Changes Coming to MOC: Will Physicians Get Relief?

Leigh Page

Disclosures

June 05, 2018

In This Article

Introducing Shorter, More Frequent Testing

Changing the MOC exam has become a more pressing issue in the past few years. In 2015, 23,000 internists and internal medicine subspecialists signed a petition demanding that the ABIM remove all activities in Parts II and IV of the MOC and base recertification just on the exam.[7]

Now the big recertification exam appears to be on its way out as the main way to assess physicians, and no one seems to be very upset about it. Big exams like the initial certification exam are a longstanding feature of the boards, but a lot of physicians don't want it for recertification, saying that it forces them to learn facts that are irrelevant to their practices.

To pass this exam, "you had to study and study and study, and then you had to sit all day for the exam," says Sue Bornstein, MD, an internist in Dallas and a Texas Medical Association (TMA) trustee. "You couldn't use sources to look things up, which is the way doctors do things—we physicians love our sources—and if you failed, you could lose your certification."

The emergence of shorter, more frequent testing seems to be a win-win sort of change: MOC advocates can assess physicians more continuously—a basic goal of the program—and physicians will be able to take smaller, more manageable tests.

Most boards are keeping the 10-year test as an option, but fully 22 of the 24 ABMS boards are introducing or planning to introduce the shorter online tests, according to Susan Morris, an ABMS media representative. Though she declined to identify the two boards that are not introducing short tests, one of them seems to be the American Board of Family Medicine (ABFM).

However, even the ABFM is getting involved in short testing. In 2017, it introduced the Continuous Knowledge Self-Assessment, an optional Part II self-assessment activity. Like many of the new tests replacing the exams, the ABFM exercise provides physicians with a set of questions they can answer online over a 3-month period. The results reveal knowledge gaps that can be used to prepare for the regular exam.[8]

While boards get ready to introduce the shorter online tests, they are thinking about putting the old exam online too. The American Board of Dermatology (ABD) is already planning to do so.[9]

How certain is the transition to small, online tests? Morris confirmed that all of the new tests are still considered pilots—even the MOCA Minute, which started 4 years ago and is a model for the rest. Also, the boards always refer to the new online tests as "assessments," and never as examinations, even though they are replacing examinations.

Even though the new testing methodology has been researched a great deal, these descriptors suggest that the ABMS may still have some reservations about its reliability. Morris was asked about this but would not comment.

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