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August 2015

The American Board of Surgery Maintenance of Certification Program: Building on Past Successes

Author Affiliations
  • 1American Board of Surgery, Philadelphia, Pennsylvania
JAMA Surg. 2015;150(8):697-698. doi:10.1001/jamasurg.2015.0885

Board certification began nearly a century ago by defining standards to recognize physicians who had developed specialized skills based on their training or experience. Since then, medicine has had the privilege of self-regulation regarding requirements for specialty practice, and certification by a member board of the American Board of Medical Specialties (ABMS) has become the de facto standard for physicians practicing allopathic medicine in the United States.

The American Board of Surgery (ABS) was established in 1937 by the leading surgical societies at the time for the purpose of certifying surgeons who had acceptable professional credentials, satisfied training requirements, and passed extensive examinations. As noted then, this was done “to protect the public and improve the specialty.”1 As new surgical specialties evolved under the purview of the ABS, such as pediatric surgery, vascular surgery, surgical critical care, and complex general surgical oncology, each specialty established their own requirements for certification, reinforcing the concept of self-regulation of our profession.

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    2 Comments for this article
    Karl Stecher (M.D.) | retired neurosurgeon
    I don't agree that the newer procedures were the main factor in pushing for recertification in the 1970s. As I recall, it was done to fend off government meddling in the practice of medicine/surgery: We will do it so you (the govt) won't force your uninformed rules upon us. After about 17 Boards had agreed to do this, it came to neurosurgery. Someone pointed out that we had already passed a most rigorous test when we took the Boards originally, and that neurosurgeons already needed many hours of meeting attendance to keep up membership. After about another dozen years, recertification was forced upon neurosurgeons, too.Most doctors voice that the recertification takes many hours away from patient care, is expensive, and does not really address how a physician interacts with and takes care of patients. The expense part of it is now a battleground, especially with the low reimbursement for services given to doctors today from insurance companies, and, worse still, Medicare and Medicaid.Further, surgeons generally operate in hospitals or multimember surgicenters where they are continually subject to ongoing peer review.
    Reforming MOC
    Lawrence A. Danto, MD FACS | UC Davis
    While all you say about the ABS and it’s history is true, I would challenge the statement that our patients know or really even care about the board status of their surgeon. While of seeming benefit, I am unaware that MOC has even been studied and shown to be of value. The MOC process can be reformed without sacrificing quality of care.