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

The case for ABIM’s maintenance of certification program

Rajeev Jain, MD
Physician
August 8, 2023
Share
Tweet
Share

A recent post on KevinMD put forward “the case for eliminating recertification by the ABIM,” in which the author expressed a number of concerns about the relevancy, time commitment and cost of maintaining certification. I have good news for the author: His concerns have already been addressed by ABIM over the last several years.

Allow me to share my case for ABIM’s Maintenance of Certification (MOC) program.

Like the author of the original post, I am also a gastroenterologist. I have been in community practice for 24 years. I wholeheartedly agree that medicine changes rapidly, necessitating more frequent and continuous approaches to assessing our knowledge currency. That’s why, in 2022, ABIM introduced the Longitudinal Knowledge Assessment (LKA), through which physicians test their medical knowledge on an ongoing basis and receive regular feedback on their performance.

I’m participating in both the internal medicine and gastroenterology LKAs, and can tell you it’s really been a great experience so far. The user interface is clean and easy to use, and, like many of my colleagues who have expressed their opinions publicly, I find I’m actually enjoying taking questions. Some have even gone so far as to say it’s fun.

As a more formative assessment designed to more closely align with how we practice, physicians aren’t expected to spend a lot of time studying. The LKA tests a physician on “walking around knowledge,” on average, participants spend less than two minutes per question, or about four hours a year for each discipline they are maintaining. Given how much I’ve been learning through the LKA, that seems like a reasonable amount of time to me, especially when weighed against the number of clinical hours in a year and the immeasurable impact on my patients.

Physicians participating in the LKA get immediate feedback if their answer is right or wrong, along with a rationale and references.

Personally, I have found that this allows me to incorporate anything I learn immediately into practice, which has been beneficial to me and my patients. After answering enough questions, we receive quarterly progress reports with more detailed information, including how we are doing compared to our peers and relative to the passing score. This allows me to understand what areas I may need to brush up on and to keep track of my progress.

ABIM recognizes that the LKA isn’t for everyone, and that’s why the traditional, 10-year MOC exam remains an option. And cardiologists can also choose the ABIM/ACC Collaborative Maintenance Pathway if that works better for them.

Why have MOC at all?

The author argues that there is an absence of compelling evidence that maintaining certification leads to improved patient outcomes. He also suggests that without MOC, physicians would be free to create their own personalized development and learning plans.

With regard to evidence, there is a substantial body of research that supports how ABIM’s MOC programs lead to better patient outcomes. To name just two examples: physicians with higher clinical knowledge scores on an MOC assessment were less likely to prescribe dangerous opioids like Oxycontin for back pain than those who scored lower. And patients are significantly less likely to face death, an emergency department visit or hospitalization for conditions at high risk for diagnostic errors when treated by a board-certified physician who scores higher on diagnostic questions on an ABIM MOC exam.

I disagree, however, that physicians left to their own devices would be informed enough about their knowledge gaps to identify the right learning opportunities accurately. We are all aware of the Dunning-Kruger effect, where people wrongly overestimate their knowledge or ability in a specific area. For example, who among us believes we are below-average drivers? Of course, there are below-average drivers on the road, but no one reading this thinks it’s them — it’s everyone else!

That’s why a rigorous process to assess and affirm medical knowledge through an independent, third-party organization like ABIM is critical for physicians and the patients they serve. It’s through this process that they can know and demonstrate their knowledge is current, and if knowledge gaps are identified, they can take steps to address them and improve.

Being a board-certified physician is not about self-declared expertise. It’s expertise that has been tested and validated by a community of peers and differentiates physicians who have demonstrated that knowledge from those who haven’t. Does it take time and energy to maintain certification? Yes, but making sure I remain current and confident in my medical knowledge is well worth that time and energy.

ADVERTISEMENT

It makes me a better doctor.

I genuinely appreciate the ongoing conversation about the evolution of MOC. ABIM didn’t always get it right, but the organization has learned from that and listened to the community. In 2015, an American Gastroenterological Association MOC Task Force that I served on recommended lifelong learning and accountability, which is the embodiment of programs like the LKA. That study, among others, shows the value and utility of MOC, which I believe can create a stronger and more knowledgeable community of physicians practicing at the top of their field in service of patients everywhere.

