The American Board of Internal Medicine (ABIM) recently unveiled its first attempt to revitalize the maintenance of certification (MOC) program with pathway alternatives to the 10-year exam. While AGA has advocated for MOC reform and welcomed the efforts of the ABIM in responding to demands for change, we object to the pathways proposed by ABIM, which fall short of our principles of individualization, lifelong education, and low-stakes testing.
ABIM proposes to replace the 10-year exam with either a 2- (or 5-) year alternative MOC pathway. Every 2 (or 5) years, diplomates can take a single, 2- (or 5-) hour open-book exam, from their office or home. The exam would provide granular feedback on learning objectives in need of remediation. The exam is promoted as “low-stakes” since failure does not result in immediate loss of certification. Rather, the diplomate has the opportunity to take the next exam and, if they pass, continue on the pathway. Failure of two exams in a row means the diplomate must pass the traditional 10-year exam before continuing the MOC pathway.
AGA joined unanimously with other GI societies and the majority of other internal medicine societies in rejecting both proposed pathways as unacceptable in their present format.
AGA’s liaison to the ABIM Liaison Committee on Certification and Recertification (LCCR), Art DeCross, MD, outlined AGA’s issues with the proposal on the AGA Community in late September and kicked off a lively discussion about the future of MOC. Visit the AGA Community at community.gasto.org to read or join the conversation.
Additionally, here are two key things to know:
1. Regarding state legislation, AGA President Tim Wang, MD, notes that “We’re monitoring legislative actions in various states and note that there would need to be commitment to the same approach by all 50 states in order to have the necessary impact to completely unlink MOC certification from hospital and insurance credentialing for AGA members. So instead, AGA is focusing our work on national advocacy, which is where we can have the most impact.”
2. While there is a lot of activity related to reforming MOC, the time horizon for changes is long. Dr. DeCross notes that “members really should plan on continuing their current, standard MOC pathway process, including taking their recertification examinations, if they want to retain that credential at this time.”
This conversation is the latest in a long advocacy campaign lead by AGA to push ABIM to reform MOC. Learn more at www.gastro.org/career-center/maintenance-of-certification.
