The maintenance of certification (MOC) process was an important topic for physicians attending the 2015 AMA Annual Meeting last week. Academic physicians had a chance to hear updates on MOC before the AMA House of Delegates considered policy to urge changes to MOC to make it more transparent and physician-friendly.
While MOC has been a controversial topic for practicing physicians, it also is an impending reality for medical students and residents. The AMA Academic Physicians Section (APS)—previously the AMA Section on Medical Schools—hosted an education session to help its members understand the data and viewpoints on MOC as they mentor future physicians.
The discussion centered on physician professionalism and the importance of physicians being involved in setting the profession’s standards as a key element of medicine’s responsibility to patients and society.
“A profession is a very important and unique social construct that has elements around a social contract,” Lois Margaret Nora, MD, president and CEO of the American Board of Medical Specialties (ABMS), said during the session. “Medicine … demands special knowledge and skills that are not available to all. We profess that we will maintain the necessary skills and knowledge. … This privilege [to be recognized as a profession] is very dependent upon society’s confidence.”
Hearing physicians’ concerns
Many physicians argue that MOC may present an additional administrative burden on top of an already heavy load of regulatory requirements that can divert time away from patient care.
In an effort to address these concerns and collaborate with physicians, the ABMS in January released refined MOC standards that better reflect educational and practice environments. The new standards include elements common to MOC for all ABMS member boards, place greater emphasis on professionalism and patient safety and include a requirement that examinations assess physicians’ judgment as well as knowledge.
But these new standards will need to be continuously revisited, Dr. Nora said.
“We need more research, and we are involved in and encouraging outside research about MOC,” Dr. Nora said. She added a plea to medical educators: “Become involved. You can be some of our most passionate and knowledgeable constructive critics.”
Encouraging transparency
Through its House of Delegates, the AMA is playing a role as a constructive critic as well. Physicians passed policy based on an AMA Council on Medical Education report that asks the ABMS to develop “fiduciary standards” for its member boards. The new policy also asks the ABMS to urge full transparency related to the costs of preparing, administering, scoring and reporting MOC exams and seeks to ensure that MOC “doesn’t lead to unintentional economic hardships.”
Read more about the AMA’s new policies on MOC at AMA Wire®.
