The American Board of Medical Specialties’ Vision Commission to improve the Maintenance of Certification (MOC) process has released its final report and recommendations.
Prior to compiling the report, the members of the Vision Commission – including Pennsylvania Medical Society (PAMED) Past President Charles Cutler, MD, MACP – gathered background information from a wide variety of stakeholders within the medical profession.
The report – which was issued on Feb. 12, 2019 – recommends abandoning use of the term “Maintenance of Certification” in favor of an as-yet-to-be-determined term that communicates the concept, intent, and expectation of continuing certification programs. The Commission’s foundational recommendation is that “continuing certification must integrate professionalism, assessment, lifelong learning, and advancing practice to determine the certification status of a diplomate.”
Additionally, the report offers recommendations that the ABMS and ABMS Boards should consider implementing in the near-term (i.e. one to two years) or within an intermediate timeframe (i.e. less than five years). Of note is the recommendation that 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.
Vision Commission Recommendations
The near-term and intermediate recommendations are:
- Continuing certification must change to incorporate longitudinal and other innovative formative assessment strategies that support learning, identify knowledge and skills gaps, and help diplomates stay current. The ABMS Boards must offer an alternative to burdensome highly-secure, point-in-time examinations of knowledge.
- The ABMS Boards must regularly communicate with their diplomates about the standards for the specialty and encourage feedback about the program.
- The ABMS and the ABMS Boards must have consistent processes and requirements for continuing certification that are fair, equitable, transparent, effective, and efficient.
- The ABMS Boards must enable multi-specialty and subspecialty diplomates to remain certified across multiple ABMS Boards without duplication of effort.
- ABMS and the ABMS Boards must facilitate and encourage independent research to build on the existing evidence base about the value of continuing certification.
- The ABMS Boards must change a diplomate’s certification status when continuing certification standards are not met.
- The ABMS Boards must have clearly defined remediation pathways to enable diplomates to meet continuing certification standards in advance of and following any loss of certification.
- ABMS and ABMS Boards must make publicly available the certification history of all diplomates, including their participation in the continuing certification process. The ABMS Boards must facilitate voluntary re-engagement into the continuing certification process for lifetime certificate holders and others not currently participating in the continuing certification process.
- The ABMS Boards must comply with all ABMS certification and organizational standards, including financial stewardship and ensuring that diverse groups of practicing physicians and the public voice are represented.
- ABMS must demonstrate and communicate that continuing certification has value, meaning, and purpose in the health care environment:
- a. Hospitals, health systems, payers, and other health care organizations can independently decide what factors are used in credentialing and privileging decisions.
- b. ABMS must inform these organizations that continuing certification should not be the only criterion used in these decisions and these organizations should use a wide portfolio of criteria in these decisions.
- c. 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.
The Vision Commission’s report also includes these “aspirational” recommendations that will require a longer time frame for implementation:
- ABMS and the ABMS Boards must seek input from other stakeholder organizations to develop consistent approaches to evaluate professionalism and professional standing while ensuring due process for the diplomate when questions of professionalism arise.
- ABMS and the ABMS Boards should collaborate with specialty societies, the CME/CPD community, and other expert stakeholders to develop the infrastructure to support learning activities that produce data-driven advances in clinical practice. The ABMS Boards must ensure that their continuing certification programs recognize and document participation in a wide range of quality assessment activities in which diplomates already engage.
- The ABMS Boards must collaborate with professional and/or CME/CPD organizations to share data and information to guide and support diplomate engagement in continuing certification.
View the full report here to find more details on each of the Commission’s recommendations.
PAMED is committed to and will continue to advocate for practical, evidence-based, and affordable life-long learning.
You can check out our advocacy efforts on this issue here.