WE, the undersigned physicians oppose the continued administration of Part II Certification Examination (oral boards) administered by the American Board of Physical Medicine and Rehabilitation (ABPMR) and demand that ABPMR work with their future and present members to transform the current state of board certification examination to meet the current and future needs of both physiatrists and our patients for the following reasons:
1. Board eligibility and board certification is essentially a requisite in working in the field of physical medicine and rehabilitation;
2. Board eligibility expires within a fixed amount of time after completion of a physical medicine and rehabilitation residency;
3. Board certification examinations should provide a minimum threshold to protect the public and ensure minimum standards for working in the field of physical medicine and rehabilitation;
4. Oral examinations have problematic issues of validity and reliability;
5. Other physiatry board counterparts have either waived or are reanalyzing the necessity of the oral boards including the Royal College of Physicians and Surgeons of Canada and the American Osteopathic Board of Physical Medicine and Rehabilitation;
6. Any published study written by ABPMR are inherently biased and furthermore such studies suggest a positive correlation between milestone competencies (reflecting expectations in residency) to Part I scaled scores but no predictive correlation between milestone competencies and Part II. (Francisco, Gerard, Yamazaki, Kenji, Raddatz, Mikaela, et al. Do Milestone Ratings Predict Physical Medicine and Rehabilitation (PM&R) Board Certification Examination Scores?. [published online ahead of print November 18, 2020]. Am J Phys Med Rehabil. Available from: Journals@Ovid, Accessed November 24, 2020.). This suggests that Part II and residency programs are not aligned in the expectation of competencies of physiatrists;
7. Keeping an exam purely as a rite of passage does not protect our patients or the physiatrists who dedicated their passion and livelihood for their patients;
8. Other specialties that regularly care for a significantly more acutely sicker population and often require quick decision making have eliminated oral examinations such as: family practice, internal medicine, pathology, diagnostic radiology, neurology, pediatrics, and psychiatry;
9. Neurology is the closest counterpart to physical medicine and rehabilitation and does not require an oral examination even though they run high intensity emergent stroke codes as well as rapid responses and code BLUE and thus require fast and deliberate thinking and yet board certified neurologists are competent and privileged to work at their highest level; and
10. Psychiatry does not require an oral examination even though they deal with patients with equally complex psychosocial issues as physical medicine and rehabilitation and yet board certified psychiatrists are competent and privileged to work at their highest level.
