• The U.S. job market has almost 600,000 openings requesting cybersecurity-related skills. 
• Employers are struggling to fill these openings due to a general cyber-skill shortage, with many openings remaining vacant each year. 
• When evaluating prospective information-security candidates, employers should look for certifications as an important measure of excellence and commitment to quality.
• This article is for business owners looking to hire cybersecurity experts, or for individuals interested in pursuing a cybersecurity career. 

Cybersecurity is one of the most crucial areas for ensuring a business’s success and longevity. With cyberattacks growing in sophistication, it’s essential for business owners to protect their companies by hiring qualified cybersecurity experts to manage this aspect of their business. The best candidates will have a certification in information security and cybersecurity. This guide breaks down the top certifications and other guidance you’ll need to make the right hire for your company. It’s also a great primer for individuals who are embarking on a cybersecurity career.

Best information security and cybersecurity certifications

When evaluating prospective InfoSec candidates, employers frequently look to certification as an important measure of excellence and commitment to quality. We examined five InfoSec certifications we consider to be leaders in the field of information security today.

This year’s list includes entry-level credentials, such as Security+, as well as more advanced certifications, like Certified Ethical Hacker (CEH), Certified Information Systems Security Professional (CISSP), Certified Information Security Manager (CISM) and Certified Information Systems Auditor (CISA). According to CyberSeek, more employers are seeking CISA, CISM and CISSP certification holders than there are credential holders, which makes these credentials a welcome addition to any certification portfolio.

Absent from our list of the top five is SANS GIAC Security Essentials (GSEC). Although this certification is still a very worthy credential, the job board numbers for CISA were so solid that it merited a spot in the top five. Farther down in this guide, we offer some additional certification options because the field of information security is both wide and varied.

1. CEH: Certified Ethical Hacker

The CEH (ANSI) certification is an intermediate-level credential offered by the International Council of E-Commerce Consultants (EC-Council). It’s a must-have for IT professionals who are pursuing careers in white hat hacking and certifies their competence in the five phases of ethical hacking: reconnaissance, enumeration, gaining of access, access maintenance and track covering. 

CEH credential holders possess skills and knowledge of hacking practices in areas such as footprinting and reconnaissance, network scanning, enumeration, system hacking, Trojans, worms and viruses, sniffers, denial-of-service attacks, social engineering, session hijacking, web server hacking, wireless networks and web applications, SQL injection, cryptography, penetration testing, IDS evasion, firewalls and honeypots. CEH V11 provides a remapping of the course to the NIST/NICE framework’s Protect and Defend (PR) job role category, as well as an additional focus on emerging threats in cloud, OT and IT security, such as fileless malware.

To obtain a CEH (ANSI) certification, candidates must pass one exam. A comprehensive five-day CEH training course is recommended, with the test presented at the course’s conclusion. Candidates may self-study for the test but must submit documentation of at least two years of work experience in information security with employer verification. Self-study candidates must also pay an additional $100 application fee. Education may be substituted for experience, but this is evaluated on a case-by-case basis. Candidates who complete any EC-Council-approved training (including with the iClass platform, academic institutions or an accredited training center) do not need to submit an application prior to attempting the exam.

Because technology in the field of hacking changes almost daily, CEH credential holders are required to obtain 120 continuing-education credits for each three-year cycle.

Once a candidate obtains the CEH (ANSI) designation, a logical progression on the EC-Council certification ladder is the CEH (Practical) credential. The CEH (Practical) designation targets the application of CEH skills to real-world security audit challenges and related scenarios. To obtain the credential, candidates must pass a rigorous six-hour practical examination. Conducted on live virtual machines, candidates are presented 20 scenarios with questions designed to validate a candidate’s ability to perform tasks such as vulnerability analysis, identification of threat vectors, web app and system hacking, OS detection, network scanning, packet sniffing, steganography and virus identification. Candidates who pass both the CEH (ANSI) and the CEH (Practical) exams earn the CEH (Master) designation.

CEH facts and figures

Certified Ethical Hacker (CEH) training

While EC-Council offers both instructor-led and online training for its CEH certification, IT professionals have plenty of other options for self-study materials, including video training, practice exams and books.

Pluralsight currently offers an ethical-hacking learning path geared toward the 312-50 exam. With a monthly subscription, you get access to all of these courses, plus everything else in Pluralsight’s training library. Through Pluralsight’s learning path, students can prepare for all of the domains covered in the CEH exam.  

CyberVista offers a practice test for the CEH 312-50 certification that includes several sets of exam-like questions, custom quizzes, flash cards and more. An test prep subscription for 180 days costs $149 and gives candidates access to online study materials, as well as the ability to download the materials for offline study. Backed by its “pass guarantee,” CyberVista is so confident its practice test will prepare you for the CEH test that the company will refund its VCE test costs if you don’t pass.

FYI: Besides certifications in information security and cybersecurity, the best IT certifications cover areas such as disaster recovery, virtualization and telecommunications.

2. CISM: Certified Information Security Manager

The CISM certification is a top credential for IT professionals who are responsible for managing, developing and overseeing information security systems in enterprise-level applications or for developing organizational security best practices. The CISM credential was introduced to security professionals in 2003 by the Information Systems Audit and Control Association (ISACA).

ISACA’s organizational goals are specifically geared toward IT professionals who are interested in the highest-quality standards with respect to the auditing, control and security of information systems. The CISM credential targets the needs of IT security professionals with enterprise-level security management responsibilities. Credential holders possess advanced and proven skills in security risk management, program development and management, governance, and incident management and response.

Holders of the CISM credential, which is designed for experienced security professionals, must agree to ISACA’s code of ethics, pass a comprehensive examination, possess at least five years of experience in information security management, comply with the organization’s continuing education policy and submit a written application. Some combinations of education and experience may be substituted for the full experience requirement.

The CISM credential is valid for three years, and credential holders must pay an annual maintenance fee of $45 (ISACA members) or $85 (nonmembers). Credential holders are also required to obtain a minimum of 120 continuing professional education (CPE) credits over the three-year term to maintain the credential. At least 20 CPE credits must be earned every year.

