Maintenance Of Certification Program Research Articles

Tips and Tricks: Starting Your Own Continuing Medical Education Course

Tips and Tricks: Starting Your Own Continuing Medical Education Course

A Knowledge Translation Framework for Improving Concussion Education Among Medical Students and Physicians

Objective: The objective of this paper is to outline key principles required for a knowledge translation (KT) strategy on concussion education for medical trainees and physicians to promote knowledge retention and practice change. Design: Qualitative review of the literature on concussion education for medical trainees and physicians utilizing the Canadian Institute of Health Research (CIHR) Knowledge to Action (KTA) Cycle as a framework. Results: Medical education on concussion appears to be increasing, but many knowledge gaps persist. Although many concussion guidelines and standardized assessments have been developed, many physicians are either not aware of them, do not use them, or provide inaccurate or inconsistent discharge instructions. Focused, interactive concussion education sessions, education outreach by trained facilitators, and adoption of a spiral curriculum are preferred modalities. To facilitate concussion education, medical professionals must recognize the importance of concussion in their practice. Interventions should deliver high-yield information and be integrated into existing programs such as academic half days (AHD) and the Maintenance of Certification Program (MOC). Many KT tools and interventions have been developed, such as the Concussion Awareness Training Tool (CATT) for Medical Professionals, but evidence of their utilization and effectiveness is limited. Existing tools should be reviewed, updated, implemented, and evaluated for their effectiveness of improving both conceptual and instrumental knowledge. Conclusion: KT strategies for concussion medical education should utilize the CIHR KTA Cycle principles outlined in this review as a guide to design interventions that improve the concussion knowledge of medical trainees and physicians.

Relationship Between Participation in ASCO's Quality Oncology Practice Initiative Program and American Board of Internal Medicine's Maintenance of Certification Program.

Medical oncologists have a variety of options for demonstrating proficiency in providing high-quality patient care. Perhaps, the best-known opportunity for demonstrating individual expertise and lifelong learning is the American Board of Internal Medicine (ABIM) maintenance of certification (MOC) program. At the practice level, ASCO has offered the Quality Oncology Practice Initiative (QOPI) as a means of optimizing cancer care delivery. In this study, we assess the association between active involvement in MOC on an individual basis and whether that individual's practice is involved with the QOPI program. We evaluated 13,600 US medical oncologists initially certified by the ABIM and divided them into those initially certified before 1990 (the year in which ABIM started to require periodic recertification), those from 1990 to 2007, and those from 2008 to 2016. It was then determined which of these had let their certificates expire by 2020. These data were then compared with practices that participated in QOPI from 2017 to 2019, resulting in the matching of 97% of physicians. Of individuals initially certified before 1990 (and technically with lifelong certification), 22% were in QOPI practices. Among those who did not have lifelong certification, there was an association between QOPI participation and maintenance of ABIM certification. For those initially certified between 1990 and 2007, 35% of oncologists with up-to-date ABIM certification were in QOPI practices, whereas only 11% with expired ABIM certification were QOPI participants (P < .0001). For those in the 2008-2016 category, the numbers were 36% v 16%, respectively (P < .0001). Our analysis identifies a relationship between participation in these ABIM and ASCO proficiency programs. The reasons for this are likely complex and based on a variety of institutional, professional, monetary, and personal factors.

Responsibilities and Interests of Pediatricians Practicing Hospital Medicine in the United States.

In 2016, the American Board of Medical Specialties (ABMS) approved pediatric hospital medicine (PHM) as the newest pediatric subspecialty. To characterize development of the field, this article aims to: (1) describe the responsibilities and practice settings of US pediatricians self-identifying as hospitalists; and (2) determine how exclusive PHM practice, compared with PHM practice in combination with general or subspecialty care, was associated with professional development interests. Pediatricians enrolling in the 2017-2018 American Board of Pediatrics (ABP) Maintenance of Certification program were offered a voluntary survey about their responsibilities, interests, and practice settings. Logistic regression was employed to characterize associations between exclusive PHM practice and: (1) interest in quality improvement (QI) leadership; (2) intention to take the PHM certifying exam; (3) satisfaction with allocation of professional time; and (4) intention to maintain more than one ABP certification. The survey response rate was 70.0%; 1662 (13.1%) self-reported PHM practice. Four-hundred ninety-one (29.5%) practiced PHM exclusively, 518 (31.1%) practiced PHM and general pediatrics, and 653 (39.3%) practiced PHM and one or more subspecialties. Respondents reporting exclusive PHM practice were significantly more likely to report interest in QI leadership or consultation (adjusted odds ratio [OR], 1.39; 95% CI, 1.09-1.79), PHM exam certification (adjusted OR, 7.10; 95% CI, 5.45-9.25), and maintenance of more than one ABP certification (adjusted OR, 2.64; 95% CI, 1.89-3.68). Hospitalists reported diverse clinical and nonclinical responsibilities. Those practicing PHM exclusively expressed high levels of interest in board certification and QI leadership. Ongoing monitoring of PHM responsibilities and practice settings will be important to support the professional development of the PHM workforce.

