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Which Board-Certified Doctors Are Renewing Their Certification, and Why?
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What is the problem and what is known about it so far?
After doctors finish their education and postgraduate specialty training, many of them take an examination given by a board of experts that certifies their knowledge in the field. Those who pass the examination are then known as board-certified specialists. Examinations can also be taken for certification in subspecialties and in areas of added qualification. In the past, once a doctor was certified, many types of board certification never had to be renewed. More than a decade ago, however, the certifying boards decided that periodic reexamination should be done to ensure that doctors were keeping up with current medical knowledge. Beginning in 1990, the American Board of Internal Medicine began issuing certificates that expired after 10 years. Maintenance of Certification (MOC) requires continuing study and passing a proctored examination every 10 years thereafter. Not all doctors who were initially board certified have taken part in the MOC process.
Why did the researchers do this particular study?
To find out the characteristics of the doctors who were taking part in MOC, what they thought about the process, and their reasons for taking part (or not taking part) in the program.
Who was studied?
1607 doctors whose initial certificates were expiring and who were still working in the field of internal medicine.
How was the study done?
The researchers sent a survey questionnaire to participants asking about their current professional activities, their reasons for taking part (or not taking part) in MOC, and what they thought about the process.
What did the researchers find?
More than half of the doctors said they participated in MOC to update their knowledge and to maintain their professional image. One third participated because of personal interest or because it was required for employment, and one quarter participated to maintain patient satisfaction. Among doctors who decided not to participate, 60% said the reason was that it took too much time, while one third said that it was not required for their employment or was too expensive. More than half of general internists thought that letting their certificates expire would have adverse consequences for their career, while only 21% of subspecialists thought it would have that effect. Two thirds of physicians agreed that doctors who take care of patients should be certified.
What were the limitations of the study?
Only doctors who volunteered to take part in the study were included in the analysis, and their opinions may have differed from those who declined to participate.
What are the implications of the study?
In general, doctors seem to have a positive attitude about the need to take part in MOC and are doing so for reasons that benefit the public as well as their own professional status.
Article and Author Information
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The summary below is from the full report titled “Who Is Maintaining Certification in Internal Medicine—and Why? A National Survey 10 Years after Initial Certification.” It is in the 3 January 2006 issue of Annals of Internal Medicine (volume 144, pages 29-36). The authors are R.S. Lipner, W.H. Bylsma, G.K. Arnold, G.S. Fortna, J. Tooker, and C.K. Cassel.
