Richard J. Baron, MD
After 2 years of reflecting on feedback from the medical community, the American Board of Internal Medicine (ABIM) has developed a new iteration of its Maintenance of Certification (MOC) testing that it hopes will satisfy the needs of physicians.
This week, the ABIM announced that in 2018 it will launch a series of once-every-2-years tests that, if taken and passed consistently, will enable physicians to avoid having to take the current 10-year MOC test. The first test will be available to physicians certified in internal medicine, with additional subspecialty tests to be developed in the near future.
Richard J. Baron, MD, ABIM’s president and CEO, said in a video message to physicians that the new testing options would provide “choice, relevance, and convenience” to the medical community. The 2-year interval test would be shorter than the 10-year test and could be taken from the physician’s home or office. Failure to pass would not mean automatic loss of certification, but failure to pass the 2-year test twice in a row would subject the physician to having to take the 10-year test and potentially undergo other qualification requirements, the ABIM said.
Two years ago, the ABIM initiated a series of changes to the 10-year testing program in order to make sure that physicians were keeping up in their fields. Prior to 1990, physicians could take an initial test and be certified for life. However, changes introduced by the ABIM in 2014 included an emphasis on ongoing learning and activities. These brought about an immediate and strong reaction from a physician community that contended the changes would be burdensome and not entirely relevant to their work.
The ABIM, in putting together the new schedule of assessments, relied on an extensive fact-finding mission that involved visits to a large number of medical societies around the country, focus groups, and a survey of almost 30,000 physicians.
“I commit that we’re going to continue in dialogue with all of you as we continuously evolve the program to work better and better meet your needs and your patients’ needs,” Baron said in his video message.
The ABIM invited all 200,000 of its board-certified physicians to provide input on the assessment program. The idea of a shorter, lower-stakes test every 2 years was highly popular, the ABIM found.
Building on the user-friendly motif of the new certification regimen, the ABIM has called its 2-year MOC assessments “knowledge check-ins.” Further, the ABIM has promised no consequences for failure to pass the inaugural test in 2018. The 10-year test will still be available as an alternative if physicians prefer.
“ABIM is continuing to collaborate with physicians to make this option more reflective of practice,” the organization said in a statement. In addition, the goal is to make the 10-year test an open book exam.
“Doctors want a certification program that integrates into their daily routine, while affirming to their patients and peers that they have up-to-date medical knowledge,” the ABIM said.
Physicians with certifications expiring in 2018 will need to take the 2-year assessment, or take and pass the 10-year exam. Failure to do so will result in loss of certification. All physicians with certifications that expire before the new assessment option is offered in their specialty will still need to take and pass the 10-year exam in order to maintain their certification. Once they pass the 10-year exam, they will have 10 years before they need to take another assessment.
The ABIM is still working out the details on MOC program fees and payment options, including for the 2-year assessments. This process is expected to be completed before the first 2-year assessment in 2018.
The certification authority said it is working as quickly as possible to make the new assessment option available for all subspecialties. The 2-year assessments will be a work in progress and will improve with each iteration, and work will also continue to be done to improve upon the traditional, long-form 10-year exam.
Late in 2015, the ABIM released the findings of a task force that studied the need for a more rigorous assessment program that would ensure that physicians’ skills are in step with current needs. The report called for more meaningful assessments and a focus on cognitive and technical skills, as well as an exploration of the need for certification in specialized areas, without the added requirement for underlying certifications. Even though it was put together by stakeholders in the medical community, the report was met with criticism that it did not reflect the workplace needs of physicians.