“ABIM clearly got it wrong. We launched programs that weren't ready and we didn't deliver an MOC program that physicians found meaningful. We want to change that.” So begins an email from Richard J. Baron, MD, president and CEO of the American Board of Internal Medicine (ABIM), to the internal medicine community outlining changes to its controversial Maintenance of Certification (MOC) program. In conversations with ACC leadership, Dr. Baron has expressed gratitude for the ACC’s support as well as its frank and constructive criticism during the past year of transition.

Last January, ABIM announced significant new changes to its MOC program, including mandated completion of any MOC activity every two years; accumulation of 100 MOC “points” distributed between Part II and Part IV activities within five years; completion of patient voice and patient safety activities; and passing a secure examination every 10 years. These changes generated legitimate criticism and sparked heated discussions across the entire internal medicine community, including ACC membership, about the validity, relevance, utility, and associated financial and opportunity costs of meeting these revised requirements.

Over the last year ACC leaders made it their #1 priority to document the concerns of our members and to advocate for changes to the process at the highest levels of ABIM leadership. The new email from the ABIM is a critical sign that we have been heard. According to the ABIM, the following changes will take place between now and the end of the year:

• Effective immediately, ABIM is suspending the Practice Assessment (Part IV), Patient Voice and Patient Safety requirements for at least two years. This means that no internist will have his or her certification status changed for not having completed activities in these areas for at least the next two years. Diplomates who are currently not certified but who have satisfied all requirements for MOC except for the Practice Assessment requirement will be issued a new certificate this year.
• Within the next six months, ABIM will change the language used to publicly report a diplomate's MOC status on its website from “meeting MOC requirements” to “participating in MOC.”
• ABIM is updating the Internal Medicine MOC exam to focus on making the exam more reflective of what physicians in practice are doing, with any changes to be incorporated beginning fall 2015, with more subspecialties to follow. This focus on relevance will also be the charge of the recently formed ABIM Cardiology Board as regards the secure examination for CV Diseases.
• MOC enrollment fees will remain at or below the 2014 levels through at least 2017.
• By the end of 2015, ABIM will assure new and more flexible ways for internists to demonstrate self-assessment of medical knowledge by recognizing most forms of ACCME-approved CME.

These changes are encouraging and the ABIM should be recognized for listening to physicians and relevant specialty societies and congratulated for its public expression of remorse. The ACC admires and respects the commitment shown by the ABIM and its leadership to address these concerns. (Read more about the changes on the ABIM’s FAQ page.) However, as the ABIM itself notes, actions will speak louder than words. How it works with both medical societies and physicians to evolve and improve the MOC process further will be key.

The ACC remains committed to advocating on behalf of its members in this area. We encourage you to continue to provide feedback to us, as well as to the ABIM, going forward. The changes announced today showcase just how successful we can be in bringing about change when we work together both as a cardiovascular profession and as a larger part of the medical community. The ACC leadership will continue to be heavily engaged with the ABIM in this upcoming period of reconsideration and evolution.

Note: The ACC will be updating its MOC hub on ACC.org in the coming days to reflect the new changes. The ABIM has prepared an FAQ with more information and have developed a Google+ Community for physicians to join, to ask questions and share ideas.

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