognize the importance of research experience. However, they are facing long working hours and insufficient training opportunities. Fundamental reforms, such as revising the training curriculum, improving work styles, and enhancing recruitment, are necessary steps forward to ensure the sustainability of HBP surgery in Japan.

Utilizing Lactation Acuity to Improve Lactation Services in a U.S. Hospital.

National staffing guidelines for hospital lactation services do not account for the lactation acuity of breastfeeding patients. Higher acuity breastfeeding couplets require a higher level of knowledge and skill from lactation care providers. In these cases, a referral to an International Board Certified Lactation Consultant (IBCLC) is recommended for appropriate management. Use of a lactation acuity classification system as a clinical practice innovation was implemented at Oklahoma University Medical Center to improve the distribution of staff resources for optimal care of breastfeeding patients. Lactation service reports from this facility, a tertiary care teaching hospital, were reviewed to evaluate staffing, number of lactation consults, reason for and acuity of consults, and time spent. The review included over 10,000 lactation consults completed over a 1-year period. Once the lactation acuity system for IBCLC staff was in place, there was an increased mean direct consult time and acuity level with 85% of IBCLC time allocated to high acuity consults. Trained bedside nurses handled most low-acuity patients. The percentage of patients needing a lactation consult who received one increased along with the number of consults per patient. Data on time spent per consult were stratified by acuity, location, and reason for consult, including details on priority consults for neonatal intensive care unit patients. The productivity of the lactation team was higher with the use of a lactation acuity system compared to without it. The data reported support the use of lactation acuity in making recommendations for staffing of hospital lactation services.

2024 Position Statement on the Use of Different Diagnostic Methods for Sleep Disorders in Adults - Brazilian Sleep Association.

Introduction The current document represents the official position of Associação Brasileira do Sono (ABS; Brazilian Sleep Association) on the application of different sleep studies and provides specific recommendations for the use of different types of polysomnography (PSG) and respiratory polygraphy. Materials and Methods The present document was based on existing guidelines. The steering committee discussed its findings and developed recommendations and contraindications, which were refined in discussions with the advisory committee. Adaptations were made based on professional experience, pathophysiological knowledge, and theoretical reasoning, especially to cover topics not discussed in previous guidelines or to adapt recommendations to the context and current practices in Brazil. Results A total of 55 recommendations were made, covering the following domains: professional requirements for the requisition and interpretation of sleep studies ( n = 7); eligibility for different sleep studies ( n = 9); diagnosis of sleep-disordered breathing (SDB; n = 5); diagnosis of SDB in special conditions ( n = 3); diagnosis of SDB in association with other sleep disorders and comorbidities ( n = 3); sleep studies on the follow-up of patients with SDB ( n = 9); sleep studies for positive air pressure titration ( n = 3); diagnosis of other sleep disorders ( n = 10); and sleep studies on other conditions ( n = 6). Conclusion The selection of the type of sleep study should be made carefully, considering resource constraints, clinical suspicion of moderate or severe obstructive sleep apnea (OSA), and individual patient needs, among other factors. It is crucial that health professionals receive appropriate training and board certification in sleep science, thus being able to determine the most suitable diagnostic method, understand their indications and limitations, and assure an accurate diagnosis for each patient.

Nationwide Survey on Incidence and Management of Recurrent Respiratory Papillomatosis in Japan.

To investigate the incidence, laryngeal distribution, management, and postoperative clinical course of patients with newly diagnosed adult-onset recurrent respiratory papillomatosis (RRP) in Japan. An initial brief questionnaire was sent to 782 institutions, including all 101 core and 627 collaborating institutions providing board certification programs accredited by the Japanese Society of Otorhinolaryngology-Head and Neck Surgery. A detailed questionnaire regarding patient age, sex, Derkay's score, surgery, and postoperative clinical course was sent to 196 institutions caring for patients with either newly or previously diagnosed RRP. A total of 186 patients with newly diagnosed adult-onset RRP from 78 institutions were identified during the present study period (2018-2019), suggesting an annual incidence of 0.20 per 100,000 population in Japan. The true vocal folds were the most frequently affected subsites in the larynx, followed by the false vocal folds, anterior commissure, and laryngeal surface of the epiglottis. The use of cold instruments was the most preferred surgical approach, followed by the carbon dioxide laser and microdebrider. A significant difference in recurrence-free period after the initial surgery was observed between patients with lesions in a single region and those with lesions in multiple regions (p = 0.001). Here, we estimated the annual incidence of adult-onset RRP for the first time in Japan. To the best of our knowledge, the present study is the largest to identify the laryngeal distribution of lesions, as well as postoperative outcomes after initial surgery in newly diagnosed adult-onset RRP patients. 4 Laryngoscope, 2024.

