Maintenance of Certification (MOC) — Benefit Vs Burden

by Journal of the American Medical Association

This commentary discusses the American Board of Internal Medicine's (ABIM) maintenance of certification (MOC) examination requirements, assessing whether they present more of a burden or benefit to physicians. New ABIM mandates require licensed physicians to satisfy MOC activity in two-year increments with a threshold of 100 MOC points every five years. Doctors estimate that a new annual fee of $220 to maintain additional certification means they will pay tens of thousands of dollars in fees to keep MOC credentials in internal medicine and one to two specialties over the coming decades. Article authors Dipesh Uprety of Wayne State University and Howard West of the City of Hope Comprehensive Cancer Center in California write: "Taken together, the evidence cited by ABIM to support the efficacy of the MOC program is not unbiased because ABIM invariably conducts and directly funds the work. The resulting evidence relies on retrospective associations and causation rather than proactively assessing causation and assesses end points that are not prospectively defined as being of greatest value to clinicians." Uprety and West recommend performing a randomized clinical trial between MOC and non-MOC test subjects to assess its effect on patient outcomes. 

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