Maintenance Of Certification Participation Research Articles

Optimizing Antibiotic Treatment of Skin Infections in Pediatric Emergency and Urgent Care Centers.

The objective was to optimize antibiotic choice and duration for uncomplicated skin/soft tissue infections (SSTIs) discharged from pediatric emergency departments (EDs) and urgent cares (UCs). Pediatric patients aged 0 to 18 years discharged from 3 pediatric EDs and 8 UCs with a diagnosis of uncomplicated SSTIs were included. Optimal treatment was defined as 5 days of cephalexin for nonpurulent SSTIs and 7 days of clindamycin or trimethoprim/sulfamethoxazole for purulent SSTIs. Exclusion criteria included erysipelas, folliculitis, felon, impetigo, lymphangitis, paronychia, perianal abscess, phlegmon, preseptal or orbital cellulitis, and cephalosporin allergy. Baseline data were collected from January 2018 to June 2019. Quality improvement (QI) interventions began July 2019 with a revised SSTI guideline, discharge order set, and maintenance of certification (MOC) QI project. MOC participants received 3 education sessions, monthly group feedback, and individual scorecards. Balancing measures included return visits within 10 days requiring escalation of care. Data were monitored through March 2021. In total, 9306 SSTIs were included. The MOC QI project included 50 ED and UC physicians (27% of eligible physicians). For purulent SSTI, optimal antibiotic choice, plus duration, increased from a baseline median of 28% to 64%. For nonpurulent SSTI, optimal antibiotic choice, plus duration, increased from a median of 2% to 43%. MOC participants had greater improvement than non-MOC providers (P < .010). Return visits did not significantly change pre- to postintervention, remaining <2%. We improved optimal choice and reduced duration of antibiotic treatment of outpatient SSTIs. MOC participation was associated with greater improvement and was sustained after the intervention period.

The Estimated Cost of Maintenance of Certification

Maintenance of Certification (MOC) is a controversial topic in medicine for many different reasons. Studies have suggested that there may be associations between fewer negative outcomes and participation in MOC. However, MOC still remains controversial because of its cost. We sought to determine the estimated cost of MOC to the average orthopaedic surgeon, including fees and time cost, defined as the market value of the physician's time. We calculated the total cost of MOC to be the sum of the fees required for applications, examinations, and other miscellaneous fees as well as the time cost to the physician and staff. Costs were calculated for the oral, written, and American Board of Orthopaedic Surgery Web-based Longitudinal Assessment (ABOS WLA) MOC pathways based on the responses of 33 orthopaedic surgeons to a survey sent to a state orthopaedic society. We calculated the average orthopaedic surgeon's total cost in time and fees over the decade-long period to be $71,440.61 ($7,144.06 per year) for the oral examination MOC pathway and $80,391.55 ($8,039.16 per year) for the written examination pathway. We calculated the cost of the American Board of Orthopaedic Surgery web-based examination pathway to be $69,721.04 ($6,972.10 per year). The actual cost of MOC is much higher than just the fees paid to organizations providing services. The majority of the cost comes in the form of time cost to the physician. The ABOS WLA was implemented to alleviate the anxiety of a high-stakes examination and to encourage efficient longitudinal learning. We found that the ABOS WLA pathway does save time and money when compared with the written examination pathway when review courses and study periods are taken. We believe that future policy changes should focus on decreasing physician time spent completing MOC requirements, and decreasing the cost of these requirements, while preserving the model of continued evidence-based medical education.

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

The American Board of Medical Specialties: Certification and the Need for Antitrust Enforcement

Certification functions as medicine’s gatekeeper. Certifying organizations ensure that their physicians meet the appropriate professional standards. Traditionally, numerous organizations have provided certification services, which often involve costly testing and exams. Competition among these organizations drove innovation and lowered healthcare costs. The domination of the American Board of Medical Specialists (ABMS) over certification is dramatically raising certification costs and indirectly accreditation costs throughout medicine, decreasing access to physicians, increasing already exploding medical budgets, and reducing healthcare innovation. Leveraging its dominant market position in certification, ABMS and its member boards are now extracting even more revenue from physicians by requiring not simply periodic recertification exams to maintain board membership but continuous participation in maintenance of certification (MOC) programs. ABMS’ growing power is spreading beyond certification. Its influence has appeared to lead to hospitals only granting privileges to, and even insurance companies only reimbursing, ABMS-certified physicians. State boards of medicine, under ABMS’ sway, are adopting policies only favoring ABMS-certified physicians. Cementing the ABMS-monopoly will only drive up healthcare costs, as physicians pass on the cost of their certification testing to patients and the government. The number of physicians will also decline, exacerbating access problems particularly in rural America.

