Maintenance of Certification is the way that the American Board of Family Physicians has determined it will know that physicians are continuing to be qualified for their work. Each year a family physician has to do online learning activities and maintain a certain level of continuing medical education hours. If you do these online activities then take the recertification test every 10 years instead of every 7 years. My last recertification was 2007, and so I am now finishing my 10 years of online testing and will take my exam next year. It is debatable whether it serves a purpose or not and most of us do not like doing it, but it is a hoop that we all jump through to maintain good standing with the Board of Family Medicine so that we can refer to ourselves as “board certified” indicating a certain level of professionalism and expertise. Maintaining this certification has been a little more of a challenge in Peru than it was in the US as the availability of affordable live CME courses is low (read nonexistent) and our internet connection is too slow to stream videos. Plus we have a monthly limit on our GB use. Video streaming eats those GBs quickly. So while in Lima I have taken advantage of some downtime to do many hours of online recertification testing. It is good to know that it is completed and that come December I will not be cramming a bunch of testing into the week before Christmas and the New Year! Now on to reviewing everything I should know to be a good doctor to pass the recertification test next year.