We got it wrong and we're sorry. ABIM has heard and agrees with the concerns of many physicians and medical specialty societies that the design and initial execution of the new Maintenance of Certification (MOC) program was flawed. We are making immediate changes. Here are some questions and answers to help you navigate today's announcement:
What changes have you announced today (2/3/15)?
Effective immediately, ABIM is suspending the Practice Assessment, Patient Voice and Patient Safety requirements for at least two years. This means that no internist will have his or her certification status changed for not having completed activities in these areas for at least the next two years.
- Diplomates who are currently not certified but who have satisfied all requirements for MOC except for the Practice Assessment requirement will be issued a new certificate this year. Requirements for earning a new certification include completing 100 points, including 20 in Self-Evaluation of Medical Knowledge and passing an exam.
- Within the next six months, ABIM will change the language used to publicly report a diplomate's MOC status on its website from “meeting MOC requirements” to “participating in MOC.”
- In addition – ABIM is updating the Internal Medicine MOC exam. The update will focus on making the exam more reflective of what physicians in practice are doing, with any changes to be incorporated beginning fall 2015, with more subspecialties to follow.
- By the end of 2015, ABIM will recognize most forms of ACCME-approved Continuing Medical Education, allowing new and more flexible ways for internists to demonstrate self-assessment of their medical knowledge.
- Finally, MOC enrollment fees will remain at or below the 2014 levels through at least 2017.
ABIM leadership has made changes so that practicing physicians WILL have a say to make sure we get it right. Going forward, ABIM will work with the community to re-design the MOC process, ensuring that it remains relevant and valued by physicians and their patients and reflects a set of common values shared by internists.
Because internists do such complex work that varies so much across disciplines, ABIM will engage our specialty boards to work with the physician community and specialty societies to develop, articulate and build an MOC program that embodies professionally shared and continuously evolving values about what it means to be an internist.
How will these changes improve the program, make it better?
ABIM has heard physicians' concerns and we're making immediate changes. The changes will reduce the burden on diplomates while ABIM works in close partnership with physicians and medical specialty societies to develop a more relevant and meaningful MOC program. Involving the community more closely in co-creating ABIM's assessments can only make them better.
If my certificate is expiring this year, do I have to do a Practice Assessment activity?
No. The Practice Assessment requirement has been temporarily suspended. As long as you have earned 100 points (with at least 20 Medical Knowledge points), you will have met the points requirement.
What if I've already completed a Practice Assessment activity? What happens to my MOC points?
Even though the Practice Assessment requirement has been temporarily suspended, the MOC points you earned will still count toward your MOC points requirements. And Practice Assessment activities from ABIM and other organizations will still be available to you and you can use them to earn MOC points.
My certificate expired prior to this year because I didn't complete a Practice Assessment activity; am I now certified? If so, when will my status on the website change?
If you are enrolled in MOC and you are current in all of the other requirements – including completing 100 points (with at least 20 Medical Knowledge points) and passing the exam for the certification in the past 10 years – ABIM will issue you a new certificate this year. ABIM will update your status on the website soon.
Do I still have to do a Patient Voice or Patient Safety activity?
The Patient Voice and Patient Safety requirements of the MOC program have been suspended for at least the next two years. No requirements will be added back to the program without input from the physician community and with at least one year's notice.
What is going to be new about the IM MOC exam?
ABIM is updating the Internal Medicine MOC exam. The update will focus on making the exam more reflective of what physicians in practice are doing, with any changes to be incorporated beginning fall 2015; more subspecialties will follow in the future.
ABIM will also seek diplomate feedback on the updated examination blueprint. ABIM is reviewing the blueprint (or table of specifications) for the Internal Medicine MOC exam, through a structured review process, to ensure that it assesses relevant content for general internists in practice. We will be inviting any and all ABIM Board Certified internal medicine practitioners to rate the relative frequency and importance of individual blueprint topics in practice.
Why can't I just do any CME to maintain certification?
ABIM is working toward recognizing most forms of CME as fulfilling ABIM's MOC expectations for knowledge self-assessment and we expect much more of what you are doing to be recognized for MOC later this year. We are absolutely interested in finding ways to recognize meaningful clinical work that you do in your practices to earn CME points, and we're particularly interested in recognizing CME activities for which there is evidence that they drive learning and/or change practice. Many forms of “passive” CME do not meet this standard.
What is the new language you will be reporting on the website?
For all ABIM Board Certified physicians, ABIM will now report whether or not you are “participating in MOC” (i.e., continuously engaging in MOC activities). Participation in MOC means that a physician is demonstrating that s/he participates in keeping up, using clearly defined continuing learning and education activities. This change will apply to all ABIM Board Certified physicians, including physicians who hold a certification that is valid indefinitely.
Does the enrollment fee freeze include both the annual and 10-year fees?
Yes, both the annual and 10-year fees will remain at or below the 2014 level through at least 2017.
What do you mean you will be listening to the community?
ABIM wants to listen to the perspectives of practicing physicians to make sure we get it right going forward, and we can't prejudge what is going to come out of those conversations. ABIM is creating a number of ways for physicians to share their thoughts on how to make the MOC program more meaningful. If there is one thing we have learned during the past couple of years, it is that internists are a very diverse community with varied opinions about what ABIM should be doing. As part of the listening, we have created “Transforming ABIM” (a Google+ Community) and a blog. In the future, ABIM will be conducting surveys and discussions with medical specialty societies and internists. ABIM leadership hopes that many physicians and others in the medical community will share their ideas and strategies on how to make the MOC program better. We expect that there will be a lot of discussion with areas of agreement and disagreement. We look forward to the discussion.
Doesn't this just illustrate that ABIM is out of touch with the practicing physician?
With new leadership in place, it is not business as usual at ABIM. Under the new leadership of Richard Baron, MD, ABIM is bringing new and different perspectives to the table. Dr. Baron worked 30 years in private, community practice and is the first non-academic physician to lead ABIM. The ABIM Board of Directors wants all physicians who work in patient care and clinical leadership to join in the dialogue and shape the credential in the future. In addition, our new specialty board members, especially the community-based physicians that now serve on each of our specialty boards, will also serve as a resource for gathering feedback from the medical societies.