Physicians who fail to enroll in the American Board of Internal Medicine’s Maintenance of Certification program will no longer automatically lose their board certification status, according to the latest change by ABIM to its MOC process.

Effective immediately, doctors who meet all other program requirements will not become “uncertified” for having not enrolled in MOC, ABIM President Richard J. Baron said in an Aug. 4 blog post .

“This change came from conversations with the community about how the program was working and how the program can be improved,” Dr. Baron said in an interview. “We’re serious about translating into action what we’re learning.”

The American College of Physicians praised the MOC modification as a necessary correction.

“ACP is pleased that ABIM changed its policy linking certification status with enrollment in the MOC program,” ACP President Wayne J. Riley said in an interview. “This was an important correction of an unintended consequence, and we appreciate ABIM’s acting on feedback from the internal medicine community to rectify the problem,” said Dr. Riley.

The change addresses a policy that previously tied board certification designation to MOC enrollment.

In 2014, ABIM made changes to simplify its fee structure by adding an annual payment option as an alternative to its 10-year fee. However, in an unintended consequence of the changes, doctors who did not enroll and pay for the program in years in which they did not have to complete any requirements were designated as “not certified,” according to ABIM’s announcement.

The policy had particularly negative effects on those in fellowships or those who had just completed training. For instance, doctors who had recently passed an internal medicine exam but were still undergoing training were advised that they needed to enroll in MOC, Dr. Baron said in an interview. The rule led to confusion and, in some cases, adversely affected job searches.

“When they tried to get moonlighting jobs, they discovered they were being reported as ‘not enrolled,’ ” he said. “That was not the board’s intention at all.”

The change will not impact all doctors, and Dr. Baron advises members to check their status page on ABIM’s website to see if the modification affects them.

The policy change means that:

• Diplomates who lost certification solely on the basis of failure to enroll in MOC or to pay MOC fees have now had their certification status updated to “certified.” There is no further action they must take.

• Diplomates who wish to be reported as “participating in MOC” must be enrolled in the MOC program, be current with their payments, and be meeting ongoing program requirements.

• Diplomates who earned initial certification since 2013 or renewed certification since 2014 and who no longer wish to be enrolled in MOC this year may, as a result of this policy change, be eligible for a refund of their 2015 MOC enrollment fees.

• Diplomates must still meet the 5- and 10-year MOC program milestones to maintain their certification.

American College of Cardiology President Kim Allan Williams Sr. called the policy change a much-needed modification that will equalize the playing field for all doctors.

“By tying together board certification and enrollment in Maintenance of Certification, the American Board of Internal Medicine appeared to devalue the secure examination passed by recently certified physicians, by setting different standards for them, compared to those certified in previous years,” Dr. Williams said in a statement .

“The ABIM should be commended for recognizing the negative impact of this policy on current and future employment opportunities, particularly for those in the early stages of their careers, and taking the steps necessary to reverse it,” Dr. Williams noted.

The certification/enrollment change is the latest in an ongoing series of modifications to ABIM’s MOC process. In July, ABIM announced that no disciplines within its MOC program will require underlying certification and that all ABIM diplomates can choose the certifications they wish to maintain. The policy goes into effect Jan. 1, 2016.

In early June, ABIM rolled out changes to its exam outline and score report. Starting with spring 2015 exams, physicians will receive enhanced score reports with more performance details, according to ABIM. The board also updated its internal medicine MOC blueprint – the exam content outline – to ensure that the exam reflects how internists are practicing today and to provide more detailed explanations of topics that may be included in the exam.

The growing list of changes follows a February announcement by ABIM apologizing to physicians for an MOC program that “clearly got it wrong.” ABIM pledged to make the program more consistent with physicians’ practice and values. Among the immediate changes are updates to its internal medicine exam; suspension of the practice assessment, patient voice, and patient safety requirements for at least 2 years; and setting MOC enrollment fees at or below 2014 levels through at least 2017.

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