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Maintenance of Certification

Does one-time board certification provide doctors and patients with enough confidence for a lifetime of complicated care decisions? While at one time this was the norm, the pace of medical advances is changing medical knowledge more rapidly than ever before, increasing the importance of keeping up-to-date.

Though this is a newer area of research and study, evidence suggests that doctors who maintain board certification experience improved quality of care.

See how ABIM uses evidence to improve the Maintenance of Certification (MOC) program.

Impact of MOC

Gray BM, Vandergrift JL, McCoy RG, Lipner RS, Landon BE. Association between primary care physician diagnostic knowledge and death, hospitalisation and emergency department visits following an outpatient visit at risk for diagnostic error: a retrospective cohort study using medicare claims. BMJ Open. 2021 Apr 1; 11(4):e041817.

Kopp JP, Ibáñez B, Jones AT, Pei X, Young A, Arnhart K, Rizzo AG, Buyske J. Association Between American Board of Surgery Initial Certification and Risk of Receiving Severe Disciplinary Actions Against Medical Licenses. Jama Surgery. 2020; Available Online Ahead of Print.

Kinney CL, Raddatz MM, Sliwa JA, Driscoll SW, Robinson LR. Association of Participation in the American Board of Physical Medicine and Rehabilitation Maintenance of Certification Program and Physician Disciplinary Actions. Am J Phys Med Rehabil. 2020 Apr; 99 (4), 325-329.

Nelson LS, Duhigg LM, Arnold GK, Lipner RS, Harvey AL, Reisdorff EJ. The association between maintaining American Board of Emergency Medicine Certification and State Medical Board disciplinary actions. The Journal of Emergency Medicine. 2019; Available Online Ahead of Print.

Zhou Y, Sun H, Macario A, Keegan MT, Patterson AJ, Minhaj MM, Wang T, Harman AE, Warner DO. Association between participation and performance in MOCA Minute and actions against the medical licenses of anesthesiologists. Anesth Analg. 2019; Available Online Ahead of Print.

Jones AT, Kopp JP, Malangoni MA. Recertification exam performance in general surgery is associated with Subsequent Loss of License Actions. Ann Surg. 2019; Available Online Ahead of Print.

Price DW, Biernacki H, Nora LM. Can Maintenance of Certification work? associations of MOC and improvements in physicians' knowledge and practice. Acad Med. 2018; 93(12): 1872-1881.

McMahon GT. Inspiring curiosity and restoring humility: the evolution of competency-based continuing medical education. Acad Med. 2018; 93(12): 1757-1759.

Zhou Y, Sun H, Macario A, Keegan MT, Patterson AJ, Minhaj MM, Wang T, Harman AE, Warner DO. Association between performance in a Maintenance of Certification program and disciplinary actions against the medical licenses of anesthesiologists. Anesthesiology. 2018; 129(4): 812-820.

Jones AT, Kopp JP, Malangoni MA. Association between maintaining certification in general surgery and loss-of-license actions. JAMA. 2018; 320(11): 1195-1196.

Heitlinger LA. Do maintenance of certification activities promote positive changes in clinical practice? J Pediatr Gastroenterol Nutr. 2016; 64(5): 655.

Hayward K, Haaland WL, Hrachovec J, et al. Reliable pregnancy testing before intravenous cyclophosphamide: a quality improvement study. Pediatrics. 2016; 138(6).

Sun H, Zhou Y, Culley DJ, Lien CA, Harman AE, Warner DO. Association between participation in an intensive longitudinal assessment program and performance on a cognitive examination in the Maintenance of Certification in Anesthesiology Program®. Anesthesiology. 2016; 125(5): 1046-1055.

Riley M, Ahmed S, Lane JC, Reed BD, Locke A. J Pediatr Adolesc Gynecol. Using maintenance of certification as a tool to improve the delivery of confidential care for adolescent patients. 2016; 30(1): 76-81.

