For years, the conversation about board certification has centered on fairness, cost, and evidence. But there is another consequence that gets far less attention: how these systems affect the supply of practicing physicians.

America’s physician shortage isn’t theoretical anymore. It is here. Hospitals are scrambling to fill call schedules, rural communities are waiting months for specialist appointments, and medical groups are watching senior clinicians retire earlier than planned. Among the many …

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If you asked ten physicians to explain how they maintain board certification, you’d get at least ten different answers, maybe more. Some take quarterly quizzes. Some submit CME attestations every five years. Some do both. Others, grandfathered in before time-limited certification existed, do nothing at all. Yet every one of them carries the same professional label: board-certified physician.

That simple title, once synonymous with competence, now hides a dizzying patchwork of …

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Every major policy in medicine is supposed to rest on evidence. We track outcomes for new drugs, devices, and procedures. We measure hospital mortality, infection rates, and adherence to guidelines. Yet one of the most time-consuming and expensive physician policies of all, Maintenance of Certification (MOC), has never been held to that same standard.

For decades, the American Board of Internal Medicine (ABIM) and other specialty boards have argued that recertification …

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The tension between physicians and the American Board of Internal Medicine (ABIM) has simmered for a decade. What began as a professional debate over maintenance of certification (MOC) has evolved into a broader question of fairness, autonomy, and accountability. Now, the courts are involved, and the legal battles are revealing as much about the profession’s frustration as they are about the structure of American medicine.

A landscape of lawsuits

Since 2018, multiple …

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The story of gastroenterology in 2025 is no longer about productivity or reimbursement, it’s about manpower. Hospitals and practices across the U.S. are struggling to recruit, retain, or even temporarily staff the specialists who manage digestive diseases, perform colon cancer screening, and handle emergency procedures like ERCP. What we’re facing isn’t simply a staffing issue; it’s a structural shortage decades in the making.

The shrinking pipeline of gastroenterologists

In the mid-1990s, roughly …

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The United States faces a worsening physician shortage despite increases in medical school enrollment and residency growth. This article provides a comprehensive, data-driven analysis of the multifactorial forces reducing effective physician supply. These include training-pathway inflation, declining board-certification throughput, shorter physician career duration, reduced reimbursement, the collapse of private practice, feminization of the workforce, declining IMG participation, and accelerating population aging. Tables and figures throughout this article illustrate how these …

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The phrase “board-certified” once carried a universal meaning. A physician had met rigorous training and testing standards and could practice confidently anywhere in the country. That clarity has faded. Today, certification and recertification requirements differ not only by specialty but also by which board you happen to fall under. What was once a single national standard has splintered into a patchwork of rules, fees, and timelines that seem designed less …

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The American Board of Internal Medicine (ABIM) made headlines in late 2024 when it announced the elimination of its unpopular two-year Maintenance of Certification (MOC) point requirement. On paper, this looked like progress, a gesture toward simplification after years of criticism from physicians who felt trapped in an expensive, time-consuming cycle that added little value to their actual practice. But beneath the surface, the reform raises a harder question: Has …

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The story of gastroenterology in 2025 is no longer about productivity or reimbursement; it’s about manpower. Hospitals and practices across the U.S. are struggling to recruit, retain, or even temporarily staff the specialists who manage digestive diseases, perform colon cancer screening, and handle emergency procedures like ERCP. What we’re facing isn’t simply a staffing issue; it’s a structural shortage decades in the making.

The shrinking pipeline of gastroenterologists

In the mid-1990s, roughly …

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The field of gastroenterology in the United States has undergone a significant transformation over the past 5 to 10 years, driven by a confluence of historical changes in training programs, changing demographics among GI doctors due to the relatively new specialty of GI endoscopy, and a dwindling supply of gastroenterologists. These factors have culminated in a notable impact on gastroenterology physician salaries and have raised important questions about the future …

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