Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

ABIM: Maintenance of Certification (MOC) exams assess clinical judgment

Christine K. Cassel, MD
Education
March 9, 2011
Share
Tweet
Share

A guest column by the American Board of Internal Medicine, exclusive to KevinMD.com.

KevinMD.com recently posted a blog noting that Watson, the IBM super computer who successfully beat two contestants on Jeopardy, would eventually make board certification exams obsolete. He argues that exams that rely on “memory-based curriculum” focused on recall of facts will become unnecessary. I agree. Recall of facts does not necessarily make one a good doctor, but recall of facts is not what Maintenance of Certification (MOC) exams are designed to test.

When Dr. Pho sits for his MOC exam, he will experience a psychometrically sophisticated exam developed by physicians in practice and academia to assess clinical judgment through mini-case simulations or patient vignettes. Research has shown that MOC exam scores are positively associated with delivery of quality patient care.

When I took the MOC exam in geriatrics, I was struck by how I needed to read each question very carefully, weighing clinical clues, and synthesizing the information to come up with the best answer. Sometimes, even if I was unsure of the generic name of a medication, the context of the question would make clear the right direction. Being able to look things up would not have helped if I didn’t have clinical experience with frail elderly patients, familiarity with the literature on risks and benefits, and the context of acute and long-term care.

 

Because of multiple benefits, the multiple-choice question is still the most commonly used question format across all major testing organizations in the U.S. They are highly efficient, and provide reliable scores since many questions can be administered to large groups in a reasonable amount of time. The large number of questions ensures broad coverage of content areas and increased rigor and reliability across test takers.

Are the exams perfect? Absolutely not. We are consistently looking for ways to improve the exam experience and make it more reflective of physicians’ real-world environment. For example, to reduce test length and testing time, ABIM is researching an alternative “adaptive” test design for MOC. This new testing model adapts to the physician’s ability level based on the physician’s responses to previous questions. Adaptive testing is expected to yield more efficient and precise measurement of individual proficiency in less time for most physicians. ABIM is also researching the effect of adding decision support to the exam based on what physicians use in daily practice.

As you prepare for your MOC exam, keep in mind the following:

  • MOC exams assess a broad range of expertise in internal medicine or a particular subspecialty. Questions often cover diagnosis and treatment of common and rare conditions that have important consequences to patients.

 

  • The questions are designed to assess what the certified internist is expected to know without access to medical resources or references, as opposed to knowledge that is appropriate – or even mandatory – to “look up.” One has to have enough knowledge and experience on your “hard drive” to make sense of decision supports.
  • The level of difficulty for each testing point is targeted to the measurement goal of the examination, which is to discriminate between candidates who possess the cognitive expertise required for Certification from candidates who do not possess this expertise.
  • Blueprints for each exam are available on www.abim.org

Former ABIM Board member Abraham Verghese recently observed that while Watson may be able to answer questions about facts, it will never be able to exercise the clinical judgment of a capable physician. I hope when Dr. Pho completes his exam he will find the experience more a test of his diagnostic acumen rather than mere recall of facts. We look forward to reading about it, either way.

Christine Cassel is President and CEO of the American Board of Internal Medicine.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

Treatment-resistant depression is a myth

March 9, 2011 Kevin 5
…
Next

Your laser facial rejuvenation questions answered

March 9, 2011 Kevin 0
…

Tagged as: Primary Care, Specialist

Post navigation

< Previous Post
Treatment-resistant depression is a myth
Next Post >
Your laser facial rejuvenation questions answered

ADVERTISEMENT

More by Christine K. Cassel, MD

  • a desk with keyboard and ipad with the kevinmd logo

    5 questions to ask before buying health insurance

    Christine K. Cassel, MD
  • a desk with keyboard and ipad with the kevinmd logo

    ABIM: Patient centered care is crucial in health reform

    Christine K. Cassel, MD
  • a desk with keyboard and ipad with the kevinmd logo

    ABIM responds to doctors sharing board certification questions

    Christine K. Cassel, MD

More in Education

  • How I learned to stop worrying and love AI

    Rajeev Dutta
  • Why medical student debt is killing primary care in America

    Alexander Camp
  • Why the pre-med path is pushing future doctors to the brink

    Jordan Williamson, MEd
  • Graduating from medical school without family: a story of strength and survival

    Anonymous
  • 2 hours to decide my future: Why the NRMP’s SOAP process is broken

    Nicolette V. S. Sewall, MD, MPH
  • What led me from nurse practitioner to medical school

    Sarah White, APRN
  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
    • How fragmented records and poor tracking degrade patient outcomes

      Michael R. McGuire | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • How I learned to stop worrying and love AI

      Rajeev Dutta | Education
    • Understanding depression beyond biology: the power of therapy and meaning

      Maire Daugharty, MD | Conditions
    • Why compassion—not credentials—defines great doctors

      Dr. Saad S. Alshohaib | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 2 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Why doctors are reclaiming control from burnout culture

      Maureen Gibbons, MD | Physician
    • How community paramedicine impacts Indigenous elders

      Noah Weinberg | Conditions
    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Why are medical students turning away from primary care? [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • Why “do no harm” might be harming modern medicine

      Sabooh S. Mubbashar, MD | Physician
    • Here’s what providers really need in a modern EHR

      Laura Kohlhagen, MD, MBA | Tech
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • How medical culture hides burnout in plain sight

      Marco Benítez | Conditions
  • Recent Posts

    • A physician’s reflection on love, loss, and finding meaning in grief [PODCAST]

      The Podcast by KevinMD | Podcast
    • How fragmented records and poor tracking degrade patient outcomes

      Michael R. McGuire | Policy
    • How New Mexico became a malpractice lawsuit hotspot

      Patrick Hudson, MD | Physician
    • How I learned to stop worrying and love AI

      Rajeev Dutta | Education
    • Understanding depression beyond biology: the power of therapy and meaning

      Maire Daugharty, MD | Conditions
    • Why compassion—not credentials—defines great doctors

      Dr. Saad S. Alshohaib | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

ABIM: Maintenance of Certification (MOC) exams assess clinical judgment
2 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...