George Koustas: Are Current Certification Examinations Truly Assessing Readiness?
George Koustas, Director of Embryology at Columbia University Fertility Center, shared a post on LinkedIn:
“Are current certification examination truly assessing readiness to lead modern clinical IVF laboratory in the US?
Having worked across different IVF healthcare systems and training pathways internationally, this is a question I’ve found myself thinking about. After completing the UK HSST pathway through the National School of Healthcare Science, NHS England to become a Consultant Embryologist (a programme heavily focused on science, leadership, governance, patient safety, troubleshooting, QMS, and real-world clinical decision-making) I recently challenged myself through the HCLD pathway with the American Board of Bioanalysis (ABB).
While preparing for and sitting the examination, I noticed how heavily the curriculum emphasize scientific recall-based assessment (90% of which has already been extensively assessed throughout our training, PhD, MSc etc). Many sections felt less connected to the realities of leading and operating a modern IVF lab.
Of course, strong scientific knowledge remains fundamental but leadership in 2026 demands expertise in:
- patient safety and governance
- quality and regulatory oversight
- complex operational decision-making
- multidisciplinary leadership
- patient-centered communication
- crisis management and troubleshooting
This is not criticism. Rather, it raises an important discussion for our profession: Should lab leadership examinations continue evolving toward broader competency-based assessment models that better reflect the realities of directing today’s IVF laboratory? There may be value in the American Board of Bioanalysis (ABB) developing structured pathways that not only examine knowledge, but also teach, coach, train, and assess leadership and operational competency within real clinical environments.
Perhaps the real question is no longer how much theoretical information one can memorise. It is whether our certification systems are evolving fast enough to identify and prepare the next generation of IVF lab leaders.
Because patients are ultimately protected not by memorisation alone, but by judgment, systems, leadership, communication, governance, quality oversight, and the ability to make safe decisions when complexity inevitably arises.
Curious to hear perspectives from others.
PS1: Sharing my thoughts before results are released, as the discussion itself is important regardless of outcome.
PS2: A model for inspiration.”
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