Evaluation of Certification Board of Infection Control and Epidemiology, Inc. Certification in Infection Control (CIC) Examination Rates

BackgroundInfection Prevention professionals develop through training and certification practices, with the Certified in Infection Control and Epidemiology (CIC®) exam being the industry standard for infection prevention and control expertise. MethodsThis study conducted a secondary analysis of Certification Board of Infection Control and Epidemiology, Inc. (CBIC) exam scores from 2013-2022. Reliability coefficients, Spearman-Brown coefficients, and Standard Error Measurement (SEM) averages were calculated for the CIC® exam’s eight objective areas from 2016-2022. ResultsOver the past decade, pass rates varied from 57.30% to 85.40%, with a mean of 69.7%. The number of exam participants ranged from 574 to 1,392. Despite the variability, the highest reliability, Spearman-Brown, and SEM averages were consistently observed in areas such as identifying infectious disease processes, surveillance, epidemiological investigation, and controlling transmission of infectious agents. ConclusionAs more facilities push for certification, the number of CIC® exam takers has increased. However, the evolving nature of infection prevention and the lack of a standardized training track contribute to variations in reliability coefficients across the exam's objective areas.

Retrospective cohort study of ambulatory care pharmacist interventions’ impact on incidence of therapeutic response in anxiety and depression

AbstractIntroductionAmbulatory care pharmacists continue to expand their involvement in the management of various disease states across the United States, including anxiety and depression. There is limited literature assessing the clinical impact of these practice advances implemented by pharmacists who do not carry psychiatric training (i.e., psychiatric board certification or mental health training) within primary care.MethodsThis was a retrospective, multicenter, cohort study of adult patients who had at least one documented visit between February 2020 and August 2023 with an ambulatory care pharmacist who did not carry additional psychiatric training to comanage their diagnosis of depression and/or anxiety. The primary outcome was the achievement of a therapeutic response (a reduction of 50% or greater in Patient Health Questionnaire 9‐item depression scale [PHQ‐9] and/or the Generalized Anxiety Disorder 7‐item scale [GAD‐7] scores). Secondary outcomes included the change in PHQ‐9 and/or GAD‐7 scores, incidence of remission, predictors of therapeutic response, pharmacist intervention subtypes, and percentage use of pharmacogenomics.ResultsTherapeutic response for PHQ‐9 was achieved for 60 (48.4%) of 124 patients included after utilization of an ambulatory care pharmacist without additional psychiatric training embedded in primary care. While two‐thirds of patients had comorbid anxiety, 43 (57.4%) could not be evaluated for clinical improvement as they did not have available GAD‐7 scores for analysis. Available PHQ‐9 and GAD‐7 scores had median score reductions of 5 (−11,0) and 4.5 (−7.75, 3.5), respectively, at approximately 6 months (p < 0.001 and p = 0.023). Patients had a median number of 4 (2, 5) visits with a pharmacist and a median number of 2 (1, 3) interventions.ConclusionsAmbulatory care pharmacists, regardless of additional psychiatric training, can help patients achieve a therapeutic response for depression and anxiety as well as significantly improve PHQ‐9 and GAD‐7 scores. Additional education on the importance of GAD‐7 monitoring is warranted given its lack of routine collection and evaluation among patients presenting with comorbid depression and anxiety.

Characteristics and career effect on PA graduates of a doctor of medical science program.

This study examined the characteristics and effect of a doctoral degree on career metrics of physician associate/assistant (PA) graduates. This was a comparative analysis study of doctor of medical science (DMSc) program graduates. Characteristics from this survey were compared with program data and the National Commission on Certification of Physician Assistants Statistical Profile of Board Certified PAs for 2022. Graduates self-reported that the DMSc degree was beneficial for receiving raises, promotions, and new leadership positions. The DMSc degree was considered a positive career benefit by graduates.