Longitudinal assessment: A strategy to improve continuing professional certification.

Healthcare certification organizations carefully balance a commitment to bring value to their membership through programs that support lifelong learning and professional growth, while protecting the public by ensuring competent certified practitioners. These certifying bodies are challenged with remaining current with their maintenance of certification programs while keeping pace with the growing breadth of knowledge, industry standards and guidelines, innovative advances, and rapid technological gains in testing and assessment. Within the context of process innovation, the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) evaluated the current landscape of Longitudinal Assessment (LA) as a potential strategy for the assessment of core knowledge as part of their Continued Professional Certification Program for Certified Registered Nurse Anesthetists. This manuscript details the evaluation of LA using a Logic Model as the tool to scaffold inquiry, a review of LA literature, an environmental scan of current LA programs with identification of LA program elements available, and the results of a LA feasibility study. The findings substantiate that continued professional certification which incorporates a LA strategy can augment lifelong learning, but is not an assessment strategy that can be implemented without thoughtful planning, customization and continuous maintenance.

APA Reports Results of Member Survey on MOC

Back to table of contents Previous article Next article Education & TrainingFull AccessAPA Reports Results of Member Survey on MOCMark MoranMark MoranSearch for more papers by this authorPublished Online:18 May 2021https://doi.org/10.1176/appi.pn.2021.6.16AbstractRespondents who participated in an APA survey on maintenance of certification (MOC) reflected deep dissatisfaction with the process as well as an appreciation of the value of continuing medical education.An APA survey about members’ attitudes toward maintenance of certification (MOC) reflects members’ endorsement of continuing medical education (CME) and lifelong learning—as well as deep dissatisfaction with the time, expense, and perceived irrelevance of other components of MOC required by the American Board of Psychiatry and Neurology (ABPN).For instance, 63% of respondents agreed with the statement, “The Continuing Medical Education (CME) component of the MOC process is relevant to my practice.” Yet only 39% agreed that the “self-assessment component of MOC is relevant to my practice,” and just 16% said that the Part IV Improvement in Medical Practice component is relevant to practice.“Maintenance of certification is a contentious issue for physicians of all disciplines, and many of our members believe aspects of the ABPN program are onerous, expensive, and not relevant to their practice,” said immediate past APA President Jeffrey Geller, M.D., M.P.H. “Our survey of more than 1,400 members who are participating in the MOC process confirms this impression. It also shows that a sizeable number of psychiatrists believe in the importance of ongoing education.“APA has been and will continue to be actively engaged with the ABPN to reform the process of maintenance of certification to make it more meaningful and useful to members, to enhance those aspects of MOC that psychiatrists find valuable, and to alter or eliminate altogether those aspects that don’t work,” Geller said.APA randomly selected 4,999 ABPN-certified members and invited them to complete the survey; 2,153 members responded. The data in the survey report are confined to the 1,446 of the respondents who are currently participating in MOC.“This approach allowed us to be sure we were soliciting the perspective of those most impacted by MOC and at the same time hearing from a representative sample of members,” said Tristan Gorrindo, M.D., director of the APA Division of Education.Of the 1,446 respondents, 48% were women; 30.36% were within 10 years of graduation from medical school, and 60.72% were 10 to 30 years from graduation. Respondents were roughly evenly spread out among the district branches in APA’s seven Areas, with Area 5 having the highest percentage of respondents (26.96%).Beliefs about the value of MOC were mixed. While 41% agreed or strongly agreed with the statement that “MOC helps me keep up to date with current information,” 38% disagreed or strongly disagreed. But just 21% agreed with the statement that MOC “improves patients’ confidence in their physicians”; 56% disagreed or strongly disagreed.The impact of MOC on career and professional status was likewise mixed:46% said that participation in MOC is required for ongoing employment; 54% said it is not.39% said that participation in MOC affects career advancement; 61% disagreed.21% said participation in MOC affects salary or bonuses.36% said that participation in MOC is required by one or more insurance panels.The most widely shared beliefs were about the time and expense of the ABPN process. A total of 76% of respondents participating in MOC said it “takes up too much time,” while 68% strongly disagreed with the statement “The cost of the MOC program is appropriate.”However, the new journal-based alternative to the 10-year knowledge exam is highly popular: 89% of respondents said they favor it over the 10-year exam (Psychiatric News).“Among those participating in MOC, these data show us that it’s not a simple ‘MOC is all good or all bad’ story,” said Gorrindo. “Many psychiatrists are unhappy with MOC, but there are also many who find value in some parts of the MOC process. The impact of MOC on an individual’s employment, ability to participate in MOC, and financial compensation is also highly variable. This underscores APA’s need for a thoughtful and nuanced approach to MOC-related issues.”Ranga Ram, M.D., chair of APA’s Caucus on MOC, highlighted the finding about the link between MOC and ongoing employment. “Forty-six percent said MOC is required for employment, which I see as something APA needs to fight,” Ram said. “In every state, we need model legislation that [prohibits requiring MOC as a condition of employment].”(APA has official policy opposing use of MOC as a condition of licensure.)Earlier this year, the Board of Trustees approved a study on the feasibility of APA’s creating its own certification process, something Ram said the caucus strongly supports (Psychiatric News). ■ ISSUES NewArchived

