From: Howard C. Berkowitz (hcb@gettcomm.com)
Date: Wed Mar 03 2004 - 11:27:58 GMT-3
At 9:08 AM -0500 3/3/04, Scott Morris wrote:
>While I agree with you that testing on new topics may be a much better
>method of doing things... There's a couple of flaws with that comparison in
>all.
>
>First, you can take any CCIE written qualifier to recert. So if you're
>looking for newer things, take a different track!
>
>Second, as you point out below, for CEU credit, all you have to have is your
>name on the attendance list. Or in some web-based or book-based things, you
>may have to turn in a short quiz that's done open book. I know a LOT of
>people in the medical profession that get together as a group and fill these
>things out "because they have to". There is no retention at that point.
Much CME isn't quite the same as CEU (Continuing Education Unit).
Most CME does involve an exam to be credited. Depending on who is
monitoring your progress, you must report a certain amount of
successfully completed CME each year.
Your point is well taken that there are cases where groups will get
together and fill out the forms. In practice, this often happens in a
good way, but this is due to medical peer pressure. It's quite
common, for example, to have CME based on understanding of the
reading of specific journal articles, with a simple exam. Also quite
common, however, are "journal clubs", often monthly, where a group of
doctors meet to discuss, actively, the article. One presents a
summary, but there is an active tradition of challenge. You may have
seen the way in which a senior physician cross-examines a junior on
teaching rounds -- this is kind and gentle compared to what goes on
in closed door Morbidity and Mortality conferences, where
complications and death are ruthlessly examined to see what, if
anything, could have been done better. Incidentally, it's sometimes
a valuable lesson that everything that could have been done was done.
>
>By taking a test like the CCIE one, even though it may be over similar
>material (although the exam does change a bit on a yearly basis), that at
>least looks at the retention of information. Or absolute lucky guessing.
>:)
>
>There's all sorts of differences to be pointed out, but getting back to it,
>I do agree that there should be exams on newer topics. But...
>
>My only gripe on the recert is that it's easier now than it was. It used to
>be you had to take a recert exam (the IP one anyway was definitely an
>interesting exam over things not really tested on before) or you had to pass
>another CCIE track written AND lab exam. Now it's just the written exam for
>anything.
I'd much rather see a set of shorter, more focused exams on new
topics. These topics could be chosen as things you can't possibly
understand unless you have retained the basics. As a trivial example,
you couldn't pass a test on VLSM unless you remembered basic
subnetting. As a definitely non-trivial example, you couldn't
specify a QoS- and VPN-enabled service provider core without a
thorough understanding of BGP, MPLS and QoS, plus understanding of
the best practices for core engineering.
>
>The idea of passing a test with potentially different information on it is
>still there, and from that viewpoint, I think the recert is perfectly fine.
>It seems (IMHO) to be more of a retention process than some of the CEU stuff
>I've seen in other professions.
>
>I think the process of getting your medical license reinstated if you don't
>get your CEU credits is a bit simpler than the CCIE requirements....
>Although this varies by state, just paying a chunk of money and having your
>name publically listed (in local professional trade rag) that you have been
>bad seems easier. (Although I like the concept of public humiliation to
>keep people motivated!)
If you actually lose a medical license due to lack of CME, or other
determination that you haven't kept up, it's much rougher than that.
You may be ordered into a full training program, such as a residency
or at least several months of one. You may be assigned clinical
supervisors to review every one of your decisions, sometimes in real
time before you can have hospital prescriptions approved -- you may
have your practice restricted to hospital settings where you can be
monitored more closely.
There are usually lots of warning before your license is threatened,
which is probably more what you have in mind. You may get told you
have to go to a week- or two-long review course, typically of the
intensity of bootcamps, which also means you don't get paid while
you're in class!
>
>:)
>
>Scott
>
>-----Original Message-----
>From: nobody@groupstudy.com [mailto:nobody@groupstudy.com] On Behalf Of
>Howard C. Berkowitz
>Sent: Wednesday, March 03, 2004 8:41 AM
>To: ccielab@groupstudy.com
>Subject: RE: Your Next Step is CCIE [Cisco feeling the burn]
>
>At 8:15 AM -0500 3/3/04, Peter van Oene wrote:
>>>In the grand scheme of things no matter what you look at, you have
>>>some good and some bad. There are bad doctors out there, although I
>>>don't see any decrease in the need for their services all in all.
>>>Economics will make the bad ones go away (or move into management? :)
>>>) I can't say that I haven't run into CCIEs that are less than bright
>>>out in the field. But this is not a new problem. You'll also notice
>>>that about 10% of R&S CCIE's are no longer certified. Perhaps these
>>>are the culling of those who can't figure out how to recertify.
