Maintenance of Certification: American Board of Anesthesiology Ends 10-Year Exam; ABIM Considers New Continuous Testing Model As Well
Recently, the American Board of Anesthesiology (ABA) announced it will become the first medical board to restructure its Maintenance of Certification (MOC) program. The Maintenance of Certification in Anesthesiology Program, or MOCA, has required physicians to take a recertification test every 10 years. It will be replaced by a program known as “MOCA 2.0,” which will allow anesthesiologists to continuously assess themselves and identify knowledge gaps through an online portal, including a "MOCA Minute" that allows physicians to answer multiple-choice questions at their own convenience.
This shift is noteworthy because over the past few years, the MOC recertification process has been under a great deal of scrutiny by specialists who have expressed dissatisfaction in the process. Hospitals often require their specialists to be board certified; however, the recurring exams are time consuming, costly, and--according to many physicians--often test on topics with little relevance to their own practice. For example, last year thousands of doctors signed a petition for the American Board of Internal Medicine (ABIM) to recall changes to their MOC activities that would further increase the testing frequency. Further, a series of Newsweek articles criticized the ABIM's certification process and financial decision-making.
ABIM and the ABA are both part of the American Board of Medical Specialties' (ABMS) 24 specialty member boards. ABA is the first specialty to officially break the mold. “We understand that once-every-10-year exams kind of promoted people studying for a couple of months, cramming for the exam, passing it and then moving on,” said Dr. James Rathmell, secretary for the ABA and chair of the department of anesthesiology as quoted in Modern Healthcare. “We all felt that wasn't a very good way of keeping physicians up to date and it probably didn't translate into tremendously better patient care.”
ABA's changes are summarized on their website, as follows:
Soon after ABA's announcement, the ABIM also announced that it will consider replacing its 10-year MOC exam with shorter, more frequent testing that physicians could take when and where they wanted to. Richard Baron, MD, ABIM's president and CEO, told Medscape Medical News that the ABA's new continuous online testing model could be a good model for replacing ABIM's s 10-year exam. "But the execution issues aren't trivial," Dr Baron said to Medscape. "We'll be monitoring what the ABA does with considerable interest."
The proposal to replace the 10-year MOC exam "quickly garnered praise from the American College of Cardiology (ACC), which represents a major subspecialty in internal medicine," Medscape writes.
[T]he ACC strongly agrees with the report about the need to develop a new, externally-validated process for measuring competence to replace the 10-year exam – with all deliberate haste! Additionally, the ACC is committed to continuing work with ABIM to research best practices for the maintenance and demonstration of competence with eventual links to patient outcomes, cost and cost-effectiveness.
Newsweek's Kurt Eichenwald, who authored the widely publicized MOC critiques, also recently weighed in on ABIM's announcement entitled "To the Barricades! The Doctors' Revolt Against ABIM is Succeeding!"