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May 2004

Maintenance of Certification and the Outside World

Arch Ophthalmol. 2004;122(5):767-769. doi:10.1001/archopht.122.5.767

The Maintenance of Certification (MOC) program, to be introduced bythe American Board of Ophthalmology (ABO) in 2004, represents a new levelof thinking about physician skills and methods of assessing them. It is fair,therefore, to ask how this came about and what it will accomplish.

When the concept of a specialty board was first developed with the formationof the ABO nearly 90 years ago, the emphasis was on a demonstration of qualificationsto practice as a specialist. This emphasis reflected the need at a time whenso many claiming to be specialists had little or no training. During the ensuingyears, the efforts of the Accreditation Council for Graduate Medical Education(ACGME) to effectively supervise training of residents and the American Boardof Medical Specialties (ABMS) boards to promote voluntary initial specialtycertification largely rectified the situation. In the meantime, however, thepractice environment did not remain stationary. Massive changes have sweptacross medicine because of an ever-accelerating expansion in medical knowledge.It is now apparent that a onetime certification of knowledge and skills isno longer an adequate measure of continuing proficiency.

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