Ensuring Physicians' Competence — Is Maintenance of Certification the Answer?

Abstract

Pressed by their leaders, external stakeholders, and a public troubled by lapses in the quality of care and unsustainable cost increases, physicians are facing stiffer challenges in initiatives designed to link more closely the goals of learning with the delivery of better care and measures of greater accountability. The initiatives are works in progress being implemented by national accrediting organizations, state medical licensing boards, the federal government, and others,^1-5 but the most contentious among them (and the focus of this article) is the maintenance of certification (MOC) program sponsored by the American Board of Medical Specialties (ABMS) and its 24 member boards, which promote continuous professional development.⁶ MOC requires most certified specialists to seek recertification on a periodic basis — typically every 10 years — by successfully completing a four-part assessment designed to test their medical knowledge, clinical competence, and skills in communicating with patients. The MOC program was initiated in 2000, but the pace of recertification has accelerated since 2009. Approximately 375,000 board-certified specialists and subspecialists (about half the number that the 24 boards certified initially) meet MOC requirements, according to the ABMS.