The year was 1999. The place was the Stanley Hotel in Estes Park, Colorado. The event was the annual summer retreat of the directors of the American Board of Orthodontics (ABO). Each summer, the directors of the ABO would set aside a few days to review and modify current policies and to discuss future perspectives regarding board certification. I was there in Estes Park, serving in my role as an ABO director from the Pacific Coast Society of Orthodontists.
Why Estes Park? Because exactly 70 years before, in 1929, Albert Ketchum and several colleagues met at the Stanley Hotel in Estes Park to initiate, formulate, and create the ABO. At that time, the American Board of Otolaryngology was the only other health-related certifying board. So, the ABO would actually become the first dental certifying board.
The late 1990s were busy years for the ABO. After 4 consecutive field tests, the board rolled out a new method of objective grading, which would be applied to the future examination of a candidate’s records. In addition, the directors were on the verge of inviting examiners to assist with candidate testing. Also, the written examination had received a major overhaul to make it comply with other national board examination standards. All parts of the examination process had been upgraded to a higher level except for one: recertification.
From its inception in 1929 in Estes Park, the originators of the ABO had proposed a “one-time examination” that would reward a successful candidate with “certification for a lifetime.” And this philosophy worked well for 70 years. So, why should the board consider recertifying previously certified orthodontists? It did not make sense, especially when only 25% of practicing orthodontists had even achieved ABO certification. Why not focus on encouraging the other 75% of orthodontists who were not certified to submit their patient records for examination?
Here’s the reason. By 1999, nearly all other medical and dental certifying boards had established a method of assessing “continued competency.” Even though the ABO was the first dental certifying board, it was the only board in dentistry that did not have a means of assessing the continued competency of its diplomates. So, that topic was brought up at our 1999 ABO retreat in Estes Park. I will never forget the nearly hour-long debate among the 8 ABO directors. All sides of the issue were discussed thoroughly.
Initially, there was no clear consensus. Good arguments were made on both sides. The major concern was that, if the ABO required diplomates to undergo a recertification examination, they might rebel and perhaps the ABO would dissolve over this contentious issue. But in the end, the directors understood that some method of verifying continued competency was the right thing to do. So, the board decided to grandfather all current ABO diplomates and to begin developing a recertification examination for candidates who would begin the certification process after 1999. The vote was close, but mandatory recertification was narrowly accepted in the same hotel where lifetime certification had been conceived.
After 70 years of a “one-time lifetime certification process,” the ABO directors passed mandatory recertification. Early on in the process, an initial certificate was valid for 15 years. Therefore, the first mandatory recertification of candidates will occur in 2014. What does recertification entail? The ABO has been field testing the recertifying process for the past decade. All current and past directors were required to undergo recertification. All orthodontists who serve as examiners for the ABO must undergo recertification. Although the requirements for recertification are still being formulated, the policy of recertification has been upheld since it was approved in 1999. I am proud of the ABO for not wavering and for maintaining a firm stance on this subject.
Fast forward to the present. Why am I writing about this event? Because the entire fall 2012 issue of the Journal of the American College of Dentists was devoted to the importance of assessing continued competency among dentists. There were 6 well-written articles on all perspectives of this topic. What’s the bottom line? The ABO got it right. Recertification is important. It is a useful method of validating continued competency.