In 2017, the American Board of Medical Specialties (ABMS) launched its Continuing Board Certification: Vision for the Future initiative to “foster an inclusive, open, collaborative, and candid dialogue across stakeholder groups” about the future of continuing board certification. This initiative, brought about by major concerns raised by diplomates about Maintenance of Certification (MOC) programs, is led by a Commission that includes a diverse group of physicians and patients as well as representatives from professional medical organizations, national specialty and state medical societies, hospitals and health systems, and the general public.
The Commission was tasked with reviewing MOC within the current context of the medical profession, as well as addressing key issues currently facing the ABMS Boards and diplomates as they fulfill their commitment to patients and their families, as well as their professional colleagues.
On December 11, 2018, the Commission released its draft report, which is geared towards the ABMS Board of Directors and outlines findings and a set of 15 recommendations for future continuing certification programs.
The report, which follows four Commission meetings and 21 hours of public testimony, falls in line with the nine guiding principles established by the Commission, including: clarifying that initial certification and continuing certification have markedly different purposes; supporting the continuous enhancement of clinical care; extending continuing certification programs beyond the assessment of medical knowledge; and evaluating and improving program effectiveness with the intended outcome being that physicians improve knowledge and skills over time.
The Commission heard a consistent commitment to a continuing certification system from diplomates and other stakeholders. The majority of the testimony did not support lifetime certification. Stakeholders, especially public stakeholders, believed that even lifetime certificate holders should participate in some continuing certification activities to help them stay current in their fields. Physician stakeholders largely testified that the continuing education system should only consist of an active state license and continuing medical education (CME) requirements.
The Commission defined the purpose of continuing certification as “to serve the diplomates, the public and the profession by providing a system that supports the ongoing commitment of diplomates to provide safe, high-quality, patient-centered care. Through participating, diplomates meet specialty continuing certification standards that reflect their commitment to professionalism, lifelong learning, and improved care.”
Below are some of the recommendations as made by the Commission, separated by categories.
Expectations for Continuing Certification Programs
Some of the recommendations under this category include: continuing certification should constitute an integrated program with standards for professionalism, assessment, lifelong learning and practice improvement; and continuing certification should incorporate assessments that support diplomate learning and retention, identify knowledge and skill gaps, and help diplomates learn advances in the field.
Stakeholders in Continuing Certification
Some of the recommendations made in this category include: ABMS Boards should collaborate with professional and CME/CPD organizations to create a continuing certification system that serves the public while supporting diplomates in their commitments to be better physicians; and ABMS must encourage hospitals, health systems, payers, and other health care organizations to not deny credentialing or privileging to a physician solely on the basis of certification status.
Research and Evaluation of Continuing Certification
Recommendations made in this category include: ABMS and the ABMS Boards should collaborate with other organizations to facilitate and encourage independent research; and ABMS Boards must collectively engage in a regular continuous quality improvement process and improve the effectiveness and efficiency of continuing certification programs.
ABMS Boards’ Support of Diplomates
Some of the recommendations in this category include: ABMS Boards must comply with all ABMS certification and organizational standards; continuing certification should be structured to expect diplomate participation on an annual basis; and ABMS Boards must regularly communicate with their diplomates about the standards for the specialty and to foster feedback about the program.
Public Comments
The public comment period will remain open until Tuesday, January 15, 2019. Following receipt of the public comments, the Commission is expected to have another meeting January 22-23, 2019, to discuss the comments received and create the final report for submission to ABMS in February 2019.
Individuals are encouraged to share their feedback on the Commission’s draft findings and recommendations. To submit a comment directly to the Commission, please click here.