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It’s useless to test skills that go unused

Dr. Charles Hirsch, under whom I trained, said few people have 20 years’ experience. Lots of people have one year’s experience repeated 20 times.

Some people spend years repeating their errors, Hirsch said. They don’t keep up with changes in their fields.

Doctors are required to keep up. Each specialty’s governing board certifies the competence of its practitioners through continuing education and recertifying examinations.

Newsweek recently reported a row that’s boiled up between practitioners of internal medicine and the American Board of Internal Medicine over new certification requirements. Pathologists are engaged in a similar dispute with the American Board of Pathology.

When I studied in forensic pathology, pathologists had to take certifying examinations only at the end of their training.

The board decided to require recertification after 2006. Recertifying exams were developed for the basic disciplines of anatomic pathology and clinical pathology or laboratory medicine and for each subspecialty, including forensic pathology.

I hold boards in all three, but I earned lifetime certifications in 1986 and 1987. I’m “grandmothered.” I’ll never have to take another test.

As originally conceived, subspecializing pathologists could retest only in their subspecialty. Their certifications in the basics of anatomic and/or clinical pathology would lapse with no penalty.

That was the route many younger forensic pathologists planned to take. The basics of hospital pathology practice covered by the anatomic and clinical pathology exams didn’t apply to their work as medical examiners. They had no reason to keep up with advances in tumor classification, blood banking or other hospital-based skills.

I didn’t maintain those skills. As practiced today, I’d find those facets of pathology unrecognizable. I don’t think that affects my competence as a forensic pathologist.

Recently, the pathology board changed its requirements again. Subspecializing pathologists certified after 2006 must recertify in anatomic and/or clinical pathology.

The board says all pathologists must “maintain a core of general knowledge in their field, regardless of their subspecialization.”

Like internists, my younger colleagues are furious. The examinations are exorbitantly expensive. It’s useless to study skills they haven’t practiced in years and will never practice again. And they’re scared they’ll fail the tests.

Some say they may boycott the process and not try to recertify at all. Trained forensic pathologists are so rare that a failure to recertify wouldn’t threaten their jobs because there’d be nobody to take their place.

They say it’s easy for the “grandpops” – including members of the board – to say it’s important to maintain certifications of competency. They don’t have to take the tests.

I sympathize. I couldn’t pass the recertification examinations required now.

chuser@durangoherald.com. Dr. Carol J. Huser, a forensic pathologist, served as La Plata County coroner from 2003-12. She now lives in Florida and Maryland.

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