Wiggins RE Jr, Etz R. Assessment of the American Board of Ophthalmology's maintenance of certification part 4 (Improvement in medical practice). JAMA Ophthalmol. 2016; 134(9): 967-74.

Morrell J, Stratman EJ. Relationship between physicians’ active participation in maintenance of certification and patients' perspective of care surveys. J Patient Exp. 2016; 3(2):43-7.

Fiks AG, Luan X, Mayne SL. Improving HPV vaccination rates using maintenance of certification requirements. Pediatrics. 2016; 137(3).

Peterson LE, Eden A, Cochrane A, Hagen M. Physician satisfaction with and practice changes resulting from American Board of Family Medicine maintenance of certification performance in practice modules. J Contin Educ Health Prof. 2016; 36(1): 55-60.

Peterson LE, Blackburn B, Puffer JC, Phillips RL Jr. Family physicians' quality interventions and performance improvement for hypertension through maintenance of certification. J Healthc Qual. 2015; 38(3): 175-86.

Steadman RH, Burden AR, Huang YM, Gaba DM, Cooper JB. Practice improvements based on participation in simulation for the maintenance of certification in anesthesiology program. 2015; 122(5): 1154-69.

Phillips RL, Blackburn B, Peterson LE, Puffer JC. Maintenance of certification, medicare quality reporting, and quality of diabetes care. Am J Med Qual. 2015; 31(3): 217-23.

Peterson LE, Blackburn B, Phillips RL, Puffer JC. Improving quality of care for diabetes through a maintenance of certification activity: family physicians' use of the chronic care model. J Contin Educ Health Prof. 2014; 34(1): 47-55.

Gray BM, Vandergrift JL, Johnston MM, Reschovsky JD, Lynn LA, Holmboe ES, McCullough JS, Lipner RS. Association between imposition of a maintenance of certification requirement and ambulatory care-sensitive hospitalizations and health care costs. JAMA. 2014; 312(22): 2348-57.

Vernacchio L, Francis ME, Epstein DM, Santangelo J, Trudell EK, Reynolds ME, Risko W. Effectiveness of an asthma quality improvement program designed for maintenance of certification. Pediatrics. 2014; 134(1): e242-8.

Wittich CM, Reed DA, Ting HH, Berger RA, Nowicki KM, Blachman MJ, Mandrekar JN, Beckman TJ. Measuring reflection on participation in quality improvement activities for maintenance of certification. Acad Med. 2014; 89(10): 1392-7.

Elward K, Blackburn B, Peterson LE, Greenawald M, Hagen MD. Improving quality of care and guideline adherence for asthma through a group self-assessment module. J Am Board Fam Med. 2014; 27(3): 391-8.

Peterson LE, Blackburn BE, Puffer JC, Phillips RL Jr. Family physicians' quality interventions and performance improvement through the ABFM diabetes performance in practice module. Ann Fam Med. 2014; 12(1): 17-20.

Galliher JM, Manning BK, Petterson SM, Dickinson LM, Brandt EC, Staton EW, Phillips RL, Pace WD. Do professional development programs for maintenance of certification (MOC) affect quality of patient care? J Am Board Fam Med. 2014; 27(1): 19-25.

Huang JS, Chun S, Sandhu A, Terrones L. Quality improvement in childhood obesity management through the maintenance of certification process. J Pediatr. 2013; 163(5): 1313-6.e1.

Iglehart JK, Baron RB. Ensuring physicians' competence — is maintenance of certification the answer? N Engl J Med. 2012; 367(26): 2543-2549.

Hess BJ, Weng W, Holmboe ES, Lipner RS. The association between physicians’ cognitive skills and quality of diabetes care. Acad Med. 2012; 87(2): 157-63.

Reed DA, West CP, Holmboe ES, Halvorsen AJ, Lipner RS, Jacobs C, McDonald FS. Relationship of electronic medical knowledge resource use and practice characteristics with internal medicine maintenance of certification examination scores. J Gen Int Med. 2012; 27(8): 917-923.

