We have been facing this the last few years in Family Medicine. The ABFM requires two different types of activities to be done in 2 year stages. If you don't keep up, not to mention all your CME requirements, you have to take the Board Exam every 7 years instead of every 10. This is being seen by more and more physicians as a meaningless waste of our time and another opportunity for the boards to profit themselves at our expense. No other professionals, such as lawyers, engineers, or others have to do this. Advanced nurses are practicing in our area without supervision, and 19 other states, and getting paid the same as I am. Not only do they avoid these requirements, but they've never been board certified or been to medical school or residency, as they are not physicians.