Dorthea Juul

Recent Trends in American Board of Psychiatry and Neurology Psychiatric Subspecialties

ObjectiveThis article reviews the current status and recent trends in the American Board of Psychiatry and Neurology (ABPN) psychiatric subspecialties and discusses the implications of those trends as well as several key questions whose answers may well determine subspecialty viability.MethodsData are presented on specialty and subspecialty programs; graduates; and ABPN certification candidates and diplomates drawn from several sources, including the records of the ABPN, the websites of the Accreditation Council for Graduate Medical Education and the American Medical Association, and the annual medical education issues of JAMA.ResultsFewer than half of psychiatry graduates pursue sub-specialty training. While most recent specialty graduates attempt to become certified by the ABPN, many subspecialists elect not to do so. There have been recent decreases in the number of fellowship programs and trainees in geriatric psychiatry and addiction psychiatry. The pass rates for fellowship graduates are superior to those for the “grandfathers” in all of the newer psychiatric subspecialties. Lower percentages of subspecialists than specialists participate in maintenance of certification, and maintenance of certification pass rates are high.ConclusionThe initial interest in training and certification in some of the ABPN subspecialties appears to have slowed, and the long-term viability of those subspecialties may well depend on the answers to a number of complicated social, economic, and political questions in the new health care era.

Relationship between resident-in-training examination in psychiatry and subsequent certification examination performances

ObjectiveThis study analyzed the relationship between performance on The American College of Psychiatrists’ Psychiatry Resident-In-Training Examination (PRITE) and the ABPN Part 1 examination.MethodsPearson correlation coefficients were used to examine the relationship between performance on the 2002 PRITE and the 2003 Part 1 examination for 297 examinees.ResultsThe correlation between the PRITE global psychiatry and the Part 1 psychiatry scores was 0.59, and the correlation between the PRITE global neurology and the Part 1 neurology scores was 0.39.ConclusionAlthough the PRITE and the Part 1 examination have different purposes and are developed independently, the significant correlations between scores on the two tests support the use of PRITE results to guide preparation for the Part 1 examination. Guidelines for PRITE scores associated with poor performance on the Part 1 examination are provided.

RITE performance predicts outcome on the ABPN Part I examination

Objective This study examined the performance correlation the American Academy of Neurology Resident Inservice Training Examination (RITE) and Part I of the American Board of Psychiatry and Neurology (ABPN) examination. Methods Candidates who took the RITE in the last year of training were tracked and their subsequent performance on the ABPN Part I examination was compared with their performance on the RITE. Results Performance on the RITE is predictive of performance on the ABPN Part I examination. Conclusions The RITE can be used to assess a resident’s readiness to take the ABPN Part I examination.

Trends in American Board of Psychiatry and Neurology specialties and neurologic subspecialties

Objective: To review the current status and recent trends in the American Board of Psychiatry and Neurology (ABPN) specialties and neurologic subspecialties and discuss the implications of those trends for subspecialty viability. Methods: Data on numbers of residency and fellowship programs and graduates and ABPN certification candidates and diplomates were drawn from several sources, including ABPN records, Web sites of the Accreditation Council for Graduate Medical Education and the American Medical Association, and the annual medical education issues of the Journal of the American Medical Association. Results: About four-fifths of neurology graduates pursue fellowship training. While most recent neurology and child neurology graduates attempt to become certified by the ABPN, many clinical neurophysiologists elect not to do so. There appears to have been little interest in establishing fellowships in neurodevelopmental disabilities. The pass rate for fellowship graduates is equivalent to that for the “grandfathers” in clinical neurophysiology. Lower percentages of clinical neurophysiologists than specialists participate in maintenance of certification, and maintenance of certification pass rates are high. Conclusion: The initial enthusiastic interest in training and certification in some of the ABPN neurologic subspecialties appears to have slowed, and the long-term viability of those subspecialties will depend upon the answers to a number of complicated social, economic, and political questions in the new health care era.