CISM facts and figures

Other ISACA certification program elements

In addition to CISM, ISACA offers numerous certifications for those interested in information security and best practices. Other credentials worth considering include the following:

• Certified Information Systems Auditor (CISA)
• Certified in the Governance of Enterprise IT (CGEIT)
• Certified in Risk and Information Systems Control (CRISC)

The CISA designation was created for professionals working with information systems auditing, control or security and is popular enough with employers to earn it a place on the leaderboard. The CGEIT credential targets IT professionals working in enterprise IT management, governance, strategic alignment, value delivery, and risk and resource performance management. IT professionals who are seeking careers in all aspects of risk management will find that the CRISC credential nicely meets their needs.

Certified Information Security Manager (CISM) training

Pluralsight offers a CISM learning path containing five courses and 17 hours of instruction. The courses cover the domains addressed in the exam, but the learning path is aimed at the CISM job practice areas. 

CyberVista offers a CISM online training course in both live and on-demand formats. The course includes more than 16 hours of training videos, supplementary lessons, custom quizzes, practice test questions and access to experts through the instructor. As with other CyberVista courses, the CISM training course comes with a “pass guarantee.” 

Did you know?: According to CyberSeek, there are enough workers to fill only 68% of the cybersecurity job openings in the U.S. A cybersecurity certification is an important way to demonstrate the knowledge and ability to succeed in these job roles.

3. CompTIA Security+

CompTIA’s Security+ is a well-respected, vendor-neutral security certification. Security+ credential holders are recognized as possessing superior technical skills, broad knowledge and expertise in multiple security-related disciplines.

Although Security+ is an entry-level certification, the ideal candidates possess at least two years of experience working in network security and should consider first obtaining the Network+ certification. IT pros who obtain this certification have expertise in areas such as threat management, cryptography, identity management, security systems, security risk identification and mitigation, network access control, and security infrastructure. The CompTIA Security+ credential is approved by the U.S. Department of Defense to meet Directive 8140/8570.01-M requirements. In addition, the Security+ credential complies with the standards for ISO 17024.

The Security+ credential requires a single exam, currently priced at $381. (Discounts may apply to employees of CompTIA member companies and full-time students.) Training is available but not required.

IT professionals who earned the Security+ certification prior to Jan. 1, 2011, remain certified for life. Those who certify after that date must renew the certification every three years to stay current. To renew, candidates must obtain 50 continuing-education units (CEUs) or complete the CertMaster CE online course prior to the expiration of the three-year period. CEUs can be obtained by engaging in activities such as teaching, blogging, publishing articles or whitepapers, and participating in professional conferences and similar activities.

CompTIA Security+ facts and figures

CompTIA Security+ training

You’ll find several companies offering online training, instructor-led and self-study courses, practice exams and books to help you prepare for and pass the Security+ exam.

Pluralsight offers a Security+ learning path as a part of its monthly subscription plan for the latest SY0-601 exam. Split into six sections, the training series is more than 24 hours long and covers attacks, threats and vulnerabilities; architecture and design; implementation of secure solutions; operations and incident response; and governance, risk and compliance.

CyberVista offers a Security+ practice test so you can test your security knowledge before attempting the SY0-601 exam. The test comes with a 180-day access period and includes multiple sets of test questions, key concept flash cards, access to InstructorLink experts, a performance tracker and more. As with CyberVista’s other offerings, this practice test comes with a “pass guarantee.”

4. CISSP: Certified Information Systems Security Professional

CISSP is an advanced-level certification for IT pros who are serious about careers in information security. Offered by the International Information Systems Security Certification Consortium, known as (ISC)2 (pronounced “ISC squared”), this vendor-neutral credential is recognized worldwide for its standards of excellence.

CISSP credential holders are decision-makers who possess the expert knowledge and technical skills necessary to develop, guide and manage security standards, policies and procedures within their organizations. The CISSP certification continues to be highly sought after by IT professionals and is well recognized by IT organizations. It is a regular fixture on most-wanted and must-have security certification surveys.

CISSP is designed for experienced security professionals. A minimum of five years of experience in at least two of (ISC)2’s eight common body of knowledge (CBK) domains, or four years of experience in at least two of (ISC)2’s CBK domains and a college degree or an approved credential, is required for this certification. The CBK domains are security and risk management, asset security, security architecture and engineering, communications and network security, identity and access management, security assessment and testing, security operations, and software development security.

(ISC)2 also offers three CISSP concentrations targeting specific areas of interest in IT security:

• Architecture (CISSP-ISSAP)
• Engineering (CISSP-ISSEP)
• Management (CISSP-ISSMP)

Each CISSP concentration test is $599, and credential seekers must currently possess a valid CISSP.

An annual fee of $125 is required to maintain the CISSP credential. Recertification is required every three years. To recertify, candidates must earn 40 CPE credits each year, for a total of 120 CPE credits within the three-year cycle.

CISSP facts and figures 

Certified Information Systems Security Professional (CISSP) training

Given the popularity of the CISSP certification, there is no shortage of available training options. These include classroom-based training offered by (ISC)2, as well as online video courses, practice exams and books from third-party companies.

Pluralsight’s CISSP learning path includes 12 courses and 25 hours of e-learning covering the security concepts required for the certification exam. Available for a low monthly fee, the CISSP courses are part of a subscription plan that gives IT professionals access to Pluralsight’s complete library of video training courses.

When you’re ready to test your security knowledge, you can take a simulated test that mimics the format and content of the real CISSP exam. Udemy offers CISSP practice exams to help you prepare for this challenging exam.

5. CISA: Certified Information Systems Auditor

ISACA’s globally recognized CISA certification is the gold standard for IT workers seeking to practice in information security, audit control and assurance. Ideal candidates can identify and assess organizational threats and vulnerabilities, assess compliance, and provide guidance and organizational security controls. CISA-certified professionals demonstrate knowledge and skill across the CISA job practice areas of auditing, governance and management, acquisition, development and implementation, maintenance and service management, and asset protection.

To earn the CISA certification, candidates must pass one exam, submit an application, agree to the code of professional ethics, agree to the CPE requirements and agree to the organization’s information systems auditing standards. In addition, candidates must possess at least five years of experience working with information systems. Some substitutions for education and experience with auditing are permitted.

To maintain the CISA certification, candidates must earn 120 CPE credits over a three-year period, with a minimum of 20 CPE credits earned annually. Candidates must also pay an annual maintenance fee ($45 for members; $85 for nonmembers).

CISA facts and figures

Certified Information Systems Auditor (CISA) training

Training opportunities for the CISA certification are plentiful. Udemy offers more than 160 CISA-related courses, lectures, practice exams, question sets and more. On Pluralsight, you’ll find 12 courses with 27 hours of information systems auditor training covering all CISA job practice domains for the CISA job practice areas.