Why so slow? The advancement of females in neurosurgery: a 30-year analysis.

As gender parity in medicine improves, neurosurgery lags behind. In pediatric neurosurgery, considered the most "female-friendly" subspecialty, determining the extent to which gender disparity has evolved over time, and how it compares to other subspecialties, can serve as an important benchmark for neurosurgery altogether. This study analyzed gender parity across different neurosurgical and subspecialty training stages to understand how female representation varies with training level and leadership positions. Data spanning from 1990 to 2023 were extracted from Association of American Medical Colleges (AAMC), Accreditation Council for Graduate Medical Education (ACGME), Accreditation Council for Pediatric Neurosurgical Fellowships (ACPNF), American Board of Neurological Surgery (ABNS), and American Board of Pediatric Neurological Surgery (ABPNS) databases and American Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) subspecialty websites to examine the proportions of female-identifying trainees and neurosurgeons. Information regarding females in leadership roles was gathered from publicly available sources. Over the last 30 years, the proportion of female medical school graduates increased from 34.0% in 1990 to 51.9% in 2023 (0.45 graduates/year, R2 = 0.813). Female neurosurgery residency applicants increased from 10.5% in 1990 to 27.9% in 2023 (0.48 applicants/year, R2 = 0.694). Female neurosurgical residents increased from 7.3% in 1990 to 23.7% in 2023 (0.46 residents/year, R2 = 0.909). Female neurosurgeons obtaining ABNS certification increased from 5.0% in 1990 to 17.0% in 2023 (0.23 surgeons/year, R2 = 0.476). Female pediatric neurosurgery fellows increased from 0.0% in 1990 to 25.0% in 2023 (0.74 applicants/year, R2 = 0.369). The number of females obtaining ABPNS certification increased at a rate of 0.42 surgeons/year (R2 = 0.067). In neurosurgical academic leadership, female representation remains low: Society of Neurological Surgeons presidents at 0.98%, AANS presidents at 3.3%, CNS presidents at 0.0%, and departmental chairs at 1.5%. In pediatric neurosurgery, only 10% of division chiefs at top US News & World Report children's hospitals are female. Only 13.3% of past presidents of the AANS/CNS Section on Pediatric Neurosurgery were female; all American Society of Pediatric Neurosurgeons presidents have been male. There are higher proportions of female directors within ABPNS (33%) and the ACPNF board (43%). Other subspecialties have comparable female leadership representation, with 5.3% in spine, 5.1% in cerebrovascular, 5.9% in tumor, and 14.3% in functional/stereotactic. Despite encouraging growth in the number of females entering neurosurgery over the past 3 decades, there continues to be significant gender disparity that is most pronounced at advanced career stages-in both academic organized neurosurgery and pediatric neurosurgery. Pediatric neurosurgery, due to a separate fellowship accreditation and board certification, provides the most accurate view within the subspecialties. Because pediatric neurosurgery exhibits the lowest gender disparity among subspecialties, these findings suggest more pronounced female underrepresentation across the stages of other neurosurgical subspecialty trainings.

Practice Patterns of Graduates of a Rural Emergency Medicine Training Program

Introduction: Rural communities continue to face a shortage of emergency physicians despite the growing number of emergency medicine (EM) residencies. In rural areas, emergency physicians tend to be older, male, and White, and are less likely to have completed EM residency training or have board certification. There is also currently a higher rate of rural physicians leaving clinical practice than in urban emergency departments (ED). In this cross-sectional study we sought to identify the work environments of graduates of a rural EM residency program, and the strengths and weaknesses of such a program. Methods: We conducted a survey among 29 graduates of a community-based EM program to evaluate the effectiveness of a residency program in training physicians who will work in rural areas. The survey assessed the graduates’ perceptions of their level of preparedness, further training, and practice location after completing the program. Results are reported using descriptive statistics. Results: Twenty respondents completed the survey (69%). Most of them identified as male (60%), White (70%), and non-Hispanic or -Latino (80%). Seventy-five percent of the graduates work in counties with fewer than 1,000,000 inhabitants, and 70% work in community hospitals and EDs caring for fewer than 100,000 patients/year. Four (20%) declared to work in critical access hospitals. Overall, respondents felt confident in their residency training. Conclusion: A community-based EM training program may be an effective strategy for producing emergency physicians who go on to work in rural and smaller communities.

