New Continuing Certification Standards Reflect Fundamental Changes

BY RICHARD E. HAWKINS, MD

Board certification by one of the 24 member boards that comprise the American Board of Medical Specialties (ABMS) represents a physician’s or medical specialist’s advanced knowledge, training, and skills in a particular area of medicine. It is a program of rigorous, continuous professional assessment and development that begins with initial certification after completing residency training and is sustained through continuing certification—an ongoing process in which board-certified physicians (diplomates) demonstrate their lifelong commitment to professional growth and excellence.

The innovative assessment models endorsed by the new Standards support and direct learning and complement continuing education.

Numerous research studies 1 demonstrate that diplomates of ABMS member boards practice safer, higher-quality medicine and have fewer disciplinary actions 2 by state medical licensing boards than physicians who are not board certified. Physician participation in continuing certification is linked to improved care 3 for patients with asthma, diabetes, and hypertension—all chronic conditions that have a significant impact on health and well-being in this country. It is also associated with improved care for children and the elderly.

In October 2021, the ABMS Board of Directors approved the new Standards for Continuing Certification 4 (Standards) to be effective Jan. 1, 2024. The board’s approval followed three years of consultation with physicians, professional and state medical societies, consumers, and other public stakeholders from across the healthcare spectrum to reconceive the way specialty physician recertification is conducted.

The new Standards also reflect the recommendations from the Continuing Board Certification: Vision for the Future Commission, 5 an independent commission that met throughout 2018 to provide strategic guidance to the ABMS Board of Directors and member boards.

This approval serves as a pivotal moment for ABMS, our member boards, and the greater healthcare community because it enables ABMS to deliver on its mission in two fundamental ways that closely align with the tagline of America’s Physicians Groups: “Taking responsibility for America’s health.”

INNOVATIVE ASSESSMENT MODELS

The first way relates to the recognition that ABMS and our member boards can bring value to board-certified physicians. The innovative assessment models endorsed by the Standards support and direct learning and complement the continuing education all physicians undertake to improve their knowledge and skills.

The transition to longitudinal assessments 6 —away from high-stakes 10-year exams—will enable the boards to better balance formative and summative approaches. Moreover, the longitudinal assessment model is founded on strong evidence to promote learning and retention.

IMPROVING HEALTH AND HEALTHCARE

The second way is equally important: Board certification continues to provide the public with a credential that it can rely and depend on. Patients expect their physicians to stay up to date with advances in their specialty and to participate in ongoing assessment and learning. The Standards support physicians in demonstrating their commitment to doing so and to engaging in activities that improve the quality of care they deliver.

The Standards also support greater opportunities for physicians to participate in relevant activities that improve health and healthcare, including recognizing quality and safety improvement activities in which they are already engaged. In doing so, the Standards stress the importance of focusing on such issues as improving health and healthcare in the communities that diplomates serve, addressing healthcare disparities, and increasing health equity.

COLLABORATING WITH STAKEHOLDERS

In support of implementing the new Standards, the boards will collaborate with their professional societies 7 and other stakeholders to enhance the practice improvement infrastructure and reduce impediments to engaging in meaningful improvement work. These innovative assessment models—combined with the “wide door” approach to approving improvement activities and a focus on improving health and healthcare—enhance the relevance of board certification to practicing physicians.

In addition, the new Standards acknowledge that effective professional self-regulation requires the involvement of our partners. Among them are specialty and state medical societies, hospitals and health systems (including academic medical centers), physician groups, continuing medical education organizations, and our Associate Members. 8

Each of these stakeholders offers continuing professional development opportunities, and therefore has an important role in supporting its members’ engagement in meaningful learning and improvement work. ABMS remains committed to seeking opportunities to work with stakeholders, such as APG, to promote physician accountability.

Many member boards have already begun to make substantial changes to their continuing certification programs to align with the Standards and address the Commission’s recommendations. Examples of these programmatic changes are highlighted in the Winter 2021 issue of ABMS Insights 9 and represent our commitment to improve and evolve the continuing certification process.

A FRAMEWORK FOR CONTINUING CERTIFICATION

The Standards reinforce the core value of board certification for all stakeholders, most notably diplomates and their patients. They also speak clearly to our intention to continue engaging with others to modify and adjust our programs as needed to maintain the integrity of the credential for those who carry it and those who use it.

Like APG, which has built a framework that enables their physicians to provide the highest quality of care for patients, ABMS believes that the new Standards provide a framework for member boards to design certification programs that maintain the social contract between the medical profession and the public to improve the quality, safety, and value of healthcare.

ABMS board certification tells a story about a diplomate’s knowledge, judgment, skills, and commitment to professionalism. The new Standards will help support diplomates and the ABMS community in meeting our promise of providing better care through higher standards. o

Richard E. Hawkins, MD, is President and Chief Executive Officer of the American Board of Medical Specialties (ABMS). You can learn more about ABMS at ABMS.org, or follow the organization on Twitter at @ABMSCert.

References:

1 A-Z References: initial certification: quality of care. American Board of Medical Specialties website. https://abms.libguides.com/ az.php?s=157166&q=quality%20of%20care.

2 A-Z References: initial certification: disciplinary. American Board of Medical Specialties website. https://abms.libguides.com/ az.php?s=157166&q=disciplinary.

3 A-Z References: continuing certification: quality of care. American Board of Medical Specialties website. https://abms.libguides.com/ az.php?s=157162&q=quality%20of%20care.

4 Standards for continuing certification. American Board of Medical Specialties website. https://www.abms.org/board-certification/boardcertification-standards/standards-for-continuing-certification/.

5 Achieving the vision. American Board of Medical Specialties website. https://www.abms.org/initiatives/achieving-the-vision/.

6 Assessments advance translation of medical knowledge. ABMS Insights. July 15, 2021. https://www.abms.org/news-events/ assessments-advance-translation-of-medical-knowledge/.

7 ABMS member boards collaborate with specialty societies on assessment activities. ABMS Insights. July 15, 2021. https://www. abms.org/news-events/abms-boards-collaborate-with-specialtysocieties/.

8 ABMS Associate Members. American Board of Medical Specialties website. https://www.abms.org/about-abms/associate-members/.

9 ABMS Insights. Winter 2021. https://mailchi.mp/abms/abmsinsights-winter-2021.

Richard E. Hawkins, MD, President and CEO, ABMS