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.