Holmboe ES, Wang Y, Meehan TP, Tate JP, Ho SY, Starkey KS, Lipner RS. Association between maintenance of certification examination scores and quality of care for medicare beneficiaries. Arch Intern Med. 2008; 168(13): 1396-1403.

Practice Assessment and Quality of Care

Weng W, Hess BJ, Lynn LA, Lipner RS. Assessing the quality of osteoporosis care in practice. J Gen Intern Med. 2015; 30(11): 1681-7.

Chesluk BJ, Reddy S, Hess B, Bernabeo E, Lynn L, Holmboe ES. Assessing interprofessional teamwork: pilot test of a new assessment module for practicing physicians. J Contin Educ Health Prof. 2015; 35(1): 3-10.

Gray BM, Vandergrift JL, Gao G, McCullough JS, Lipner RS. Website ratings of physicians and their quality of care. JAMA Intern Medicine. 2015; 175(2): 291-293.

Kolasinski VA, Price DW. Maintenance of certification part IV quality-improvement project for hypertension control: a preliminary retrospective analysis. Perm J. 2015; 19(2): 36-40.

Bernabeo EC, Reddy SG, Ginsburg S, Holmboe ES. Professionalism and maintenance of certification: using vignettes describing interpersonal dilemmas to stimulate reflection and learning. J Contin Educ Health Prof. 2014; 34(2): 112-122.

Lipner RS, Weng W, Caverzagie KJ, Hess BJ. Physician performance assessment: prevention of cardiovascular disease. Adv Health Scie Educ. 2013; 18(5): 1029-45.

Hess BJ, Johnston MM, Iobst WF, Lipner RS. Practice-based learning can improve osteoporosis care. J Am Geriatr Soc. 2013; 61(10): 1651-60.

Reddy SG, Kogan JR, Iobst WF, Holmboe ES. The ABIM's clinical supervision practice improvement module and its effect on faculty's supervisory skills. Acad Med. 2012; 87(11): 1632-8.

Hess BJ, Weng W, Lynn LA, Holmboe ES, Lipner RS. Setting a fair performance standard for physicians' quality of patient care. J Gen Intern Med. 2011; 26(5): 467-473.

Holmboe ES, Weng W, Arnold GK, Kaplan SH, Normand SL, Greenfield S, Hood S, Lipner RS. The comprehensive care project: measuring physician performance in ambulatory practice. Health Serv Res. 2010; 45(6): 1912-33.

Weng W, Hess BJ, Lynn LA, Holmboe ES, Lipner RS. Measuring physicians' performance in clinical practice: reliability, classification accuracy, and validity. Eval Health Prof. 2010; 33(3): 302-20.

Hess BJ, Lynn LA, Holmboe ES, Lipner RS. Toward better care coordination through improved communication with referring physicians. Acad Med. 2009; 84(10 Suppl): S109-12.

Duffy FD, Lynn LA, Didura H, Hess BJ, Caverzagie K, Grosso L, Lipner RS, Holmboe ES. Self-assessment of practice performance: development of the ABIM practice improvement module (PIM). J Contin Educ Health Prof. 2008; 28(1): 38-46.

Holmboe ES, Lynn LA, Duffy FD. Improving the quality of care via maintenance of certification and the web: an early status report. Perspect Biol Med. 2008; 51(1): 71-83.

Lipner RS, Weng W, Arnold GK, Duffy FD, Lynn LA, Holmboe ES. A three-part model for measuring diabetes care in physician practice. Acad Med. 2007; 82(10 suppl): S48-52.

Simpkins J, Divine G, Wang M, Holmboe ES, Pladevall M, Williams LK. Improving asthma care through recertification: a cluster randomized trial. Arch Intern Med. 2007; 167(20): 2240-8.

Holmboe ES, Meehan TP, Lynn LA, Doyle P, Sherwin T, Duffy FD. Promoting physicians' self-assessment and quality improvement: the ABIM diabetes practice improvement module. J Contin Educ Health Prof. 2006; 26(2): 109-19.

