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Dr. Burke at ABIM on March 4, 2016
Dr. Burke at ABIM on March 4, 2016

Representing ACG and Reassessing MOC:  A Meeting With ABIM

by Carol A. Burke, MD, FACG, ACG President-Elect, Cleveland Clinic Foundation

Last Thursday evening when I was leaving my office after another 13-hour day, I passed by my colleague to say good night. He was still knee-deep in returning patient phone calls, responding to patient-generated secure emails called “my chart” messages, and churning out pathology result letters. He asked if I was going to make it to the 7 AM meeting Friday morning, but I told him that I was en route to the airport for a Friday meeting in Philadelphia with the American Board of Internal Medicine (ABIM).

His immediate exclamation was, “Just tell me I don’t have to take the 10 year recertification exam next year.”

I assured him that he would need to take the recertification exam in 2017, but the American College of Gastroenterology would continue to work with the ABIM to endorse the College’s guiding principles regarding the ABIM maintenance of certification program (MOC) to make the assessment less of a burden for practicing gastroenterologists.

The College’s position includes a call for an end to the 10 year high stakes recertification exam and the support of lifelong learning with ongoing CME activities – not lifelong testing.

As many of you may be aware, the College sent a set of consensus principles to Dr. Richard Baron, President of the ABIM in November 2015.  We proposed ending the 10-year recertification examination and abrogating closed book assessments, while making MOC simpler, less intrusive, less expensive and sufficiently flexible enough to tailor assessments to subspecialists’ clinical practice areas.

On March 4, I was joined at ABIM by Meredith Phillips, ACG’s Vice President of Professional Education, at a meeting with the ABIM senior leadership team, including Richard Baron, MD, Richard Battaglia, MD, ABIM’s Chief Medical Officer, as well as members of the ABIM Gastroenterology Board.  The meeting was an opportunity to represent the ACG membership and voice their concerns about the current status of MOC and reiterate ACG’s position with ABIM leaders.  The day- long meeting provided the ABIM an opportunity to update the College on the status of activities underway to reassess the whole MOC program.

ACG’s Stance on MOC

In a letter to ABIM’s President, Dr. Richard Baron, on November 6, 2015, and in subsequent conversations and communications, the College raised significant concerns that the ABIM MOC program is largely duplicative, time consuming and expensive.  The College questioned the relevance of the MOC program overall, as well as the unacceptable – and at times clinically irrelevant – content of the recertification exam.  ACG voiced the frustration of many GI physicians when we argued that the ABIM’s MOC model has failed to be practical or effective.

ACG is now working with ABIM to re-imagine physician recertification and to find ways to make it more practical to earn MOC through ACG programs, ensuring that the process becomes as easy and seamless as possible while also minimizing costs to our members.

To that end, the College restructured the Educational Affairs Committee to add a new working group focused entirely on MOC.  This subcommittee is charged with supporting ACG’s advocacy on behalf of busy GI clinicians and exploring ways to make MOC more relevant and to make earning MOC credits through ACG more accessible.

The ACG also signed a joint, multi-society communication to the ABIM last fall outlining our response to their recent report “2020 Task Force Report,”and advocating for the following key principles:

  • MOC needs to be simpler, less intrusive and less expensive
  • We support ending the high-stakes, every 10-year exam
  • We do not support closed book assessments as they do not represent the current realities of medicine in the digital age
  • We support the principles of lifelong learning as evidenced by ongoing CME activities, rather than lifelong testing
  • We support the concept that, for the many diplomates who specialize within certain areas of gastroenterology and hepatology, MOC should not need to include high-stakes assessments of areas in which the diplomate may not practice

ACG will continue to represent our members in the ongoing dialogue with ABIM and to craft educational programs that meet the needs of busy GI clinicians.