A recurrent theme we’re hearing from physicians is their commitment to keeping their knowledge current amid a rapidly changing profession. There are numerous ways to stay up-to-date and many doctors have written to me and ABIM about what learning approach works best for them. Some have found aspects of Maintenance of Certification (MOC) helpful for keeping up in their fields, while some prefer other methods.
I’m sharing a few e-mails here from physicians who have offered opinions and suggestions on how our MOC program could be more meaningful. Their e-mails were used with permission and the views expressed are their own.
We want MOC to be a practical and manageable option for today’s physicians. In an effort to better link MOC with activities that physicians are already doing to stay current, later this year we will begin to accept a wider variety of ACCME-approved CME activities for MOC credit.
As you will see, we are hearing a broad diversity of thoughtful opinions from our colleagues, and it is just what we need as we are re-designing parts of our program. We welcome more feedback on what works and what doesn’t work for you in your pursuit of lifelong learning. Share your thoughts and ideas with me at firstname.lastname@example.org.
As someone who just recertified in IM and ID (third time now as I am in my third decade of practice), I feel well qualified to comment on your process. I think the MOC modules, and especially if thoughtfully written to include new information that every specialist should know, can be good learning tools. I do not think you would get a lot of push back on those especially as they can count toward CME as well, so not adding on multiple extra requirements. I think the idea of a closed book test is ridiculous in a world where we have access to computers in our pockets now, and can look up anything we need in an instant. (And I did well on them so this is not sour grapes!) Finally, I do not believe it is the ABIM’s role to be reviewing patient satisfaction and practice quality projects. Certainly every organization has their own processes for these, and is now bound to do so through CMS regulations. ABIM should eliminate these requirements, and stick with knowledge-based MOCs.
You asked for comments – I hope you meant it!
Barbara M. Gripshover, MD, Internist and Infectious Diseases specialist from Ohio
I am a pulmonologist and sleep medicine physician. Overall I agree with the concept of continuing medical education but I absolutely reject the concept that we have to keep taking “tests” every ten years to show that we are “qualified”. I don’t believe this proves that you are a more competent physician and only serves to waste our time and money. Also, in my case, I have to take the internal medicine, pulmonary medicine and sleep medicine exams, and my colleagues that are also critical care boarded have to take that one as well. Adding on the MOC to all the test taking is really the straw that has broken the camel’s back!
If the ABIM wants to stay relevant, I suggest the following:
No more tests.
Continue MOC but in a more user friendly format. For instance, the ABIM could develop modules (not just quizzes) about certain topics in each specialty that have clinical relevance. So it would be great, as a pulmonologist, to receive in the mail from the ABIM a module on updates in pulmonary hypertension. This would include a review article and several other articles that may impact the current treatment or management of the disease. I can then read this information at my own pace and then send in an open book quiz on the information. The ABIM could require that in each specialty a certain number of these modules be done a year to maintain certification. Quite honestly, I would not mind paying money for this kind of service as long as it is reasonably priced and I would also feel the ABIM is providing an excellent service to me – i.e. making it much easier for me to keep current on all of the most important information.
I hope you take the above into consideration,
Peter L. Fort, MD, Pulmonologist and Sleep Medicine specialist from Wyoming
Editor’s note: In most subspecialties, physicians are not required to maintain internal medicine certification in order to maintain subspecialty certification. ABIM encourages physicians to maintain only those certifications relevant to their practice.