Author + information
- Kim Allan Williams Sr., MD, FACC, ACC President∗ ()
- ↵∗Address correspondence to:
Dr. Kim Allan Williams, Sr., American College of Cardiology, 2400 N Street NW, Washington, DC 20037.
In response to ongoing efforts by the American College of Cardiology (ACC), other cardiology specialty societies, and other internal medicine stakeholders, the American Board of Internal Medicine (ABIM) has reversed several of its most contentious Maintenance of Certification (MOC) policies over the last several months.
The most recent reversal announced in August lifts the requirement that physicians who passed the initial certification exam in 2014 or later must be enrolled in the MOC process in order to be listed as board certified. As a result of the change, physicians meeting all other programmatic requirements will not lose certification simply for failure to enroll in MOC.
This decision was a direct result of the ACC's efforts seeking an expedited resolution of this issue by the ABIM. In May 2015, College leadership was made aware of an e-mail from the ABIM to early career cardiologists who had passed the Cardiovascular Disease Certification Exam in 2014. The e-mail informed them of the need to enroll in MOC by March 31, 2015, in order to be publicly reported as certified in Cardiovascular Disease. It also stated their certification would remain valid only as long as they were participating in MOC. Concerned about the implications of this new process, ACC leadership engaged ABIM leaders immediately, encouraging them to level the playing field for all diplomats.
By tying together board certification and enrollment in MOC, the ABIM set different standards for recently certified physicians compared with those certified in previous years. The ABIM should be commended for recognizing the negative impact of this policy on current and future employment opportunities, particularly for those in the early stages of their careers, and taking the steps necessary to reverse it.
Under the new policy, physicians who lost certification solely on the basis of failure to enroll in MOC or to pay MOC fees have had their certification status updated to “Certified” on the ABIM’s website. However, those wishing to be reported as “Participating in MOC” must be enrolled in the MOC program, be current with their payments, and be meeting ongoing program requirements. Physicians who earned initial certification since 2013 or renewed certification since 2014 and who no longer wish to be enrolled in MOC in 2015 as a result of this policy change may be eligible for a refund of their 2015 MOC enrollment fee(s). Those receiving a refund will be reported as “Certified, Not Participating in MOC.” Finally, physicians must still meet 5- and 10-year MOC program milestones to maintain their certification.
Another major change to MOC includes the elimination of the “double jeopardy” requirement to maintain underlying certification in a foundational discipline in order to remain certified in a subspecialty, effective January 1, 2016. For cardiologists, this means that those specializing in interventional cardiology, electrophysiology, advanced heart failure and transplant, and adult congenital heart disease no longer need to maintain certification in general cardiology in order to maintain certification in a cardiology subspecialty. Other changes include an updated “Application for ABIM MOC Recognition” that provides more opportunities for physicians to earn MOC Part II points for activities with a self-assessment component that have traditionally been designated as continuing medical education credits only, and a suspension for at least 2 years for MOC Part IV practice improvement modules along with patient safety and patient voice requirements.
All of these changes reflect the engagement and collaboration of the ACC, other cardiovascular societies, and the broader internal medicine community, on behalf of their members. We are clearly being heard. At the ACC’s recent Board of Trustees (BOT) meeting, leaders heard recommendations from the 2 task forces charged with identifying how best to work with the ABIM going forward to address additional recommendations and exploring alternatives to ABIM MOC certification, respectively.
The BOT chose to move forward in the following areas. First, ACC immediate Past President Patrick T. O’Gara, MD, MACC, and ACC Executive Vice President of Science, Quality and Education William J. Oetgen, MD, MBA, FACC, were appointed as liaisons for continued communications with the ABIM. Second, the BOT agreed to move forward on working with the ABIM to develop a new, externally validated process for maintenance of competence that would replace the 10-year exam; and on researching best practices for maintenance and demonstration of competence with eventual linkage to patient outcomes, cost, and cost effectiveness. The BOT also recommended integrating federally mandated elements related to Part IV and patient experience into existing hospital and practice programs. Finally, BOT members agreed that the ACC will continue its work toward an alternative board pending ongoing discussions with the ABIM.
Members of both task forces have worked tirelessly over the last 3 months to determine the best courses of action for the College, its members, and the patients they serve, and should be commended for their due diligence and their thoughtful recommendations. We have made tremendous headway in the past year, and our goal is to make sure this success continues. Stay tuned to the ACC in Touch Blog (blog.acc.org) and the ACC’s online MOC Hub (www.acc.org/MOC) for ongoing updates.
- American College of Cardiology Foundation