Beyond the top 5: More cybersecurity certifications

In addition to these must-have credentials, many other certifications are available to fit the career needs of any IT professional interested in information security. Business owners should consider employing workers with these credentials as well.

• The SANS GIAC Security Essentials (GSEC) certification remains an excellent entry-level credential for IT professionals seeking to demonstrate that they not only understand information security terminology and concepts but also possess the skills and technical expertise necessary to occupy “hands-on” security roles.
• If you find incident response and investigation intriguing, check out the Logical Operations CyberSec First Responder (CFR) certification. This ANSI-accredited and U.S. DoD-8570-compliant credential recognizes security professionals who can design secure IT environments, perform threat analysis, and respond appropriately and effectively to cyberattacks. Logical Operations also offers other certifications, including Master Mobile Application Developer (MMAD), Certified Virtualization Professional (CVP), Cyber Secure Coder and CloudMASTER.
• The associate-level Cisco Certified CyberOps Associate certification is aimed at analysts in security operations centers at large companies and organizations. Candidates who qualify through Cisco’s global scholarship program may receive free training, mentoring and testing to help them achieve a range of entry-level to expert certifications that the company offers. CompTIA Cybersecurity Analyst (CySA+), which launched in 2017, is a vendor-neutral certification designed for professionals with three to four years of security and behavioral analytics experience.
• The Identity Management Institute offers several credentials for identity and access management, data protection, identity protection, identity governance and more. The International Association of Privacy Professionals (IAPP), which focuses on privacy, has a small but growing number of certifications as well.
• The SECO-Institute, in cooperation with the Security Academy Netherlands and APMG, is behind the Cyber Security & Governance Certification Program; SECO-Institute certifications aren’t well known in the United States, but their popularity is growing. 
• It also may be worth your time to browse the Chartered Institute of Information Security accreditations, the U.K. equivalent of the U.S. DoD 8570 certifications and the corresponding 8140 framework.

Also, consider these five entry-level cybersecurity certifications for more options.

Tip: Before you decide to purchase training for a certification or an test voucher, see if your employer will cover the cost. Employers may cover all or part of the cost if you have a continuing education or training allowance, or if the certification is in line with your current or potential job duties.

Information security and cybersecurity jobs

According to CyberSeek, the number of cybersecurity job openings in the U.S. stands at almost 598,000, with about 1.05 million cybersecurity professionals employed in today’s workforce. Projections continue to be robust: The U.S. Bureau of Labor Statistics expects 33% growth in information security analyst positions between 2020 and 2030; in comparison, the average rate of growth for all occupations is about 8%.

Security-related job roles include information security specialist, security analyst, network security administrator, system administrator (with security as a responsibility) and security engineer, as well as specialized roles, like malware engineer, intrusion analyst and penetration tester.

Average salaries for information security specialists and security engineers – two of the most common job roles – vary depending on the source. For example, SimplyHired reports about $74,000 for specialist positions, whereas Glassdoor‘s national average is about $108,000. For security engineers, SimplyHired reports almost $112,000, while Glassdoor’s average is more than $111,000, with salaries on the high end reported at $261,000. Note that these numbers frequently change as the sources regularly update their data. [Meet the man who kept Microsoft safe and secure for more than a decade.]

Our informal job board survey from April 2022 reports the number of job posts nationwide in which our featured certifications were mentioned on a given day. This should deliver you an idea of the relative popularity of each certification.

Job board search results (in alphabetical order by cybersecurity certification)

Did you know?: Cybersecurity matters even when you’re traveling. Find out how to keep your computer secure when you’re on the road for business or pleasure.

The importance of hiring information security and cybersecurity professionals

According to Risk Based Security‘s 2021 Year End Data Breach Quickview Report, there were 4,145 publicly disclosed breaches throughout 2021, containing over 22 billion records. This is the second-highest number of breached records, after an all-time high the year before. The U.S. was particularly affected, with the number of breaches increasing 10% compared with the previous year. More than 80% of the records exposed throughout 2021 were due to human error, highlighting an ever-increasing need for cybersecurity education, as well as for highly skilled and trained cybersecurity professionals. [Learn how to recover from a data breach.]

If you’re serious about advancing your career in the IT field and are interested in specializing in security, certification is a great choice. It’s an effective way to validate your skills and show a current or prospective employer that you’re qualified and properly trained. If you’re a business owner, hiring certified professionals and skilled IT managers can help prevent cyberattacks and provide confidence that your company’s security is in the right hands. In the meantime, review our quick cybersecurity tips to Strengthen your company’s protection.

Jeremy Bender contributed to the writing and research in this article.

Geno Smith has been good over the first month of the season but if the Seahawks are in position to take a franchise QB they'll deliver it serious consideration. Levis is coming off a tough loss vs. Ole Miss, but NFL teams are much higher on how Levis' skills translate to the next level than the media.

Quarterback could be in play here, too, but Davis Mills has a chance to be a good NFL starter. If Texans stay with Mills, Anderson is a layup. He's the best defensive player to come out of Alabama in the Nick Saban era, and possibly No. 2 all time behind only Derrick Thomas.

Richardson is raw -- he attempted just 68 passes in 2021 -- and through four games this season we've seen the highs (Utah, Arkansas) and the lows (Kentucky, South Florida). But what's important to remember is that he's going to get better -- likely a lot better, and he's already doing things with the football that very few people on this planet would even consider.

The Jets have one of the NFL's worst defenses, and while this could be a prove-it year for Zach Wilson, it's more likely the team addresses needs elsewhere with a high pick. Enter Carter, who has been hobbled by an ankle injury early in the Bulldogs season, but he was arguably the best player on the '21 Georgia defense, a group that had eight players drafted.

The Georgia-to-first-round pipeline continues. A year after five Bulldogs went in Round 1, expect a handful this time around, too. Ringo is a long, physical corner who has matched up against some of the best players in the country. The Bears beefed up the secondary with early picks last spring, and perhaps offensive line or wide receiver would be better targets, just not this high.

If you told us Sam Darnold was wearing a Baker Mayfield mask to start the season we would believe you because the results have been the same. And maybe that's more a knock on the offense, in general, and not the QB. Either way, it's hard to imagine owner David Tepper doesn't finally address the position this offseason, and if C.J. Stroud is available, it's easy to imagine him being the pick.

