In response to physician pushback, ABIM announces new option for Maintenance of Certification

Doctor computer
Internal medicine physicians will soon be able to maintain their board certification via shorter, more frequent online tests. (Getty/andrei_r)

Physicians certified by the American Board of Internal Medicine (ABIM) will soon have a new option that takes some of the pain out of maintaining their certification.

In a letter sent to its diplomates, the ABIM board of directors announced that it plans to add a longitudinal assessment option for Maintenance of Certification (MOC) that will allow physicians to take shorter, more frequent tests online.

“We have heard from many colleagues that they would like to see the process of maintaining certification offer more flexibility and choice. They also expressed a desire for options that enhance the educational value of the process,” wrote Marianne Green, M.D., chair of the board of directors, and Richard Baron, M.D., president and CEO.

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As a result, the ABIM board in August committed to providing a longitudinal assessment option that will allow physicians to take tests online to maintain their board certification.

“We recognize that some physicians may prefer a more continuous process that easily integrates into their lives and allows them to engage seamlessly at their preferred pace while being able to access the resources they use in practice,” Green and Baron said.

The American Board of Medical Specialties (ABMS), made up of 24 medical specialty boards including ABIM, has faced a backlash in recent years from physicians over tougher requirements and costs of MOC. That prompted changes in the process by those certifying boards, including the ability to take the exam online as well as allowing doctors to use clinical references to answer questions as they do in practice.

The ABIM said it is developing the new option, and, in the meantime, its current MOC program with the choice of its two-year “knowledge check-in” and traditional long-form exam physicians take every 10 years will remain in effect. The board, which certifies internal medicine doctors to practice in the specialty, said more details about the new option will be revealed in the months ahead as it looks for physicians to play an active role in providing feedback.

RELATED: Survey—Vast majority of doctors say MOC is a burden

The ABMS said other boards have developed a longitudinal assessment option including the American Board of Colon and Rectal Surgery, the American Board of Dermatology, the American Board of Medical Genetics and Genomics, the American Board of Nuclear Medicine, the American Board of Otolaryngology-Head and Neck Surgery, the American Board of Pathology and the American Board of Physical Medicine and Rehabilitation.

The longitudinal assessment option will offer “a self-paced pathway for physicians to acquire and demonstrate ongoing knowledge,” said Green and Baron. However, the traditional long-form assessment will remain an option as some physicians prefer a point-in-time exam taken less frequently.

With the new option, physicians will be able to answer a question and receive immediate feedback as to whether it was correct, along with rationale and links to educational material. “By engaging in such a pathway, physicians can assure their medical knowledge is up to date and utilize—in real time—learning activities to address gaps,” they said.

RELATED: Doctors unified in their fight over Maintenance of Certification

The ABIM said it developed the new option based on feedback from internal medicine physicians including focus groups and interviews as well as information from other ABMS boards.

The ABMS said its member boards are exploring and piloting longitudinal assessment as part of their continuing certification programs. Longitudinal assessment draws on the principles of adult learning combined with modern technology to promote learning, retention and transfer of information, the group said.

With a longitudinal approach, physicians take shorter assessments of specific content, such as medical knowledge, repeatedly over a period of time, according to the ABMS. Through a recurring examination process, concepts and information are reinforced so that knowledge is retained and accumulated gradually. Knowledge gained in this fashion can be more readily retrieved and applied to various situations, the ABMS said.

The MOC process has been controversial among doctors. One survey last year found 65% of physicians said MOC adds no clinical value to the practice of medicine. Almost 55% of respondents said they want to see those controversial MOC requirements revoked, while 48.5% said they would prefer more continuing medical education hours to replace the current MOC recertification process.

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