The Public Trusts Physician Certification

American Board of Medical Specialties. Facts about the ABMS consumer survey: lifelong learning and other qualities in choosing a doctor (pdf). ABMS; 2011.

Freed GL, Dunham KM, Clark SJ, Davis MM, Research Advisory Committee of the American Board of Pediatrics. Perspectives and preferences among the general public regarding physician selection and board certification. J Pediatr. 2010; 156(5): 841-5.

Brennan TA, Horwitz RI, Duffy FD, Cassel CK, Goode LD, Lipner RS. The role of physician specialty board certification status in the quality movement. JAMA. 2004; 292(9): 1038-43.

Physicians Perception of MOC

Cordovani L, Wong A, Monteiro S. Maintenance of certification for practicing physicians: a review of current challenges and considerations. Can Med Educ J. 2020 Mar 16; 11(1):e70-e80.

Chesluk B, Gray B, Eden A, Hansen E, Lynn L, Peterson L. "That was pretty powerful": A qualitative study of what physicians learn when preparing for their Maintenance of Certification Exams. J Gen Intern Med. 2019; Available Online Ahead of Print.

Valentine CM, Cox DA, Deering TF, Starling RC. What Should I Do? Maintenance of Certification for All Cardiologists in 2019 and Beyond. J Am Coll Cardiol. 2019; 73(4): 517-520.

Weinberger SE. Can Maintenance of Certification Pass the Test? JAMA. 2019; 321(7): 641-642.

Stephenson CR, Wittich CM, Pacyna JE, Wynia MK, Hasan O, Tilburt JC. Primary care physicians' perceptions of practice improvement as a professional responsibility: a cross-sectional study. Med Educ Online. 2018; 23(1): 1474700.

Nangia S. Transforming the American Board of Internal Medicine (ABIM) and Maintenance of Certification (MOC). Am J Kidney Dis. 2018; 72(5): 714-716.

Ibrahim T. Maintenance of Certification, self-regulation, and the decline of physician autonomy. Am J Kidney Dis. 2018; 72(5): 711-713.

Valentine CM, Chazal RA, Oetgen WJ. ABIM Maintenance of Certification: options for ACC members. J Am Coll Cardiol. 2018; 72(1): 119-121.

Cook DA, Blachman MJ, West CP, Wittich CM. Physician attitudes about maintenance of certification: a cross-specialty national survey. Mayo Clin Proc. 2016; 91(10): 1336-1345.

Babu MA, Liau LM, Spinner RJ, Meyer FB. Maintenance of certification and the aging neurosurgeon. Neurosurgery. 2016; 63 Suppl 1:194-5.

Marco CA, Wahl RP, Counselman FL, Heller BN, Harvey AL, Joldersma KB, Kowalenko T, Coombs AB, Reisdorff EJ. The American Board of Emergency Medicine ConCert™ examination: emergency physicians' perceptions of learning and career benefits. Acad Emerg Med. 2016; 23(9):1082-5.

Peterson LE, Blackburn B, Phillips RL Jr, Mainous AG 3rd. Family medicine residency program directors' plans to incorporate maintenance of certification into residency training: a CERA survey. Fam Med. 2014; 46(4): 299-303.

Gallagher TH, Prouty CD, Brock DM, Liao JM, Weissman A, Holmboe ES. Internists' attitudes about assessing and maintaining clinical competence. J Gen Intern Med. 2014; 29(4): 608-614.

Kilo CM. Commentary: maintenance of certification: moving forward. Arch Intern Med. 2011 ;171(2): 176-177.

Levinson W, Holmboe ES. Commentary: maintenance of certification in internal medicine: facts and misconceptions. Arch Intern Med. 2011; 171(2): 174-176.

Lipner RS, Bylsma WH, Arnold GK, Fortna GS, Tooker J, Cassel CK. Who is maintaining certification in internal medicine--and why? A national survey 10 years after initial certification. Ann Intern Med. 2006; 144(1): 29-37.