This offensive line class isn't deep but Skoronski has gotten off to a strong start to the '22 season. He was dominant vs. Nebraska in the opener and has continued to dominate throughout September. Washington's O-line has struggled at times and if the team is happy with Carson Wentz, protecting him should be a priority.

Murphy won't be 21 until next spring and while we'd like to see him play with more consistency ... he won't be 21 until next spring. On top of that, when he's on, he's hard to stop, which makes him such an interesting prospect. The Steelers defense has been stuck in neutral since T.J. Watt went down, and adding more depth to the position seems prudent here, especially if there isn't an O-line target they like on the board.

Jeffrey Okudah is healthy for the first time in his NFL career and looks every bit like a top-5 selection. There's still room to add a another top-flight corner as the Lions go about reshaping their defense around young players Aidan Hutchinson, Malcolm Rodriguez and Jeff Okudah at all three levels.

Whichever wide receiver you like best, put him here. The Patriots did draft Tyquan Thornton in Round 2 but he's missed the start of the season with an injury. Maybe he returns and transforms an offense that lacks downfield playmakers. But even if that does happen, Mac Jones would no doubt still welcome the chance for more dynamism in the passing offense.

We get Boogie Basham vibes watching Wilson, who is long and thick. He's a high-motor player who consistently finds his way into the backfield, and in Las Vegas he'll beef up a defense that has been exposed during the first four weeks of the '22 campaign.

Young would be in the running for the No. 1 overall pick if he was, say, two inches taller and 20 pounds heavier. There's a lot to love about his game but some NFL teams are concerned about his size and durability. But as the old saying goes, it only takes one, and Young is undoubtedly a first-round talent who could easily find his way into the top 10.

The Eagles have few holes but perhaps they could use some depth at the safety position. Johnson flies around the field like he's shot out of a cannon, looks to run through the ball carrier at the line of scrimmage, and is a wrap-up tackler in space. He can line up in deep center field or near the line of scrimmage and that versatility makes him one of the best defensive backs in this class.

The Titans miss A.J. Brown. Rookie Treylon Burks (who was injured on Sunday) has been good, but he could use a running mate. Boutte put up impressive numbers in '20 and '21, despite the lack of consistent QB play in LSU, but make no mistake: he's one of the best wideouts in this class.

Is a running back worth a top-half-of-the-first-round selection? Yeah, we think so, especially when that player is Robinson and he's going to an offense like Arizona's, where he could take some of the pressure off Kyler Murray, who spends most Sundays running for his life. Robinson is part Adrian Peterson, Derek Henry and Shaun Alexander, but he's also a threat as a receiver.

Hey, look at that, the Jags are really good! And paying Christian Kirk and Zay Jones those big-money deals appear to be the right call. Adding Mayer gives Lawrence another downfield weapon, especially with Evan Engram currently playing on a one-year deal.

The Texans bolstered the defense by taking Anderson with the No. 2 pick above, and here they deliver Mills some much-needed help at wide receiver. Addison is off to a strong start for the Trojans, and it's easy to see him having early success in the NFL, too.

Gonzalez, a Colorado transfer, is a big-time athlete who is still growing into the position. He has the size, strength and speed to line up against NFL wide receivers, who needs to Strengthen in run support.

Branch isn't the first name you hear about when the conversation turns to Alabama's defense, but maybe he should be. He left Saturday's win over Arkansas before halftime because of an injury, but when he's healthy, he's on the field for just about every snap. He's a sure tackler, can blitz off the edge, and is solid in coverage, and if Saban trusts him, that's all you need to know about his NFL prospects.

Ojulari, whose brother played at Georgia and plays for the Giants, is off to a strong start for the Tigers. He has 3.5 sacks and 4.5 tackles for loss in his last two games against Mississippi State and Auburn, and he has many of the same explosive qualities that made his brother so hard to block for the Bulldogs. Ojulari could end up being better than his brother, and that's saying something.

Seattle found its franchise QB at the top of the draft and here it adds edge rusher Smith. Smith is listed at just 235 pounds so he'll need to add weight, but he's also scratching the surface on what he'll be able to do at the next level.

Torrence transferred from Louisiana and didn't miss a beat. He's been dominant for Florida and in Cincinnati, the Bengals should make fixing the O-line an offseason priority until they get it right.

Johnson is a consistently good run blocker, but his pass protection needs refinement. That said, his athleticism jumps off the screen and it's not every day you find a 6-foot-6 offensive lineman who can move the way he does.

Simpson's athleticism is what immediately gets your attention, and in today's NFL, where sideline-to-sideline speed coupled with the ability to blow up the ball carrier is at a premium, Simpson is easy to like.

After addressing the secondary earlier in this mock draft, the Lions beef up the defensive line here with Ika, who is a one-man pocket collapser. Related: We're now living in a world where the Lions have legit playmakers at the skill position, a really good offensive line, and a QB they trust. If they can shore up a few of the holes on defense, this feels like a playoff team in the near future.

Jones is a former five-star who is off to a strong start this season for the Bulldogs. The Ravens have had injuries along their O-line but either way, Jones has the talent to be a longtime starter in the league.

Fashanu is short on experience but it's hard not to love the potential based on what we've seen so far. The Packers could be a team in transition if Aaron Rodgers retires in the offseason but whoever ends up under center in '23 will benefit from the addition of Fashanu.

Two running backs went in the first round in 2021 (Najee Harris and Travis Etienne) so it has happened recently, but that '21 class feels more like an anomaly than a trend. Whatever happens, you can't ignore what Gibbs, a Georgia Tech transfer, has done for Alabama. Look no further than Saturday's game against Arkansas, where Gibbs took over after Bryce Young left with a shoulder injury. When it was over, Gibbs rushed for more than 206 yards (with two runs of more than 70 yards) and two scores.

The Eagles double-down on defense in this mock draft, first adding a big-hitting safety in Johnson and here getting an edge rusher in Foskey. He can line up all over the field, from a seven technique to weakside linebacker to middle linebacker in subpackages. Foskey is a high-end athlete and chess piece who is still learning the position.

Johnston has gotten off to a slow start in '22 but he's an above-the-rim playmaker whose athleticism and contested-catch abilities reminds us of Chase Claypool.

