Alicia Ault

May 17, 2016

WASHINGTON, DC — The secure, written exam required for maintenance of certification (MOC) for diplomates of the American Board of Obstetricians and Gynecology (ABOG) will likely become optional for most of those licensed in the specialty, according to the board's incoming executive director.

The proposal to allow an exemption from the current MOC exam is undergoing a 2-year test drive, said George Wendel, MD, who is currently the director of MOC for the ABOG.

"Our proposal is that the ongoing assessment throughout a cycle at least three times a year for 6 years is just as valuable an assessment of your fund of knowledge as an external assessment done in year 6," he explained here at the American Congress of Obstetricians and Gynecologists 2016 Annual Clinical Meeting.

Since the beginning of the pilot in January, "not a whole lot of people are opting to take the MOC examination," said Dr Wendel, who becomes executive director of the ABOG in January 2017.

The ABOG will assess data from the pilot when it ends to decide whether it's feasible to proceed with the exam alternative, after which the organization will present its proposal to the American Board of Medical Specialties. That board will determine whether the exemption still allows obstetricians and gynecologists to meet national MOC standards, Dr Wendel told Medscape Medical News.

My sense is that the American Board of Medical Specialties will approve our proposal in 2017 or 2018.

"My sense is that the American Board of Medical Specialties will approve our proposal in 2017 or 2018," he said.

The ABOG has to assure the American Board of Medical Specialties that diplomates won't be able to cheat or game the exam alternative, and that, below a certain threshold, they will lose certification, Dr Wendel said. The process has to ensure that diplomates can't repeatedly perform poorly on the exam alternative "and still get certified," he added.

For the pilot, ABOG diplomates in the sixth (and final) year of their MOC cycle in 2016 who have scored 86% or better in aggregate on the first answers to questions posed as part of the life-long learning and self-assessment module get an exemption from the written MOC exam.

Currently, ABOG diplomates who are generalists must read 30 articles and answer 120 questions each year. Over a 6-year period, they read 165 articles and answer 720 questions. Starting in 2016, subspecialists will receive the same number of articles and questions each year. Ten of the 30 articles will be on general obstetric and gynecologic topics and 20 will be from the subspecialty.

An individualized dashboard on the ABOG website reports performance and alerts the diplomate whether he or she is exempt from the exam, Dr Wendel explained.

An estimated 2216 diplomates will reach year 6 in 2016 and 2346 will reach it in 2017, he reported.

Although the cut point in the pilot is 86%, "it may be, going forward, that the threshold needs to be higher," Dr Wendel told Medscape Medical News.

Because performance in the pilot will be used to determine the eventual threshold, he said he is encouraging everyone to do well on the first answers submitted.

Other boards are proposing a similar exam exemption, he said, but none seem to be as far along as the ABOG, with the exception of the American Board of Anesthesiology, which he called "the big innovator" in MOC.

Unlike many other medical boards, the ABOG has not gotten a lot of complaints about its MOC process, said Dr Wendel. "The comment we get the most is, 'thanks for helping me be a better doc'," he said.

Dr Wendel has disclosed no relevant financial relationships.

American Congress of Obstetricians and Gynecologists (ACOG) 2016 Annual Clinical Meeting. Presented May 16, 2016.


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