Controversial Certification Rules of American Board of Internal Medicine

certificateThe American Board of Internal Medicine (ABIM) released changes to the accreditation process at the beginning of 2014, and nearly 20,000 physicians have signed a petition calling for those changes to be rescinded. Additionally, the controversy surrounding the Maintenance of Certification (MOC) program has continued to swirl with no signs of abating as we enter 2015.

ABIM has faced significant backlash from physicians and advocate groups over MOC’s cost and time requirements. For family physicians, the application fee alone can range from $1,300 to $1,500.

The ABIM and other MOC proponents say that the program is necessary to ensure that physicians maintain their medical knowledge. However, some primary care physicians and their advocates argue that the test material often is not applicable to typical occurrences within their specialty.

Another point of contention is that the ABIM publishes physician certification statuses on its website as either “meeting” or “not meeting” MOC requirements. The ABIM has stated that it will revisit this policy following feedback that the current language used for reporting status was confusing.

In June, the American Medical Association’s House of Delegates voted to assess the feasibility of conducting an impact study on MOC’s impact on the medical professional and patient outcomes. That assessment is still pending.

The American College of Physicians’ (ACP) Board of Regents issued this MOC policy statement in October:

“ACP does not support using participation in MOC as an absolute prerequisite for state licensure, hospital credentialing, or insurer credentialing. Instead, decisions about licensure and credentialing should be based on the physician’s performance in his or her practice setting and a broader set of criteria for assessing competence, professionalism, commitment to continuous professional development, and quality of care provided.”

To help physicians understand the program’s requirements and prepare for their examinations, the ACP has developed an interactive tool called the ACP MOC Navigator, which is available on the ACP website.

MOC Requirements

For Internists

Lifelong learning and self assessment (part II):

Earn a total of 100 self-evaluation points every 5 years

  • 20 points in self-evaluation of medical knowledge
  • 20 points in self-evaluation of practice performance
  • 60 points from either self-evaluation of medical knowledge, self-evaluation of practice performance or a combination of both

Practice performance assessment (part IV):

Earn a total of 100 self-evaluation points every five years

  • 20 points in self-evaluation of medical knowledge
  • 20 points in self-evaluation of practice performance
  • 60 points from either self-evaluation of medical knowledge, self-evaluation of practice performance or a combination of both

For Family Physicians

Lifelong learning and self assessment (part II):

  • Must complete a minimum of one Self-Assessment Module (SAM) comprised of a 60-question Knowledge Assessment and a clinical simulation in a specific health care topic per each three-year stage.
  • An average of 50 CME credits per year or 150 CME credits per stage.

Practice performance assessment (part IV):

  • Diplomates must complete either a Performance in Practice Module (PPM) or an approved alternative module in each 3-year stage.

Understanding Examination Costs:

American Board of Internal Medicine

Internal Medicine certification exam: $1,365
Subspecialty certification exams: $2,200
Subspecialty certification in cardiovascular disease: $2,345
Subspecialty certification exams:(Adult Congenital Heart Disease, Advanced Heart Failure & Transplant Cardiology, Transplant Hepatology, Interventional Cardiology and Clinical Cardiac Electrophysiology) $2,830
Non-refundable late registration fee: $400
International test center fee: $500

American Board of Family Physicians

Application fee: $500
Late filing fee: $200

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