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longitudinal assessment (LA) is quickly replacing traditional assessment methods for maintaining medical specialty certifications. Diplomates of one medical specialty board complete 30 multiple-choice questions (MCQs) per calendar quarter, 120 questions annually to maintain their certifications. This study included 5,804,640 responses to LA questions administered to 25,419 physicians during 2018 and 2019. A proportion of physicians’ LA questions are “repeat questions” that they initially answered incorrectly. The median interval before a question was first repeated was 291 days. The average percentage of correct responses to questions seen a 2nd time was 9% higher than that of the questions seen the 1st time. Answering a question correctly was more strongly associated with physicians’ confidence rating than with their question relevance rating.