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.

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.

A Survey of Perceived Effectiveness of Part 4 Maintenance of Certification.

Evaluative assessment is needed to inform improvement of Part 4 Maintenance of Certification (MOC), a large-scale program that aims to improve physician knowledge, engagement, and skills in quality improvement (QI). We sought to determine if Part 4 MOC participation improves perceived educational and clinical outcomes by piloting a new physician survey. We administered a new online survey (MOC Practice, Engagement, Attitude, and Knowledge Survey) to physicians at the beginning and end of a Part 4 MOC project sponsored by a pediatric hospital's American Board of Medical Specialties' portfolio program during 2015. Participants worked in academic and community settings and in various accredited specialties. The main outcome was change in survey response on a 5-point Likert scale (1 = best) for 3 learning domains (QI engagement and attitude; QI method application, and improved patient care). Of 123 complete responses and a 97% response rate, mean baseline responses were positive or neutral (2.2, 2.3, 1.9, respectively). Responses improved in QI engagement and attitude (-0.15, z score = -2.78, P = .005), QI method application (-0.39, z score = -7.364, P < .005), and improved patient care (-0.11, z score = -1.728, P = .084). A Part 4 MOC physician survey provides valuable data to evaluate and improve the learning activity. In this children's hospital program, physicians view Part 4 favorably. Participation was associated with modest improvements in perceptions of QI engagement and attitude, application of QI methods, and patient care. Systematic evaluation of all Part 4 MOC projects and programs has the potential to improve the program nationally.

Assembly Backs Blocking MOC as a Condition of Licensure

Assembly Backs Blocking MOC as a Condition of Licensure

Quality metrics currently used in academic radiology departments: results of the QUALMET survey.

We present the results of the 2015 quality metrics (QUALMET) survey, which was designed to assess the commonalities and variability of selected quality and productivity metrics currently employed by a large sample of academic radiology departments representing all regions in the USA. The survey of key radiology metrics was distributed in March-April of 2015 via personal e-mail to 112 academic radiology departments. There was a 34.8% institutional response rate. We found that most academic departments of radiology commonly utilize metrics of hand hygiene, report turn around time (RTAT), relative value unit (RVU) productivity, patient satisfaction and participation in peer review. RTAT targets were found to vary widely. The implementation of radiology peer review and the variety of ways in which peer review results are used within academic radiology departments, the use of clinical decision support tools and requirements for radiologist participation in Maintenance of Certification also varied. Policies for hand hygiene and critical results communication were very similar across all institutions reporting, and most departments utilized some form of missed case/difficult case conference as part of their quality and safety programme, as well as some form of periodic radiologist performance reviews. Results of the QUALMET survey suggest many similarities in tracking and utilization of the selected quality and productivity metrics included in our survey. Use of quality indicators is not a fully standardized process among academic radiology departments. Advances in knowledge: This article examines the current quality and productivity metrics in academic radiology.

Relationship Between Physicians' Active Participation in Maintenance of Certification and Patients' Perspective of Care Surveys.

Objective:Medical specialty boards have a Maintenance of Certification (MOC) paradigm whose intention is to ensure high-quality patient care. How the patient experience is affected by physician MOC enrollment/participation is unknown. Our goal was to determine if patient experience is associated with physician board certification and MOC status.Methods:We analyzed physician experience and MOC databases to determine the relationships among physicians’ patient experience national percentile rankings and board certification status and MOC enrollment and activity status.Results:Board-certified physicians enrolled in MOC did not have statistically significant different patient experience scores compared to board-certified physicians not enrolled in MOC. Mid-career physicians enrolled in MOC had patients more likely to recommend them and reported higher confidence in them. Patients did not perceive physicians participating in MOC patient safety modules as more cautious in providing patient care.Conclusion:Although most analyses did not demonstrate significant differences in patient experience scores for physicians actively participating in MOC compared to those not, some differences were noted. Higher provider-specific patient experience scores were noted, particularly for mid-career physicians.

