Changing patterns of psychiatry specialty certification in the English-speaking countries.

Specialty certification is not a static process but is developing and changing. The author reviews traditional and current patterns of examinations given in English-speaking countries and reports recent concerns and criticisms of the certification process. New developments in the United States include the audiovisual examination, changes in the neurology examination, and institution of examiner training. In Canada there is a heavy emphasis on improving multiple-choice questions and using examiner training. The United Kingdom is experimenting with audiovisual techniques. Australasia is increasing the length of its training programs. Recent research by the American Board of Psychiatry and Neurology includes concordance studies, the relationship between residency training and Board performance, and feedback techniques.