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Association of changing practice settings on maintenance of certification exam outcomes.


Jones AT, Barnhart BJ, Lipner RS. — American Board of Internal Medicine

Durning SJ. — Uniformed Services University of the Health Sciences

Presented: American Educational Research Association Conference, April 2016

Purpose: To investigate how changing to or from solo practice settings relates to MOC exam performance.

Method: A retrospective analysis of exam pass/fail outcomes of physicians who successfully completed their initial Maintenance of Certification (MOC) cycle from 2000 to 2004 (n=7,112). Initial physician MOC practice characteristics records, demographic information, and exam performance were linked with exam pass/fail outcomes from their second MOC cycle from 2006 to 2014 (n=5,215 after attrition). Exam pass/fail outcomes for physician’s second MOC cycle were compared among four groups: those who remained in group practice across both MOC cycles, those who changed from group practice to solo practice, those who changed from solo to group practice, and those who remained in solo practice across both MOC cycles.

Results: Physicians who changed from solo to group practice performed significantly better than those who remained in solo practice (odds ratio = 1.67; 95% CI = 1.11-2.51, p = .027). Conversely, physicians changing from group to solo practice performed significantly worse than physicians who stayed in group practice (odds ratio = 0.60; 95% CI = 0.45-0.80, p = .002). Meanwhile, physicians who changed from solo to group practice performed similarly to physicians remaining in group practice (odds ratio = 0.95; 95% CI = 0.67-1.35, p = 0.76).

Conclusions: Changes in solo/group practice status were associated with second cycle MOC exam performance. This study provides evidence that the context in which a physician practices may have an impact on their MOC exam performance.

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