More Comprehensive Care Among Family Physicians is Associated with Lower Costs and Fewer Hospitalizations.

Comprehensiveness is lauded as 1 of the 5 core virtues of primary care, but its relationship with outcomes is unclear. We measured associations between variations in comprehensiveness of practice among family physicians and healthcare utilization and costs for their Medicare beneficiaries. We merged data from 2011 Medicare Part A and B claims files for a complex random sample of family physicians engaged in direct patient care, including 100% of their claimed care of Medicare beneficiaries, with data reported by the same physicians during their participation in Maintenance of Certification for Family Physicians (MC-FP) between the years 2007 and 2011. We created a measure of comprehensiveness from mandatory self-reported survey items as part of MC-FP examination registration. We compared this measure to another derived from Medicare's Berenson-Eggers Type of Service (BETOS) codes. We then examined the association between the 2 measures of comprehensiveness and hospitalizations, Part B payments, and combined Part A and B payments. Our full family physician sample consists of 3,652 physicians providing the plurality of care to 555,165 Medicare beneficiaries. Of these, 1,133 recertified between 2007 and 2011 and cared for 185,044 beneficiaries. There was a modest correlation (0.30) between the BETOS and self-reported comprehensiveness measures. After adjusting for beneficiary and physician characteristics, increasing comprehensiveness was associated with lower total Medicare Part A and B costs and Part B costs alone, but not with hospitalizations; the association with spending was stronger for the BETOS measure than for the self-reported measure; higher BETOS scores significantly reduced the likelihood of a hospitalization. Increasing family physician comprehensiveness of care, especially as measured by claims measures, is associated with decreasing Medicare costs and hospitalizations. Payment and practice policies that enhance primary care comprehensiveness may help "bend the cost curve."

Point: Twin Dogmas of Maintenance of Certification

The introduction of time-limited certificates by the American Board of Medical Specialties (ABMS) was partly in response to the low participation in recertification when it was voluntary [1]. Physicians’ belief in the value of maintenance of certification (MOC) is low. Only 1% of grandfathered internists voluntarily recertified [2]. In an online survey in the New England Journal of Medicine, readers were asked whether a fictitious physician who was grandfathered should recertify. Nearly two-thirds responded in the negative [3]. The reasons for the low confidence are several, including concerns about the methodology of studies showing the value of MOC [4], mission creep [5], the large and increasing number of physicians who fail recertification, the monopolistic nature of the specialty boards [6], tying MOC to maintenance of licensure (MOL), which some call the “regulatory capture of medicine” [7,8], and the onerous nature of participation in MOC [9]. Furthermore, the secure setting of testing for recertification, which encourages short-term retention, bears little resemblance to the reality of clinical practice, in which information is more freely referenced [10]. Finally, opponents say that MOC lacks consistency of internal logic. Midlevel providers, who share some of the same work and autonomy as physicians, do not have to face an

Certification status of family physicians in the initial cohort entering maintenance of certification.

There existed considerable concern that participation in Maintenance of Certification by board-certified physicians would be less than optimal when it was introduced by the American Board of Medical Specialties in 2000. However, family physicians who entered the first 10-year Maintenance of Certification for Family Physicians cycle in 2003 participated at levels consistent with historical norms.

The American Board of Pathology's Maintenance of Certification Program Update

The American Board of Pathology (ABP) began issuing time-limited certificates in 2006. New diplomates of the ABP are required to participate in the ABP's Maintenance of Certification (MOC) program to maintain certification. Voluntary participation in the MOC program is also available to diplomates with non-time-limited certificates. To update the pathology community on the requirements of the ABP's MOC program and some current MOC policies and to demonstrate the value of MOC participation for both time-limited and non-time-limited certificate holders. This review uses ABP-archived minutes of the MOC Committee, the ABP MOC Booklet of Information, the ABP Pathway system reports, and the collective experiences of the ABP trustees and staff. The ABP's MOC program has active participation by almost 5000 diplomates of the ABP. The ABP, in conjunction with the American Board of Medical Specialties, continually strives to enhance the relevance and value of MOC to our diplomates and to the public.

