The American Board of Internal Medicine (ABIM) issued an unprecedented apology letter to its diplomats, penned by Richard Baron, MD, President and CEO. “We got it wrong and sincerely apologize,” the letter states. Dr. Baron further reported that ABIM launched its Maintenance of Certification (MOC) program before it was ready for prime time.This release from ABIM has likely sensitized critics of MOC to the possibility that, perhaps, other member specialty boards—such as the American Board of Emergency Medicine (ABEM)—have also “gotten it wrong.”

Will ABEM be releasing an apology? That’s unlikely as it seems the similarities between ABIM and ABEM’s MOC programs stop with the use of the term MOC.

In order to clarify ABEM’s position on MOC and to address the potential concerns of ABEM diplomates, ACEP Now’s Medical Editor-in-Chief, Kevin Klauer, DO, EJD, FACEP, posed these questions to the ABEM leadership. Below, Francis L. Counselman, MD, President of ABEM, responds.

KK: What do you (or ABEM) think about ABIM’s letter of apology?

FC: ABEM supports ABIM’s need to create a MOC program that is meaningful to its certified physicians (diplomates), and it appears to be seeking a process by which an effective program of continuous professional development can be offered. It is imperative that we keep in mind that ABIM is not eliminating its MOC program or discontinuing its key elements, but rather, it is temporarily suspending parts of the ABIM MOC program to make adjustments that will be in better service to its diplomates and the public.

KK: How is ABEM’s MOC program different than ABIM’s?

FC: The ABEM MOC program is distinctly different largely because emergency physicians are engaged daily in adherence to quality measures. We enjoy a specialty that, in its 35 years of recognition by the American Board of Medical Specialties (ABMS), has constantly been transforming itself by improving the manner in which emergency physicians deliver compassionate, quality care to every patient, in every circumstance, and at every moment.

Two specific differences between the ABEM and ABIM programs are the Part II Lifelong Learning and Self-Assessment (LLSA) and the Part IV Assessment of Practice Performance Practice Improvement (APP PI) components. The ABEM LLSA has been shown to be highly relevant and improve patient care.¹ This is, in part, because the selected articles come largely from recommendations submitted by major emergency medicine organizations and individual emergency physicians. Having representatives from EM organizations provide CME for the activity is a further indicator of the relevance of the articles. Because emergency physicians are universally involved in department-based quality improvement activities, meeting APP PI requirements tends to be straightforward.

In order for a specialty to have legitimacy in the house of medicine, it must be recognized by the ABMS. This is why emergency medicine fought so hard decades ago to be recognized by the ABMS as the 23rd medical specialty.

Another distinguishing feature of the ABEM MOC program is the extremely high rates of participation by ABEM diplomates. In 2013, there were about 6,000 physicians with APP PI (Part IV) requirements, and more than 9,000 physicians attested to participating in these activities. In 2014, more than 10,000 diplomates attested to completing APP PI activities. Of the more than 2,000 diplomates who successfully passed the ConCert examination in 2013, only eight physicians lost certification solely due to not meeting MOC LLSA or APP PI requirements. Since then, five have completed the requirements and regained certification.