Difficulty With Board Certification in Urology Is Associated With Adverse Medical License Actions

Abstract

Introduction: Board certification in urology is a multistep process including a written qualifying examination, followed by an oral certifying examination approximately 2 years after residency or fellowship completion. The goal of this process is to ensure that urologists are well trained, have an extensive fund of knowledge, demonstrate professionalism and competence in practice, and are safe to practice urology. Board certification in urology serves to both establish and confirm physician competence and ultimately protect the public. We sought to examine the relationship between board certification in urology and adverse medical license actions.

Methods: We retrospectively studied deidentified physicians who attempted initial American Board of Urology certification between 1980 and 2022. The primary outcome was adverse state medical license action, defined as severe (surrendered, suspended, or denied licenses) or moderate (required continuing medical education, imposed conditions, fines, reprimands, and probations). Statistical analyses were conducted using χ² and Fisher exact tests.

Results: Five thousand five physicians were included in analyses. One hundred nineteen physicians did not obtain board certification. Only 1.4% of physicians who certified on initial attempt received disciplinary action compared with 3.0% who obtained certification on repeated attempts (Fisher exact test 0.013, P < .05) and 5.9% who never obtained certification (Fisher exact test 0.0018, P < .05).

Conclusions: Failure to complete or repeated attempts at board certification was associated with increased rates of disciplinary actions. This association highlights the continued relevance of American Board of Urology certification in protecting the public.

Keywords: board certification; license; qualifications; safety.