Rajeev Jain is a gastroenterologist and chair, board of directors, American Board of Internal Medicine.

Prev

Shame behind the stethoscope [PODCAST]

August 7, 2023 Kevin 0
…
Next

A love letter to the doctor I was

August 8, 2023 Kevin 3
…

Tagged as: Primary Care

Post navigation

< Previous Post
Shame behind the stethoscope [PODCAST]
Next Post >
A love letter to the doctor I was

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

Related Posts

  • Master the ABIM Certification exam with effective strategies: insider tips for success

    Farzana Hoque, MD
  • A physician’s addiction to social media

    Amanda Xi, MD
  • The post-baccalaureate pre-health program experience

    Sheindel Ifrah
  • What makes up the ideal residency program for you?

    Adam Bitterman, DO and Randy M. Cohn, DO
  • How hospitals are taking advantage of the 340B Drug Pricing Program

    Peter Ubel, MD
  • Chasing numbers contributes to physician burnout

    DrizzleMD

More in Physician

  • Why the physician shortage may be our last line of defense

    Yuri Aronov, MD
  • 5 years later: Doctors reveal the untold truths of COVID-19

    Arthur Lazarus, MD, MBA
  • The hidden cost of health care: burnout, disillusionment, and systemic betrayal

    Nivedita U. Jerath, MD
  • Why this doctor hid her story for a decade

    Diane W. Shannon, MD, MPH
  • When errors of nature are treated as medical negligence

    Howard Smith, MD
  • The hidden chains holding doctors back

    Neil Baum, MD
  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why physicians deserve more than an oxygen mask

      Jessie Mahoney, MD | Physician
    • Avarie’s story: Confronting the deadly gaps in food allergy education and emergency response [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Avarie’s story: Confronting the deadly gaps in food allergy education and emergency response [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why the physician shortage may be our last line of defense

      Yuri Aronov, MD | Physician
    • 5 years later: Doctors reveal the untold truths of COVID-19

      Arthur Lazarus, MD, MBA | Physician
    • The hidden cost of health care: burnout, disillusionment, and systemic betrayal

      Nivedita U. Jerath, MD | Physician
    • What one diagnosis can change: the movement to make dining safer

      Lianne Mandelbaum, PT | Conditions
    • Why this doctor hid her story for a decade

      Diane W. Shannon, MD, MPH | 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 5 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

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Addressing the physician shortage: How AI can help, not replace

      Amelia Mercado | Tech
    • Why medical students are trading empathy for publications

      Vijay Rajput, MD | Education
    • Why does rifaximin cost 95 percent more in the U.S. than in Asia?

      Jai Kumar, MD, Brian Nohomovich, DO, PhD and Leonid Shamban, DO | Meds
    • Why physicians deserve more than an oxygen mask

      Jessie Mahoney, MD | Physician
    • Avarie’s story: Confronting the deadly gaps in food allergy education and emergency response [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • What’s driving medical students away from primary care?

      ​​Vineeth Amba, MPH, Archita Goyal, and Wayne Altman, MD | Education
    • How dismantling DEI endangers the future of medical care

      Shashank Madhu and Christian Tallo | Education
    • How scales of justice saved a doctor-patient relationship

      Neil Baum, MD | Physician
    • A faster path to becoming a doctor is possible—here’s how

      Ankit Jain | Education
    • Make cognitive testing as routine as a blood pressure check

      Joshua Baker and James Jackson, PsyD | Conditions
    • The broken health care system doesn’t have to break you

      Jessie Mahoney, MD | Physician
  • Recent Posts

    • Avarie’s story: Confronting the deadly gaps in food allergy education and emergency response [PODCAST]

      The Podcast by KevinMD | Podcast
    • Why the physician shortage may be our last line of defense

      Yuri Aronov, MD | Physician
    • 5 years later: Doctors reveal the untold truths of COVID-19

      Arthur Lazarus, MD, MBA | Physician
    • The hidden cost of health care: burnout, disillusionment, and systemic betrayal

      Nivedita U. Jerath, MD | Physician
    • What one diagnosis can change: the movement to make dining safer

      Lianne Mandelbaum, PT | Conditions
    • Why this doctor hid her story for a decade

      Diane W. Shannon, MD, MPH | 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

The case for ABIM’s maintenance of certification program
5 comments

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

Loading Comments...