Maintenance of Certification (MOC)
Encyclopedia
Maintenance of Certification (MOC) is the process of keeping physician certification up-to-date through one of the 24 approved medical specialty boards of the American Board of Medical Specialties (ABMS). The ABMS, a non-profit organization
, is one entity overseeing physician certification in the United States.
The Maintenance of Certification program provides an ongoing process that was designed to help physicians keep abreast of advances in their fields, develop better practice systems, and demonstrate a commitment to lifelong learning
. Physicians need to have - and maintain - the clinical judgment and skills upon which high quality care depends.
and measuring physicians' continued competency, including the following:
program evaluations:
competencies through four program elements:
Studies suggest that board-certified physicians provide improved quality of patient care and better clinical outcomes than those physicians without board certification, including a 15% reduction in mortality rate
among heart attack
patients treated by board-certified physicians. Considering a recent meta-analysis
that shows a decline in physician performance associated with the time elapsed since the physician's initial training, it is essential for physicians to participate in programs such as Maintenance of Certification in order to keep current with medicine's expanding knowledge base
and technical advances, and to apply this knowledge to quality improvement in their medical practice. Maintenance of Certification helps physicians and other health care stakeholders address the critical need to enhance patient safety
and patient care quality.
Ironically, many of the certifying boards, such as the American Board of Internal Medicine and the American Board of Pediatrics, have "grandfathered" physicians certified prior to circa 1990, and there is no requirement for such physicians to re-certify. These are physicians who have had substantial time elapse since their initial training. Many of the current members of both boards have chosen not to re-certify themselves although this is recommended by the boards of which they are diplomates.
Non-profit organization
Nonprofit organization is neither a legal nor technical definition but generally refers to an organization that uses surplus revenues to achieve its goals, rather than distributing them as profit or dividends...
, is one entity overseeing physician certification in the United States.
The Maintenance of Certification program provides an ongoing process that was designed to help physicians keep abreast of advances in their fields, develop better practice systems, and demonstrate a commitment to lifelong learning
Lifelong learning
Lifelong learning is the continuous building of skills and knowledge throughout the life of an individual. It occurs through experiences encountered in the course of a lifetime...
. Physicians need to have - and maintain - the clinical judgment and skills upon which high quality care depends.
Maintenance of Certification and the Medical Community
Many major medical organizations have expressed support for the Maintenance of Certification program as a valuable means of facilitating physicians' continuous professional developmentContinuing Professional Development
Continuing professional development or Continuing professional education is the means by which people maintain their knowledge and skills related to their professional lives.-CPD research:...
and measuring physicians' continued competency, including the following:
- The American Board of Medical Specialties (ABMS)
- The American Medical Association
- The American Hospital Association (AHA)
- The National Board of Medical Examiners (NBME)
- The Federation of State Medical Boards (FSMB)
- The Council of Medical Specialty Societies (CMSS)
- The Accreditation Council for Graduate Medical Education (ACGME)
- The Association of American Medical Colleges (AAMC)
- The Educational Commission for Foreign Medical Graduates (ECFMG)
Maintenance of Certification Competencies
The Maintenance of Certification program assesses the six general competencies identified through the ACGME Outcome Project and subsequently required in medical residencyResidency (medicine)
Residency is a stage of graduate medical training. A resident physician or resident is a person who has received a medical degree , Podiatric degree , Dental Degree and who practices...
program evaluations:
- patient careHealth careHealth care is the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in humans. Health care is delivered by practitioners in medicine, chiropractic, dentistry, nursing, pharmacy, allied health, and other care providers...
- medical knowledge
- practice-based learning and improvement
- interpersonal and communications skills
- professionalism
- systems-based practice
Maintenance of Certification Components
Maintenance of Certification incorporates the ACGMEAccreditation Council for Graduate Medical Education
The Accreditation Council for Graduate Medical Education is the body responsible for the accreditation for graduate medical training programs for medical doctors in the United States. It is a non-profit private council that evaluates and accredits medical residency and internship programs...
competencies through four program elements:
- Professional Standing: Physicians must have a valid, unrestricted license to practice medicine and confirmation of good standing in their local practice community.
- Lifelong Learning and Self-Assessment: Through open-book examinations developed by ABMS member Boards, medical societies, and others, physicians assess their clinical and practical knowledge. This component stimulates learning, requires that physicians document their learning, and ensures that physicians keep up with the rapidly evolving medical knowledge essential to quality patient care.
- Cognitive Expertise: Physicians are required to pass a closed-book, proctored examination in their specialty area that assesses critical aspects of clinical knowledge and judgment in scenarios like those encountered in physician practice. This examination evaluates not only what physicians know, but how they use what they know to promote health, diagnose and treat illness effectively and efficiently.
- Practice Performance Assessment: Physicians use tools to self-assess their performance in medical practice, with an emphasis on patient care quality, measurement, and documented quality improvement. These assessment tools include various Practice Improvement Modules (PIMs) that evaluate physicians' performance in a clinical area relevant to their practice, compare their performance to clinical guidelines, help them to develop a plan to improve important aspects of their practice, and assess the impact of that improvement plan.
Maintenance of Certification and Other Stakeholders
Many health plans are implementing programs that recognize and reward physicians who are actively participating in Maintenance of Certification activities. ABMS member boards are actively working with other health care organizations to advance quality initiatives and reduce measurement redundancy through recognition of physicians' Maintenance of Certification program participation. Hospitals and health systems are beginning to use Maintenance of Certification components to engage physicians in quality improvement.Studies suggest that board-certified physicians provide improved quality of patient care and better clinical outcomes than those physicians without board certification, including a 15% reduction in mortality rate
Mortality rate
Mortality rate is a measure of the number of deaths in a population, scaled to the size of that population, per unit time...
among heart attack
Myocardial infarction
Myocardial infarction or acute myocardial infarction , commonly known as a heart attack, results from the interruption of blood supply to a part of the heart, causing heart cells to die...
patients treated by board-certified physicians. Considering a recent meta-analysis
Meta-analysis
In statistics, a meta-analysis combines the results of several studies that address a set of related research hypotheses. In its simplest form, this is normally by identification of a common measure of effect size, for which a weighted average might be the output of a meta-analyses. Here the...
that shows a decline in physician performance associated with the time elapsed since the physician's initial training, it is essential for physicians to participate in programs such as Maintenance of Certification in order to keep current with medicine's expanding knowledge base
Knowledge base
A knowledge base is a special kind of database for knowledge management. A Knowledge Base provides a means for information to be collected, organised, shared, searched and utilised.-Types:...
and technical advances, and to apply this knowledge to quality improvement in their medical practice. Maintenance of Certification helps physicians and other health care stakeholders address the critical need to enhance patient safety
Patient safety
Patient safety is a new healthcare discipline that emphasizes the reporting, analysis, and prevention of medical error that often leads to adverse healthcare events. The frequency and magnitude of avoidable adverse patient events was not well known until the 1990s, when multiple countries reported...
and patient care quality.
Ironically, many of the certifying boards, such as the American Board of Internal Medicine and the American Board of Pediatrics, have "grandfathered" physicians certified prior to circa 1990, and there is no requirement for such physicians to re-certify. These are physicians who have had substantial time elapse since their initial training. Many of the current members of both boards have chosen not to re-certify themselves although this is recommended by the boards of which they are diplomates.
See also
- American Board of Medical Specialties (ABMS)
- American Board of Family Medicine (ABFM)
- American Board of Internal Medicine (ABIM)