Board Approves Action Items on Maintenance of Certification

Board Approves Action Items on Maintenance of Certification

15669 A survey-based study on maintenance of certification programs during grand rounds at the University of Texas Southwestern Medical Center

Maintenance of Certification (MOC) is a recertification program required by the American Board of Dermatology (ABD) for dermatologists. The program was created because continuing medical education (CME) was viewed as inadequate in keeping physicians’ knowledge up to date. Many dermatologists are opposed to the program. In July 2016, UTSW incorporated MOC content into their Grand Rounds. The purpose of this study was to identify whether the dermatologists at UTSW find MOC Grand Rounds to be useful and whether or not they believe this method of obtaining MOC credit could be utilized in other institutions.

Issues with the Maintenance of Certification program; Overcoming a ‘quadruple threat’

Issues with the Maintenance of Certification program; Overcoming a ‘quadruple threat’

A Survey Based Study on Maintenance of Certification Programs during Grand Rounds at UT Southwestern Medical Center

Background: Maintenance of Certification (MOC) is a recertification program required by the American Board of Dermatology (ABD). The program was created because continuing medical education (CME) was viewed as inadequate in keeping physicians’ knowledge up to date. In July 2016, UTSW incorporated MOC content into Grand Rounds.Objective: To identify whether dermatologists at UTSW find MOC Grand Rounds to be useful and whether this process could be utilized in other institutions.Methods: A five question survey was piloted by a few dermatologists at UTSW. The survey was emailed to dermatologists who attended the MOC Grand Rounds. Three questions were scored on a scale of 1-6 (1= strongly disagree, 2=moderately disagree, 3= neutral, 4= mildly agree, 5= moderately agree, 6=strongly agree) with 2 free response questions.Results: 13/20 dermatologists responded to the survey (65% response rate). 11/13 dermatologists (84.6%) reported that MOC at Grand Rounds is valuable to them. 11/13 dermatologists (84.6%) reported that other dermatology programs should incorporate this method of obtaining MOC credit. 9/13 dermatologists (69.2%) reported audience response sessions improve the Grand Rounds experience.Conclusion: Dermatologists found the MOC content to be useful when incorporated into Grand Rounds.

Maintenance of Certification and the Platinum Rule: An Existential Crisis

Maintenance of Certification (MOC) programs administered by American Board of Medical Specialties (ABMS) member boards are facing an existential crisis. A series of lawsuits have been filed against various member boards challenging the validity of MOC programs. Granted, these lawsuits appear to be coordinated by a relatively small group of anti-MOC activists, and although none of the plaintiffs have yet to prevail, the lawsuits have underscored the inescapable fact that MOC programs generally are disliked by the very group they were designed to benefit, the diplomates.

