State Medical Board Disciplinary Actions Related to Medical Knowledge Deficits

Introduction: The proportion of state medical board disciplinary actions taken due to medical knowledge deficits is not known. We measured the percentage of disciplinary actions with medical knowledge deficits and the association between disciplinary actions and board certification exam performance, among American Board of Internal Medicine (ABIM) physicians in California. Methods: We investigated all physicians in California with an ABIM identification number who were disciplined from January 1, 2011 to December 31, 2022. We reviewed disciplinary documentation on California's medical board website for each physician and determined through a systematic process whether actions had to do with a medical knowledge deficit. We also examined the association between these disciplinary actions and whether a physician failed on their first certification exam attempt using a chi-squared analysis. Results: Among the 558 California disciplinary actions from 2011 to 2022, 52.3% were related to a medical knowledge deficit. In addition, 43.7% were not related to medical knowledge, and 3.9% had an ‘Ambiguous’ classification. Physicians who had a disciplinary action associated with a medical knowledge deficit were less likely to have passed the initial certification exam on the first attempt (chi-square=3.90, P = .048). Discussion: About half of the disciplinary actions received by physicians in California with an ABIM identification number were related to medical knowledge deficits and these types of disciplinary actions were more likely among physicians who failed to pass the ABIM certification exam on the first attempt compared with those who passed. Since medical knowledge can potentially be improved, this finding allows for the possibility of a reduction in future disciplinary actions.