Pursuit and recognition of excellence is central to our profession. But not everyone can be first in the class. Part of our contract with the society that grants us the status of a profession is the responsibility to regulate ourselves and to assure society that members of our profession meet minimal requirements and do not endanger the public. By any measure, it is easier to judge who is at the top of the class than it is to objectively determine and enforce minimal standards of competence. This challenge has been made even more difficult by the rapidly expanding knowledge base and technical skill required of today's cardiologists.
Board certification is now time limited.
Our CME credits, utilization of services, and markers of our clinical outcomes all are monitored. Some cardiologists understandably feel oppressed by what can appear to be a perpetual winnowing process, with Big Brother always looking over the shoulder, constantly demanding that individuals pay for and pass yet another test, fill out yet another form, or go to yet another continuing medical education course so that they can continue to practice their profession. Quality is an elusive concept, as medicine remains an art as well as a science. But to improve quality and to assure society that minimum acceptable standards are met requires that quality be objectively measured. The quality of a cardiologist's training can be measured by testing his or her knowledge base at the end of a controlled curriculum.