The $12 Billion Board Certification Process: Examination Characteristics, Revenues, and Expenditures

Over 90% of U.S. physicians are currently board certified. Although the American Board of Medical Specialties (ABMS) has established standards for physicians to acquire and maintain board certification, a comprehensive description of this process and its associated costs has not been performed. Population-level data of currently active diplomates was extracted from published ABMS reports. Examination characteristics of the initial and continuing certification process were extracted from each member board website. Revenue, expenditures, liabilities, and assets of each board for the latest tax year were extracted from published IRS Form 990s. Between 2016 to 2023, the number of physicians with active and continuous certification increased by 14% and 33%, respectively. Initial certification had a mean of 300 questions over 6 hours, an 89% pass rate, and a cost of $2,942. Continuous certification had a mean of 49 questions with 4 minutes per question, a 93% pass rate, and a cost of $263 annually. Total industry costs were estimated as $2,908,864,254 for initial certification and $9,101,324,085 for continuing certification. For the tax year 2022, this certification process generated $47 million in surplus and yielded $839 million net balance for all ABMS member boards. ABMS board certification costs nearly $3 billion for initial certification and an additional $9 billion for continuing certification for currently practicing physicians over their careers. Ongoing research should evaluate the utility of the board certification system and explore ways to add value to this process.

Where Are They Now? Attrition Rates of Emergency Medicine Residency Graduates by Gender

Prior studies examined the retention of women emergency physicians through residency training, but their career paths on completing residency are less well understood. Our primary objective was to identify a difference in attrition rates between binary genders of practicing clinical emergency physicians within 10 to 30 years after residency graduation. Our secondary aims investigated gender differences in geographic practice location, academic, and community practice. We hypothesized that women emergency physicians have higher rates of attrition from clinical practice than men. In this cohort study, we tracked employment over 10 to 30 years of graduates from allopathic emergency medicine residency programs established before 2005 and those who graduated before 2010. We obtained graduate lists from 21 residency programs representing geographically diverse training programs in the United States. We utilized public databases to investigate current licensure, board certification, practice location, and occupation for graduates more than 10 years after residency graduation. Physicians who do not practice clinically in emergency medicine or an emergency medicine subspecialty were placed in the "attrition" category. "Not available" was defined as those individuals who did not have adequate information available online. We analyzed differences in attrition of women and men emergency physicians in clinical practice in 2020. We also noted whether they worked in an academic or community setting and assessed their geographic clinical practice region. We identified a total of 4,170 graduates. Of those, 445 (10.6%) were excluded because of insufficient information. Of the 3,725 emergency medicine residency graduates, 71% were men. The attrition rate from clinical emergency medicine for men was 5.3% (95% confidence interval, 4.4% to 6.1%) and the attrition rate for women was 5.8% (95% confidence interval, 4.4% to 7.2%). The difference between the 2 proportions was -0.005 (95% confidence interval, -0.02 to 0.01). There were no gender differences in geographic location or practice type. We did not observe differences in attrition rates by gender in our sample from 21 programs over a 30-year period. The findings from this cohort are disparate from reports of recent emergency medicine graduates and identifying reasons for attrition of emergency physicians will be important to understanding the workforce needs of the future.

“Patent Productivity among Academic Plastic Surgeons in the United States over 20 Years”

BackgroundInnovation is a cornerstone of plastic and reconstructive surgery. Patents are one way to measure innovation. The objective of this study was to quantify and understand patent productivity in the career of academic plastic surgeons. MethodsFaculty affiliated with United States academic medical centers with integrated plastic surgery residencies were searched by name on Google Patents from inception through April 2024. Included patents were active or pending and related to a fundamental clinical or basic science area of plastic surgery. ResultsAmong 977 academic plastic surgeons across 89 programs, there were 191 active or pending patents published by 68 (7.0%) surgeons. The average number of patents per inventor was 2.8 (4.3). The highest number of active or pending patents attributed to a surgeon-inventor was 25. Nearly 50% (n=91) of patents were held by four universities. Time since initial board certification correlated poorly with the number of patents produced (R2 = 0.17, P > 0.1). Being at a program with more affiliated patents correlated with the presence of more patent-producers (rs = 0.66; P <0.001). There was no indication that higher percent revenue distribution to an inventor increased patent productivity (rs= 0.002; P > 0.05). ConclusionsPlastic surgery remains a field driving innovation. Plastic surgeons at all career stages hold patents, highlighting the possibility for early patent pursuit. Patent-productivity was concentrated in several programs in the US, suggesting certain centers of innovations exist and may be worthy of further study.

