Dr. Carol A. Burke

ABIM Announces Its Version of Improvement on MOC: Are “Open-Book”, Frequent Exams Diplomate-Centered?

ABIM today announced a plan which makes certain concessions to the overwhelming opposition to the state of MOC from physicians by substituting optional, more frequent “open-book” testing for earlier ill-conceived MOC proposals.

For ABIM diplomates, the long-form, 10-year Board assessment taken at a secure testing facility remains in place, but now will be “open book.” Open book to the ABIM means provision of access to an “external resource” – created by the ABIM.

Alternatively, Board certification can be maintained by passing an open-book “Knowledge Check-In” every two years. The fine print of the ABIM announcement notes that this two-year option will contain questions covering the breadth of the discipline.

ABIM reports that it is “continuing to explore focusing assessments on a subset of knowledge relevant to specific practice types.” Until this issue of whether ABIM will test on the full spectrum of the comprehensive knowledge base for GI every two years is clarified, we see extremely limited value in this two-year option, which could effectively morph into a broad-based, perpetual testing scenario.

“Until this issue of whether ABIM will test on the full spectrum of the comprehensive knowledge base for GI every two years is clarified, we see extremely limited value in this two-year option…”

The College believes this plan is the ABIM response to the overwhelming opposition to the state of MOC from physicians. The major concerns of our members, which the College continually shares with the ABIM, are the cost, lack of clinical pertinence, and evidence to support the impact of MOC on the quality of care provided by physicians, as well as impact on ability to practice if one loses MOC.

The College continues to stand firm in its fundamental commitment to push ABIM to re-envision and overhaul the MOC process. We are guided by these Core Principles:

  • MOC needs to be simpler, less intrusive and less expensive
  • We continue to 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 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
  • We support the principles of lifelong learning,as evidenced by ongoing CME activities, rather than lifelong testing

ACG has been working on your behalf with ABIM while exploring alternatives at the state and national level. I want to recognize the leadership of Dr. Daniel Pambianco, who is spearheading a work group tasked with an overview of MOC and is coordinating with efforts by the ACG Board of Governors on these issues, which have such a significant impact on GI practice for ACG member physicians.

In today’s announcement, we are pleased to see that ABIM appears to be offering an option that backs away from one of the most onerous aspects of MOC – a high-stakes, closed-book exam. But until we learn more, the College will continue to explore new possibilities for our members and strive to meet your needs for relevant and timely clinical GI education, CME, while facilitating Maintenance of Certification for ACG members who choose to do so. We are exploring potential alternative assessment models which more accurately reflect the realities of GI practice beyond ABIM’s two-year and 10-year tests.

— Carol