Maintenance of certification: How does it affect cytopathologists?

Maintenance of certification: How does it affect cytopathologists?

Specialty Board Certification in the United States: Issues and Evidence

The American Board of Medical Specialties (ABMS) certification and maintenance of certification (MOC) programs strive to provide the public with guidance about a physician's competence. This study summarizes the literature on the effectiveness of these programs. A literature search was conducted for studies published between 1986 and April 2013 and limited to ABMS certification. A modified version of Kirkpatrick's 4 levels of program evaluation included the reaction of stakeholders to certification, the extent to which physicians are encouraged to improve, the relationship between performance in the programs and nonclinical external measures of physician competence, and the relationship of performance in the programs with clinical quality measures. Patients' and hospitals' value of board certification and physician participation in MOC are high. Physicians are conflicted as to whether the effort involved is worth its value. Self-reported evidence shows improvement in knowledge, practice infrastructure, communication with patients and peers, and clinical care. Certification performance is generally related to nonclinical external measures such as types of training, practice characteristics, demographics, and disciplinary actions. In general, physicians who are board certified provide better patient care, albeit the results have modest effect sizes and are not unequivocal. Certification boards should continuously try to improve their programs in response to feedback from stakeholders, changes in the way physicians practice, as well as the growth in the fields of measurement and technology. Keeping pace with these changes in a responsible and evidence-based way is important.

Internists' Views of Maintenance of Certification: A Stages-of-Change Perspective

Board certification has evolved from a "point-in-time" event to a process of periodic learning and reevaluation of medical competence through maintenance of certification (MOC). To better understand MOC participation, the transtheoretical model (TTM) was used to describe physicians' perceptions of MOC as a sequence of attitudinal changes. Data were from a survey of internal medicine (IM) physicians' attitudes toward periodic reevaluation through MOC. An overall importance or decisional balance score was computed for each physician by summing his or her ratings across the 10 quality measures. The decisional balance score was used to classify physicians according to their acceptance of MOC, aligned with the 3 early TTM stages-of-change groups-precontemplation (PC), contemplation (C), and preparation (P)-where PC was least accepting and P was most accepting. Effect sizes assessed whether differences in attitudes toward reevaluation via MOC were of sufficient magnitude to support the TTM principles. The difference in degree of acceptance of MOC between the P group and the PC and C groups was significant (p < 0.001), but the effect size was lower than predicted by the "strong" principle. Resistance to MOC for the PC and C groups was significantly greater than the P group (p < 0.001) and supported the "weak" principle. Physicians' beliefs about how often they should demonstrate performance on quality measures aligned well with the American Board of Internal Medicine's MOC requirements, with the P group believing in more frequent assessments than the PC and C groups (p < 0.001). Results show that physicians in the Preparation stage had overcome resistance to MOC as predicted by the "weak" principle of the TTM, but their attitude scores about the benefits of MOC were below what was expected by theory. This suggests that the structure of MOC may have made it easier for physicians to overcome barriers to MOC participation but may have lacked adequate resources to promote the benefits of participating in the process. More effort is needed to understand the specific benefits of MOC for reevaluating competencies, how to engage physicians and other stakeholders in the design of MOC, and how to communicate the rationale and evidence to those who are less accepting of MOC.