Performance evaluation of ChatGPT 4.0 on cardiovascular questions from the medical knowledge self-assessment program

Abstract Background Medical trainees are increasingly using online chat-based artificial intelligence (AI) platforms as supplementary resources for board exam preparation and clinical decision support. Prior studies have evaluated the performance of AI chatbots like ChatGPT on various general standardized tests such as the United States Medical Licensing Examination (USMLE), but little is known about their performance on subspecialty-focused exam questions, particularly related to clinical management and treatment. Objective This study aims to evaluate the performance of ChatGPT version 4.0 on the cardiovascular questions from the Medical Knowledge Self-Assessment Program (MKSAP) 19, a widely used resource for board exam preparation in the United States. Methods We submitted all cardiovascular questions from MKSAP 19 to ChatGPT 4.0, covering a broad range of cardiology topics in a multiple-choice format. Performance was gauged against both the official MKSAP answer key and average trainee scores obtained from the MKSAP website. Out of 129 questions, 4 were invalidated due to post-publication data, and 18 were excluded due to reliance on visual aids, leaving 107 questions for analysis. Results ChatGPT 4.0 correctly answered 93 out of 107 questions, reflecting an 87% accuracy rate, compared to a 60% accuracy rate averaged among all human users for the same questions (p&amp;lt;0.0001). ChatGPT accuracy rates for each question category (e.g., heart failure, electrophysiology, etc.) are provided in the figure. On the 14 questions that ChatGPT answered incorrectly, human users averaged a 47% accuracy rate. All 14 incorrectly answered questions were related to clinical management and treatment (as opposed to diagnosis or epidemiology), and the majority (10/14) involved choosing treatment medications or choosing between medications versus interventions. Conclusion ChatGPT 4.0 surpassed the typical 70% accuracy threshold required for passing the internal medicine board certification but performed less well in answering questions about clinical management and treatment. This performance suggests that ChatGPT 4.0 could be an effective adjunct tool for cardiology education, but raises some concerns about its use in clinical decision support for trainees.

Board of Pharmacy Specialties 2022 recertification data: Characteristics and perceptions of pharmacists successfully recertified.

In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. The purpose of this retrospective study was to utilize existing data to (1) compare the characteristics of Board of Pharmacy Specialties (BPS) credentials successfully recertified vs those that were not successfully recertified in 2022 and (2) compare survey responses about maintaining board certification by continuing pharmacy education (CPE) vs examination among those who successfully recertified. The characteristics of BPS credentials eligible for recertification in 2022 (n = 4,812) and survey responses from board-certified pharmacists who successfully recertified in 2022 (n = 3,629) were retrieved from the MyBPS database. Across all specialties, 75.4% of credentials were successfully recertified in 2022. Most credentials were recertified by CPE (92.1%). Successfully recertified credentials were predominately held by pharmacists practicing within the US (96.7%), those between the ages of 31 and 40 years (51.9%), and those completing the first 7-year certification cycle (73.9%). A significant difference was found between recertified credentials and those that were not recertified based on specialty, recertification pathway, credential holder practice location, and credential holder age. Over 89% of respondents reported that a primary benefit of maintaining board certification is to "expand knowledge and skills in pharmacy." Several factors influence the decision and/or ability of board-certified pharmacists to recertify and maintain their credentials. Successfully recertified board-certified pharmacists report expanded competency, credibility, personal gratification, and increased confidence among the primary benefits of maintaining board certification. Board-certified pharmacists who successfully recertify also report a preference for a recertification process that is temporally and financially efficient.

Evaluation of a Large Language Model on the American Academy of Pediatrics' PREP Emergency Medicine Question Bank.

