Dear Colleagues,


The National Board of Physicians and Surgeons (NBPAS), as advocates for reasonable and appropriate certification of physicians, would like to update you on new developments relevant to Maintenance of Certification (MOC) process.  Last week the final Vision Commission Report on MOC was released.  To view:


As you know, NBPAS created a shared public comment to the draft report that recommended strengthening the Commission’s recommendations to include, among other things, a moratorium on harmful MOC exams. Over 21,000 physicians signed the “petition-like” comment. To view the shared comment, click here:

We believe our efforts had impact. 


Of note, the Commission’s report recommends all ABMS boards move to assessments that are “formative” (“assessment of a physician with the primary purpose of providing feedback for learning and improvement…without passing judgement”), not “summative” (“assessment of learning with the primary purpose of establishing whether performance at a single defined point in time meets established performance standards, permanently recorded in the form of a score”). 


As examples, the Commission report is supportive of the anesthesia board’s (ABA) MOCA Minute and the OB/GYN (ABOG) article-based assessments (both are formative) that have received encouraging feedback from diplomates, and is highly critical of the ABIM’s new Knowledge Check-in tests (which is summative).


While the final report does not recommend a moratorium on “summative” exams, the report’s recommendations are significantly strengthened to now include a timeline.

Page 9-10 : Short-Term and Intermediate Recommendations. Final paragraph: “Unlike initial certification, assessments for continuing certification should be formative…The Commission recommends that by the end of 2019 all ABMS Boards that have not moved to these types of assessments…submit a transition plan with milestones and timelines.”


We also bring to your attention a very strong Vision Commission recommendation about the use of board certification status that could significantly mitigate physician harm from MOC:

Page 16: “ABMS must encourage hospitals, health systems, payers and other health care organizations to not deny credentialing or privileging to a physician solely on the basis of certification.”


While not fully embracing our “petition,” we believe the Vision Commission report represents a significant step in the right direction. The over 21,000 physicians who signed the “petition” are to be congratulated. Those of you who signed positively influenced the final report. 


We still have a long way to go, but at a minimum, NBPAS strongly urges all ABMS boards to immediately adopt the Vision Commission’s recommendations, especially the recommendation against the use of board certification status, or the lack thereof, to deny credentialing and privileging.  One class action lawsuit has already been filed (against the ABIM) and there are indications of several more to come. NBPAS will be looking for significant announcements of change on the part of ABMS boards while carefully watching this litigation.


To learn more about obtaining Board Certification from the National Board of Physicians and Surgeons (NBPAS), visit our website  



Paul Teirstein, MD on behalf of the NBPAS Board
NBPAS, President
Chief of Cardiology, Scripps Clinic