AMA Calls for End to Manditory Secured Exam for MOC

In June 2016, at the AMA House of Delegates meeting in Chicago, one of the topics discussed was Maintenance of Certification. However, what was not mentioned in the AMA press (or really, any other press) was the fact that the AMA officially opposes mandatory ABMS recertification exams.

Interestingly, the position took place with little fanfare: it wasn’t listed in the Top 10 Stories from the AMA 2016 Meeting, nor was it listed in the coverage of the MOC resolutions that passed. It was only mentioned in tweets by attendees. AMA only focused on publicizing the following MOC resolutions:

• Examining the activities that medical specialty organizations have underway to review alternative pathways for board recertification
• Determining whether there is a need to establish criteria and construct a tool to evaluate whether alternative methods for board recertification are equivalent to established pathways
• Asking the American Board of Medical Specialties to encourage its member boards to review their MOC policies regarding the requirements for maintaining underlying primary or initial specialty board certification in addition to subspecialty board certification to allow physicians the option to focus on MOC activities most relevant to their practice.

While the AMA House of Delegates Reference Committee C did try to amend the resolution that called for an “immediate end of any mandatory, recertifying examination by the American Board of Medical Specialties (ABMS) or other certifying organizations as part of the recertification process,” the HOD rejected modifications made by the committee, extracted it to a full vote on the house floor, and restored the language of the resolution. The resolution language, as passed, reads:

RESOLVED, That our American Medical Association call for the immediate end of any mandatory, secured recertifying examination by the American Board of Medical Specialties (ABMS) or other certifying organizations as part of the recertification process for all those specialties that still require a secure, high-stakes recertification examination.

There were several delegates that opposed the house action, saying that it shouldn’t try to do away with secure exams. Donna Sweet, MD, stated, “Secure simply means that it guarantees that you or the person are the person who is taking the test.”

ABMS, of course, opposes the AMA resolution. In a statement released by the Association, they stated:

Consumers, patients, hospitals and other users of the Board Certification credential expect board certified physicians to be up-to-date with the knowledge, judgment and skills of their specialty—both at the point of initial certification and along the physician’s career path – and to verify it through an external assessment. The privilege to self-regulate which physicians enjoy demands that we meet that expectation with more than just continuing medical education.

Continuing medical education is an important component of a physician’s continuous learning and an important part of Maintenance of Certification (MOC), but by itself is not sufficient to verify that a physician is up to date. The other components of MOC—professionalism, external assessment of knowledge, judgment and skills, and improvement in medical practice—are also important.

The AMA also approved a resolution to continue working with ABMS to “encourage the development by and sharing between specialty boards” of alternate ways to assess medical knowledge, other than by a secure exam. The AMA HOD also bolstered its support of using appropriate continuing medical education (CME) courses to maintain quality assessments of physicians.