Large language models (LLMs), including ChatGPT (Chat Generative Pretrained Transformer), a popular, publicly available LLM, represent an important innovation in the application of artificial intelligence. These systems generate relevant content by identifying patterns in large text datasets based on user input across various topics. We sought to evaluate the performance of ChatGPT in practice test questions designed to assess knowledge competency for pediatric emergency medicine (PEM). We evaluated the performance of ChatGPT for PEM board certification using a popular question bank used for board certification in PEM published between 2022 and 2024. Clinicians assessed performance of ChatGPT by inputting prompts and recording the software's responses, asking each question over 3 separate iterations. We calculated correct answer percentages (defined as correct in at least 2/3 iterations) and assessed for agreement between the iterations using Fleiss' κ. We included 215 questions over the 3 study years. ChatGPT responded correctly to 161 of PREP EM questions over 3 years (74.5%; 95% confidence interval, 68.5%-80.5%), which was similar within each study year (75.0%, 71.8%, and 77.8% for study years 2022, 2023, and 2024, respectively). Among correct responses, most were answered correctly on all 3 iterations (137/161, 85.1%). Performance varied by topic, with the highest scores in research and medical specialties and lower in procedures and toxicology. Fleiss' κ across the 3 iterations was 0.71, indicating substantial agreement. ChatGPT provided correct answers to PEM responses in three-quarters of cases, over the recommended minimum of 65% provided by the question publisher for passing. Responses by ChatGPT included detailed explanations, suggesting potential use for medical education. We identified limitations in specific topics and image interpretation. These results demonstrate opportunities for LLMs to enhance both the education and clinical practice of PEM.

Enhancing Laboratory Outcomes Through “Stacked” Professional Credentials: A Study of ASCP BOC Trends

Abstract Introduction/Objective Laboratory medicine and pathology are rapidly evolving, requiring laboratory professionals to continuously adapt and enhance their skills to ensure high standards of patient care. The American Society for Clinical Pathology (ASCP), Board of Certification (BOC) has observed a notable increase in the number of credential holders obtaining multiple, or stacked, BOC credentials. This phenomenon is not limited to the U.S. but is also evident in various countries globally. This study aims to explore the trends of stacking credentials among BOC credential holders, examining its implications for professional development, career progression, and the overall impact on laboratory outcomes. Methods/Case Report This study utilized a comprehensive analysis of ASCP BOC’s credentialing data, focusing on individuals with multiple credentials. Data were segmented by degree (Bachelor’s, MBA, PhD, etc.), credential count (ranging from 2 to 10), and geographical distribution across the U.S. and internationally. The analysis sought to identify patterns, growth trends, and the professional demographics most inclined towards obtaining stacked credentials. Results (if a Case Study enter NA) The study revealed that approximately 11% of BOC credential holders possess two or more credentials, indicating a significant trend towards continuous professional development and specialization. The breakdown of stacked credentials by degree shows a higher percentage propensity among individuals with MBAs (as one degree type). Geographical analyses highlighted hotspots for professionals seeking multiple credentials both at the domestic U.S. level and internationally. Conclusion This suggests the BOC, and by extension the laboratory medicine and pathology community, can greatly benefit from promoting and facilitating the acquisition of multiple credentials. By doing so, the field can ensure a workforce that is not only highly qualified but also adaptable to the changing dynamics of healthcare, thereby reinforcing the indispensable role of laboratory professionals in the broader healthcare ecosystem.

Pediatric pain physician workforce: an assessment of supply and demand.

Many youth with pain lack access to pediatric pain expertise. There is a critical shortage of pediatric pain physicians, due partly to a paucity of training programs in Pediatric Pain Medicine. Pain fellowships are Anesthesiology-based and there is no pathway to fellowship training or Pain Medicine board certification for pediatricians. This workforce assessment sought to examine the current state of Pediatric Pain Medicine in the United States and future interest in pursuing Pain Medicine among pediatricians. A multidisciplinary working group of Pain Medicine clinicians designed three surveys to examine pediatric comprehensive pain programs in the US, practice patterns of pediatricians and their motivations and opinions regarding Pain Medicine board certification, and current residents' exposure to and interest in Pediatric Pain Medicine. Wait times for initial evaluations are two months or longer for two-thirds of responding centers, and barriers to increase staff size and resources were reported, including an inadequate number of trained or available physicians. Pediatricians expressed interest in earning board certification in Pain Medicine, given the opportunity. Additionally, there is interest among pediatric residents in pursuing Pediatric Pain Medicine, and qualitative data highlight information residents perceived needing in order to pursue a career in the field. Results demonstrate the need for increased training opportunities in pediatric pain medicine. A formal pathway to Pain Medicine for Pediatricians should be developed to increase the potential workforce and to address the lack of trained pediatric pain specialists, thereby improving access to care for youth with pain.

