The American Board of Internal Medicine Maintenance of Certification Examination and State Medical Board Disciplinary Actions: a Population Cohort Study

The American Board of Internal Medicine Maintenance of Certification Examination and State Medical Board Disciplinary Actions: a Population Cohort Study

Background Some have questioned whether successful performance in the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) program is meaningful. The association of the ABIM Internal Medicine (IM) MOC examination with state medical board disciplinary actions is unknown. Obje...

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Bibliographic Details
Published in:Journal of general internal medicine : JGIM Vol. 33; no. 8; pp. 1292 - 1298
Main Authors: McDonald, Furman S., Duhigg, Lauren M., Arnold, Gerald K., Hafer, Ruth M., Lipner, Rebecca S.
Format: Journal Article
Language:English
Published: New York Springer US 01-08-2018
Springer Nature B.V
Subjects:
Certification
Cohort analysis
Demographic variables
Demographics
Internal Medicine
Medical personnel
Medicine
Medicine & Public Health
Original Research
Physicians
Population studies
MOC
maintenance of certification
ABIM
disciplinary action
certification
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Summary:Background Some have questioned whether successful performance in the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) program is meaningful. The association of the ABIM Internal Medicine (IM) MOC examination with state medical board disciplinary actions is unknown. Objective To assess risk of disciplinary actions among general internists who did and did not pass the MOC examination within 10 years of initial certification. Design Historical population cohort study. Participants The population of internists certified in internal medicine, but not a subspecialty, from 1990 through 2003 ( n  = 47,971). Intervention ABIM IM MOC examination. Setting General internal medicine in the USA. Main Measures The primary outcome measure was time to disciplinary action assessed in association with whether the physician passed the ABIM IM MOC examination within 10 years of initial certification, adjusted for training, certification, demographic, and regulatory variables including state medical board Continuing Medical Education (CME) requirements. Key Results The risk for discipline among physicians who did not pass the IM MOC examination within the 10 year requirement window was more than double than that of those who did pass the examination (adjusted HR 2.09; 95% CI, 1.83 to 2.39). Disciplinary actions did not vary by state CME requirements (adjusted HR 1.02; 95% CI, 0.94 to 1.16), but declined with increasing MOC examination scores (Kendall’s tau-b coefficient = − 0.98 for trend, p  < 0.001). Among disciplined physicians, actions were less severe among those passing the IM MOC examination within the 10-year requirement window than among those who did not pass the examination. Conclusions Passing a periodic assessment of medical knowledge is associated with decreased state medical board disciplinary actions, an important quality outcome of relevance to patients and the profession.
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ISSN:0884-8734
1525-1497
DOI:10.1007/s11606-018-4376-z