An Update from ASCO on the ABIM MOC Program

An Update from ASCO on the ABIM MOC Program

Julie Vose, MD, MBA, FASCO

Oct 21, 2015

Dear ASCO Member:

Over the past year the American Board of Internal Medicine (ABIM) has engaged with ASCO and other stakeholders to listen to the concerns of physicians and redesign their Maintenance of Certification (MOC) program. We have advocated for reform and the ABIM is responding.  The following changes have already been approved by the ABIM:

  • If you are dual boarded (for example, internal medicine and medical oncology) by one or more of the other American Board of Medical Specialties member boards, the need to maintain the underlying certificate for the primary specialty has been eliminated; and
  • All ACCME accredited providers developing CME activities may now also offer MOC points for these activities.

In 2013 the ABIM commissioned a task force to develop a vision for the future of assessment for certification and recertification of internal medicine and its associated subspecialties. Last month, they released their report, A Vision for Certification in Internal Medicine in 2020. The report outlines several significant recommendations for change, including:

  • Reconsider the "high stakes" examination (recertification exam) and replace it with a series of low-stakes modular assessments that might be completed at home or in the workplace and might be 'open-book'. A more formal evaluation would be required only in the absence of satisfactory completion of the low-stakes assessments. This model would likely eliminate the current self-assessment component (prior part 2 knowledge self-assessment activities) of the MOC program.
  • Focus assessment on relevant cognitive and technical/procedural skills appropriate to the specialty. This will eliminate the prior Part IV requirement and offer an opportunity for customization of MOC according to a physician's practice. For example, recertification may be focused on specific tumor types such as hematologic malignancies or breast cancer.

While we recognize that these recommendations will require approval of the ABIM Board of Directors, we are hopeful that the Board will act swiftly to implement these changes. We have had ongoing discussions with the ABIM over the past few years regarding the needed changes in the recertification process and are encouraged by these changes and the openness of ABIM to consider additional modifications.

The ABIM has also expressed a desire for more innovative approaches to the redesign of the recertification process.  ASCO has formed a task force with the charge to formulate a recertification process that is personalized, aligned with physicians' practice and knowledge needs, and integrated into ongoing physician activities. I look forward to reporting their ideas and recommendations during the coming year.

We appreciate all of your input and engagement with this issue.  Please continue to provide your insights and concerns regarding the ongoing changes in the redesign of the recertification process. We are committed to developing a recertification process that is efficient, meaningful and meets the continuing education goals of practicing oncologists.


Julie M. Vose, MD, MBA, FASCO
ASCO President


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Sanjeev Gopal, MD

Nov, 13 2015 11:10 AM

it sounds like this will result in more expenses rather than less. If this is true than ASCO and ABIM are just trying to milk the physicians more. Thanks a lot.

Julie Vose, MD, MBA, FASCO

Nov, 13 2015 11:20 AM

The modifications if adopted would allow a much more streamlined approach to receiving MOC credit in our everyday lives for CME events that we already are doing as well as focusing the activities in the areas of interest for the physicians.  The whole purpose of life-long learning is to help physicians keep up with current information that is helpful to them and leads to high quality care.  We need to harmonize the current and future educational needs with the certification system - this will benefit the physicians, patients, and the public. 

Mehmet Sitki Copur, MD, FACP

Nov, 14 2015 12:25 AM

I would like to thank to ASCO and to Dr.Vose taking the  initiative and working on behalf of us  on this very complicated and difficult process. There is no good data regarding the costs to physicians except the article published online on July 28, 2015 in Annals of Internal Medicne by Sandhu AT et al. A Cost Analysis of the American Board of Internal Medicne`s Maintenance of Ceretifcation Program. Ann Intern Med. doi:10.7326/M15-1011.This is the first study to quantify the cost of the ABIM MOC program and they reported that "the 2015 MOC will cost $5.7 billion over 10 years, including $5.1 billion in time costs resulting from 32.7 million physician-hours spent on completion of MOC. There is significant interphysician variability in MOC-related costs: Subspecialists face higher costs than general internists, primarily because they take additional certification examinations that generate more fees and a greater time outlay.The changes announced by the ABIM  are a step in the right direction. Because medical boards in all but 5 U.S. states already require physicians to provide evidence of CME in order to hold a medical license, counting educational activities toward both CME and MOC would substantially decrease time costs. As part of the 2015 overhaul of its MOC program, ABIM has offered MOC credit for “most forms of CME,”with evidence to support that they “drive learning and/or change practice”. In a scenario in which a quarter of all CME activities that physicians currently undertake also earned MOC points, costs decreased by $1.1 billion compared with a scenario in which no such credits were available. Increasing MOC credits for CME activities would produce additional savings". Harmonization of MOC and CME requirements can be guided and coordianted by ASCO to make this even more effective.  Again Thank you ASCO and Thank you Dr.Vose.

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