ABMS MOC CME New System of CME Accreditation: George Mejicano, MD President of Alliance for CME Clarifies

Earlier this week we published an article about the American Board of Medical Specialties (ABMS) white paper on Maintenance of Certification Continuing Medical Education (MOC/CME).   We have received various responses for leaders in CME community to help explain the white paper and its recommendations. 

We are encouraging everyone to read the white paper for themselves and submit comments to the ABMS by March 1^st to ABMS at ABMS_MOC_Support_Program@abms.org.   

George Mejicano, MD is a leader in the continuing medical education and adult learning  and current president of the Alliance for Coninuing Medical Education (the Alliance).  

I would like to respond to your posting from February 14, 2011.  I served on the ABMS/ACCME MOC CME Working Group and I am the current President of the Alliance for Continuing Medical Education.  However, my comments are purely my own and they do not represent the opinon of the Alliance, the ABMS, the ABMS MOC Committee, the ACCME, the Working Group, or the University of Wisconsin.  Importantly, the Alliance Advocacy Committee will be crafting a response to the call for comments in the near future.  That response must go to the Alliance Board of Directors before it is publically released.   

There appears to be some disconnect between MOC (Part II and Part IV) and certified CME.  Specifically, at this point in time there are projects and activities that are certified for CME credit but they have not been approved for MOC (Part II or Part IV).  Similarly, there are projects and activities that are approved for MOC (Part II or Part IV) that are not currently certified for CME credit.  However, this does not mean that a separate accreditation system is being created or is desirable.   

 In addition, each of the 24 member boards of the ABMS has the autonomy to make its own decisions about what they will approve for MOC and some of these issues are unrelated to CME at this point (e.g., oral examination or case loads in some specialties).   

I believe that CME/CPD will continue to play a vital role in the MOC process but stakeholders must be confident that appropriate standards are met and are in the best interest of the public.  For example, it is critically important that the content within certified CME/CPD reflect the best available scientific and medical evidence and it is just as important that the educational formats and evaluation methods reflect the best available educational evidence regarding knowledge translation and implementation science.  In other words, there is an evidence-base regarding effective educational modalities that I believe is not currently being used in many settings.   

Verification of individual CME activities, let alone what happens to an individual clinician as she/he moves through a learning activity, is not a part of the current ACCME accreditation system and that has raised questions about quality control.   

Together, we must continue to advance CME/CPD so that learning translates into safe, effective, patient-centric, team-based care that improves health outcomes.   

From what I understand, ABMS is interested in exploring a process to work through the various issues and solutions, and clarity regarding many unresolved issues will become evident over time.  For now, the White Paper does not represent policy or standards but is a place to start thinking about the issues related to CME/CPD and its role in MOC. 

I encourage individuals and organizations to respond to the White Paper and its associated Call for Comments.

George C. Mejicano, MD, MS, FACP, FACME

Professor and Associate Dean

School of Medicine and Public Health

University of Wisconsin – Madison