Straight Talk: ABIM Maintenance of Certification: What's the Current Status? | Richard A. Chazal, MD, President, American College of Cardiology

CardioSource WorldNews | The American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) process continues to be a topic of high interest to members of the American College of Cardiology (ACC.)

Since 2014, the ACC has focused on a three-pronged approach to MOC. We have positioned ourselves as a source of information about MOC. We have provided tools and resources to help those members who choose to participate more easily fulfill MOC requirements. In addition, we have advocated on behalf of our members to ease the burden of MOC. The ACC’s Board of Trustees (BOT) has also explored alternative options to ABIM certification. After careful investigation, the current decision regarding this option is to continue to engage with ABIM rather than commit resources to creating an alternative.

Over the past 2.5 years, the ABIM has been receptive to input from the ACC and other similar organizations. This has been manifested by several significant changes: 1) elimination of the “double jeopardy” provision, which required cardiology diplomates to recertify in both general cardiology and in their subspecialty; 2) decoupling of the initial board certification from MOC participation; 3) streamlining the ability for practitioners to get both continuing medical education and MOC credit for the same activity; 4) suspending the requirements for patient safety, patient voice, and practice improvement activities; and 5) announcing plans to provide diplomates with an alternative option to the 10-year exam starting in 2018.

In September 2015, the ABIM released the report of their Assessment 2020 Task Force which made 3 recommendations to the ABIM: 1) exploring alternatives to the current every-10-year MOC assessment; 2) focusing assessments on cognitive skills and technical skills; and 3) recognizing specialization.

The first recommendation of the Assessment 2020 Task Force is being addressed now; however, details still need to be worked out. The third recommendation was essentially completed by the elimination of the “double jeopardy” problem noted above.

The ACC’s current recommendations to the ABIM are:

  • Model the upcoming new, more frequent focused assessments of cognitive skills after the “SAP” model, using the 2016 ACC Lifelong Learning Clinical Competencies as the basis of these assessments. An open-book format is preferable for those diplomates choosing to take the 10-year exam.
  • Enable diplomates to seamlessly receive credit for activities that they participate in on behalf of hospitals, health care systems, payers, and licensure boards.
  • Allow the ACC, other professional societies, and other qualified entities to put forth standards-based processes that would be recognized by the ABIM.
  • Permanently eliminate practice improvement (part-IV) activities as a requirement for MOC. Practice improvement activities are important and will soon be required of all providers by federal law. Appropriate practice improvement activities should be acceptable for fulfillment of MOC participation, but a specific minimum level of practice improvement activities should not be returned to the list of MOC requirements.
  • Undertake research to test the effect of MOC activities on the actual improvement in patient care and outcomes to provide an evidence base for the value of MOC.

The ACC leadership will continue to constructively engage with the ABIM to move the MOC process closer to supporting the goals of improved patient outcomes, improved quality of care, and improving the cost-effectiveness of care.

Read the full June issue of CardioSource WorldNews at

Keywords: CardioSource WorldNews, Certification, Internal Medicine

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