Lifelong Learning in Psychiatry and the Role of Certification.

In the early twentieth century, the medical profession focused on the development of specialties and specialty/subspecialty training. Parallel to this development was the establishment of certifying boards, which can evaluate and attest to a physician's mastery of a set of knowledge and skills; the goal is to provide assurance to patients and the public of a certain guarantee of quality of care. In the early decades of "board certification," the examination was a one-time, relatively high-stakes process that assessed knowledge, and often certain skills and clinical reasoning.