It won’t be as explosive as Afghanistan President Hamid Karzai’s recent peace jirga, but a retreat this weekend called by the American Board of Dermatology will attempt to reach peace between conflicting factions within the specialty on the issue of a certifying exam in procedural dermatology.
The Board is bringing together the “tribal leaders” of dermatology associations on June 12 in Chicago to discuss the controversial exam, which drew fire from some dermatologists and opposition from the American Society for Mohs Surgery, the American Academy of Dermatology, and others.
Concerns have centered around perceptions that eventually only fellowship-trained dermatologists would be eligible to take the exam and insurers would refuse payments for procedures by non-certified physicians, thus restricting patients’ access to care. Non-fellowship physicians want a piece of the procedural dermatology pie, too. (See previous coverage of this story by my colleague Mary Ellen Schneider here.)
On the other hand, the American College of Mohs Surgery, which accepts only members who have completed a 1- to 2-year fellowship, supports the certifying exam idea.
Under the original proposal, the exam would be open to physicians who have completed a procedural dermatology fellowship, and (for a limited time) those who haven’t done a fellowship but have significant surgical experience would be “grandfathered” in. Dr. Leonard M. Dzubow, president of the American College of Mohs Surgery, expressed confidence in an interview that the subspecialty certification process would include several pathways for qualification, making it available to all physicians with “sufficient experience and knowledge.”
Dr. Matthew M. Goodman, founding president of the American Society for Mohs Surgery, remains concerned that the certifying exam could divide the house of dermatology. “One of the large questions is, who will be deemed qualified to sit for the exam? That very question may be the dividing point,” he said in an interview at the Society’s annual meeting. “There’s nothing against fellowships or against a certifying exam per se. We just would rather not see those as divisive forces.”
The American Board of Dermatology’s president, Dr. Elaine C. Siegfried, declined to comment until after the retreat. Stay tuned — we’ll be following this issue.