ABPN Leaders Explain Goals, Background of MOC Program

Back to table of contents Previous article Next article Education & TrainingFull AccessABPN Leaders Explain Goals, Background of MOC ProgramPatricia A. Vondrak, B.A., and Larry R. Faulkner, M.D.Patricia A. VondrakSearch for more papers by this author, B.A., and Larry R. FaulknerSearch for more papers by this author, M.D.Published Online:20 Apr 2012https://doi.org/10.1176/pn.47.8.psychnews_47_8_6-aAbstractThe American Board of Psychiatry and Neurology (ABPN) Maintenance of Certification (MOC) Program reflects the ABPN’s commitment to lifelong learning. The mission of the MOC Program is to advance the clinical practice of psychiatry and neurology by promoting the highest evidence-based guidelines and standards to ensure excellence in all areas of care and practice improvement.In keeping with the evolving nature of the MOC requirements for all physicians, the ABPN’s must remain consistent with the American Board of Medical Specialties’ (ABMS) guidelines. In sensing the growing threats from outside the medical field, the ABMS determined that ABMS specialists within every discipline should be required to meet the highest standards of quality patient health care. In response, the ABMS designed the MOC process. The goal of MOC is for diplomates to reflect on their personal knowledge and performance and commit to a process of improvement and reevaluation of performance measures over a specified time, ultimately leading to improved care for their patients.Each specialty board within the ABMS adheres to four components in their programs. The four components are designed to assess important physician characteristics: Professional Standing (Part 1), Self-Assessment and CME (Part 2), Cognitive Expertise (Part 3), and Performance in Practice (Part 4). These components are outlined in detail on the ABPN Web site at www.abpn.com, along with a list of ABPN-approved MOC products for self-assessment, CME, and performance in practice.Continuous Pathway to Lifelong LearningBeginning in 2012, diplomates who pass their initial certification or MOC examination will enter into the Continuous Pathway to Lifelong Learning (CP-MOC). Diplomates who passed their initial certification or MOC examination prior to 2012 will not be required to participate in this program, but they may elect to do so.This year, the ABPN is required to begin reporting diplomates as “Meeting” or “Not Meeting” MOC requirements. Lifetime certificate holders will be listed as “Certified but Not Meeting MOC requirements.” There will be a special note that meeting MOC requirements is not mandatory for lifetime certificate holders. However, lifetime certificate holders may elect to enter the CP-MOC Program by passing an MOC cognitive examination in their specialty.The CP-MOC Program will assist diplomates to comply with MOC requirements and time frames to facilitate the required annual recording and reporting of MOC participation. Instead of paying a higher fee at the time of the MOC examination, diplomates will pay a much smaller annual fee. This annual fee covers participation in ABPN Physician Folios and includes one MOC cognitive examination in a 10-year period.The focal point of the Continuous Pathway to Lifelong Learning Program is the ABPN Physician Folios, which offer a single source for personalized information regarding certification and MOC status. There is a large catalog of ABPN-approved MOC products in self-assessment, CME, and performance in practice listed on the ABPN Web site. We strongly recommend diplomates use ABPN-approved products to ensure they meet ABPN MOC Program requirements. For protection against incorrectly advertised MOC products, a diplomate will be required to utilize only ABPN-approved products beginning in 2014. This policy change was in response to diplomates’ frustration at misleading advertised products.While passing the cognitive examination is still required at least every 10 years, a diplomate’s certification status is dependent upon fulfillment of all four MOC Program components, along with annually logging into the ABPN’s Physician Folios and payment of an annual MOC registration fee.Future PlansThe ABPN continues to monitor the landscape and gather feedback from our diplomates on the MOC Program. The ABPN strives to give MOC credit to diplomates who are already participating in practice-improvement activities that meet the ABPN MOC Program requirements.Here are some examples of ABPN’s responses to diplomates’ feedback on MOC:Our acceptance of institutional quality assurance programs and patient surveys that meet our requirements.Our plan to ultimately provide Part IV credit for team projects completed at institutions that join a formal Institutional Recognition Program.Our plan to give credit for one stage of MOC activities (as outlined on the ABPN Web site) for diplomates who complete ACGME-accredited/ABPN-approved subspecialty training and sit for and pass an ABPN subspecialty examination. MOC information, ABPN Physician Folios, and ABPN-approved MOC products are posted at www.abpn.com/moc.Patricia Vondrak, B.A., is director of Examination Administration and MOC at ABPN; Larry Faulkner, M.D., is ABPN’s president and CEO. ISSUES NewArchived

Maintenance of Certification: Confession of a Grandfather

Maintenance of Certification: Confession of a Grandfather