For decades, initial board certification has been considered the gold standard for demonstrating a physician’s competence in their specialty. Yet, as the landscape of medicine evolves, so do physicians' expectations of what lifelong learning through continued board certification should look like. Many, frustrated with burdensome and costly traditional Maintenance of Certification (MOC) programs, are rethinking their views.
Fortunately, in recent years, the National Board of Physicians and Surgeons (NBPAS) emerged as an alternative for those seeking a more clinically relevant and physician-driven alternative. In this article, we’ll explore what NBPAS is, why more doctors are making the switch, and what this trend could mean for the future of continuing board certification.
What Is NBPAS?
The National Board of Physicians and Surgeons (NBPAS) was founded in 2015 by over 20 physician leaders, including Dr. Paul Teirstein, a prominent cardiologist and Chief of Cardiology at Scripps Clinic. Their vision was for a non-profit organization that focused on physician-driven methods to promote lifelong learning through specialty-focused, fully accredited Continuing Medical Education (CME), an alternative to the rigid guidelines and excessive, but unproven, testing required by standard recertification methods.
NBPAS currently offers continuous board certification to board-certified physicians in good standing who want to maintain rigorous standards while avoiding unnecessary and cumbersome bureaucratic hurdles.
Traditional MOC Programs
Many physicians find traditional MOC programs to be ineffective educational systems that are out of touch with their needs.
Let’s take a look at a few of the most common complaints:
1. Time Burden
Preparing for high-stakes exams every 10 years or completing time-consuming, longitudinal assessments adds hours of administrative work to an already demanding schedule. Many physicians would rather spend their time on patient care or relevant CME.
2. High Costs
Fees for MOC exams, study materials, prep courses, and travel expenses can total thousands of dollars. These expenses are often not reimbursed by employers and can add up significantly over a career.
3. Questionable Relevance
Physicians frequently criticize MOC exams for covering outdated material or topics irrelevant to their specialty or current practice. Furthermore, the closed-book exam standard is outdated, with most physicians working in collaborative environments that foster open communication and encourage research. Even newer open-book formats often feel disconnected from daily practice, relying on quizzes that can be easily answered with AI, yet still consume valuable time without meaningfully improving care.
4. Lack of Evidence
Numerous studies* have failed to show that MOC participation improves patient outcomes. Physicians, then, are left to wonder, “Who does the system benefit?”
Why More Physicians Are Choosing NBPAS
NBPAS has positioned itself as an effective and affordable alternative to the traditional MOC pathway. Through open collaboration and a commitment to fostering lifelong learning, NBPAS sets itself apart in several ways.
1. No Recertification Exams
As an alternative to lengthy and outdated recertification assessments, NBPAS provides a pathway to utilizing nationally recognized, clinically relevant, evidence-based CME to demonstrate competence.
2. Cost-Effective
Traditional board recertification costs can total thousands of dollars for testing and preparation fees, depending on chosen methods. However, NBPAS offers upfront and straightforward pricing with certification costing just $189 every two years, and discounts available for medical fellows and military servicemembers.
Furthermore, the NBPAS credentialing team provides free verification of your NBPAS board certification to hospitals and health systems.
3. Simplified Process
NBPAS aims to simplify the entire certification process. Physicians applying to NBPAS must meet four main criteria:
● Hold an active and unrestricted medical license
● Have an initial board certification through an ABMS (American Board of Medical Specialties) or AOA (American Osteopathic Association) member board
● Hold outpatient/hospital privileges (certain surgical specialties)
● Complete 50 hours of CME within the past two years (exceptions for candidates in or within 2 years of training)
You can read more about NBPAS requirements on their certification criteria page.
4. Physician-Run
NBPAS was founded and is governed by a board of physicians from diverse specialties who receive no compensation for their service. It was designed by physicians, for physicians, to create a solution that values professionalism without unnecessary burden.
5. Growing Acceptance
More hospitals and health systems are recognizing NBPAS certification. While not yet universally accepted, the number of institutions adding NBPAS to their credentialing criteria continues to rise, particularly as physicians advocate for choice in continuous board certification.
Is NBPAS Widely Accepted?
As of 2025, over 250 major health systems and hospitals across all 50 states within the U.S. accept NBPAS. Unfortunately, some medical centers and insurers still require traditional ABMS or AOA board certification for credentialing. However, as membership continues to grow and physicians advocate for acceptance, the number of organizations that accept NBPAS is expected to increase significantly.
If you’d like to get involved and encourage your health system to accept NBPAS, visit NBPAS’s physician resource center.
Addressing the Concerns
No certification pathway is without scrutiny, and some have raised concerns about NBPAS. Critics argue that:
● CME alone may not adequately measure clinical competence.
● NBPAS lacks the long history and clout of legacy boards.
However, proponents counter that traditional MOC exams fail to measure day-to-day clinical judgment and often test memorization over practical skills. Furthermore, Continuing Medical Education (CME) is already a proven mechanism for keeping physicians up to date, is required by every state medical board, is tailored to individual practice areas, and has been shown in multiple studies* to improve physician knowledge and patient outcomes.
While relatively new to the field, transparency is one of NBPAS’s core principles. Its requirements are public, its leadership is physician-led, and it is always open to feedback.
The Broader Implications for Medicine
The growing interest in NBPAS reflects a modern trend in healthcare: physician empowerment and value-driven, high-quality care. Previously, systems governing medical practice operated with limited physician input. Now, with NBPAS, physicians are empowered to participate in reforming policies and developing educational and certification systems that benefit both themselves and their patients.
Is NBPAS Right for You?
If you're a board-certified physician seeking a more effective and streamlined recertification process, NBPAS is worth exploring. An alternative to high-stakes, low-relevance exams and expensive, burdensome processes, NBPAS:
● Meets national accreditation standards for both hospitals and health plans
● Performs the required Primary Source Verification (PSV) of physicians’ education and training
● Provides recertification through rigorous, specialty-specific, ACCME-accredited AMA PRA Category 1™ CME, the gold standard in continuing medical education.
● Offers transparent pricing
● Maintains physician leadership within the organization
To learn more or begin the certification process, visit NBPAS.org.
*If you’d like to delve into some of the research related to this topic, the NBPAS MOC Journal Club is a great resource where you can find notes on studies in this area.
Byline
Tammy McKinney, RN, is a professional healthcare writer whose work has been featured across top-ranking medical websites. With a deep understanding of healthcare nuances and a passion for empowering professionals, Tammy provides clear, informed guidance on key healthcare topics. To learn more about her work or inquire about availability, find her on LinkedIn.
