Maintenance of Certification: ABIM Announces Immediate Changes to MOC Program

In a surprise move, the American Board of Internal Medicine (ABIM) suspended aspects of its maintenance-of-certification program and apologized after many internists and medical specialty societies raised concerns that it was a waste of time and money.

ABIM President and CEO Richard J. Baron, MD, reached out to open a conversation on how to improve MOC. He stated:

A year ago, ABIM changed its once-every-10-years Maintenance of Certification (MOC) program to a more continuous one. This change generated legitimate criticism among internists and medical specialty societies. Some believe ABIM has turned a deaf ear to practicing physicians and has not adequately developed a relevant, meaningful program for them as they strive to keep up to date in their fields.

ABIM is listening and wants to be responsive to your concerns. While ABIM’s Board believes that a more-continuous certification helps all of us keep up with the rapidly changing nature of modern medical practice, it is clear that parts of the new program are not meeting the needs of physicians like yourself.

We got it wrong and sincerely apologize. We are sorry.

We wrote last year that thousands of internists had signed a petition to recall the ABIM’s new changes to its MOC requirements. Furthermore, doctors had become frustrated that despite questionable evidence linking MOC to patient protection, participation in MOC is increasingly becoming mandatory for doctors across the country.

ABIM is taking the following steps to improve its processes:

• Effective immediately, ABIM is suspending the Practice Assessment, Patient Voice and Patient Safety requirements for at least two years. This means that no internist will have his or her certification status changed for not having completed activities in these areas for at least the next two years. Diplomates who are currently not certified but who have satisfied all requirements for Maintenance of Certification except for the Practice Assessment requirement will be issued a new certificate this year.
• Within the next six months, ABIM will change the language used to publicly report a diplomate’s MOC status on its website from “meeting MOC requirements” to “participating in MOC.”
• ABIM is updating the Internal Medicine MOC exam. The update will focus on making the exam more reflective of what physicians in practice are doing, with any changes to be incorporated beginning fall 2015, with more subspecialties to follow.
• MOC enrollment fees will remain at or below the 2014 levels through at least 2017.
• By the end of 2015, ABIM will assure new and more flexible ways for internists to demonstrate self-assessment of medical knowledge by recognizing most forms of ACCME-approved Continuing Medical Education. “We are absolutely interested in finding ways to recognize meaningful clinical work that you do in your practices to earn CME points,” states the ABIM, “and we’re particularly interested in recognizing CME activities for which there is evidence that they drive learning and/or change practice.”

The AMA said in a statement that they was “delighted” that the board was listening to physician concerns and that the ABIM would align the MOC program with policies discussed during the 2014 AMA Interim Meeting in Dallas. There, the AMA House of Delegates voted to update the AMA’s policy on MOC. Their adopted policy outlines principles that emphasize the need for an evidence-based process that is evaluated regularly to ensure physician needs are being met and activities are relevant to clinical practice.

The Alliance for Continuing Education in the Health Profession (ACEP) lauded the move and commented that “of particular relevance to our education community, the ABIM will start recognizing most forms of ACCME-approved CME as a way for internists to demonstrate self-assessment of medical knowledge. This significantly expands the relevance of CME to Board certification as up until now, the ABIM had been awarding MOC points for select “ABIM-approved” CME. Going forward, ABIM will not be doing any independent review and will greatly increase the types of CME activities that can be applied to MOC.”

View the full statement from ABIM