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Maintenance of certification, revalidation, and professional self-regulation.

In this special supplement, authors from Canada, the United Kingdom, and the United States discuss the rationale and current evidence behind programs designed to concomitantly help physicians demonstrate and improve individual competence while improving care for the patients and public they serve. Programs in all three countries, labeled as either maintenance of certification (MOC, Canada and the United States) or revalidation (United Kingdom), are grounded to a large but variable extent in the principles of professional self-regulation. In all 3 countries, the notion of professional self-regulation is under increasing scrutiny by policy makers and the public as the result of high-profile scandals involving physicians and concerns about slow progress in improving quality and safety of care.1–9 Despite these concerns, professional self-regulation is still seen as vital, but with the public and medical leaders calling for better oversight and assessment of physicians longitudinally over a career.1–3,10–11 MOC and revalidation have been primarily developed and implemented by members of the medical profession to provide a meaningful and impactful approach to physician assessment and continuous professional development in response to these latest public and professional concerns. The Royal Colleges in Canada and in the United Kingdom and the certification boards in the United States are independent, nongovernmental entities. The certification boards in the United States also do not have members; all US-certified