ABIM on Maintenance of Certification program: ‘[We] got it wrong’

The American Board of Internal Medicine announced immediate and significant changes to its Maintenance of Certification program as a result of concerns from the internist community that the program was not keeping them up to date in their field.

MOC controversy

Controversy surrounding the program's efficacy has continued to grow. Many physicians have spoken out against MOC, questioning the value of ongoing learning programs and voicing concerns about the financial burden of meeting new requirements and the additional work the program will add to their busy schedules. In response to this criticism, the ABIM seeks to better align its program with the needs of physicians.

“[The American Board of Internal Medicine] clearly got it wrong,” ABIM President and CEO Richard J. Baron, MD, wrote in a press release. “We launched programs that weren’t ready and we didn’t deliver a [Maintenance of Certification] program that physicians found meaningful. We want to change that.”

Richard J. Baron

This announcement comes 1 year after the American Board of Internal Medicine (ABIM) changed its Maintenance of Certification (MOC) requirements from once every 10 years to continuous requirements.

The organization pointed out its desire to work closely with the internal medicine community to develop the changes.

Program improvements

Program changes included:

ABIM will immediately suspend the Practice Assessment, Patient Voice and Patient Safety program for 2 years. Diplomates will not have their certification statuses changed if they do not complete activities in this program for the next 2 years, according to the release.
The language ABIM uses to report a diplomate’s MOC status will change from “meeting MOC requirements” to “participating in MOC” within the next 6 months.

The MOC exam will be updated beginning in the Fall of 2015 to more closely reflect what current practices do.
Enrollment fees will stay at or less than the current rates through 2017.
New and flexible ways for internists to validate their self-assessment of medical knowledge will be available by the end of 2015.

The ABIM will work with medical societies and diplomates through meetings, webinars, forums, online communication channels, surveys and more, to develop a more effective MOC program.

While Baron said that updates will take time, he urged diplomates to visit the ABIM’s frequently asked questions page for more information about the changes and to learn how to get involved in the program’s reformation.

“The ABIM Board of Directors, staff and I are fully committed to doing a better job – to ensure that ABIM and MOC evolve to better reflect the changing nature of medical practice,” Baron said in the release.

Support for change

Following the ABIM announcement, Charlie Chambers, MD, FSCAI, president of the Society for Cardiovascular Angiography and Interventions (SCAI), issued a statement recognizing the society’s members who voiced their concerns and supported SCAI in the effort to initiate changes. He also recognized the changes made by ABIM, though he noted additional work is needed.

“Our fourth request, to require one recertification exam in the physician’s primary (sub)-specialty, still needs to be addressed,” he wrote. “Previously the ABIM suggested that requirements to pass multiple boards may be set aside by individual ABIM councils. If so, we hope that the ABIM Cardiology Council will require interventionalists to stay current only with the interventional cardiology board exams.”

Three other concerns raised by SCAI which were addressed in the announcement included changes to the language used to describe MOC status, the quality and expense of the program and the ability for physicians to earn MOC credit for completed CME.

The Endocrine Society also issued a statement “praising” the ABIM for their changes.

“We are satisfied that the ABIM has heard our concerns and is responding with appropriate changes to the MOC program,” Richard J. Santen, MD, president of the Endocrine Society, said in a press release. “We fully support the concepts of continuous learning, improvement and self-regulation that the ABIM espouses and recognize that the changes outlined are designed to enhance these processes.”

Changes requested by the society, including those to the exam and fee structures, as well as approved activities, were made, according to the press release.