American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

American Board of Surgery Moves Forward with New Direction for Continuous Certification

Dr. BuyskeIn early July, the American Board of Surgery (ABS) announced a new direction for our program of lifelong learning and continuous board certification, currently known as Maintenance of Certification (MOC). The changes were the result of feedback received in recent years from our diplomates and societies, as well as from our directors themselves. The overwhelming sentiment was for the development of an MOC program that offered greater flexibility and more practice-relevant options, and that would be more helpful to diplomates in staying up to date in their practice.

The ABS was founded in 1937 by the leading surgical organizations of the time, including the American College of Surgeons (ACS), to differentiate formally trained surgeons from physicians in general practice. Its charge was to establish standards and a certification process that would “protect the public and improve the specialty.”

Throughout its history, the ABS has recognized that continued self-regulation relies on high but evolving standards. In 1976, the ABS became the second medical specialty board to institute recertification. The concept of MOC even began with a surgeon, former ACS Regent and Past-Interim ACS Director Dr. David L. Nahrwold, who recognized that for board certification to remain relevant, it had to evolve beyond initial certification, or even once-in-10-years recertification.

When MOC was introduced by the ABS in 2005, it built upon the requirements already in place for recertification, including a secure examination every 10 years. The ABS recognizes that it is time to evolve once more, in recognition of the increasing diversity of practice of our diplomates and advancements in technology that allow for new methods of assessment.

Today, more than 30,000 surgeons across the U.S. hold current ABS certificates, with 96 percent certified in general surgery. The current MOC exam consists of 200 multiple-choice questions covering the breadth of general surgery, and must be taken every 10 years at a secure testing center. The ABS plans to institute a new program with shorter but more frequent assessments as an alternative to the 10-year exam. In August, all current diplomates were sent a survey, building upon answers to the previous year’s survey, asking for feedback to inform the design of this new program.

In addition to shorter, more frequent assessments, the new program will include the choice of a practice-related component. Diplomates will be able to choose from components covering various areas of general surgery, and select the one that best reflects their practice, including one on comprehensive general surgery for those who maintain a broad general surgery practice. The initial divisions will of necessity be fairly broad and selected based upon reported case logs from our current MOC reporting process. More components will be added as the program develops.

The new program will also be lower stakes with immediate feedback, completed online, at a time and place of the diplomate’s choosing. Furthermore, it will enable the ABS to incorporate advances in surgical knowledge more rapidly into our assessments, better serving both diplomates and the public.

The 10-year secure exam will remain an option for those who prefer a longer, overarching assessment of their general surgery knowledge. The ABS also plans to survey diplomates certified in other ABS specialties in the coming months for feedback on alternative programs for other ABS specialties.

Our goal is to have the best combination of practice-pertinent, timely, and valuable assessment tools to assure our patients that ABS-certified surgeons are knowledgeable and up-to-date. We plan to work with diplomates and with the ACS and other societies in what will be an ongoing effort.

This is a beginning, as we work to balance the needs of our diplomates with our obligation to the public, as well as our obligation to the profession to uphold the importance and value of self-regulation. We will continue to work to streamline the process for meeting MOC requirements, and continue to explore additional options to make meeting the requirements more convenient and valuable to diplomates.