Supporting the Physiatrist, Strengthening the Specialty

AAPM&R Members:

The Vision for the Future Commission (Vision Commission), convened by the American Board of Medical Specialties (ABMS), released its draft report of the Future Vision of Continuing Certification. The 96-page report details the Vision Commission’s findings and proposed recommendations.

As a reminder, the Academy’s consistent position regarding Maintenance of Certification^® (MOC^®) has been as follows:

• We urge the immediate discontinuation of the high stakes and expensive Part III exam (Assessment of Knowledge, Judgment, and Skills).
• We urge the immediate suspension of Part IV, Improvement in Medical Practice.
• We support the rapid implementation of a longitudinal formative assessment in lieu of Parts II, III, IV.
• Implementation of the revised structure must:
  • be meaningful and demonstrate value for all physiatrists.
  • reduce the financial burden on all physiatrists.
  • provide an immediate transitional pathway for those who are currently MOC^® Part III eligible so they are not penalized.

The Commission’s findings firmly reinforce that widespread change is critically needed regarding MOC^® and strongly align with and reinforce our Academy positions, including a change to a longitudinal, formative assessment. However, we are disappointed that the report stops short of providing definitive, actionable recommendations in many critical areas. This must be addressed in order for this effort to be impactful and transformative.

The Academy has been a strong advocate for the PM&R specialty, previously providing oral and written testimony to the Commission. Additionally, on behalf of its members, your Academy is now submitting the below comment letter to the Commission, which expresses key concerns and outlines definitive actions for the Commission to consider. We have also worked with the Council for Medical Specialty Societies (CMSS), a coalition of peer specialty organizations, to develop and endorse a more detailed statement and series of specific actionable recommendations, which will be released to the public in the coming days. We will notify members through your weekly e-newsletter, Connection, when it is released.

Together, let’s push for meaningful change to continuing certification (MOC^®). Click here to submit your own comments directly to the Vision Commission. Feel free to copy, paste, and edit from the Academy comments. Comments are due January 15, 2019. 

To the Vision for the Future Commission:

As the representative for more than 9,000 physiatrists and those in training, the American Academy of Physical Medicine and Rehabilitation (AAPM&R) appreciates the opportunity to provide comments to the draft report of the Continuing Board Certification: Vision for the Future Commission (the Vision Commission). AAPM&R commends the Vision Commission on its efforts to understand the concerns and frustrations of physicians related to Maintenance of Certification^® (MOC^®). In 2018, AAPM&R testified, at the request of the Vision Commission, and 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.

Based on the proposed report, AAPM&R has identified 3 primary concerns:

• The continued use of the high-stakes summative examination as part of continuing certification in the current health care environment.
• The absence of specific standards and guidelines for the practice improvement component.
• The lack of role clarity between certifying boards and specialty societies.

We call upon the Commission to make more definitive, actionable recommendations in their final report, including:

• Immediate discontinuation of the high stakes and expensive Part III exam (related to Recommendation 2f).
• Suspension of the current Performance Improvement Project (Part IV) requirements until ABMS confirms and establishes standards and guidelines to assure experiences that are meaningful, demonstrate value, and not overly burdensome (related to Recommendation 4).
• Rapid implementation of a longitudinal formative assessment in lieu of Parts II, III, IV (related to Recommendation 2a).

AAPM&R also requests that the Commission provide greater clarity regarding the roles of certifying boards and specialty societies in the certification process. Certifying boards exist to set standards and to assess performance. Specialty societies are committed to life-long learning, performance improvement, and the development of continuing professional development programs. Several recommendations in the draft report blur the lines between “learning” and “assessment,” and blur the roles and accountabilities of certifying boards and specialty societies.

AAPM&R supports the intent of continuing certification, as it is rooted in our commitment to medical professionalism and self-regulation. We are committed to, and will continue to advocate for, the transformation of continuing certification to ensure the advancement of the physicians we represent, and the care they provide to a diverse and complex patient population.

