Your hero, Dr. Grumpy, is (along with a lot of other docs) certified by the American Board of Psychiatry and Neurology (ABPN).
You can be certified in either or both (I have no idea why anyone would want both).
All of us neurologists and psychiatrists pay the board a hefty amount to stay certified. It's a few hundred bucks a year, and every 10 years it's a few thousand more to prepare for and take a written test to maintain certification. This is in addition to all the continuing medical education required.
What the ABPN does with this money, besides writing new test questions and issuing certificates, I have no idea. But, in a recent newsletter I received, it was nice to see that the money is being put to good use: