Additional Resources about the ABMS Maintenance of Certification® program
(Response to NEJM article – 12/27/2012)

The American Board of Medical Specialties (ABMS) applauds the New England Journal of Medicine (NEJM) for drawing attention to the important topic of physician Maintenance of Certification with its article entitled Ensuring Physicians’ Competence—Is Maintenance of Certification the Answer? published in the Dec. 27, 2012 issue. As the article suggests, professionals in all areas of health care recognize that quality care, outcomes and cost-effectiveness are important to the patients, families, and communities we serve and are under increasing scrutiny in the United States. Consequently, it is important that physician organizations, such as ABMS and its 24 Member Boards, continue to take the lead in demonstrating physician commitment to rigorous, voluntary programs of lifelong learning, self-assessment and quality improvement.

As the article notes, initiatives by national accrediting organizations, state medical licensing boards, the federal government and others “designed to link more closely the goals of learning with the delivery of better care and measures of greater accountability” are “works in progress.” So too is the ABMS MOC® program. Nearly 80 years ago, ABMS created standards of excellence in the various specialties for physicians to pursue and the public to rely upon. Just as medical curricula and continuing medical education have evolved over time, so has the Board Certification process. As the health care community has broadened its understanding of what constitutes physician excellence, Member Boards’ MOC programs have evolved to include innovative lifelong learning opportunities through evidence-based requirements that help achieve better patient outcomes.

Although the MOC program is relatively new, early studies demonstrate a link between MOC and improved clinical performance and outcomes by participating physicians. To learn more about the evidence supporting Board Certification and the ABMS MOC program, view the bibliography of independent studies that documents the value these programs deliver to physicians and their patients compiled by ABMS. A document, MOC Myths & Facts, provides insights into some common misconceptions about the program. We also encourage consumers to learn more about ABMS Member Board Certification at www.CertificationMatters.org. As part of its 2012-2015 Strategic Plan, ABMS will continue to develop robust evidence regarding the impact of MOC on the quality of care, enhance the quality of all MOC activities, match the investment of diplomate effort and resources in MOC with the resulting value, and integrate MOC with the current practice environment and the requirements of health care organizations.

ABMS acknowledges that participation in Member Boards’ MOC programs places expectations on physicians. Representing oneself as an ABMS Board Certified physician/specialist to the public and the health care community is a privilege that is associated with effort. Physicians participating in MOC commit to, and complete, a substantive program of learning and assessment. MOC participation represents both dedication and hard work on the part of the physician in order to remain current in his or her specialty and provide up-to-date care for patients. ABMS and the Member Boards continue to work to provide MOC programs that are rigorous, relevant, and provide value to the physicians engaged in the MOC process.

As the article indicates, some Member Boards report low recertification rates among their diplomates who hold lifetime (sometimes referred to as non-time-limited) certificates. However, others report significantly higher rates. For example, nearly two-thirds of physicians holding lifetime certificates from the American Board of Obstetrics and Gynecology and nearly 30 percent of those from the American Board of Allergy and Immunology are participating in MOC activities. More than 3,000 American Board of Pediatrics lifetime certificate holders are meeting MOC requirements, and feedback from participants has been overwhelmingly positive. We project that by 2020, 93 percent of Board Certified physicians will hold time-limited certificates and will be engaged in on-going MOC activities. Furthermore, ABMS and its Member Boards encourage all Board Certified physicians to take advantage of their Boards’ MOC programs to improve their skills and demonstrate to patients their commitment to quality care. ABMS Member Boards certify nearly 800,000 physicians nationally; more than 375,000 physicians are now actively involved in Member Board MOC programs.

The article suggests that the flexibility granted to Member Boards to design their own MOC programs have resulted in the adoption of different approaches, most notably in the implementation of Part IV activities. ABMS provides guidelines and standards for the Member Boards to use so that their programs reflect a common framework, while the Member Boards ensure that the assessments are relevant and tailored to their unique specialties and subspecialties. Hence, the differences among the 24 Member Boards’ MOC programs reflect a judgment by experts in each specialty about what is required to maintain knowledge, skills and practices in the respective discipline. Each of the 24 ABMS Member Boards tailors the requirements of practice performance assessment (i.e., Part IV of the MOC program) to the needs of its specialty. While their approaches may not be the same, most of the ABMS Member Boards use practice improvement modules or similar approaches in their Part IV activities.

As the article recognizes, in ABMS’ attempt to minimize redundant data-collection tasks for Board Certified physicians it has forged relationships and collaborations with several medical organizations. Additionally, the ABMS MOC program encourages quality improvement initiatives across specialties and within health care teams that will help to improve care in health care systems and other organizations where we serve patients. Moving forward, ABMS remains committed to facilitate the growth and acceptance of Board Certification and ABMS MOC programs as a leading indicator of quality and efficacy for health care delivered in this country.

The 24 Member Boards that comprise the ABMS Board Enterprise include the: American Board of Allergy and Immunology, American Board of Anesthesiology, American Board of Colon and Rectal Surgery, American Board of Dermatology, American Board of Emergency Medicine, American Board of Family Medicine, American Board of Internal Medicine, American Board of Medical Genetics, American Board of Neurological Surgery, American Board of Nuclear Medicine, American Board of Obstetrics and Gynecology, American Board of Ophthalmology, American Board of Orthopaedic Surgery, American Board of Otolaryngology, American Board of Pathology, American Board of Pediatrics, American Board of Physical Medicine and Rehabilitation, American Board of Plastic Surgery, American Board of Preventive Medicine, American Board of Psychiatry and Neurology, American Board of Radiology, American Board of Surgery, American Board of Thoracic Surgery and American Board of Urology.