>>
>>Some of us who have aged out our certs are sick of Cisco extorting
>>money from us with 300 buck sylvan exams. Maybe we're culled, or maybe
>>we just don't care.
>>
>
>Knowing you, Peter, it's not a matter of your not caring about your
>profession. In what you do, having achieved a certification is a point of
>reference in your career. More significant is what you've accomplished,
>often well beyond the level of the CCIE lab, after receiving that
>certification.
>
>Keeping a Cisco certification renewed is obviously of importance to
>resellers, trainers, etc., that need an endorsment by Cisco, or where having
>a current certification brings value to one's employer or market value to
>firms that need people with current certifications.
>
>Since good and bad doctors have been mentioned, let me comment on how
>continuing education and certification are handled in that profession. In
>the first year of medical school, a student will take core courses such as
>gross anatomy, biochemistry and physiology. In the second year, they will
>take more clinically oriented science courses such as pharmacology and
>pathologic diagnosis. In the third and fourth years, they rotate through
>lectures and clinical observations in different specialties, and then, in
>internship, residency and fellowship, get increasingly advanced supervised
>practice.
>
>At the end of medical school in the US, one takes the standardized tests of
>the American Board of Medical Examiners, checking on basic knowledge. In
>subsequent graduate medical education, the resident is constantly evaluated
>by faculty.
>
>Eventually (the details depend on the rules of the specialty), the candidate
>demonstrates they have completed a specialty-board-approved training
>program, may take additional exams both oral and written, and possibly have
>to do "essay" type case presentations. Again depending on the specific
>specialty, they will then be Board-Eligible or Board-Certified. Full
>certification may require a certain number of years of practice after
>eligibility, and perhaps additional presentations or examinations. Of
>course, in parallel to their specialty review, they also will be monitored
>constantly by hospitals, insurance companies, etc.
>
>But there is a concept of continuing medical education. I'm quite familiar
>with this, as I find it useful to take CME as a part of staying abreast of
>the requirements for medical networks and computing. CME is not always
>scored; it may be attendance only, and jurisdictions and specialties vary as
>to whether, and how much, CME they require.
>
>What I find to be a really significant difference between CME and Cisco
>recertification, however, is CME assumes the basics. It's not just taking
>the latest CCIE written, which may contain basic skills for a CCIE. It
>concentrates on new information. Here's a list of recent CME topics from one
>site I visit regularly; note none of them are about basic anatomy, IP
>addressing, basic physiology, or show ip
>interface:
>
>CME Antiretroviral Drug Sequencing
>Learn about sequencing of NRTI/NtRTIs for the treatment of patients with
>HIV.
>CME Management of Alzheimer's Disease and Related Dementias Examine the
>effects of cholinesterase inhibitors on the symptom domains of AD and
>related dementias.
>CME Opioid Analgesia: Practical Treatment of the Patient With Chronic Pain
>Review theories of chronic pain management, with particular emphasis on
>practical management of medication in typical patients, using the case-study
>approach.
>CME Stabilizing Depression in Bipolar Disorder Understand the challenges of
>diagnosing and treating bipolar depression, and review the data on mood
>stabilizers, including lamotrigine, in its management.
>CME Infectious Complications in Neutropenic Cancer Patients Discuss
>improvements in the mortality rate of immunocompromised patients, the
>changing profiles of pathogens, and fungal infections in cancer patients.
>CME Therapeutic Challenges in the Treatment of Cardiovascular
>Diseases: Issues and Answers
>Review results from ongoing and recently completed trials using dual
>antiplatelet therapy in patients with atherothrombotic disease and discuss
>their potential implications for clinical practice.
>CME Diabetes and Macrovascular Disease: Risk Factor Management Recognize the
>risk factors in patients with diabetes that are linked to vascular
>dysfunction and how they can be successfully managed.
>CME A New Dawn in the Treatment of Dyslipidemia: Cardiovascular Risk
>Reduction Through Emerging Science and Proven Clinical Results Review the
>clinical trials on current and novel therapies that emphasize the importance
>of intensifying lipid-lowering treatment to improve outcomes.
>
>
>Does everyone see the difference between retaking a CCIE Written as opposed,
>say, to taking brief (most of these take a few hours), highly focused
>education on new networking topics, or the latest thinking on old ones?
>Does everyone see how the primary focus of these CME examples is teaching,
>although they contain exams, while recertification is more focused on the
>process of exam-taking?
>
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