October 19, 2015
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ACG President calls for continued improvement to 'maintenance of competencies'

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HONOLULU — Though progress has been made in the discussions and revisions of the American Board of Internal Medicine’s far-reaching maintenance of certification program, outgoing American College of Gastroenterology president during a his presidential address at ACG 2015 called for additional considerations to be made for what should be “maintenance of competencies.”

“As we meet here in Honolulu, we are responding to the ABIM in collaboration with our sister societies,” Stephen B. Hanauer, MD, FACG, professor of medicine at Northwestern University Feinberg School of Medicine, said. “While we all concur with the principles of lifetime learning, as exemplified by the success of our CME activities and our annual meetings, regional courses, hands-on training, hepatitis school, publications and online activities, we are united with our sister organizations and have advised the ABIM on several key clinical points.”

Stephen B. Hanauer

Hanauer said that ACG and its collaborative societies have requested a “simpler, less intrusive and less expensive process to maintain our competencies,” which includes ending the required exam every 10 years and eliminated the closed-book approach, “as they do not represent the current realities of medicine in the digital age.”

“We believe alternative models that rely on oversight of CME providers and tracking of participation could provide a reasonable alternative pathway that would better meet the needs of clinicians,” he said. “We endorse the concept of individualized self-assessment pathways, which give more control to the physicians for their maintenance and believe professional societies are best positioned to determine the key competencies that are to be assessed and to determine areas that should be open book vs. knowledge based. We advise less emphasis on busy work and more opportunities to participate in activities that are useful, efficient and engaging, with a focus on activities that physicians are already doing.”

By focusing on what physicians already do to educate themselves and improve their practice, Hanauer suggested there would be an elimination of unnecessary duplication currently in place and an opportunity for physicians to concentrate in their own subspecialization.

“While there is a basic level of clinical gastroenterology that any board-certified gastroenterologist should know, in an era of increased specialization within practices, it is important to have a tiered approach to examinations,” he said.  “Testing should be flexible and dynamic but we do not believe there should be further board certification for subspecialization within gastroenterology.”

Within that flexibility, Hanauer suggested ABIM could offer multiple testing formats from open-book to more frequent, but smaller and individualized questions.

“We hear you. We agree and we are collaborating with our sister societies to provide a strong and unified outline that is buttressed by the unique attributes of our college’s continued efforts to support lifetime learning for our members,” he said. – by Katrina Altersitz

Reference: 

Hanauer S, et al. Presidential Address. Presented at: ACG; Oct. 16-21, 2015; Honolulu.

Disclosures: The speaker reports no relevant financial disclosures.