The Association Between Maintaining American Board of Emergency Medicine Certification and State Medical Board Disciplinary Actions.

Background: In certain medical specialties, board certification is associated with a lower risk of state medical board disciplinary actions.

Objective: The association between maintaining American Board of Emergency Medicine (ABEM) certification and state medical disciplinary actions had not been studied. This study was undertaken to determine if maintaining ABEM certification was associated with a lower risk of disciplinary action.

Methods: This investigation was a historical cohort study using Cox regression. Physicians who did not have a lapse in ABEM certification were compared with physicians who had a lapse to determine the risk of disciplinary action. Lapsing was determined at the expiration of the initial certificate. This study included all physicians who obtained initial ABEM certification from 1980-2005. Additional covariates of interest included the number of attempts on the ABEM Qualifying Examination (1 vs. >1), the geographic region of the physician's residence, and the country of medical school.

Results: There were 23,002 physicians in the study cohort. Of these, 3370 (14.7%) let their certification lapse after initial certification. There were 701 (3.0%) physicians with disciplinary events. Lapsed physicians had higher rates of disciplinary actions than physicians who did not lapse (6.4% vs. 2.5%). ABEM-certified physicians who did not lapse were significantly less likely to be disciplined as physicians who let their certificate lapse (hazard ratio 0.50 [95% confidence interval 0.42-0.59]).

Conclusions: The absolute incidence of physicians with a disciplinary action in this study cohort was low (3.0%). Maintaining ABEM certification was associated with a lower risk of state medical board disciplinary actions.