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June 13, 2017

Alternative Pathways to Board Recertification: To What End?

Author Affiliations
  • 1Medical Education Outcomes, American Medical Association, Chicago, Illinois
  • 2Southwestern Medical School, University of Texas Southwestern Medical Center at Dallas
JAMA. 2017;317(22):2279-2280. doi:10.1001/jama.2017.6120

Physicians want to maintain current knowledge of evidence-based medicine, new therapies, and changing technology while providing high-quality care to patients. Although many physicians participate in continuous learning, debate continues regarding how best to improve clinical performance and patient outcomes.

The American Board of Medical Specialties (ABMS) established its maintenance of certification (MOC) program in 2000 to provide a comprehensive approach to physician professionalism, lifelong learning, self-assessment, and quality improvement. There are conflicting data that MOC activities are resulting in performance improvement. For example, among 1046 ophthalmologists who completed practice improvement modules (MOC part IV) in 2012-2014, there was reported improvement in 80% of process measures and 38.9% of outcome measures.1 Primary care pediatricians (N = 27) who participated in MOC part IV in 2012-2013 reported improved immunization rates at low cost with high user satisfaction.2 In contrast, 2 comprehensive studies involving 105 internal medicine physicians in 2012-2013 and 1930 internists in 1999-2000 and 2002-2005 did not demonstrate a difference in quality outcomes among those required to participate in MOC compared with those with time-unlimited certificates.3,4