Certification: The Position of AAPM&R
Your Academy has been advocating for necessary changes in Maintenance of Certification (MOC) with both the American Board of Medical Specialties (ABMS) and the American Board of Physical Medicine and Rehabilitation (ABPMR).
The Academy has called for substantive changes to the current MOC requirements and process. Beyond the immediate need to address the current MOC program, the Academy has framed and advanced critical questions that need to be addressed regarding the future needs of certification in a dramatically changing healthcare environment—the future meaning and value of certification, the changing stakeholders and customers, and how to work together to assure physicians remain leaders in tomorrow's health care environment.
The Academy is focused both on an immediate resolve to the current situation as well as a long-term dialogue regarding future needs, and believes the MOC debate must be resolved internally within medicine and without government interference.
AAPM&R supports the intent of certification, as it is rooted in our commitment to medical professionalism and self-regulation. The Academy believes that:
- Board certification should not be a criterion for medical licensing and should not be utilized as a sole criterion for credentialing and/or privileging. There are other critical factors that should be considered in the credentialing and privileging process.
- Some components of the current MOC process, while well-intentioned, place significant burdens on physicians without having been shown to achieve the desired objectives.
In 2017, AAPM&R presented physiatry's concerns at the ABMS summer board meeting and called for the end of MOC in its current form.
In 2018, the Academy testified at the ABMS-convened Vision for the Future Commission. AAPM&R advocated that true changes in certification and continuing certification must be forward thinking and based on an understanding of the future customers and stakeholders' needs.
Immediately, AAPM&R has called on:
- ABPMR to make changes in MOC III and IV requirements. In 2015, AAPM&R released the Academy position statement specifically requesting the following changes to:
- MOC Part III:
- An alternative to the high-stakes, 10-year exam
- The need for the Part III solution to best cover the common core aspects of PM&R while reflecting individual practice patterns.
- The Part III solution should reflect the current practice of medicine, incorporating accepted adult-learning principles, e.g., collaborative decision-making.
- MOC Part IV:
- The suspension of the Practice Improvement Project (PIP) requirement until there are more meaningful, less burdensome, and relevant options for Part IV.
AAPM&R acknowledges and appreciates the commitment of ABPMR's leadership to evolve MOC III, exemplified through the recent pilot launch of CertLink. Your Academy continues to express urgency of a full transition beyond the current pilot efforts in order to provide immediate relief for physiatrists.
Leaders from AAPM&R and ABPMR will meet again this summer to continue discussions that began in 2015 on how immediate changes can be made to support physiatrists and reduce burnout. Stay tuned for an update from the Academy.