Maintenance of Certification: How Will It Affect Pathology Practice?(Editorial‪)‬

The Accreditation Council for Graduate Medical Education Outcome Project and concerns about safe and effective medical care led to adoption by both that council and the American Board of Medical Specialties of a set of core competencies for physicians. In addition to patient care and medical knowledge, these core competencies include interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. All 24 member boards of the American Board of Medical Specialties have implemented a Maintenance of Certification (MOC) program that encompasses the core competency concepts. (1,2) The MOC program differs from previous recertification programs required by most American Board of Medical Specialties boards in that practitioners must demonstrate participation in educational and quality improvement activities on an ongoing basis; demonstration of cognitive knowledge is no longer enough. The timeliness of the decision to implement MOC is supported by a recent Gallup poll, which found that the American public wants medical care provided by specialists who are certified on a regular basis. (3) The American Board of Pathology (ABP) instituted a voluntary recertification (VR) program in 1996 and began issuing time-limited certificates in 2006. All diplomates with time-limited certificates are required to participate in a 10-year MOC cycle. Satisfactory participation in MOC requires documentation of activities at 2- to 4-year intervals throughout the MOC cycle. The ABP VR program and the MOC process have similarities in that they both require documentation of information regarding the diplomate's practice. They differ in the number and type of continuing medical education (CME) credits, the distribution of CME throughout the cycle, the depth of practice assessment, and in the MOC requirement for a secure closed-book examination. Maintenance of Certification is a prospective and ongoing process, whereas the ABP voluntary program is a review and confirmation of the diplomate's activities in the previous 10 years.