In the Editor’s Page for the JACC October 14, 2025 issue, JACC Editor-in-Chief Harlan M. Krumholz, MD, SM, critiques the current physician certification system, arguing it is outdated, misaligned with real-world clinical practice, and contributes to physician burnout without clear evidence of improved patient outcomes. He proposes a modernized, two-tiered framework for certification—distinguishing between essential, instantly recallable knowledge (Type 1) and complex, reasoning-based skills (Type 2)—that emphasizes continuous learning, relevance, and support over high-stakes testing.

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