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ACP offers a number of resources to help members make sense of the MOC requirements and earn points.
Understanding MOC Requirements
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April 11-13, 2019
Internal Medicine Meeting 2019
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Prepared October 6, 2004
The recent Board of Governors meeting in Tucson was marked by
genuine enthusiasm regarding substantial progress in ACP-ABIM
discussions about maintenance of certification. Over the past six
months, intensive discussions between Drs. Steven Weinberger (ACP
Senior VP for Medical Knowledge and Education) and F. Daniel Duffy
(ABIM Executive VP) have resulted in a welcome and productive
atmosphere of collaboration rather than confrontation between the
two organizations, also reflected in simultaneous parallel
discussions at the level of the CEOs (Dr. John Tooker from ACP and
Dr. Christine Cassel from ABIM) and the Board Chairs (Dr. Eric
Larson from ACP and Dr. Troyen Brennan from ABIM).
After agreeing upon a set of goals and principles that would
form the framework for their discussions, Drs. Weinberger and Duffy
developed initial recommendations that were endorsed by the
relevant committees and boards of both organizations. These
recommendations took into account the evolution of the
recertification process into a 4-part Maintenance of Certification
(MOC) process, as mandated by the American Board of Medical
Specialties (ABMS), the umbrella organization for all medical
specialty Boards. The four components of MOC are:
Parts 2 and 4 have so far been fulfilled by completion of 5 ABIM
SEP (Self-Evaluation Process) modules chosen from several module
types, without a specific requirement that one or more of the SEP
modules be of a type that meets the Part 4 requirement.
What is new? Based on the 4-part MOC framework, the ABIM has
agreed to accept the combination of MKSAP plus an acceptable
demonstration of Evaluation of Performance in Practice to fulfill
the Part 2 and Part 4 components of MOC, respectively. The MKSAP
option for fulfilling the Part 2 requirement will consist of
computer-based completion of pre-selected sets of questions from
MKSAP 13 (and future editions of MKSAP), delivered in a way that
combines self-assessment with education and immediate feedback.
Three 60-question MKSAP modules will substitute for 3 SEP modules
and will satisfy the entire Part 2 requirement. Part 2 credit will
be based on completion of the questions and not on the candidate's
score, which is provided to the candidate as a form of feedback
about the candidate's level of preparation.
Given the evolving MOC framework and the growing national
movement for patient safety and quality improvement in patient
care, both ABIM and ACP agreed on the need for a Part 4 component
of MOC, but implemented in a way that is efficient, effective, and
not redundant. ACP and ABIM have started working together to
develop a "wide door" and a variety of options for fulfilling the
Part 4 requirement, which would be instituted at the same time the
MKSAP option is available to fulfill the Part 2 requirement.
Finally, ACP and ABIM have established a joint, staff-level
workgroup to examine options for improving the Part 3 component of
MOC (the secure examination for demonstration of cognitive
expertise). The goals are to: a) reduce the anxiety provided by a
high-stakes examination; b) increase the relevance of an
examination to the physician's scope of practice; and c) consider
options that might allow the examination to better reflect the way
in which physicians have access to informational resources in their
clinical practice. The overall intent is to explore options for
improving the Part 3 process in a way that would address physician
concerns, but would not compromise the integrity, standards, or
quality of the process.
ACP and its staff are committed to continued discussions with
ABIM and exploration of innovative ways to ease the MOC process and
make it as educational and attractive as possible. A collaborative
approach to these discussions has been particularly effective and
productive, based upon those principles and goals that the two
organizations share for the betterment of the profession and for
improved patient care.