Best Practices

A.B.I.M. | Doctors’ prep for ABFM/ABIM Maintenance of Certification exams offers clues to improving patient care

OCTOBER 24-26, 2019 – ATLANTA, GA USA – Click Here To Learn More …

Criticism intensified in 2014 when ABIM announced that doctors would need to earn accreditation points on a continual basis over the 10 years between taking the recertifying examination. The outcry led to modifications of some MOC requirements, along with an apology from Baron. The controversy also spawned an alternative maintenance-certification group, the National Board of Physicians and Surgeons. The ABIM says it plans to continue offering its current “knowledge check-in” and day-long examination certification paths. The ABIM certifies over 200,000 internists, or about 25 percent of physicians in the U.S. (~Jeffrey Bendix, Senior Editor; August 26, 2019;

Philadelphia, PA, July 23, 2019 – New research by the American Board of Family Medicine (ABFM) and American Board of Internal Medicine (ABIM) finds that physicians learn information differently when they prepare for Maintenance of Certification (MOC) exams than they do in the normal process of staying current with medical advances.

The study entitled “How Physicians Prepare for Maintenance of Certification Exams: A Qualitative Study”, which was published online ahead of print in the June 2019 issue of Academic Medicine, provides insight into the learning methods employed by physicians that can be used to enhance medical education and associated assessments.

Board certification is a process by which physicians demonstrate expertise in a specialty area by meeting training requirements and passing an examination designed to assess their knowledge, judgment, and diagnostic and clinical management abilities. Unlike state licensure, certification is not a legal requirement to practice medicine in the U.S., though many health plans and hospitals use board certification as part of their credentialing. Physicians maintain their certification through their board’s MOC program. One current component of MOC for the ABIM and the ABFM is the requirement to pass a comprehensive exam at least every 10 years.

About the Study

The study explored the physician MOC exam preparation experience: how they prepared for the exams and decided what to study; how exam preparation compares with what they normally do to keep their medical knowledge current; and what relevant information they learn in the process.

“Little is known about how board certified physicians prepare for their MOC exams. Knowing how they prepare, and how that compares with what they do apart from preparing for an exam, can help researchers, educators, and certifying boards better understand how to improve the MOC process and enhance the learning experiences of physicians,” wrote lead study author Benjamin J. Chesluk, PhD, Senior Researcher for Ethnographic Research at ABIM.


Physicians’ battle to limit maintenance of certification requirements continues despite testing changes

Between September 2016 and March 2017, the authors interviewed 80 primary care physicians who had recently taken either the ABFM or ABIM MOC exam. They analyzed transcripts and notes from these interviews looking for patterns and emergent themes.

Dr. Chesluk noted that this was one of several forthcoming peer-reviewed articles that studied the impact of MOC exams on physicians. Another article, which looks at what physicians learn when preparing for their MOC exams, was published in the Journal of General Internal Medicine.

Most interviewees studied for their MOC exams by varying from their routines for staying current with medical knowledge, both by engaging with a different scope of information and by adopting different study methods. Physicians described exam preparation as returning to a student/testing mindset. The researchers sought to document the full range of physician experiences of preparing for an MOC exam, including the burdens and stresses involved.

“We were surprised at how differently physicians described MOC exam preparation activities compared to what they do to keep up on a regular basis,” said Aimee Eden, Medical Anthropologist at ABFM. “To prepare for the exam, physicians reviewed a broader range of topics and were motivated by the exam to delve deeper into certain topics than they would during what they routinely do to keep up. We were also surprised by how many physicians expressed their appreciation for the extra push to study, and a few even enjoyed the exam preparation process. We also heard from those who felt additional stress and burden during the process.”

Researchers noted that understanding how physicians engage with MOC exams can help improve patient care in two ways: (1) by shedding light on how MOC programs may contribute to better patient care and (2) by pointing to possible enhancements to MOC programs for physicians that could also result in improvements for their patients.

Additional Information

View the research article in Academic Medicine (Subscription may be required to access the full article).

Read more research from ABIM and other organizations about board certification, MOC and physician assessment.

The American Board of Family Medicine (ABFM) is one of the twenty-four Member Boards of the American Board of Medical Specialties. Founded in 1969, it is a voluntary, not-for-profit, private organization whose objective is to encourage excellence in medical care. The ABFM believes that its certified family physicians have successfully demonstrated their ability and have proven their commitment to the public, the specialty of Family Medicine and the profession. Through its certification processes, the ABFM seeks to provide patients the assurance that their certified family physicians have the necessary education, training, skills and experience to provide high quality care to patients and their families and that this commitment to excellence is maintained throughout their years of practice.

ABIM Board Certified Doctors Make a Difference
Internists and subspecialists who earn and maintain board certification from the American Board of Internal Medicine (ABIM) differentiate themselves every day through their specialized knowledge and commitment to continual learning in service of their patients. Established as an independent nonprofit more than 80 years ago, ABIM continues to be driven by doctors who want to achieve higher standards for better care in a rapidly changing world. Visit ABIM’s blog to learn more and follow ABIM on Facebook and Twitter. ABIM is a member of the American Board of Medical Specialties.

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