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Family physicians get new MOC option


Pilot program offers 25 quarterly questions in lieu of 10-year test.

Family physicians who dislike the high-stakes maintenance of certification test they have to take every 10 years are being offered a new option that will be piloted in 2019. 

The alternative test will deliver 25 online questions each quarter to those who prefer this new option, according to the American Board of Family Medicine (ABFM). Not only will diplomates be able to take the test at a time and place of their choosing, they will also be able to use clinical references to answer the questions, just like they would in practice.

“This approach is more aligned with the ongoing changes in medicine and draws upon adult learning principles, combined with modern technology, to promote learning, retention and transfer of information,” Jerry Kruse, MD, chair of the ABFM board of directors, said in a release. “Over time, we will be able to assess the core clinical knowledge of board-certified family physicians and recognize the vast majority who work to keep up to date to take care of their patients."

According to the ABFM, a combination of physician experience with the testing platform, feedback from diplomates, an independent survey, and information gleaned from the experience of other specialty boards contributed to the design of the new online, longitudinal assessment. The original 10-year test is still available for those who prefer that method.

The American Association of Family Physicians (AAFP) is pleased with the changes. “We at AAFP have been encouraging the ABFM to implement some alternatives to the traditional high-stakes exam,” says Clif Knight, MD, FAAFP, senior vice president of education for AAFP. “We see this as a positive step forward.”

Knight says allowing the use of clinical references during the test is more relevant than the traditional method of memorizing everything, because it better reflects how a physician would work in practice. The ability to take the test online is also a major benefit.

“For many family physicians, taking time away from their practice to travel to a test center is a big commitment,” Knight says. “By being able to complete 25 questions every quarter from home, the office or wherever is convenient, certainly is an improvement.”

While the pilot program is a good option, Knight says the testing process should be improved in all areas. The pilot program covers the knowledge assessment portion of the overall certification process, but the self-assessment and practice-improvement areas need to be examined. “There are options in both of those areas that can be better,” says Knight. “We encourage the ABFM leadership to look at alternatives to the current options. The traditional methods have not always felt relevant and often felt onerous from a time and cost standpoint.”

Pressure from state legislators and groups offering alternative certification options contributed to the changes, but ABFM also heard from physicians, insurers and other stakeholders, says Knight. “I think they were feeling pressure from lots of different directions and responding appropriately,” Knight adds. “We recognize nothing will be perfect, but we commend ABFM for adding this alternative to the traditional way it’s been done and look forward to continued improvement.”

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Jennifer N. Lee, MD, FAAFP
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
© National Institute for Occupational Safety and Health
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© National Institute for Occupational Safety and Health