MOC Exams: Nuances and Need-to-Knows
This is Jeffrey Berns, editor-in-chief of Medscape Nephrology, from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. I want to talk today about the American Board of Internal Medicine (ABIM)'s Maintenance of Certification (MOC) program, which has been in the medical news quite a bit lately because of changes that are occurring in the MOC program.
I didn't pay much attention to MOC because I was "grandfathered," as they call it, having taken my initial nephrology certification before it was required to recertify every 10 years. However, several years ago I became a member of the ABIM Nephrology Subspecialty Exam Writing Committee and I was required to recertify with the complete MOC program, which was a very eye-opening experience. In the past year or so, much more has changed with the MOC program. It is now a much more continuous process. We are required to participate in MOC activities every 2 years, and to have 100 points of MOC activities every 5 years that are related to self-evaluation of medical knowledge and self-evaluation of practice. There are new requirements related to patient safety and the patient voice. An exam is still required every 10 years. I suspect that we will be seeing some changes in that over time. It has generated a fair amount of opinion. The ABIM website now lists whether we have participated in meeting requirements of board certification.
It's interesting to go back and look at what has happened in the field of nephrology and at what is happening now with respect to the nephrology examination for MOC. The first subspecialty exam in nephrology was offered in 1972, and in 2005 it was offered for the first time as a computer-based exam. The pass rate for MOC is about the same right now as it was for first-time test takers: 85%-87%. Of interest, the eventual pass rate is 95%-96%. Almost everybody eventually passes, and most individuals pass it the first time, which is good.
There has been a change in some of the governance structure of ABIM, which is important for nephrologists and people in other specialties. The ABIM has created what they call "specialty boards." I am honored to have been asked to chair this board, which is going to have its first meeting in a couple of weeks. The nephrology board is tasked by the ABIM counseling board of directors with the responsibility of overseeing the secure exam, the medical knowledge and practice assessments of MOC, society relations, and the requirements of nephrology fellowship training.
I hope that we will have some impact in these areas. I have already reached out to some of our subspecialty societies, and we will be looking very carefully at the content of the secure exam. The so-called "blueprint," which describes the content of the exam, has changed over the years and will continue to evolve to reflect practice, with an increasing emphasis on thought-and-analysis–type questions and a diminishing emphasis on memorization-type questions or fact-type questions. Hopefully we will have a significant impact on improving the quality, quantity, and availability of modules that we can all use for getting MOC points as they relate to medical knowledge and practice assessment. The patient voice and patient safety components of MOC are continuing to evolve, and I suggest that you stay tuned at the ABIM.org website to see what is going on in this important area. I will provide periodic updates for readers of Medscape Nephrology on what is happening in the ABIM MOC world, because it is changing literally as we speak. I will be learning a lot more about it over the next year and beyond as our ABIM specialty council begins its work.
If you have any constructive thoughts about ABIM MOC, you can post them through the Medscape Nephrology website. I can't promise that I will be able to respond to all of them, but it will be informative for me to take your ideas about the MOC program back to the specialty committee and the specialty board meetings. This is Jeffrey Burns, editor-in-chief of Medscape Nephrology.
This is Jeffrey Berns, editor-in-chief of Medscape Nephrology, from the Perelman School of Medicine at the University of Pennsylvania in Philadelphia. I want to talk today about the American Board of Internal Medicine (ABIM)'s Maintenance of Certification (MOC) program, which has been in the medical news quite a bit lately because of changes that are occurring in the MOC program.
I didn't pay much attention to MOC because I was "grandfathered," as they call it, having taken my initial nephrology certification before it was required to recertify every 10 years. However, several years ago I became a member of the ABIM Nephrology Subspecialty Exam Writing Committee and I was required to recertify with the complete MOC program, which was a very eye-opening experience. In the past year or so, much more has changed with the MOC program. It is now a much more continuous process. We are required to participate in MOC activities every 2 years, and to have 100 points of MOC activities every 5 years that are related to self-evaluation of medical knowledge and self-evaluation of practice. There are new requirements related to patient safety and the patient voice. An exam is still required every 10 years. I suspect that we will be seeing some changes in that over time. It has generated a fair amount of opinion. The ABIM website now lists whether we have participated in meeting requirements of board certification.
It's interesting to go back and look at what has happened in the field of nephrology and at what is happening now with respect to the nephrology examination for MOC. The first subspecialty exam in nephrology was offered in 1972, and in 2005 it was offered for the first time as a computer-based exam. The pass rate for MOC is about the same right now as it was for first-time test takers: 85%-87%. Of interest, the eventual pass rate is 95%-96%. Almost everybody eventually passes, and most individuals pass it the first time, which is good.
There has been a change in some of the governance structure of ABIM, which is important for nephrologists and people in other specialties. The ABIM has created what they call "specialty boards." I am honored to have been asked to chair this board, which is going to have its first meeting in a couple of weeks. The nephrology board is tasked by the ABIM counseling board of directors with the responsibility of overseeing the secure exam, the medical knowledge and practice assessments of MOC, society relations, and the requirements of nephrology fellowship training.
I hope that we will have some impact in these areas. I have already reached out to some of our subspecialty societies, and we will be looking very carefully at the content of the secure exam. The so-called "blueprint," which describes the content of the exam, has changed over the years and will continue to evolve to reflect practice, with an increasing emphasis on thought-and-analysis–type questions and a diminishing emphasis on memorization-type questions or fact-type questions. Hopefully we will have a significant impact on improving the quality, quantity, and availability of modules that we can all use for getting MOC points as they relate to medical knowledge and practice assessment. The patient voice and patient safety components of MOC are continuing to evolve, and I suggest that you stay tuned at the ABIM.org website to see what is going on in this important area. I will provide periodic updates for readers of Medscape Nephrology on what is happening in the ABIM MOC world, because it is changing literally as we speak. I will be learning a lot more about it over the next year and beyond as our ABIM specialty council begins its work.
If you have any constructive thoughts about ABIM MOC, you can post them through the Medscape Nephrology website. I can't promise that I will be able to respond to all of them, but it will be informative for me to take your ideas about the MOC program back to the specialty committee and the specialty board meetings. This is Jeffrey Burns, editor-in-chief of Medscape Nephrology.
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