I took the re-certification exam for the third time 3-4 years ago, without studying or taking the modules, as I have left patient care and am now a full-time clinical trials designer/lead for a Pharma company. The exam was not particularly meaningful, in my opinion, as there was a great deal of opinion rather than fact, and it is unrealistic to practice medicine without access to databases online anymore (why keep so many fact in our heads nowadays? It should be about principles.). I passed without difficulty (as I think all of you can if you were awake during your Fellowship) and sent Richard Baron an email letting him know I think he and the Board have become obsolete and the money grabbing organization they have become is an embarrassment to it's members. I will never pay them again for an exam/modules/etc. I do believe in what Dr. Terstein and colleagues have done and supported them by paying thier much lower fee ( $300, as I recall?) for certification by sending them valid license and proof of up-to-date CME (which comes from our ACR Annual Scientific Meeting).