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MOC Update: ABMS Plans Implementation of Board Certification Recommendations

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

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MOC Study Committee’s Official Statement on “Vision Initiative” Draft Report

MOC Study Committee’s Official Statement on “Vision Initiative” Draft Report

In response to the Medical Association and other state and national medical and physician specialty societies’ grievances with ABMS, its member Boards, and specifically the MOC program, ABMS sought input from a broad range of stakeholders in an effort to envision and craft a board certification system that is responsive and meaningful to physicians. This effort has included professional medical organizations, national specialty and state medical societies, hospitals and health systems and others. The group released its vision for the future of board certification – dubbed the “Vision Initiative.”

The Medical Association has been active on the MOC issue, through both its MOC Study Committee and advocacy at the national and even 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

For more information, see also:

MOC UPDATE: Working to Solve Problems with Certification

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MOC Update: Two Certification Programs Transition from Pilot to Permanent

MOC Update: Two Certification Programs Transition from Pilot to Permanent

Last year, the Medical Association worked to bring together physicians, medical organizations, state medical societies, hospitals, health systems, patients and the American Board of Medical Specialties to investigate the future of board certification. The first in-person meeting in March produced testimony on continuing certification from stakeholders who provided their perspectives and experiences with continuing certification, the challenges they currently face, and their thoughts about opportunities about the future. Now, the pilot certification programs for two medical specialty organizations has become permanent.

In May, the American Board of Obstetrics and Gynecology and the American Board of Anesthesiology each received notification from the ABMS that their respective Maintenance of Certification pilot programs have been made permanent options for specific members of their groups who reach specific standards.

American Board of Obstetrics and Gynecology

The MOC pilot program is now a permanent option for ABOG Diplomates. If Diplomates meet the high-performance threshold determined by ABOG on the Part II: Lifelong Learning and Self-Assessment component in Years 1-6 of the MOC cycle, they can receive credit for meeting the MOC external assessment requirement. Diplomates must also continue to meet other MOC standards, including the annual MOC Professionalism and Professional Standing requirements. Upon entering Year 6, Diplomates will receive notification they qualify for the new pathway on their personal page in the ABOG physician portal if they have met all requirements. Diplomates that do not meet the eligibility requirements will continue to meet the external assessment standard by passing the MOC examination.

ABOG members can read the full statement here.

American Board of Anesthesiology, Inc.

The American Board of Anesthesiology’s MOCA Minute pilot is now a permanent component of the Maintenance of Certification in Anesthesiology™ (MOCA®) program. MOCA Minute launched in 2014 as a web-based tool that was expanded in 2016 to include most Diplomates. In 2017 those maintaining subspecialty certificates began participating as well. Diplomates answer 30 multiple-choice questions online each calendar quarter (120 per year) at their convenience. Their questions are customized based on which certificate(s) physicians are maintaining and their practice profile, which they fill out indicating the focus of the clinical practice. Upon answering questions, they learn immediately if their answers are correct and see the rationale, a critique and links to learning resources related to the questions.

ABA members can read the full statement here.

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MOC UPDATE: Working to Solve Problems with Certifications

MOC UPDATE: Working to Solve Problems with Certifications

UPDATE DEC. 12, 2018:  The Continuing Board Certification: Vision for the Future Commission has released its draft report for public comment. The report, which includes the Commission’s key findings and recommendations, will be posted on the Vision Initiative website for comment through Tuesday, Jan. 15, 2019 at 11:00 p.m. CST.

The Medical Association continues to work with the American Board of Medical Specialties concerning physician frustrations with the current Maintenance of Certification process, but this is your opportunity to voice your opinion as well. Take a moment, review the draft report, and offer your comments by Jan. 15.

The Medical Association remains committed to working with the American Board of Medical Specialties and its 24 Member Boards to improve the continuing certification process so that it becomes a system that demonstrates the profession’s commitment to professional self-regulation, offers a consistent and clear understanding of what continuing certification means, and establishes a meaningful, relevant and valuable program that meets the highest standard of quality patient care. The Boards will seriously consider the Commission’s findings and recommendations once finalized, as they continue implementation of improvements and pilots currently underway.


UPDATE JULY 20, 2018: The Continuing Board Certification: Vision for the Future or “Vision Initiative” is a collaborative effort that brings together multiple stakeholders to envision a system that is responsive to the needs of those who rely on it and that is relevant, meaningful and of value to physicians. The Vision Initiative includes physicians, professional medical organizations, national specialty and state medical societies, hospitals and health systems, the general public and patients, and the 24 Member Boards of the American Board of Medical Specialties.

The Vision Initiative held in-person meetings in March and May to solicit testimony from ABMS member boards, national specialty and state medical societies, key stakeholders, and the public regarding their perspectives on the continuous certification system as well as innovations and possible changes.

Here is a summary of the March and May meetings for your information.

Upcoming meetings, to be held August 29-30 and October 15-16 will discuss solutions in relation to MOC. (See timeline.) A draft report for public comment is anticipated in November 2018, with a final report from the Commission to ABMS due February 2019.

Interested medical societies can sign up for monthly updates to follow the Commission’s progress and be notified about opportunities for feedback and input at this link.

