During last week’s 2014 AMA Interim Meeting in Dallas, AMA House of Delegates voted to update the AMA’s policy on maintenance of certification (MOC). The adopted policy outlines principles that emphasize the need for an evidence-based process that is evaluated regularly to ensure physician needs are being met and activities are relevant to clinical practice.
The MOC principles will now include:
- MOC should be based on evidence and designed to identify performance gaps and unmet needs, providing direction and guidance for improvement in physician performance and delivery of care.
- The MOC process should be evaluated periodically to measure physician satisfaction, knowledge uptake, and intent to maintain or change practice.
- MOC should be used as a tool for continuous improvement.
- The MOC program should not be a mandated requirement for licensure, credentialing, payment, network participation or employment.
- Actively practicing physicians should be well-represented on specialty boards developing MOC.
- MOC activities and measurement should be relevant to clinical practice.
- The MOC process should not be cost-prohibitive or present barriers to patient care.
The policy encourages specialty boards to investigate alternative approaches to MOC and directs the AMA to report annually on the MOC process.
One of the unadopted resolutions (Resolution 928) asked the AMA “strongly advocate for the cancellation of the current Maintenance of Certification (MOC) program and promote physician utilization of continuing medical education as currently required due to the overwhelming consensus of physicians that the current MOC program is ineffective, time-consuming, and economically burdensome.”
While this extreme measure was not adopted, the AMA principles show increased scrutiny over MOC programs. The new principles make it clear that MOC may not be a "mandated requirement for licensure." Furthermore, the MOC process may not be "cost-prohibitive" or "present barriers to patient care." Many of these principles have been points of critique against MOC recently.
The American Board of Medical Specialties (ABMS) is the organization responsible for developing the MOC process. ABMS works with its 24 member boards in the ongoing evaluation and certification of physicians.
View the AMA's previous policy here.
Per AMA Wire, “AMA policy supports physician accountability, life-long learning and self-assessment. The AMA will continue to work with the appropriate organizations to ensure the MOC process does not disrupt physician practice or reduce the capacity of the overall physician workforce.”
In June, the AMA and ABMS convened stakeholders in Chicago to discuss Part III of the MOC exam, focusing on the value of MOC Part III and innovative concepts that could potentially enhance or replace the current thinking around the secure exam requirement of MOC.
AMA's resolutions come soon after a recent MOC study published online in JAMA Internal Medicine, where physicians in focus groups agreed that the maintenance of certification process is unnecessarily complex and is "of little benefit to physicians, patients, or society."