ABU plans maintenance of certification to be flexible, relevant

January 1, 2007

Maintenance of Certification (MOC) has become a controversial topic among practicing urologists since the concept was first introduced by the American Board of Medical Specialties (ABMS) 8 years ago. As work on a final MOC plan for urologists continues, the American Board of Urology (ABU) says its plan will be flexible in format, relevant to clinical practice, and not overly burdensome. In this exclusive interview, current ABU President Linda D. Shortliffe, MD, outlines details of the program and how it will relate to actual practice.

Maintenance of Certification (MOC) has become a controversial topic among practicing urologists since the concept was first introduced by the American Board of Medical Specialties (ABMS) 8 years ago. As work on a final MOC plan for urologists continues, the American Board of Urology (ABU) says its plan will be flexible in format, relevant to clinical practice, and not overly burdensome. In this exclusive interview, current ABU President Linda D. Shortliffe, MD, outlines details of the program and how it will relate to actual practice. Dr. Shortliffe is the Stanley McCormick Memorial Professor and chair of the department of urology, Stanford University School of Medicine, Stanford, CA. She was interviewed by Richard D. Williams, MD, professor and chairman of the department of urology at the University of Iowa, Iowa City. Tables outlining details of the four components of maintenance of certification and a timeline for implementation are available at www.urologytimes.com/MOC.

Q. Please define the Maintenance of Certification concept and explain what the impetus is for the American Board of Urology to develop such a program?

I think it's important to consider that practicing urology or any form of medicine is different from the old analogy about riding a bicycle because medicine is constantly changing. It's more like progressing from a bicycle to a motorcycle and then to a car: Just because you know how to ride a bicycle and may always know how to ride a bicycle, it doesn't mean you know how to drive a car.

Q. Beside MOC, are there other methods to determine who is and who is not up to speed as a urologist?

A. We have re-certification at this time. This only measures medical knowledge, and does not even attempt to measure or monitor practice. Re-certification also occurs only every 10 years, and the scope of urologic knowledge changes tremendously during such an interval.

Q. Within the framework of the MOC concept promulgated by ABMS, does the ABU have flexibility or latitude in the plan it develops?

A. Yes, there is flexibility in how we fulfill the goals. The ABMS is asking physicians to fulfill four components: 1) evidence of professional standing, 2) evidence of commitment to lifelong learning and involvement in periodic self-assessment processes, 3) evidence of cognitive expertise, and 4) evidence of evaluation and performance in practice. Two of these components-evidence of professional standing and cognitive expertise-are already accomplished in the initial certification process. The other two-periodic self-assessment processes and evidence of evaluation and performance in practice-are the areas in which the AMBS is requesting more documentation.