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Maintenance of certification.

The process of Maintenance of Certification (MOC) adopted by the American Board of Medical Specialties (ABMS), which comprises 24 medical specialty Boards, has recently come under fire. Although the program for MOC has met with some skepticism since its inception in 2000, recent changes to the American Board of Internal Medicine’s MOC program aimed at creating a more seamless process of continuous learning and assessment elicited a barrage of complaints and criticism from some of its Diplomates. The Trustees of the American Board of Urology (ABU) took note of this condemnation, and sought to address the misconceptions and presumptions shared by Diplomates from a variety of Boards about MOC. The program for MOC facilitates the process by which physicians uphold their inherent contract with patients as formalized in the Physician Charter: Medical Professionalism in the New Millennium. Published in 2002 by representatives from numerous international societies, the Physician Charter is almost universally endorsed by the Boards, including ABU. According to the Charter, “Physicians must be committed to lifelong learning and be responsible for maintaining the medical knowledge and clinical and team skills necessary for the provision of quality care.” It further states that “the profession as a whole must strive to see that all of its members are competent and must insure that appropriate mechanisms are available for physicians to accomplish this goal.” These statements are only a snippet of the Physician Charter but they comprise the foundation of MOC programs. Responsible for administering MOC, the Boards are committed to ensuring that its requirements are neither onerous nor frivolous. Staying current with medical knowledge is not a simple task. It is estimated that medical knowledge doubles every 8 years. At the current rate, clinicians will need to learn, unlearn and then re-learn half of their medical knowledge base