Every two years, my hospital cre­dentials need to be re-certified. I am required to have a physi­cal evaluation. Also, my physician has to certify that I am reasonably sane. Fortunately, he manages to get away with it. At least they haven’t ques­tioned him so far. I also have to report that I haven’t been sued too many times for malpractice, and haven’t been convicted of felonious assault, major sex crimes, cheating at cards, and armed robbery and such. When I get to the box concerning recerti­fication of specialty and last date of recertification, I can laugh. As pres­ently, Oral Medicine doesn’t require diplomates of the American Board of Oral Medicine (ABOM) to go through a formal recertification pro­cess. As the present secretary of the board, I am required to send letters to five percent of the diplomates and request documentation of oral medi­cine continuing education. I think it is the rare diplomate that doesn’t have an excess of such requirements. At present, we include attending oral medicine meetings, attending other continuing dental education presen­tations that reasonably apply to oral medicine, authorship of papers, post­ers, oral medicine presentations, and dental and graduate teaching as meet­ing the definition of oral medicine continuing education requirements.

I am fortunate to be included in a bone marrow transplant research group at NHLBI/NIH. My sponsor is a board-certified hematologist. He happens to be more than twenty years younger than I. In spite of the fact that he is a world recognized expert within his field and an unpar­alleled clinician and researcher, he was required to take the recertifica­tion examinations in hematology. He took some time to hit the books and prepare but reported that the recerti­fication examinations in hematology were a bear. He passed but not with­out a significant effort. His group of relatively younger physicians was required to recertify. Older hematol­ogists who had passed the boards and received their diplomate credentials many years ago were “grandfathered.”

“Having a recertification process in a particular specialty also enhances the reputation of the specialty.”

Virtually all medical specialties today require recertification every seven years or so. Some of the recertifica­tion examinations are more difficult than others, but all require a degree of knowledge and reasoning ability.

Presently, even a number of den­tal specialties have gotten on board with regard to required recertifica­tion including Oral & Maxillofacial Pathology and Pediatric Dentistry. It won’t be long and recertification will be the accepted standard. The con­cept of being board certified provides a process for individuals to challenge board examinations to demonstrate a particular level of knowledge. But be­cause medical and dental knowledge is based upon evidence and the amount of evidence increases daily, it is neces­sary to keep abreast of newly emerging evidence. Therefore, in order to pro­vide the public with the confidence that board-certified clinicians are up on the latest evidence, these clinicians must be retested at regular time inter­vals. Having a recertification process in a particular specialty also enhances the reputation of the specialty. A spe­cialty that requires a process to insure that clinicians are continuing to keep up with the increasing knowledge base is viewed more favorably than a specialty that doesn’t require such a process.

But as a clinician, I am loathe to take another (take your choice of an appropriate expletive) examina­tion. I took enough of them in dental school, and the state, regional, and national boards. I certainly do not wish to entertain taking another if I can possibly avoid it. So how have other specialties put these recertifi­cation boards in place? The answer is that in order to make such a situ­ation politically viable, the vote is to make the younger guys and gals have to take them and “grandfather” or “grandmother” ourselves (those of us voting the process in) OUT. That is why my sponsor at NIH had to take the hematology recertification -be­cause he was younger. So this is why the group of oral medicine residency graduates need to think about taking their diplomate’s oral medicine board examinations in the very near future. Because it may not be too long before recertification becomes the rule in oral medicine.