RELATED NEWS: MOC UPDATE: Two Certification Programs Transition from Pilot to Permanent


UPDATE APRIL 20, 2018:  The Continuing Board Certification: Vision for the Future Commission is continuing its quest  to bring together physicians, medical organization, state medical societies, hospitals, health systems, patients and the ABMS to investigate the future of board certification and recently hosted its first in-person meeting in March in Washington, D.C. Commission members heard testimony on continuing certification from stakeholders who provided their perspectives and experiences with continuing certification, the challenges they currently face, and their thoughts about opportunities about the future. The presentation components of the meeting were open to the public and video streamed for all to view live.

HOW  CAN YOU PARTICIPATE? The Commission launched a stakeholder survey in February, which will remain open until May 11. Complete the survey, share the link with your colleagues, and urge them to participate as well. TAKE THE SURVEY

The next Commission meeting will be held May 30 – June 1. The meeting will feature sections open to the public and will be live video streamed. Details regarding the agenda and live streaming will be featured in next month’s update and posted on visioninitiative.org. Please make sure to bookmark the site for access to Commission meeting information, progress updates, and opportunities for your feedback and input, and remember to share this update with your colleagues and encourage them to become involved in the process as well.


The Medical Association continues to work with the American Board of Medical Specialties concerning physician frustrations with the current Maintenance of Certification process. Late last year, Association Executive Director Mark Jackson and Council on Medical Service member Jeff Rickert, M.D., joined representatives from other state medical societies and individual specialty boards for a meeting with the ABMS in Chicago, which included discussions about innovations the medical boards are working on to address continuous learning for physicians, many of which include input from various outside stakeholders and focus on greater consistency amongst the medical boards.

Following the Association’s Annual Governmental Affairs Meeting in Washington in February where Richard Hawkins, President and Chief Executive Officer of ABMS, was a guest speaker, the organization issued a statement as an update on the progress of issues of concern to physicians about Maintenance of Certification.

As a result of these meetings, and other meetings initiated by State Medical Societies, the Continuing Board Certification: Vision for the Future was formed as a collaborative effort bringing together physicians, medical organization, state medical societies, hospitals, health systems, patients and the ABMS to investigate the future of board certification.

The Commission invites input from all stakeholders. To participate in the discussion, you may provide comments to inform the future of board certification, learn how you can engage in the process, and sign up for monthly email updates from the Commission. LEARN MORE

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Medical Association Works to Ease MOC Frustrations

Medical Association Works to Ease MOC Frustrations

Frustrations with the current Maintenance of Certification process brought together Medical Association Executive Director Mark Jackson and Council on Medical Service member Jeff Rickert, M.D., and representatives from other state medical societies and individual specialty boards for a series of meetings with the American Board of Medical Specialties.

The daylong meeting in Chicago was called at the request of state medical societies, including the Medical Association, who have expressed increasing frustration with the MOC process and have demanded changes be made. Leadership within ABMS and the specialty boards engaged in meaningful dialogue during the meeting with promises to address criticisms of the current MOC process.

Discussions included 170 innovations the medical boards are working on to address continuous learning for physicians, many of which include input from various outside stakeholders and focus on greater consistency amongst the medical boards. Innovations also include alternatives to the high-stakes exams with a focus on longitudinal learning for physicians in their relevant practice areas. Many medical boards outlined current (or moving to) learning modules that would be seamless for physicians and provide a gap analysis. Most medical boards seemed to be moving away from the high-stakes examination that has been the challenge of the physicians. There was also discussion by some of the medical boards on reducing the fees collected from physicians for the tests and the need to be more customer friendly.

The Medical Association’s Board of Censors created MOC study committee to fully examine the MOC issue and provide feedback to the Board. Dr. Rickert is a member of this committee and will provide input in the coming weeks as the committee discusses recommendations to the Board of Censors.

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Association Voices Concern with MOC in Letter to ABMS

Association Voices Concern with MOC in Letter to ABMS

Earlier this year, the Association’s House of Delegates passed a resolution formally opposing additional Maintenance of Certification requirements as dictated by the American Board of Medical Specialties and the American Osteopathic Association. While it was agreed that the need for continuing medical education to improve the quality of care, the expense and clinically irrelevant process of MOC often proved overly burdensome. Now, the Association has joined with other state associations to send a message to ABMS expressing concerns about MOC and have requested a meeting later this year to discuss the issues.

As discussions concerning MOC mounted during the June AMA meeting, a small group of national medical specialty society and state medical society CEOs furthered the discussion with a high-level summit that recently took place to discuss these problems, and a meeting this December with the American Board of Medical Specialties, the Council of Medical Specialty Societies, and state medical societies to directly share our views and seek agreement on how to reshape the MOC process to the betterment of our physicians and the patients in their care.

In the letter to ABMS, the groups were quick to explain that the intention is not to diminish patient care or physician training. However, the letter addressed that not only had many state legislatures addressed the issue of maintenance of certification either successfully passing new laws or laws that were pending but that this trend of legislative interference was another threat to a physician’s right to professional self-regulation. Along with the exorbitant costs of the MOC process and the lack of transparent communication from certifying boards have damaged the integrity of the MOC brand, all of which presents an opportunity to realign the process.

The Medical Association has begun to address this situation, and with the formation of this new joint initiative, will continue to be active in discussions to create a long-term solution for MOC. The joint meeting is currently scheduled for early December.

Read the letter to ABMS

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