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MOC change rooted in self-assessment


New certification option grew out of review begun three years ago.

The recently-announced new option for maintaining certification in internal medicine is the result of an evaluation of the certification process the American Board of Internal Medicine launched in 2013, and is a harbinger of future changes.


Related: MOC is crazy and unfair


On May 5, the American Board of Internal Medicine (ABIM) said that beginning in 2018 internists in some sub-specialties will be able to fulfill their certification requirements with shorter exams that use some form of self-proctoring. Physicians can also remain with the current 10-year recertification cycle if they choose.

Addressing a session of the American College of Physicians 2016 Internal Medicine Meeting in Washington, D.C., Richard Baron, MD, chief executive officer of ABIM, said the new maintenance of certification (MOC) option was among the recommendations of the ABIM’s “Assessment 2020” study that launched in 2013, and results of which were announced in the summer of 2015.

 Referring to the shorter test cycle Baron said, “People told us that’s what we really want you [ABIM] to be doing.” He added that about 20% of those now certified by the ABIM have said they prefer to stay with the current system.


Further reading: The MOC revolt-NBPAS fights for relevancy


 Baron said the new option will be available to some as-yet-undetermined subspecialties beginning in January 2018, and rolled out to the rest over their program cycles. Doctors whose certifications expire before the new system is introduced will still need to recertify using the current long-form exam. Baron spoke as part of a panel titled, “Engaging the Internal Medicine Community in Redesigning MOC.”

Next: 'We have to improve the alignment of MOC'


Panelist Yul Ejnes, MD, MACP, a member of the ABIM’s internal medicine specialty board and a past chair of the ACP’s Board of Regents, said the college has held its own focus groups on ways to improve the MOC process and shared the results with the ABIM. Staff and leadership of the two organizations have also been meeting regularly to discuss how to make MOC more relevant and less burdensome to physicians.


Related: Maintenance of certification pushed me out of medicine


 “We have to improve the alignment of MOC to other things that physician do,” Ejnes said. “If I’m practicing general internal medicine there are certain things I see [in my practice], and certain things I don’t see but probably should know about, and things I don’t see and probably don’t need to know about. People don’t want to do things that are time wasters. They want to learn things that are meaningful to them and their practice.”

Patricia Conolly, MD, FACP, chair-elect of the ABIM and associate executive director of the Permanente Medical Group, recounted some of the other changes that resulted from Assessment 2020, including the decision to suspend the practice assessment, patient voice and patient safety requirements through 2017. “We heard you. Those products weren’t good enough to be worthy of your time,” she said.





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