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Professionalism, Career-Long Assessment, and the American Board of Medical Specialties’ Maintenance of Certification: An Introduction to This Special Supplement
LOIS MARGARET NORA, MD, JD
Key Words: professionalism/ethics, maintenance of certification, self-assessment, board certification, assessment, longitudinal
Professions, including those professions served by this journal, have certain characteristics in common.1 Members of a profession have special knowledge and skills that other members of the community at large do not have, and they are called upon to use that knowledge and skills in situations of uncertainty. The community has often made substantial investments to assist the individual professional to develop this expertise; government support of health professions education and patients allowing student involvement in their care are two examples. Members of the profession commit to use their special knowledge and skills to serve the best interest of the patients, families, and communities for whom they care. This commitment is a key element in most health professions’ curricula, and the public professing of this commitment is an important element of transitional events including white coat ceremonies and graduation. Members of a profession, through the development of oversight bodies, take responsibility for the quality of practice and education in the unique knowledge and skills of the profession. This responsibility and privilege of oversight is granted by the public,
Disclosure: The author reports she is salaried by the American Board of Medical Specialties. Dr. Nora: President and Chief Executive Officer, American Board of Medical Specialties Correspondence: Lois Margaret Nora, American Board of Medical Specialties, 222 North LaSalle Street, Suite 1500, Chicago, IL 60601; e-mail: [email protected]. © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education. • Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/chp.21199
which recognizes its limited abilities in the disciplinary content and is confident that the profession will act in the public’s best interest. Among the obligations that health professionals (and, for the purposes of this supplement to the Journal of Continuing Education for the Health Professions, physicians in particular) assume, and on which the public relies, is demonstrating knowledge, skill, and professionalism over the course of one’s career. The rapid pace of change in scientific and medical knowledge and the ongoing development of procedures and technologies are well recognized, making continuous learning and improvement a professional necessity and a patient safety issue. Further, the public demands that ongoing learning and assessment be rigorous and transparent if the professions are to continue to have the privilege of self-regulation. Participation in the American Board of Medical Specialties (ABMS) Maintenance of Certification (MOC) program is one important way that over 450,000 ABMS board-certified physicians across the primary care and focused specialties participate in and demonstrate ongoing learning, self-assessment, and assessment by others. Available to the physicians who have achieved board certification by one of the 24 ABMS member specialty boards, the ABMS MOC program is relatively young. While several ABMS member boards have had time-limited board certification since the 1970s, it was in 2000 that all of the 24 ABMS member boards committed to a rigorous 4-part program for maintaining certification. The MOC program is based on the 6 ABMS/Accreditation Council for Graduate Medical Education core competencies and incorporates requirements for professional standing and professionalism, engagement in learning, assessment of knowledge, and ongoing improvement in practice.
JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, 33(S1):S5–S6, 2013
Nora
ABMS is pleased to sponsor this supplement to the Fall 2013 issue of JCEHP. This supplement explores issues inherent in career-long learning and assessment of physicians. Several articles focus on the ABMS MOC program. These articles explain the ABMS MOC process, underscore the philosophy and evidence-based nature of ABMS MOC requirements, and highlight the principles of adult learning embedded within ABMS MOC. Opportunities for improvement in the ABMS MOC program are also identified, and these findings have value for the continuous quality improvement approach to maintenance of certification that ABMS employs and to the current development of its MOC 2015 Standards. Several authors highlight how Canada and the United Kingdom are incorporating career-long learning and assessment programs into their systems of professional regulation, demonstrating that the emphasis on ongo-
S6
ing professional development is not exclusive to the United States. The scholarly works presented in this supplement will contribute to the ongoing evaluation and continuous improvement of the ABMS MOC Program. For example, the current standards for the program have been reviewed over the past 18 months with plans to implement program improvements in 2015. As importantly, this supplement will contribute to the ongoing dialogue about adult learning, assessment, and professional obligations of the entire community of health professions. Reference 1. Gardner H, Shulman LS. The professions in America today: crucial but fragile. Daedalus. 2005;134(3):13–18.
JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS—33(S1), 2013 DOI: 10.1002/chp
Professionalism, Career-Long Assessment, and the American Board of Medical Specialties’ Maintenance of Certification: An Introduction to This Special Supplement
LOIS MARGARET NORA, MD, JD
Key Words: professionalism/ethics, maintenance of certification, self-assessment, board certification, assessment, longitudinal
Professions, including those professions served by this journal, have certain characteristics in common.1 Members of a profession have special knowledge and skills that other members of the community at large do not have, and they are called upon to use that knowledge and skills in situations of uncertainty. The community has often made substantial investments to assist the individual professional to develop this expertise; government support of health professions education and patients allowing student involvement in their care are two examples. Members of the profession commit to use their special knowledge and skills to serve the best interest of the patients, families, and communities for whom they care. This commitment is a key element in most health professions’ curricula, and the public professing of this commitment is an important element of transitional events including white coat ceremonies and graduation. Members of a profession, through the development of oversight bodies, take responsibility for the quality of practice and education in the unique knowledge and skills of the profession. This responsibility and privilege of oversight is granted by the public,
Disclosure: The author reports she is salaried by the American Board of Medical Specialties. Dr. Nora: President and Chief Executive Officer, American Board of Medical Specialties Correspondence: Lois Margaret Nora, American Board of Medical Specialties, 222 North LaSalle Street, Suite 1500, Chicago, IL 60601; e-mail: [email protected]. © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on Continuing Medical Education, Association for Hospital Medical Education. • Published online in Wiley Online Library (wileyonlinelibrary.com). DOI: 10.1002/chp.21199
which recognizes its limited abilities in the disciplinary content and is confident that the profession will act in the public’s best interest. Among the obligations that health professionals (and, for the purposes of this supplement to the Journal of Continuing Education for the Health Professions, physicians in particular) assume, and on which the public relies, is demonstrating knowledge, skill, and professionalism over the course of one’s career. The rapid pace of change in scientific and medical knowledge and the ongoing development of procedures and technologies are well recognized, making continuous learning and improvement a professional necessity and a patient safety issue. Further, the public demands that ongoing learning and assessment be rigorous and transparent if the professions are to continue to have the privilege of self-regulation. Participation in the American Board of Medical Specialties (ABMS) Maintenance of Certification (MOC) program is one important way that over 450,000 ABMS board-certified physicians across the primary care and focused specialties participate in and demonstrate ongoing learning, self-assessment, and assessment by others. Available to the physicians who have achieved board certification by one of the 24 ABMS member specialty boards, the ABMS MOC program is relatively young. While several ABMS member boards have had time-limited board certification since the 1970s, it was in 2000 that all of the 24 ABMS member boards committed to a rigorous 4-part program for maintaining certification. The MOC program is based on the 6 ABMS/Accreditation Council for Graduate Medical Education core competencies and incorporates requirements for professional standing and professionalism, engagement in learning, assessment of knowledge, and ongoing improvement in practice.
JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, 33(S1):S5–S6, 2013
Nora
ABMS is pleased to sponsor this supplement to the Fall 2013 issue of JCEHP. This supplement explores issues inherent in career-long learning and assessment of physicians. Several articles focus on the ABMS MOC program. These articles explain the ABMS MOC process, underscore the philosophy and evidence-based nature of ABMS MOC requirements, and highlight the principles of adult learning embedded within ABMS MOC. Opportunities for improvement in the ABMS MOC program are also identified, and these findings have value for the continuous quality improvement approach to maintenance of certification that ABMS employs and to the current development of its MOC 2015 Standards. Several authors highlight how Canada and the United Kingdom are incorporating career-long learning and assessment programs into their systems of professional regulation, demonstrating that the emphasis on ongo-
S6
ing professional development is not exclusive to the United States. The scholarly works presented in this supplement will contribute to the ongoing evaluation and continuous improvement of the ABMS MOC Program. For example, the current standards for the program have been reviewed over the past 18 months with plans to implement program improvements in 2015. As importantly, this supplement will contribute to the ongoing dialogue about adult learning, assessment, and professional obligations of the entire community of health professions. Reference 1. Gardner H, Shulman LS. The professions in America today: crucial but fragile. Daedalus. 2005;134(3):13–18.
JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS—33(S1), 2013 DOI: 10.1002/chp
