Friday March 12, 2010
American Board of Internal Medicine Maintenance of Certification Program
(Poll at NEJM)
"A 55-year-old physician, who graduated from medical school in 1979, completed his internship and junior residency in internal medicine in 1981. He did 3 years of fellowship training in endocrinology, followed by a third year of residency in internal medicine. He then completed and passed the American Board of Internal Medicine (ABIM) qualifying examinations in internal medicine and endocrinology; the ABIM issued to him certificates of unlimited duration, specifying that he held board certification in internal medicine and endocrinology. For the past 24 years, he has been in the practice of general internal medicine with an emphasis on endocrinology. He estimates that about half of his patients see him for endocrine problems exclusively and the remainder see him for issues regarding general internal medicine. He is on the faculty of the medical school from which he graduated, but he spends most of his time caring for patients in an outpatient setting. For 6 months of each year, he has third-year residents, training in internal medicine, shadowing him at his outpatient practice. For one 3-week block each year, he serves as an attending physician on the general medical service of the hospital where he has inpatient privileges, a minor teaching hospital of his medical school at which he trained. During this 3-week period, he has two medical students, two interns, and a senior medical resident under his direct supervision.
He attends the grand rounds lecture series regularly. Once a year, he leaves his practice to attend a weeklong postgraduate course, alternating between internal medicine and general endocrinology. He has never considered enrolling in the maintenance of certification (MOC) program in either internal medicine or endocrinology. His reasoning is that he is up to date in his practice, that he makes frequent use of point-of-care reference services to check on the latest diagnostic or therapeutics practices when he encounters a condition that he does not see frequently, and that the money and time needed to undertake MOC would not be well spent. He has received a communication from the ABIM urging him to undergo the MOC process. He consults you, as a friend and colleague, for advice about what to do.."
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(last 1169 people voted with 66% voting against MOC!)