Comprehensive review of resources and strategy for dermatology board certification exams in the United States.

This article offers an up-to-date overview of resources tailored for dermatology residents in the United States preparing for their board certification exams. We have assembled a comprehensive list of exam preparation resources categorized by cost, alongside recommendations from attending and resident physicians regarding the most effective resources for each exam. Although examinations are only one facet of the training involved in becoming a competent dermatologist, these exams help residents focus on learning crucial aspects of medicine. This review aims to furnish a concise summary of available resources for dermatology residents, organized by cost. The average cost of a paid dermatology question bank resource in this review was approximately $279, reflecting the need for review resources for board exam preparation that can fit a resident physician's budget or are free to use.

The American Society for Clinical Pathology's 2023 wage survey of medical laboratories in the United States.

To inform the pathology and laboratory field of the most recent national wage data. Historically, the results of this biennial survey have served as a basis for additional research on laboratory professional recruitment, retention, education, marketing, certification, and advocacy. The 2023 Wage Survey was conducted in collaboration between the American Society for Clinical Pathology's (ASCP's) Institute of Science, Technology, and Policy in Washington, DC, and ASCP Board of Certification in Chicago, Illinois. Compared to 2021, results show that more occupations at the staff level had an increased average hourly wage (pathologists' assistant, molecular biology technologist, phlebotomist, cytogenetic technologist, and medical laboratory technician [MLT]), after adjusting for inflation. Wages by time in current occupational title are significantly higher in 2023 than in 2021. Histotechnicians, histotechnologists, and MLTs show consistent increases in pay rates for a longer length of time in the laboratory. Over half (52.4%) of the respondents feel the pandemic continues to influence their salary and/or well-being. Survey results call for continued efforts in promoting visibility of the profession and greater representation through advocacy. While burnout rates are lower compared to 2021, staffing challenges remain a relevant concern. Efforts to support the workforce have multiplied since the pandemic and have been the forefront focus of the laboratory community. However, continued support and advocacy are needed to increase the promotion and value of laboratory careers for laboratory professionals and patients alike.

Special Issue on Informatics Education A Longitudinal Graduate Medical Education Curriculum in Clinical Informatics: Function, Structure, and Evaluation.

There is a need to integrate informatics education into medical training programs given the rise in demand for health informaticians and the call on the Accreditation Council for Graduate Medical Education (ACGME) and the body of undergraduate medical education (UGME) for implementation of informatics curricula. This report outlines a 2-year longitudinal informatics curriculum now currently in its seventh year of implementation. This report is intended to inform United States (US) Graduate Medical Education (GME) program leaders of the necessary requirements for implementation of a similar program at their institution. The curriculum aligns with the core content for the subspecialty of clinical informatics (CI) and is led by a multidisciplinary team with both informatics and clinical expertise. This educational pathway has a low direct cost and is a practical example of the academic learning health system (aLHS) in action. The pathway is housed within an internal medicine department at a large tertiary academic medical center. The curriculum has yielded 13 graduates from both internal medicine (11, 85%) and pediatrics (2, 15%) whose projects have spanned acute and ambulatory care and multiple specialties. Projects have included Clinical Decision Support (CDS) tools, of which some will be leveraged as substrate in applications seeking extramural funding. Graduates have gone on to CI board certification and fellowship, as well as several other specialties, creating a distributed network of clinicians with specialized experience in applied CI. An informatics curriculum at the GME level may increase matriculation to CI fellowship and more broadly increase development of the CI workforce through building a cadre of physicians with HIT expertise across specialties without formal CI board certification. We offer an example of a longitudinal pathway which is rooted in aLHS principles. The pathway requires a dedicated multidisciplinary team and departmental and IT leadership support.