When worlds collide: Challenges to implementing communication research in community oncology practices

ObjectiveDuring a recent trial assessing the effectiveness of an online communication training for community practice oncologists, we encountered multiple barriers. MethodsWe asked oncologists to participate through the American Board of Internal Medicine (ABIM) Maintenance of Certification program. Oncologists collected 25 Clinician and Group Consumer Assessment of Healthcare Providers (CAHPS) surveys from patients and 4 audio-recorded clinic encounters. They then completed either the ABIM Action Plan (control) or the online Study of Communication in Oncologist Patient Encounters (SCOPE) program (intervention). Oncologists collected another 25 CAHPS surveys and 4 audio-recorded encounters as follow-up. ResultsWe enrolled 146 oncologists in the study. Only 27 completed the study; another 27 actively withdrew, and 94 did not complete the study. We identified four main challenges to participation: commitment discrepancies, burden of research, informed consent, and technology. We introduced efforts to overcome these barriers with success limited by time and resources. ConclusionWhen conducting research in community practices, investigators must provide significant support, limit burden, increase flexibility, and conduct thorough pilot testing. Practice implicationsTo improve patient care, research must translate well into the workflow of actual practices. Assessing our experience, we identified challenges and effective solutions to be used by investigators as they plan and implement future communication interventions.

Maintenance of certification for practicing physicians: a review of current challenges and considerations.

Maintenance of certification (MOC) has become increasingly important in medicine to ensure maintenance of competence throughout a physician’s career. This paper reviews current issues and challenges associated with MOC in medicine, including how to define medical competencies for practicing physicians, assessment, and how best to support physicians’ lifelong learning in a continuous and self-motivated way. We explore how the combination of self-monitoring, regular feedback, and peer support could improve self-assessment. Effective MOC programs are learner-driven, focused on every day practice, and incorporate educational principles. We discuss the importance of MOC to the physicians’ actual practice to improve acceptability. We review the benefits of tailored programs as well as decentralization of MOC programs to better characterize the physician’s practice. Lastly, we discuss the value of simulation-based medical education in MOC programs. Simulation-based education could be used to practice uncommon complications, life-threatening scenarios, non-technical skills improvement, and become proficient with new technology. As learners find simulation experiences educationally valuable, clinically relevant, and positive, simulation could be a way of increasing physicians’ participation in MOC programs.

Diagnostic Radiologists' Participation in the American Board of Radiology Maintenance of Certification Program.

OBJECTIVE. Physicians across specialties have expressed concerns about Maintenance of Certification (MOC) programs of American Board of Medical Specialties member boards, calling for research about MOC acceptance, adoption, and value. The purpose of this study was to characterize diagnostic radiologists' participation in the American Board of Radiology (ABR) MOC program, the framework for its new Online Longitudinal Assessment program. MATERIALS AND METHODS. Practicing U.S. radiologists were identified from the Centers for Medicare & Medicaid Services Physician and Other Supplier Public Use File. Corresponding ABR diplomate certification information was obtained through the ABR public search engine. Focused on diagnostic radiologists (defined as those whose only ABR certificate is in diagnostic radiology), MOC participation rates were calculated across various physician characteristics for those whose participation was mandated by the ABR (time-limited certificates) and for those whose participation was not mandated (lifetime certificates). RESULTS. Among 20,354 included diagnostic radiologists, 11,479 (56.4%) participated in MOC. Participation rates were 99.6% (10,058/10,099) among those whose MOC was ABR mandated and 13.9% (1421/10,225) among those whose participation was not mandated (p < 0.001). The rates of nonmandated participation were higher (all p < 0.001) for academic than for non-academic radiologists (28.0% vs 11.3%), subspecialists than for generalists (17.0% vs 11.5%), and those in larger practice groups (< 10 members, 5.0%; 10-49 members, 12.6%; ≥ 50 members, 20.7%). State-level rates of nonmandated participation varied from 0.0% (South Dakota, Montana) to 32.6% (Virginia) and positively correlated with state population density (r = 0.315). CONCLUSION. Although diagnostic radiologists with time-limited certificates nearly universally participate in MOC, those with lifetime certificates (particularly general radiologists and those in smaller and nonacademic practices) participate infrequently. Low rates of nonmandated participation may reflect diplomate dissatisfaction or negative perceptions about MOC.

A Call to Restore Your Calling: Self-care of the Emergency Physician in the Face of Life-Changing Stress-Part 1 of 6.

