After months of heated debate within the optometric community, the AOA House of Delegates voted for an updated version of the proposed board certification model during its annual meeting in Washington, D.C., on Friday, June 26. The vote capped off one of the most controversial and significant decisions for the profession in decades.

The AOA House of Delegates final vote was 1,126 to 887 in favor of the proposed board certification model. States that voted for board certification included New Jersey, Pennsylvania, Texas, California, Kansas, Washington, Illinois and Michigan. States that voted against board certification included North Carolina, Florida, Indiana, Ohio, Massachusetts and Wisconsin. However, many states split their votes in an attempt to reflect the opinion of their membership. These included New York, Virginia, Arkansas, Montana and Maryland.

4 Steps to Become Board Certified While not all the details have been determined, here are the proposed steps to become board certified: 1. Initial Application. Send in your application, an application fee, a statement of adherence to American Board of Optometry Code of Ethics, and evidence that you are a graduate of a school or college of optometry accredited by the Accreditation Council on Optometric Education and are in possession of an active license to practice therapeutic optometry. You also need clearance of search of National Practitioner Data Bank & Healthcare Integrity and Protection Data Bank.   2. Application for the Board Certification Examination. Before you can sit for the exam, you must accumulate 150 points during a three-year period immediately leading up to sitting for the test. There are a variety of ways to accumulate these points: residency; fellowship in the American Academy of Optometry; experience in practice; fellowship in the College of Optometrists in Vision Development; continuing education courses; and other avenues, such as poster presentations, documented point of care learning, and publication in a peer-reviewed journal.   3. Completion of the Board Certification Examination. You must pass the exam within 12 months of submitting your application. The tests cover the gamut of optometric areas of interest, but you are able to select three areas of interest and your test will be weighted toward those areas.   4. Your Board Certified Status. Your status as a Board Certified Optometrist is good for 10 years. However, maintenance of certification is necessary and you must accumulate another 150 points every three years before you take the test again in year nine or 10.

Proponents of the issue held firm in their stance that optometry needed board certification in order to have a seat at the national health care reform table with other physicians. Additionally, proponents argued that the federal government is moving toward a board certification requirement and maintenance of certification as a performance measure for such programs as the Physician Quality Reporting Initiative and the new Medical Home program.

If we are going to be successful as a profession, we must always be under construction, stated Lesley Walls, O.D., M.D., of Tulsa, Okla., to the House of Delegates.

However, many other clinicians expressed concern about the requirements for certification in the proposed model. I understand the motivation for the project, but I am a bit surprised that it passed given the polls taken by various organizations, says optometrist Howell M. Findley, of Lexington, Ky. I am interested to see how the final program will look. Who will develop the test, and what will be tested? Will there be review courses offered? Who will provide these courses? And, of course, where does the moneyand powergo?

Following the daylong debate, two modifications to the original board certification and maintenance of certification model were accepted in the final motion:

Experience in Practice. For O.D.s who apply within three years from the date when applications are accepted, a maximum of 150 Experience in Practice points will be accrued, equal to five points per year of active licensure.

COVD Fellowship. Fellowship in the College of Optometrists in Vision Development will be worth 50 points for those O.D.s who apply within three years from the date when applications are accepted.

Now that the vote has been decided, the next step is to establish the American Board of Optometry (ABO) as the entity to develop and implement the framework for board certification and maintenance of certification. ABO will be an independent not-for-profit corporation with seven members, consisting of one public member and one representative each nominated by the AAO, the American Optometric Student Association, the Association of Regulatory Boards of Optometry and the Association of Schools and Colleges of Optometry. The AOA will have two representatives on the board.

Our members actions Friday indicate that optometrists see the need for a mechanism to clearly demonstrate continued competency to patients, legislators and payers, says Randolph E. Brooks, O.D., newly inducted president of the AOA. The creation of the American Board of Optometry will provide a unified national platform to establish and demonstrate competency and value and will position our profession solidly for the future.            

Formal adoption of the resolution is subject to final action by the AOAs Judicial Council.