Association between performance on Neurology In-Training and Certification Examinations

Objective: This study analyzed the relationship between performance on the American Academy of Neurology Residency In-Service Training Examination (RITE) and subsequent performance on the American Board of Psychiatry and Neurology (ABPN) Certification Examination. Methods: Pearson correlation coefficients were used to examine the relationship between performance on the RITE and the Certification Examination for 2 cohorts of adult neurologists and 2 cohorts of child neurologists. The 2 cohorts represented test takers for 2008 and 2009. Results: For adult neurologists, the correlation between the total RITE and the Certification Examination scores was 0.77 (p < 0.01) in 2008 and 0.65 (p < 0.01) in 2009. For child neurologists, it was 0.74 (p < 0.01) in 2008 and 0.56 (p < 0.01) in 2009. Discussion: For 2 consecutive years, there was a significant correlation between performance on the RITE and performance on the ABPN Certification Examination for both adult and child neurologists. The RITE is a self-assessment examination, and performance on the test is a positive predictor of future performance on the ABPN Certification Examination.

Subspecialty Certification in Geriatric Psychiatry

OBJECTIVE The authors describe the development of certification and recertification processes for geriatric psychiatry, the American Board of Psychiatry and Neurologys second subspecialty in psychiatry. METHODS Authors referenced databases of the certifying organizations and consulted published surveys of examinees. RESULTS Since the first certification examination was administered in 1991, 2,595 certificates have been awarded. Because the certificates are time-limited, diplomates must sit for recertification every 10 years. Thus far, about 63% of the diplomates who have needed to do so have been recertified. CONCLUSION It is estimated that 5,000 geriatric psychiatrists will be needed to meet future healthcare needs. Thus, the demand for this expertise will be increasing, and it is anticipated that board-certified geriatric psychiatrists will continue to play leading roles in educating practitioners from multiple disciplines.

Child neurology training via the research pathway: outcome study.

This article describes a residency training track that was developed by the American Board of Psychiatry and Neurology to promote the career development of child neurologists who wanted to become researchers. In this pathway, 1 year of research in the basic neurosciences replaces 1 year of pediatrics or internal medicine. Since 1992, 38 residents from more than 20 training programs have been accepted into this pathway. Of the 28 who have completed residency training, 22 are in academic positions as faculty or fellows, and 6 are working in nonacademic hospital settings. Of these 22, 6 describe their research as basic, and 12 describe their research as being both basic and clinical; 15 have been successful in obtaining external funding. Thus far, these trainees have published more than 125 articles in peer-reviewed journals. Although small in scope, this training track has met its objective of producing clinician-scientists. ( J Child Neurol 2004;19:142—144).

Board certification in child neurology and neurology: cohort study.

This study followed the progress of a cohort of child neurology and neurology graduates who sought certification by the American Board of Psychiatry and Neurology (ABPN). The 211 candidates were recent graduates when they initiated the certification process in October 1994, and 92% of them have achieved certification. First-attempt performances on the Part I and Part II examinations were related; 62% of those certified passed both on their first attempts. Of those who were certified, 24% also achieved certification in at least one additional ABPN specialty (psychiatry) or subspecialty (clinical neurophysiology, neurodevelopmental disabilities, and pain medicine). Overall, it was estimated that 82% of the 1994 child neurology and neurology graduates sought ABPN certification, and of these, 82% were successful. (J Child Neurol 2005;20:25—27).

Certification in Child Neurology: New Directions for the Twenty-First Century

The American Board of Psychiatry and Neurology was formed in 1934, and the first certifying examination was administered in 1935. It was not until 1969 that the American Board of Psychiatry and Neurology began conducting certifying examinations in child neurology. Since then, 10 child neurologists have served as American Board of Psychiatry and Neurology directors and nearly 1500 child neurologists have been certified, more than 200 of whom have also attained certification in the subspecialties of clinical neurophysiology, neurodevelopmental disabilities, and pain medicine. This article describes the evolution of the certification process as the Board has endeavored to use the best testing methodologies to fulfill its commitment to the public and to its constituents in psychiatry and neurology. Training pathways in child neurology are also reviewed as they have evolved in response to evident staff shortages and to promote entry into academic careers. (J Child Neurol 2005;20:644—647).

Vascular neurology: a new neurologic subspecialty in the United States.

The American Board of Psychiatry and Neurology (ABPN) has established a certification process for the subspecialty of vascular neurology. In addition, the Accreditation Council for Graduate Medical Education has approved residencies (fellowships) in vascular neurology in the United States. These steps are in response to the growth of a special body of knowledge related to the diagnosis and treatment of patients with cerebrovascular disease. The certificate in vascular neurology recognizes those ABPN-certified neurologists or child neurologists who have demonstrated proficiency in the management of patients with vascular diseases of the central nervous system. This may have implications for similar initiatives in other countries