Few practicing emergency physicians will avoid life-changing stressors such as a medical error, personal illness, malpractice litigation, or death of a patient. Many will be unprepared for the toll they will take on their lives. Some may ultimately experience burnout, post-traumatic stress disorder, and suicidal ideation. Medical education, continuing education, and maintenance of certification programs do not teach physicians to recognize helplessness, moral distress, or maladaptive coping mechanisms in themselves. Academic physicians receive little instruction on how to teach trainees and medical students the art of thriving through life-changing stressors in their career paths. Most importantly, handling a life-changing stressor is that much more overwhelming today, as physicians struggle to meet the daily challenge of providing the best patient care in a business-modeled health care environment where profit-driven performance measures (eg, productivity tracking, patient reviews) can conflict with the quality of medical care they wish to provide.Using personal vignettes and with a focus on the emergency department setting, this 6-article series examines the impact life-changing stressors have on physicians, trainees, and medical students. The authors identify internal constraints that inhibit healthy coping and tools for individuals, training programs, and health care organizations to consider adopting, as they seek to increase physician satisfaction and retention. The reader will learn to recognize physician distress and acquire strategies for self-care and peer support. The series will highlight the concept that professional fulfillment requires ongoing attention and is a work in progress.

Physician Opinions about American Board of Family Medicine Self-Assessment Modules (2006-2016).

Maintenance of Certification (MOC) was implemented to help physicians remain current with evolving medical standards, but has been criticized for being irrelevant to practice. We assessed family physicians' (FPs') opinions about the content of American Board of Family Medicine (ABFM) self-assessment modules (SAMs). We used ABFM administrative data from feedback surveys completed after each of the 16 SAMs from 2006 to 2016. FPs rated agreement with 2 statements-1) "Content is appropriate for my practice," and 2) "Content was presented at an appropriate level"-on a scale of 1 (strongly disagree) to 6 (strongly agree). We calculated mean ratings of each statement by year and stratified by Knowledge Assessment (KA) and Clinical Simulation (CS) portions of the SAM. We plotted mean ratings by FPs' age at their first SAM completion and the total number of SAMs completed. SAMs were completed (n = 633,198) from 2006 to 2016 with 448,408 (71%) feedback surveys completed. The annual mean ratings of both statements varied little (less than 0.5) and were above 4.5 for all SAMs. CS ratings were consistently lower than KA ratings. FPs of all ages at first SAM provided similar ratings and agreement with content appropriateness increased with repeated exposure to SAMs. Over 11 years, the content of ABFM SAMs was regarded by FPs as appropriate for practice and presented at an appropriate level. Continued monitoring of feedback is necessary to keep the content of MOC programs relevant for physicians' practice.

Pediatricians' Participation in Quality Improvement at the Time of Enrollment in MOC.

Although national bodies have proclaimed the importance of incorporating quality improvement (QI) into the daily fabric of clinical care, the actual proportion of practicing pediatricians who participate in QI activities on an annual basis is unknown. Correspondingly little is known about pediatrician motivations for, attitudes about, and support received for QI participation. Pediatric diplomates enrolling in the American Board of Pediatrics' Maintenance of Certification program during calendar year 2016 were provided with the opportunity to complete a brief survey. A portion of the survey was focused on issues related to participation in QI programs. Survey responses were received from 8714 of the 11 890 diplomates who enrolled in Maintenance of Certification in 2016 (response rate: 73.3%). Overall, 86.6% of respondents reported participation in at least 1 QI project in the previous year. There was variation in previous-year participation in a QI project by practice affiliation categories, ranging from 79.9% for nonacademic generalists to 92.4% for academic specialists. The extrinsic requirement for QI to maintain board certification was the dominant motivator among all respondents (50.7%), followed by 2 intrinsic factors: identify gaps in practice and implement change (40.3%) and opportunity to collaborate with others (36.9%). Although the results are encouraging, despite almost 2 decades of national attention to the quality of health care and efforts to embed continual QI in health care delivery activities, ∼1 in 5 nonacademic pediatricians and 1 in 10 academic pediatricians did not report participating in any QI activities in the previous year.

Association between Performance in a Maintenance of Certification Program and Disciplinary Actions against the Medical Licenses of Anesthesiologists.