Sanders is a former five-star who transferred from Alabama after the 2021 season and all he's done is dominate for the Razorbacks. He was an edge rusher for the Crimson Tide but he lines up all over the defense for Arkansas and he's been a one-man wrecking crew when he's on the field.

Unlike for many other professions, there is no age limit for practicing medicine. According to international standards, airplane pilots, for example, who are responsible for the safety of many human lives, must retire by the age of 60 if they work alone, or 65 if they have a co-pilot. In Brazil, however, this age limit does not exist for pilots or physicians.

The only restriction on professional practice within the medical context is the mandatory retirement imposed on medical professors who teach at public (state and federal) universities, starting at the age of 75. Nevertheless, these professionals can continue practicing administrative and research-related activities. After "expulsion," as this mandatory retirement is often called, professors who stood out or contributed to the institution and science may receive the title of professor emeritus.

In the private sector, age limits are not formally set, but the hiring of middle-aged professionals is limited.

At the Heart Institute of the University of São Paulo School of Medicine Clinical Hospital (InCor/HCFMUSP), São Paulo, Brazil, one of the world's largest teaching and research centers for cardiovascular and pulmonary diseases, several octogenarian specialists lead studies and teams. One of these is Noedir Stolf, MD, an 82-year-old cardiovascular surgeon who operates almost every day and coordinates studies on transplants, mechanical circulatory support, and aortic surgery. There is also Protásio Lemos da Luz, MD, an 82-year-old clinical cardiologist who guides research on subjects ranging from atherosclerosis, the endothelium, microbiota, and diabetes. The protective effect of wine on atherosclerosis is one of his best-known studies.

No longer working is also not in the cards for Angelita Habr-Gama, MD, who, at 89 years old, is one of the oldest physicians in current practice. With a career spanning more than seven decades, she is a world reference in coloproctology. She was the first woman to become a surgical resident at the HCFMUSP, where she later founded the coloproctology specialty and created the first residency program for the specialty. In April 2022, Habr-Gama joined the ranks of the 100 most influential scientists in the world, nominated by researchers at Stanford University, Stanford, California, in the United States and published in PLOS Biology.

In 2020, she was sedated, intubated, and hospitalized in the intensive care unit of the Oswaldo Cruz German Hospital for 54 days due to a SARS-CoV-2 infection. After her discharge, she went back to work in less than 10 days — and added chess classes to her routine. "To get up and go to work makes me very happy. Work is my greatest hobby. No one has ever heard me complain about my life," Habr-Gama told Medscape Portuguese edition after having rescheduled the interview twice because of emergency surgeries.

"Doctors have a professional longevity that does not exist for other professions in which the person retires and stops practicing their profession or goes on to do something else for entertainment. Doctors can retire from one place of employment or public practice and continue practicing medicine in the office as an administrator or consultant," Ângelo Vattimo, first secretary of the state of São Paulo Regional Board of Medicine (CREMESP), stated. The board regularly organizes a ceremony to honor professionals who have been practicing for 50 years, awarding them a certificate and engraved medal. "Many of them are around 80 years old, working and teaching. This always makes us very happy. What profession has such exceptional compliance for so long?" said Vattimo.

In the medical field, the older the age range, the smaller the number of women. According to the 2020 Medical Demographics in Brazil survey, only two out of 10 practicing professionals older than 70 are women.

Not everyone over 80 has Habr-Gama's vitality, because the impact of aging is not equal. "If you look at a group of 80-year-olds, there will be much more variability than within a group of 40-year-olds," stated Mark Katlic, MD, chief of surgery at LifeBridge Health System in the United States, who has dedicated his life to studying the subject. Katlic spoke on the subject in an interview with Medscape that was published in the article "How Old Is Too Old to Work as a Doctor?" The article discusses the evaluations of elderly physicians' skills and competences that US companies conduct. The subject has been leading to profound debate.

Katlic defends screening programs for elderly physicians, which already are in effect at the company for which he works, LifeBridge Health, and various others in the United States. "We do [screen elderly physicians at LifeBridge Health], and so do a few dozen other [US institutions], but there are hundreds [of healthcare institutions] that do not conduct this screening," he pointed out.

Age-related assessment faces great resistance in the US. One physician who is against the initiative is Frank Stockdale, MD, PhD, an 86-year-old practicing oncologist affiliated with Stanford University Health. "It's age discrimination.... Physicians [in the United States] receive assessments throughout their careers as part of the accreditation process — there's no need to change that as physicians reach a certain age," Stockdale told Medscape.

The US initiative of instituting physician assessment programs for those of a certain age has even been tested in court. According to the article published in Medscape, "in New Haven, Connecticut, for instance, the US Equal Employment Opportunity Commission (EEOC) filed a suit in 2020 on behalf of the Yale New Haven Hospital staff, alleging a discriminatory late career practitioner policy."

Also, according to the article, a similar case in Minnesota, also in the United States, reached a settlement in 2021, providing monetary relief to staff impacted by out-of-pocket costs for the assessment, in addition to requiring that the hospital in question report to the EEOC any complaints related to age discrimination.

The fact is that increased life expectancy and, subsequently, the number of middle-aged physicians in practice has raised several questions regarding the impact of aging on professional practice. In Brazil, the subject is of interest to more than 34,571 physicians between 65 and 69 years of age and 34,237 physicians older than 70. In all, this population represents approximately 14.3% of the country's active workforce, according to the 2020 Medical Demographics in Brazil survey.

The significant participation of healthcare professionals over age 50 in a survey conducted by Medscape to learn what physicians think about the age limit for practicing their professions is evidence that the subject is a present concern. Of a total of 1641 participants, 57% were age 60 or older, 17% were between 50 and 59 years, and 12% were between 40 and 49 years. Among all participants, 51% were against these limitations, 17% approved of the idea for all specialties, and 32% believed the restriction was appropriate only for some specialties. Regarding the possibility of older physicians undergoing regular assessments, the opinions were divided: 31% thought they should be assessed in all specialties. Furthermore, 31% believed that cognitive abilities should be regularly tested in all specialties, 31% thought this should take place for some specialties, and 38% were against this approach.

Professionals want to know, for example, how (and whether) advanced age can interfere with performance, what are the competences required to practice their activities, and if the criteria vary by specialty. "A psychiatrist doesn't have to have perfect visual acuity, as required from a dermatologist, but it is important that they have good hearing, for example," argued Clóvis Constantino, MD, former president of the São Paulo Regional Medical Board (CRM-SP) and former vice president of the Brazilian Federal Medical Board (CFM). "However, a surgeon has to stand for several hours in positions that may be uncomfortable. It's not easy," he told Medscape.

