Background

The certification of medical specialists is a fundamental task to protect society and document the achievement of competences in a specific field. The medical certifying process has advanced and disseminated globally, becoming more evidence-based, sophisticated and complex. Formal physicians' certification in Mexico started in 1963, but the quality and validity of the process is heterogeneous due to a variety of reasons. The Mexican Board of Otorhinolaryngology and Head and Neck

Surgery (MBO) was created in 1970. Recently the Board implemented an initiative to diagnose and improve its test development and analysis processes. The objective of this study is to describe the quality improvement process of a medical specialty certification exam in Mexico.

Methods

Single descriptive instrumental case study. Review of the MBO normative documents and previous exams' reports. Interviews with the Board's main stakeholders and information obtained during the test development and analysis activities. I mplementation of a two-year change process for improvement of the MBO certifying examination, using Downing's model for test development and Greenhalgh's model for dissemination of innovations.

Results

A two-year agenda of academic and administrative activities was designed (strategic planning, diag nosis and analysis of the test development and implementation processes, faculty development workshops). Implementation strategies and validity sources for the test were developed. Areas of opportunity were identified and improved. The whole process of test development and analysis was revamped.

Conclusions

Specialty board certification exams in developing countries need to be developed with rigorous methodology. Political, technical, financial and human resource issues that emerged must be addressed. Les sons for the dissemination of sound medical specialty certification strategies are discussed.