WHAT THIS ARTICLE TELLS US THAT IS NEW: BACKGROUND:: In 2000, the American Board of Anesthesiology (Raleigh, North Carolina) began issuing time-limited certificates requiring renewal every 10 yr through a maintenance of certification program. This study investigated the association between performance in this program and disciplinary actions against medical licenses. The incidence of postcertification prejudicial license actions was compared (1) between anesthesiologists certified between 1994 and 1999 (non-time-limited certificates not requiring maintenance of certification) and those certified between 2000 and 2005 (time-limited certificates requiring maintenance of certification); (2) within the non-time-limited cohort, between those who did and did not voluntarily participate in maintenance of certification; and (3) within the time-limited cohort, between those who did and did not complete maintenance of certification requirements within 10 yr. The cumulative incidence of license actions was 3.8% (587 of 15,486). The incidence did not significantly differ after time-limited certificates were introduced (hazard ratio = 1.15; 95% CI, 0.95 to 1.39; for non-time-limited cohort compared with time-limited cohort). In the non-time-limited cohort, 10% (n = 953) voluntarily participated in maintenance of certification. Maintenance of certification participation was associated with a lower incidence of license actions (hazard ratio = 0.60; 95% CI, 0.38 to 0.94). In the time-limited cohort, 90% (n = 5,329) completed maintenance of certification requirements within 10 yr of certificate issuance. Not completing maintenance of certification requirements (n = 588) was associated with a higher incidence of license actions (hazard ratio = 4.61; 95% CI, 3.27 to 6.51). These findings suggest that meeting maintenance of certification requirements is associated with a lower likelihood of being disciplined by a state licensing agency. The introduction of time-limited certificates in 2000 was not associated with a significant change in the rate of license actions.

Impact of an American board of pediatrics maintenance of certification (MOC) on weight-related counseling at well-child check-ups

ObjectiveThe Healthy Weight Counseling Maintenance of Certification (MOC) program integrates pediatrician training and clinic changes to promote use of evidence-based, diet and physical activity (PA) health messages and counseling strategies. This interrupted time series study assessed the impact of this MOC program on provision of weight-related counseling. MethodsWe randomly selected 10–15 well-child visit charts at three time points before and three time points after 102 Georgia pediatricians began the MOC in 2012–2015. Linear binomial regression compared the frequency of behavior-change goal setting and health messaging documentation (fruit/vegetable consumption, sugar-sweetened beverage consumption, out-of-home food consumption, PA, and screen time) before and after MOC participation. ResultsAt baseline, pediatricians documented behavior-change goals with 44% of patients, with an additional 49% of patients having documented goals after their pediatrician started the MOC (99.5% confidence interval [CI]: 21–77%). Similarly, absolute increases in the proportion of patients with documentation for sugar-sweetened beverage consumption (adjusted prevalence difference [aPD]: 37%; 99.5% CI: 13–62%) and out-of-home eating were observed (aPD: 38%; 99.5% CI: 12–64%). ConclusionThe Healthy Weight Counseling MOC is associated with increased and sustained use of evidence-based health messages and counseling strategies. Practice implicationsContinuing education and facilitation of system changes help improve physicians’ weight-related counseling.

Dreyfus and Dreyfus and Indicators of Behavioral Performance: A Study of Measurement Convergence.

Assessment of efficacy of continuous professional development is an important part of continuing professional development programing as one of its goals is to increase the performance of the clinicians that serve the community. A frequently used and researched classification system for skill mastery is the Dreyfus and Dreyfus Model of Skill Acquisition. An alternative approach is the core competency framework that informs the assessment of residents and forms the foundation of the American Board of Medical Specialties Program for Maintenance of Certification. There are a number of methods of assessment of each competence. One of the most broadly employed and researched methods is a multisource assessment (360°) methodology. Three hundred sixty-degree data were collected from 264 raters of physicians holding supervisory roles. Raters included the physicians' leaders, peers, and support/reports. The scale items were taken from an instrument developed for the assessment of interpersonal and communications skills, professionalism, and system-based practice. The Dreyfus scale was purposely built for this application. The Dreyfus scale was reduced to a single dimension, and raters assigned their score on that dimension as the indicator of their assessment of the physician's level of mastery. Results of a multivariate analysis of variance indicated a significant relationship between Dreyfus mastery score and competency items (P < .0001). These findings demonstrate a relationship between a measure of Dreyfus skill acquisition and measures based on the American Board of Medical Specialties/Accreditation Council for Graduate Medical Education six core competency framework. Results have implication for continuing professional development design and assessment.