In the opinion of 82-year-old Henrique Klajner, MD, the oldest pediatrician in practice at the Albert Einstein Israeli Hospital in São Paulo, the physician cannot be subjected to the types of evaluations that have been applied in the United States. "Physicians should conduct constant self-evaluations to see if they have the competences and skills needed to practice their profession.... Moreover, this is not a matter of age. It is a matter of ethics,” said Klajner.

The ability to adapt to change and implement innovation is critical to professional longevity, he said. "Nowadays, when I admit patients, I no longer do hospital rounds, which requires a mobility equal to physical abuse for me. Therefore, I work with physicians who take care of my hospitalized patients."

Klajner also feels there is a distinction between innovations learned through studies and what can be offered safely to patients. "If I have to care for a hospitalized patient with severe pneumonia, for example, since I am not up to date in this specialty, I am going to call upon a pulmonologist I trust and forgo my honorarium for this admission. But I will remain on the team, monitoring the patient's progression," he said.

During the COVID-19 pandemic, Klajner stopped seeing patients in person under the recommendation of his son, Sidney Klajner, MD, who is also a physician. The elder Klajner began exploring telemedicine, which opened a whole new world of possibilities. "I have conducted several online visits to provide educational instruction to mothers returning home post delivery, for example," he told Medscape Portuguese edition. The time to stop is not something that concerns Klajner. "I'm only going to stop when I have a really important reason to do so. For example, if I can no longer write or study, practicing and rereading an article without being able to understand what is being said. At this time, none of that is happening."

In the US, as well as in Brazil, physicians rarely provide information to human resources departments on colleagues showing signs of cognitive or motor decline affecting their professional performance. "The expectation is that healthcare professionals will report colleagues with cognitive impairments, but that often does not happen," Katlic told Medscape.

It is also not common for professionals to report their own deficits to their institutions. In large part, this is caused by a lack of well-defined policies for dealing with this issue. Medscape Portuguese edition sought out several public and private hospitals in Brazil to see if there is any guidance on professional longevity: most said that there is not. Only the A. C. Camargo Cancer Center reported, through its public relations team, that a committee is discussing the subject but that it is still in the early stages.

Brazilian specialist associations do not offer guidelines or instructions on the various aspects of professional longevity. Constantino tried to put the subject on the agenda during the years in which he was an administrator with the CFM. "We tried to open up discussions regarding truly elderly physicians, but the subject was not well received. I believe that it is precisely because there is a tradition of physicians working until they are no longer able that this is more difficult in Brazil.... No one exactly knows what to do in this respect." Constantino is against the use of age as a criterion for quitting practice.

"Of course, this is a point that has to be considered, but I always defended the need for regular assessment of physicians, regardless of age range. And, although assessments are always welcome, in any profession, I also believe this would not be well received in Brazil." He endorses an assessment of one's knowledge and not of physical abilities, which are generally assessed through investigation when needed.

The absence of guidelines increases individual responsibility, as well as vulnerability. "Consciously, physicians will not put patients at risk if they do not have the competence to care for them or to perform a surgical procedure," Clystenes Odyr Soares Silva, MD, PhD, adjunct professor of pulmonology of the Federal University of São Paulo School of Medicine (UNIFESP), São Paulo, Brazil, told Medscape. "Your peers will tell you if you are no longer able," he added. The problem is that physicians rarely admit to or talk about their colleagues' deficits, especially if they are in the spotlight because of advanced age. In this situation, the observation and opinion of family members regarding the healthcare professional's competences and skills will also hold more weight.

In case of health-related physical impairment, such as partial loss of hand movement, for example, "it is expected that this will set off an ethical warning in the person," said Constantino. When this warning does not occur naturally, patients or colleagues can report the professional, and this may lead to the opening of an administrative investigation. If the report is found to be true, this investigation is used to suspend physicians who do not have the physical or mental ability to continue practicing medicine.

"If it's something very serious, the physician's license can be temporarily suspended while [the physician] is treated by a psychiatrist, with follow-up by the professional board. When discharged, the physician will get his or her [professional] license back and can go back to work," Constantino explained. If an expert evaluation is needed, the physician will then be assessed by a forensic psychiatrist. One of the most in-demand forensic psychiatrists in Brazil is Guido Arturo Palomba, MD, 73 years old. "I have assessed some physicians for actions reported to see if they were normal people or not, but never for circumstances related to age," Palomba told Medscape.

In practice, Brazilian medical entities do not have policies or programs to guide physicians who wish to grow old while they work or those who have started to notice they are not performing as they used to. "We have never lived as long; therefore, the quality of life in old age, as well as the concept of aging, are some of the most relevant questions of our time. These are subjects requiring additional discussion, broadening understanding and awareness in this regard," observed Vattimo.

Constantino and Silva, who are completely against age-based assessments, believe that recertification of the specialist license every 5 years is the best path to confirming whether the physician is still able to practice. "A knowledge-based test every 5 years to recertify the specialist license has often been a syllabu of conversation. I think it's an excellent idea. The person would provide a dossier of all they have done in terms of courses, conferences, and other activities, present it, and receive a score," said Silva.

In practice, recertification of the specialist license is a syllabu of discussion that has been raised for years, and it is an idea that the Brazilian Medical Association (AMB) defends. In conjunction with the CFM, the association is studying a way to best implement this assessment. "It's important to emphasize that this measure would not be retroactive at first. Instead, it would only be in effect for professionals licensed after the recertification requirement is established," the AMB pointed out in a note sent to Medscape Portuguese edition. Even so, the measure has faced significant resistance from a faction of the profession, and its enactment does not seem to be imminent.

The debate regarding professional longevity is taking place in various countries. In 2021, the American Medical Association (AMA) Council on Medical Education released a report with a set of guidelines for the screening and assessment of physicians. The document is the product of a committee created in 2015 to study the subject. The AMA recommends that the assessment of elderly physicians be based on evidence and ethical, relevant, fair, equitable, transparent, verifiable, nonexhaustive principles, contemplating support and protecting against legal proceedings. In April of this year, a new AMA document highlighted the same principles.