AAPM&R Members:

The Vision for the Future Commission (Vision Commission), convened by the American Board of Medical Specialties (ABMS), released its draft report of the Future Vision of Continuing Certification. The 96-page report details the Vision Commission’s findings and proposed recommendations.

As a reminder, the Academy’s consistent position regarding Maintenance of Certification^® (MOC^®) has been as follows:

• We urge the immediate discontinuation of the high stakes and expensive Part III exam (Assessment of Knowledge, Judgment, and Skills).
• We urge the immediate suspension of Part IV, Improvement in Medical Practice.
• We support the rapid implementation of a longitudinal formative assessment in lieu of Parts II, III, IV.
• Implementation of the revised structure must:
  • be meaningful and demonstrate value for all physiatrists.
  • reduce the financial burden on all physiatrists.
  • provide an immediate transitional pathway for those who are currently MOC^® Part III eligible so they are not penalized.

The Commission’s findings firmly reinforce that widespread change is critically needed regarding MOC^® and strongly align with and reinforce our Academy positions, including a change to a longitudinal, formative assessment. However, we are disappointed that the report stops short of providing definitive, actionable recommendations in many critical areas. This must be addressed in order for this effort to be impactful and transformative.

The Academy has been a strong advocate for the PM&R specialty, previously providing oral and written testimony to the Commission. Additionally, on behalf of its members, your Academy is now submitting the below comment letter to the Commission, which expresses key concerns and outlines definitive actions for the Commission to consider. We have also worked with the Council for Medical Specialty Societies (CMSS), a coalition of peer specialty organizations, to develop and endorse a more detailed statement and series of specific actionable recommendations, which will be released to the public in the coming days. We will notify members through your weekly e-newsletter, Connection, when it is released.

Together, let’s push for meaningful change to continuing certification (MOC^®). Click here to submit your own comments directly to the Vision Commission. Feel free to copy, paste, and edit from the Academy comments. Comments are due January 15, 2019. 

To the Vision for the Future Commission:

As the representative for more than 9,000 physiatrists and those in training, the American Academy of Physical Medicine and Rehabilitation (AAPM&R) appreciates the opportunity to provide comments to the draft report of the Continuing Board Certification: Vision for the Future Commission (the Vision Commission). AAPM&R commends the Vision Commission on its efforts to understand the concerns and frustrations of physicians related to Maintenance of Certification^® (MOC^®). In 2018, AAPM&R testified, at the request of the Vision Commission, and 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.

Based on the proposed report, AAPM&R has identified 3 primary concerns:

• The continued use of the high-stakes summative examination as part of continuing certification in the current health care environment.
• The absence of specific standards and guidelines for the practice improvement component.
• The lack of role clarity between certifying boards and specialty societies.

We call upon the Commission to make more definitive, actionable recommendations in their final report, including:

• Immediate discontinuation of the high stakes and expensive Part III exam (related to Recommendation 2f).
• Suspension of the current Performance Improvement Project (Part IV) requirements until ABMS confirms and establishes standards and guidelines to assure experiences that are meaningful, demonstrate value, and not overly burdensome (related to Recommendation 4).
• Rapid implementation of a longitudinal formative assessment in lieu of Parts II, III, IV (related to Recommendation 2a).

AAPM&R also requests that the Commission provide greater clarity regarding the roles of certifying boards and specialty societies in the certification process. Certifying boards exist to set standards and to assess performance. Specialty societies are committed to life-long learning, performance improvement, and the development of continuing professional development programs. Several recommendations in the draft report blur the lines between “learning” and “assessment,” and blur the roles and accountabilities of certifying boards and specialty societies.

AAPM&R supports the intent of continuing certification, as it is rooted in our commitment to medical professionalism and self-regulation. We are committed to, and will continue to advocate for, the transformation of continuing certification to ensure the advancement of the physicians we represent, and the care they provide to a diverse and complex patient population.