Fellowship‐trained physicians who let their geriatric medicine certification lapse: A national survey

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 72; no. 4; pp. 1177 - 1182
• Main Authors: Ross, Kathryn, Lynn, Lorna, Foley, Kevin T., Barczi, Steven R., Widera, Eric, Parks, Susan, Luz, Clare, Colburn, Jessica L., Leff, Bruce
• Format: Journal Article
• Language: English
• Published: Hoboken, USA John Wiley & Sons, Inc 01-04-2024; Wiley Subscription Services, Inc
• Subjects: Aged; board certification; Certification; Fellowships and Scholarships; geriatric medicine; Geriatrics; Humans; Internal medicine; maintenance of certification; Medicare; Medicine; Older people; Physicians; Scholarships & fellowships; Surveys; United States; workforce development; United States; board certification; maintenance of certification; workforce development; geriatric medicine
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/jgs.18781

Background
Only 62.6% of fellowship‐trained and American Board of Internal Medicine (ABIM)‐certified geriatricians maintain their specialty certification in geriatric medicine, the lowest rate among all internal medicine subspecialties and the only subspecialty in which physicians maintain their internal medicine certification at higher rates than their specialty certification. This study aims to better understand underlying issues related to the low rate of maintaining geriatric medicine certification in order to inform geriatric workforce development strategies.
Methods
Eighteen‐item online survey of internists who completed a geriatric medicine fellowship, earned initial ABIM certification in geriatric medicine between 1999 and 2009, and maintained certification in internal medicine (and/or another specialty but not geriatric medicine). Survey domains: demographics, issues related to maintaining geriatric medicine certification, professional identity, and current professional duties.
Results
153/723 eligible completed surveys (21.5% response). Top reasons for not maintaining geriatric medicine certification were time (56%), cost of maintenance of certification (MOC) (45%), low Medicare reimbursement for geriatricians' work (32%), and no employer requirement to maintain geriatric medicine certification (31%). Though not maintaining geriatric medicine certification, 68% reported engaging in professional activities related to geriatric medicine. Reflecting on career decisions, 56% would again complete geriatric medicine fellowship, 21% would not, and 23% were unsure. 54% considered recertifying in geriatric medicine. 49% reported flexible MOC assessment options would increase likelihood of maintaining certification.
Conclusions
The value proposition of geriatric medicine certification needs strengthening. Geriatric medicine leaders must develop strategies and tactics to reduce attrition of geriatricians by enhancing the value of geriatric medicine expertise to key stakeholders.
See related articles by Ouslander et al., Colenda and Applegate, and Chad Boult in this issue.