MOC Update: ABMS Plans Implementation of Board Certification Recommendations

March 12, 2019 CHICAGO – The American Board of Medical Specialties (ABMS) Board of Directors plans to address the recommendations shared in the Continuing Board Certification: Vision for the Future Commission’s final report. Presented to the ABMS Board in mid-February, the Commission’s final report is the culmination of research, testimony and public feedback from stakeholders throughout the Boards and greater health care communities. The Commission took all of this input into consideration, developing a set of recommendations to help continuing certification evolve into a meaningful and relevant program bringing value to a physician’s practice and meeting the highest standard of quality patient care.

The ABMS Board reviewed the Commission’s final report in detail during its February meeting, assessing how best to address the recommendations outlined. The Board agreed to the following as necessary first steps in implementing the Commission’s findings:

• Establishment of the “Achieving the Vision for Continuing Board Certification” Oversight Committee charged with directing the implementation strategy. This committee will seek guidance from the ABMS’ new Stakeholder Council and various stakeholders in the continuing certification process throughout the implementation.
• Creation of the following four Collaborative Task Forces that will include representatives from professional and state societies and other external stakeholders, focusing on the following areas identified in the Commission’s report:

o Remediation pathways
o Professionalism
o Advancing Practice
o Information and Data Sharing

• Agreement of all 24 ABMS Member Boards to commit to longitudinal or other formative assessment strategies and offer alternatives to the highly-secure, point-in-time examinations of knowledge.
• Commitment by ABMS to develop new, integrated standards for continuing certification programs by 2020. The standards will address the Commission recommendations for flexibility in knowledge assessment and advancing practice, feedback to diplomates and consistency.
• Establishment of a meeting of the ABMS/Council of Medical Specialty Societies joint Board Leadership to ensure full specialty society engagement in building the road map defined by the Commission report especially with regard to the role of continuing certification in advancing clinical practice.

The Commission’s report affirmed that it is the role of the Boards to make summative decisions about continuing the certification of a physician based on a portfolio of information. However, the Commission called for the Boards to create formative processes that offer opportunities for learning and improvement as well as remediation when necessary before summative decisions are made. And, while the report itself didn’t comment directly on the work the Boards have already undertaken to enhance their programs, many of the Commission’s recommendations affirmed those actions, most notably those referencing alternative formative assessment strategies and improving communications with key stakeholders and diplomates.

The Medical Association has been active on the MOC issue, through both its MOC Study Committee and advocacy at the national and state levels. Below is the official statement on the “Vision Initiative” from MOC Study Committee Chairman Dr. Greg Ayers:

“The Medical Association of the State of Alabama’s MOC Study Committee supports a voluntary process for board certification in medical specialties and a departure from the sometimes punitive approach toward certification taken by some American Board of Medical Specialties’ specialty boards. This process must maintain high standards for professionalism and encourage lifelong learning that is clinically relevant to patient care within physicians’ individual practices. The MOC Study Committee believes the ABMS various specialty boards should continue efforts to improve upon and ensure inexpensive, accessible options for increasing the breadth and scope of physicians’ skills and knowledge so they may best serve their patients; however, those efforts should never, of themselves, hinder, obstruct nor supersede the actual provision of care. The ABMS Boards should collaborate to pursue implementation of reciprocal, longitudinal pathways for multi-specialty diplomates. The continuing physician specialty certification process of the future should not include the current high-stakes examination and burdensome, duplicative components of Maintenance of Certification. Given physicians’ support for self-regulation, the MOC Study Committee calls upon the ABMS Boards to fulfill its duty to administer specialty board certification in a manner that assists physicians in continuing to improve the quality of care patients receive.”

Greg Ayers, M.D., Chairman, MOC Study Committee