To NCCPA From a PA in Hepatology

Regarding the current model: The PANRE every six or 10 years is fine along with the 100 CME every two years.  I work in academic center thanks to my subspecialty (Hepatology), and receive regular Category I and II CME.  I, also, have to remain up-to-date on general medicine information because medications and practices affect the liver, so I attend family practice CME.  By attending both of these, I not only receive enough CME credits but remain up-to-date.

The use of PI-CME is not relevant to my practice and unfortunately with information changing so frequently these days; it is difficult to say if this is going to help me pass the PANRE.

Regarding the new proposed model:

I do not believe this is a good idea – the tests are too frequent.  I prefer taking it every 10 years like the physicians.

Also, I do not believe being open-book/open-resource is a good idea.  There are too many resources available (between textbooks and the Internet) and the information is evolving.  My answer and the proposed correct answer may not agree.  This will involve contesting the answer by finding the resources used by the Board and myself.  This is very time consuming.

Another concern I have with the new model is the following – do they really ensure that I am up-to-date on my knowledge?  Being in the medical profession requires life-long learning.  There has to be a better way to do this.  How about defining how many CMEs (out of the 100 every two years) are required in our specialty and other specialties? For example, since I am in hepatology and not GI, I would need 50 per year from hepatology and the rest from Family Medicine. This can confirm we are up-to-date on all the specialties and help us prepare for the PANRE.

I am also concerned about the cost of taking all of these exams, CMEs, etc.?  Offices only have so much money available for us to use on these things.  Then, I have to pay out of pocket.  Also, is there a difference in cost between specialty examinations and general medicine examinations? This is not clearly defined in the proposal.

Lastly, by having specialty examinations available, it may make it difficult for those who take the general exam to get a job in the future. Hospitals and insurance companies may require these to obtain privileges just as they are requiring physicians to currently remain certified in all of their specialties. What happens to physicians can and most likely will happen to us. So, if companies require this of us as well, how will it affect me getting a job in the future if the specialty exam does not exist?  This needs to be addressed.