To the Editor The American Board of Medical Specialties (ABMS) appreciates the research and feedback presented in the study by Cook et al.1 At approximately the same time this study was undertaken, the ABMS was conducting a 2-year review as part of an ongoing quality improvement process and soliciting input about the ABMS Program for Maintenance of Certification (ABMS MOC) from medical professionals, health care organizations, and the public. This review resulted in the 2015 Standards for the ABMS Program for MOC2 approved in January 2014. As the authors acknowledged, the updated standards “address several of the barriers and shortcomings identified in this study.”