Maintenance of Certification (MOC) is a recently implemented and controversial process of physician certification maintenance through one of the 24 approved medical specialty boards of the American Board of Medical Specialties (ABMS) and the 18 approved medical specialty boards of the American Osteopathic Association (AOA). The MOC process is controversial within the medical community, with proponents claiming that it is a voluntary program that improves physician knowledge and demonstrates a commitment to lifelong learning. Critics claim that MOC is an expensive, burdensome, involuntary and clinically irrelevant process that has been created primarily as a money-making scheme for the ABMS and the AOA.
Proponents claim that the Maintenance of Certification program was designed to help physicians keep abreast of advances in their fields, develop better practice systems, and demonstrate a commitment to lifelong learning.
Whether or not the MOC program accomplishes any of these stated goals is a matter of intense debate.
Opponents claim that the Maintenance of Certification program is overly burdensome in both time and expense, reducing time available to spend with both family and patients. The exams have had little relevance to the individual physician's practice requiring tremendous effort to relearn material not useful to daily practice, only useful for passing the board exam. There is no proof that it improves patient care and little to no supporting data except for controversial articles written by board members. Serious questions have been raised regarding Member Board finances.
Starting with Oklahoma, effective 1 November 2016, a growing number States have passed or are considering passage of legislation prohibiting use of participation in Maintenance of Certification as a reason to exclude a physician from hospital staff appointment or from insurance company physician panels.,
Medical community
Some major medical organizations gain profit from and have expressed support for the Maintenance of Certification program including the following: The American Board of Medical Specialties (ABMS) The American Osteopathic Association (AOA) The American Medical Association (May soon be changing based upon a resolution voted on from the floor at their June 2016 meeting. The American Hospital Association (AHA) The National Board of Medical Examiners (NBME) The Federation of State Medical Boards (FSMB) The Council of Medical Specialty Societies (CMSS) The Accreditation Council for Graduate Medical Education (ACGME) The Association of American Medical Colleges (AAMC) The Educational Commission for Foreign Medical Graduates (ECFMG)
Some major medical organizations do not gain profit from and do not support the Maintenance of Certification program, including the following: Association of American Physicians and Surgeons (AAPS) The National Board of Physicians and Surgeons (NBPAS) Docs 4 Patient Care Foundation (D4PC) Physicians for Certification Change Independent Physicians for Patient Independence (IP4PI)
Competencies
The ABMS Program for MOC involves ongoing measurement of six core competencies defined by ABMS and ACGME: Practice-based Learning and Improvement Patient Care and Procedural Skills Systems-based Practice Medical Knowledge Interpersonal and Communication Skills Professionalism
Components
These competencies, which are the same ones used in the ACGME's Next Accreditation System, are measured in the ABMS Program for MOC within a four-part framework: Part I: Professionalism and Professional Standing Part II: Lifelong Learning and Self-Assessment Part III: Assessment of Knowledge, Judgment, and Skills Part IV: Improvement in Medical Practice
Other stakeholders
Some health plans are implementing programs that recognize and reward physicians who are actively participating in Maintenance of Certification activities. ABMS member boards are actively working with other health care organizations to advance quality initiatives and reduce measurement redundancy through recognition of physicians' Maintenance of Certification program participation. A growing number of hospitals and health systems are beginning to use Maintenance of Certification components to engage physicians in quality improvement. Many hospitals are now endorsing and accepting certification from the National Board of Physicians and Surgeons (NBPAS.org) instead of ABMS board certification.