• Guest Editorial

    AAFP Working to Improve Continuing Board Certification  

    January 22, 2018, 01:10 pm Aaron Saguil, M.D., M.P.H. – I'm a board-certified family physician. I spent four years in medical school, three years in residency and have been in practice for nearly 20 years. Despite my education, training and experience, I'll have to pass a high-stakes exam next year to maintain my certification. That will require preparation, time away from my practice and a significant financial investment. 

    headshot of Aaron Saguil, M.D., M.P.H.

    In other words, I get it.

    The costs and effort involved in initial board certification and continuing certification (perhaps better known as maintenance of certification, or MOC) are exorbitant, frustrating and duplicative of other practice requirements, and family physicians are justifiably angry with the way in which the American Board of Family Medicine (ABFM) implements and executes Family Medicine Certification and continuing board certification.

    Initial board certification and continuing certification were intended to be voluntary acts of professionalism that could demonstrate a physician's exceptional expertise in a particular specialty. However, they have become requirements for many physicians when it comes to credentialing, privileging, payment, employment and licensure. Along the way, the process has become unnecessarily complicated, expensive and stressful.

    Before I go any further, let me make a few critical points clear.

    The AAFP and the ABFM are two separate organizations.

    We are not them.

    We understand.

    And we are trying to fix it.

    In the AAFP's annual Member Satisfaction Survey, continuing certification was one of the top four issues that members asked the Academy to prioritize. Members also have requested relief regarding this issue via resolutions to the Congress of Delegates and the National Conference of Constituency Leaders that asked the AAFP to identify alternatives to the ABFM's high-stakes exam, as well as other methods to demonstrate ongoing learning.

    Acting on those requests, the AAFP Board of Directors tasked the Academy's Commission on Continuing Professional Development (COCPD) with developing new policies and principles related to continuing certification prior to the Board's July 2017 meeting. The COCPD formed two work groups to address that directive. One group developed a proposed new policy on board certification, and the second developed a proposed statement describing the criteria to be used when evaluating a certifying board.

    In response to the COCPD's recommendations, the AAFP Board established a task force to build on the work of the commission and to deal with the thorny issues surrounding certification and continuing certification in a manner that is equitable and fair to our members while meeting our patients' needs for trained and knowledgeable family physicians.

    That task force met for the first time in December and will convene again Jan. 25 before the AAFP's commissions meet Jan. 26-28 in Kansas City, Mo. The task force is expected to finalize the policy and statement, consider alternative options for ongoing certification, and make other relevant recommendations before the AAFP Board's April meeting.

    It should be clear to the certifying boards that the AAFP is serious about improving the process of board certification and continuing certification. Leadership from the AAFP and ABFM meet twice a year, and Academy officers have conveyed members' concerns regarding the time and expense of certification. The COCPD also has ongoing communications with ABFM, as well as with the American Board of Medical Specialties and the American Osteopathic Association.

    Members can read more about the Academy's efforts on certification in the Board Report (pages 193-195) presented last fall during the Congress of Delegates. The COCPD put a great deal of effort into this issue, and now the task force will carry it forward. Stay tuned.

    Aaron Saguil, M.D., M.P.H., is the former chair of the AAFP Commission on Continuing Professional Development. He is the associate dean for recruitment and admissions at the Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine in Bethesda, Md.