As I approached my first recertification for internal medicine and endocrinology, diabetes, and metabolism, some essential questions loomed in my mind: What is the real value of a recertification process for me? Should I devote the study time for the board exams and pay the money for my ABIM maintenance of certification (MOC)? And, if I do, how can I get lasting value from the process and make it both relevant and rewarding?
I know colleagues — including some very good ones — who let their board certifications lapse, and I understand the skepticism in some quarters about the MOC process. The benefit is hard to quantify, and it costs both time and money. Some physicians question the exam’s relevance to the problems we are called upon to solve each day and ask whether we’d be better off spending our educational time otherwise. And, although other professions in the U.S. require a process of recertification, most do not require an exam. For many physicians, recertification has been a rite of passage to be tolerated, and we study “just to get through it.” Indeed, while the principle of participating in board certification for our profession is easy to embrace, the process has been problematic.
But physicians have unique responsibilities in society, even among healthcare providers. When it comes to a patient’s most difficult and complex problems, we are the last recourse. With calls for increased oversight, transparency, and regulation of physicians in recent years, it’s in our profession’s interest to show that we can regulate quality ourselves.
When we are students and in training, built-in feedback from teachers and peers lets us know where we perform well and what needs improvement. But after training, our clinical practice is done mostly alone and independently. How can we know if our decisions are on par with current standards?
Why I Opted for ABIM Recertification
A certification/recertification program to measure competence encourages us to keep pace with change. Research shows that without continuous updating, a physician’s skills and knowledge tend to decline with time – and that clinicians who choose to recertify tend to perform better on standardized measures of quality and patient outcomes than clinicians who do not recertify.
The certification and recertification process establishes a blueprint for the body of knowledge we should challenge ourselves to keep fresh, sets a quality standard, and provides a publicly accountable measure for that quality. The current ABIM MOC process, with recent changes, is the avenue we currently have, designed by our peers.
I decided to take the ABIM recertification exams in both internal medicine exam and endocrinology, diabetes, and metabolism. Even though it called for a commitment of time and expense, this was my personal way of participating in the process of staying current and demonstrating my commitment to continuous self-improvement.
What I Gained from My ABIM Board Review Preparation
As I worked through the material to review for my board exams, I reviewed guidelines that were useful to my practice. I used a combination of modules from ABIM and the Endocrine Society and completed a practice audit on diabetes care. With these materials, I updated myself on new guidelines, and I reviewed cases that I see less frequently in my diabetology-focused practice but would expect myself to know. I found some elements of my practice that could be, and were, improved through the practice improvement module. Ultimately, it was good for me and good for my patients.
I’m glad I recertified. (Yes, I passed both exams.) Going through the process assured me that amidst my own busy practice — with its paperwork, phone calls, and endless distractions — I am prepared to make tricky clinical decisions and to work through and solve challenging problems. Recertification was an opportunity to check in with myself, to make sure I am positioned to make those decisions.
By saying yes to recertification and using an approach that is relevant and intellectually invigorating, we stand to gain as individual physicians, and perhaps ultimately the profession gains too.