The American Board of Internal Medicine rolled out changes to its Maintenance of Certification program, including updates to its exam outline and score report, after more input from the internal medicine community.
Starting with spring 2015 exams, doctors will receive enhanced score reports with more performance details, according to a June 9 announcement by ABIM. The board has also updated its internal medicine MOC blueprint – the exam content outline – to ensure that the exam reflects how internists are practicing today and to provide more detailed explanations of topics that may be included in the exam.
Vanderbilt University
Dr. Wayne J. Riley
The changes are positive and reflect the concerns that physicians have long expressed about the shortcomings of the past MOC process, said Dr. Wayne J. Riley, president of the American College of Physicians and a clinical professor of medicine at Vanderbilt University in Nashville, Tenn.
“This new and improved examination blueprint addresses the strong concerns that recertifiers have voiced about the inadequacy of the previous version,” Dr. Riley said in an interview. “It is a key first step in ultimately reforming and/or replacing the secure examination.”
Dr. Richard J. Baron, ABIM president and CEO, said both initiatives reflect ABIM’s efforts to listen to physicians and engage the internal medicine community in the design of ABIM programs.
“The updates to the score report and internal medicine MOC blueprint are early evidence of ABIM’s ongoing commitment to ensure that our resources are relevant to physicians working to keep their knowledge current in the rapidly changing field of medicine,” Dr. Baron said in a statement. “Many other efforts of this kind are planned as we continue to work with physicians to design ABIM’s programs.”
As part of the enhanced score report, examinees will receive information in a new, electronic format that includes a visual presentation of results, more detailed feedback about missed questions, and links to supplemental data.
Dr. Richard J. Baron
The revised score report format was created in collaboration with ABIM board-certified physicians across several specialties through focus groups, a survey, and interviews, ABIM stated in its release. Dr. Riley said the ACP contributed to the changes through suggestions and input from its education division.
Meanwhile, the updated blueprint will be implemented starting with the fall 2015 internal medicine MOC exam.
The blueprint now includes a greater level of detail, with a task breakdown in addition to topics covered, and is color coded to indicate how specific combinations of topics and tasks are prioritized for selecting MOC exam questions, according to ABIM.
Most exam questions will address content rated as high-importance, while some questions will address content rated as medium-importance. No questions will address content rated as low-importance.
In addition, ABIM is implementing a process that will give all ABIM board-certified physicians the opportunity to participate in an annual blueprint review. The process will be introduced for some specialties by the end of 2015, and will be rolled out across all ABIM specialties over the next 2 years.
Dr. Kim Williams
ABIM turned to practicing physicians to help determine which topics to emphasize in the updated internal medicine MOC blueprint, said Dr. Nick Fitterman, chair of ABIM’s Internal Medicine Board Exam Committee.
“As the practice of medicine changes, ABIM must work closely with the physician community to continuously ensure that our exams reflect foundational knowledge that doctors in practice today need to serve their patients,” Dr. Fitterman said in a statement.
The American College of Cardiology welcomed the closer collaboration with physicians.
“The American College of Cardiology recognizes that the American Board of Internal Medicine has heard concerns from the medical community about the relevance of its Maintenance of Certification process to patient care,” said ACC President Kim Allan Williams Sr., M.D. “It is important that physicians are continually engaged in making Maintenance of Certification a valuable and relevant process to their practice of medicine.”
However, “the ACC is exploring options for a certification process that ensures professionalism in the constantly changing field of medicine,” Dr. Williams added. “Maintenance of certification should not be overly cumbersome or excessively costly in terms of time or money. In the end, we must remember what is most important – offering quality care to our patients.”
The new changes follow a February announcement by ABIM apologizing to doctors for an MOC program that “clearly got it wrong.”
ABIM pledged to make the program more consistent with physicians’ practice and values. Among the immediate changes are updates to its internal medicine exam, suspension of the practice assessment, patient voice, and patient safety requirements for at least 2 years, and setting MOC enrollment fees at or below 2014 levels through at least 2017.