Also in the US, one of oldest initiatives created to support physicians in the process of remedial education and competency assessments, the University of California San Diego (UC San Diego) Physician Assessment and Clinical Education Program (PACE), has a Late Career Health Screening. For those wanting to learn more about discussions on this subject, there are online presentations on experiences in Quebec and Ontario, Canada, with assessing aging physicians, neuropsychological perspectives on the aging medical population, and what to expect of healthy aging, among other subjects.

Created in 1996, PACE mostly provides services to physicians who need to address requirements of the state medical boards. Few physicians enroll on their own.

PACE's Late Career Health Screening is a physical and mental health screening for late-career physicians and healthcare professionals who have reached a certain age (generally 70 and older) but otherwise have no known impairment or competency problems. The screening is designed to detect the presence of any physical or mental health problems affecting the provider's ability to practice. If concerns are identified, further evaluation will be recommended.

This article was translated from the Medscape Portuguese edition.

In South Africa, newly qualified professional nurses often face great difficulties when entering clinical practice after completion of their studies. The transition from theory to practice can be daunting.

These challenges can be assigned to various factors, among others, being ill-prepared and having no guidance or support. For many, this role transition period can be traumatic and stressful due to insufficient clinical skills, a heavy workload, prioritisation of tasks, and decision-making.

Own experiences

My own experience as a nursing student, especially when I was placed in a theatre, was not pleasant. What stood out was how badly the theatre staff would treat nursing students. As a newly qualified nurse, my own transition experience was awful. It felt like I was in hell and I was constantly looking for other work.

After eight months, things improved as I gained experience. I realised that we need a culture change in theatre - behaviour needs to change and that behavioural change should start with me. That set me off on a journey to develop a preceptorship model for newly qualified professional nurses as part of my PhD in Nursing Science.

What we know

It is well-reported that in South Africa, and globally, health services are hamstrung by a shortage of nurses. Based on statistics from the South African Nursing Council (SANC) the total nursing workforce registered in the country by December last year was 276 415. There were 15 469 professional nurses in training at the time. This output of nurses who have completed the four-year degree has hovered around 3 500 every year since 2017, with last year's output at 4 445 specialist nurses.

Amid an ageing nursing population and limited output of trained nurses that are not enough to wither the storm of nurse vacancies in the country, it becomes crucial to use who and what we have efficiently. It is of great importance to ensure that nurse graduates when they take up their roles in health facilities, are not only competent to do the work required of them but also confident. It is equally important to support rather than alienate them to the extent that they pursue other careers. We must keep and hang on to what we have.

But these nurses need support and guidance during their transition into their professional roles. Upon entry to professional practice, newly qualified nurses experience reality shocks, stress, fear, uncertainty, confusion about their role, lack of confidence and motivation, and feelings of being overwhelmed.

Preceptors, through preceptorship, are then ideal to support novice nurses and promote the transfer of learning.

It is of great importance to ensure that nurse graduates when they take up their roles in health facilities, are not only competent to do the work required of them but also confident.

What is meant by preceptorship?

Preceptorship is a period of support to newly qualified persons. This is a time when an experienced person guides and supports the newly qualified based on a predetermined programme or plan. The person facilitating and who provides this support and hands-on training is called a preceptor.

The preceptor and preceptee (the newly qualified nurse in this instance) will work together one-on-one, like a medical specialist who teaches surgical skills to a new medical officer. In nursing, the preceptor is a professional nurse with two or more years of experience within a specific unit and provides clinical teaching to newly qualified professional nurses. The most significant type of support provided is clinical support.

For this role, it is crucial that a preceptor must be good at teamwork, knowledgeable, and professional, and employ evidence-based practice and self-reflection.

The findings

Included as participants in my study were seven nursing managers, seven nursing preceptors, and eleven newly qualified professional nurses. Using semi-structured interviews, I investigated the transition experiences of newly qualified professional nurses with the aim of developing a preceptorship model. The purpose of the model is to, among others, reduce the transition challenges newly qualified professional nurses face, prevent newly qualified professional nurses from feeling as if they are being thrown into the deep end, reduce the reality shock experienced by the newly qualified professional nurses, and lessen the anxiety experienced by the newly qualified nurses.

The study participants described the newly qualified nurses' transition to professional nursing as challenging. Newly qualified professional nurses described their experiences as that of feeling poorly prepared. "From the student to professional nurse, ... you have a big job description and you have to take responsibility ... , ja (yes) responsibility for everything. I think being a student, they don't really prepare you for that," said one participant about her transition experience.

Preceptors described the situation as akin to newly qualified nurses being thrown into the deep end. "They've never worked in the department before, so that nurse will not be practically prepared. Again, this largely depends on the previous placements. If they worked previously in that unit, you will be fine," said one preceptor. Some of the operational managers described their experience as a reality shock. One operational manager experienced the readiness of newly qualified nurses for the professional role as: "Guidance in the way they need to be shown everything, they need to be taught everything as a professional nurse because the month before they started, they were still and the mentality is that I am still a student."

So, developing this preceptorship model for newly qualified professional nurses, I believe, will contribute to the body of knowledge in nursing practice and nursing education. But, what does this model entail?

One operational manager experienced the readiness of newly qualified nurses for the professional role as: "Guidance in the way they need to be shown everything, they need to be taught everything as a professional nurse because the month before they started, they were still and the mentality is that I am still a student."

How it works

Based on this preceptorship model, once a newly qualified professional nurse is assigned to a unit they will be enrolled in the preceptorship as soon as possible. The preceptorship will be based on the learning objectives identified for that specific unit. An initial baseline competency assessment is done to determine the newly qualified professional nurses' competency and to prevent the repetition of things the preceptee already mastered. This will determine the context of the preceptorship programme and is done by the operational manager and preceptor.

Thereafter, the preceptor will facilitate the preceptorship and the operational manager will assist where needed. It is crucial to have the buy-in of the operational manager for a preceptorship's success.

The preceptor will plan teaching and learning activities to develop the skills of the newly qualified professional nurse and address the set objectives. Usually, this is based on the problem areas within the unit. To address this, the newly qualified professional nurse will go through specifically designed learning experiences and activities. This process will include, among others, a learning outcome, teaching activity, and assessment of learning. After this process, the newly qualified professional nurses' competency is then determined.

This model was evaluated by a panel consisting of one deputy manager nursing, one operational manager, six preceptors, and four newly qualified professional nurses. I wanted to establish if the concepts of this model were clearly defined, applicable, and simple and to rate the action points for operationalisation of the model. All these aspects were rated from very good to excellent. The deputy manager of nursing said, "A systematic approach to capacitate and develop newly qualified nurses has long been overdue. This model can only benefit all the parties involved and eventually enhance patient care."

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First of its kind

Despite the obvious benefits of such a model, I could not find a preceptorship model for newly qualified professional nurses in the country, therefore, this is the first of its kind for professional nurses in South Africa. This model is based on newly qualified nurses as adult learners. This model can be used in clinical settings during newly qualified nurses' transition period and with any newly qualified person's learning activity. This model may guide operational managers and preceptors in the effective preceptorship of newly qualified nurses and clarify their role within the preceptorship process. By applying this model, newly qualified nurses may experience a positive transition period, improving their clinical competence. Furthermore, this model provides information on the implementation and sustainability of a preceptorship programme.

There is a need for professional support and guidance of newly qualified professional nurses to help them prepare for their roles and enhance their clinical independence. The developed preceptorship model for the newly qualified professional nurses, I believe, will contribute to the transition of these cadres; ensuring that they receive clinical training from trained preceptors and support from nursing managers who collaborate to achieve an effective preceptorship. Thus, the results of this study can greatly benefit the body of knowledge of nursing education and the nursing profession.

*Hansen is a lecturer at the Western Cape College of Nursing, Boland/Overberg campus. He teaches Ethos and Professional Practice to undergraduate students, from the first - to fourth year.

This article is based on his presentation at the Rural Health Conference in September.

A Mayo-based solicitor told a judge that he was unwilling to accept payment of a debt from another solicitor until he was certain that the money was not the proceeds of crime.

Evan O’Dwyer told Judge Alan Mitchell, sitting on Friday in Ballaghaderreen District Court, that he had been interviewed by detectives from the Criminal Assets Bureau (Cab) who were examining the accounts of Declan O’Callaghan, a solicitor from the Roscommon town barred by the High Court from professional practice because of questions over his handling of clients’ money.

Mr O’Callaghan, formerly of Ardeeven, Ballaghaderreen, Co Roscommon, is facing legal actions from former clients, as well as action against him by the Law Society and the Solicitors’ Disciplinary Tribunal, over unaccounted-for money taken from clients.

In court, Mr O’Callaghan, who was present and represented by Rob Lowe, instructed by Mr O’Callaghan’s daughter, Aoife O’Callaghan of Staunton Caufield Solicitors of Castlerea, agreed to obtain a bank draft for €70,000 to discharge a debt to Evan and John T O’Dwyer solicitors. After an adjournment, a draft was given to Evan O’Dwyer.

‘Bizarre allegations’

Mr Lowe complained about the proceedings and what he termed “bizarre allegations that have been made in respect of Mr O’Callaghan and Cab. The matter could have been dealt with in correspondence.”

Mr O’Dwyer acknowledged that payment had been offered by the debtor in August 2022. He told the court that the sum of €70,000 offered “purports” to be from the sale of Mr O’Callaghan’s former home at Ardeevan, in Ballaghaderreen.

Mr O’Dwyer said that he refused to accept the payment at the time, stating that he would only accept payment if there was “independent proof” of the source of the money.

The judge noted that whether the money was the proceeds of crime “might or might not be relevant”, but only to An Garda Síochána and not Mr O’Dwyer.

On the tendering of the €70,000 by means of a bank draft, the judge struck out an application for an instalment order made against Mr O’Callaghan, previously sought by Mr O’Dwyer.

49ers head coach Kyle Shanahan has said that star edge rusher Nick Bosa has “a chance” to play Sunday’s game against the Falcons.

But according to multiple reporters on the scene, Bosa is not practicing again on Thursday.

Bosa is dealing with a groin injury suffered against the Panthers last week. A key piece of San Francisco’s defense, Bosa is currently tied for the league lead with 6.0 sacks. He’d recorded at least one sack in every game until the Week Five win over Carolina.

The 49ers are dealing with several injuries along their defensive line. Per Jennifer Lee Chan of NBCSportsBayArea.com, defensive lineman Javon Kinlaw also was not practicing on Thursday. Defensive lineman Arik Armstead did not make the trip — the 49ers are staying in West Virginia between trips to Charlotte and Atlanta — so he was also not on the field.

But edge rusher Samson Ebukam (Achilles) was practicing after he sat out Wednesday’s session.

San Francisco’s full injury report will be released later on Thursday.

The Steelers handed in their second injury report of the week on Thursday and it shows that safety Minkah Fitzpatrick sat out of practice for the second straight day.

Fitzpatrick is listed with a knee injury that head coach Mike Tomlin said last week will have to be managed in order to keep him on the field on gameday. That management saw Fitzpatrick miss practice last Wednesday before returning on Thursday, so thinks are unfolding differently ahead of this Sunday’s game against the Buccaneers.

Playing without Fitzpatrick would make it more difficult for the Steelers to snap their four-game losing streak.

Cornerbacks Cam Sutton and Ahkello Witherspoon each missed their second straight practice with hamstring injuries. Offensive lineman Mason Cole (foot) and defensive lineman Larry Ogunjobi (back) were also out on Thursday.

Tight end Pat Freiermuth (concussion) and cornerback Levi Wallace (concussion) were both listed as limited participants.

The New Orleans Saints announced a flurry of practice squad transactions Tuesday, including the addition of veteran defensive back Chris Harris. 

In addition to bringing Harris on board, the Saints also signed fullback Adam Prentice and defensive back Jordan Brown to the practice squad. In corresponding moves, they released defensive back Tre Swilling from the practice squad and waived defensive back DaMarcus Fields from the active roster. 

Harris is the most notable name. He is an 11-year veteran who, earlier in his career, accumulated a first-team All-Pro nod and four Pro Bowl appearances with the Denver Broncos.

Along with Saints defenders Tyrann Mathieu and Cameron Jordan, Harris was named to the Pro Football Hall of Fame's 2010s All-Decade team. 

He last played with the Los Angeles Chargers, with whom he signed a 2-year, $17 million contract prior to the 2020 season. In two seasons with Los Angeles, Harris intercepted two passes in 23 games. 

The 33-year-old Harris has appeared in 162 games in his NFL career, recording 22 interceptions with four pick-sixes and 94 passes broken up. He was teammates with Saints corner Bradley Roby on the Broncos' 2015 Super Bowl champion team.