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rstanley{at}ajroffice.org
The 1999 report by the President's Advisory Commission on Consumer Protection and Quality in the Health Care Industry, entitled "Quality First: Better Health Care for All Americans," which includes the so-called Consumer Bill of Rights, strongly proposed a need for improved quality in the appropriate provision of health care services [1]. The more widely publicized reports of the Institute of Medicine, entitled "To Err Is Human" and "Crossing the Quality Chasm" [2, 3], represented wake-up calls for our nation's medical leadership to develop a program that would show measurable quality improvement and restore confidence in the American health care system. Safeguarding patient care became an overriding concern of Congress, the media, and some medical professional organizations. The time to develop a wide-reaching program of improvement had arrived.
Even before these President's advisory and Institute of Medicine reports, the members of the ABMS had already begun to address similar challenges through time-limited board certification. All 24 members of the ABMS now offer time-limited certificates to their diplomates that range in duration from 6 to 10 years. In radiology, both time-limited primary board certification and subspecialty certificates are in place. Radiation oncology began issuing 10-year time-limited certificates to its diplomates in 1995. Radiation oncologists have already initiated the 10-year renewal process with a recertifying examination measuring cognitive knowledge.
Diagnostic radiology and radiological physics were among the last to change from non–time-limited to time-limited certificates. The first classes of primary diagnostic radiology and radiological physics diplomates received this 10-year certificate in 2002, so the first 10-year cycle for these primary certificate holders will end in 2012. Subspecialty certificates of added qualification (CAQs) in pediatric radiology, vascular radiology, and neuroradiology have been 10-year time-limited since 1994, 1994, and 1995, respectively. The first renewal examinations for these CAQs will be offered in 2004 and 2005.
The ABR MOC program will ultimately affect all holders of time-limited primary board and subspecialty certificates. The management of recertification for holders of more than one time-limited certificate (e.g., primary board certification in 2002 and a CAQ in neuroradiology in 2004) is currently evolving, and those involved will be sensitive to the specialized nature of each person's practices. However, the full MOC program is only now beginning for all groups in the ABR.
The ABR MOC is a comprehensive program with major emphasis on lifelong learning, self-assessment, and evaluation of practice performance. It is a voluntary program in which all who are certified as diplomates after 2002 are assumed to be automatically enrolled. Detailed guidance for all concerned will be available on the ABR Web site, www.theabr.org.
Diplomates will be encouraged to become active participants in the process because it will be continuous; they will be expected to annually record their lifelong learning and self-assessment activities in the form of continuing medical education (CME) and completed self-assessment modules. The latter will be made available through the Accreditation Council for Continuing Medical Education–recognized scientific and educational entities (such as ARRS, RSNA, and subspecialty societies). The specific requirements for CME and self-assessment activities will be spelled out on the ABR Web site. The general requirements include the accumulation of a minimum of 500 CME hours, at least half of which are category 1, during the 10-year cycle (50 per year), with 70% of the 500 being broadly specific to diagnostic radiology.
Sometime in the 7th–10th year of the MOC cycle, the cognitive expertise of the diplomates will be tested using a secure, monitored, computer-based examination offered at convenient times and sites. Much effort will be made by the ABR to tailor the examinations to an individual's practice, with either a general or highly specialized emphasis. The examinations will also be coordinated with the types of self-assessment modules selected by the candidates over the 7- to 10-year cycle. Passing the examination will be an integral part of the ABR MOC process, but, unquestionably, the lifelong learning aspect of this program is the most important element and will predominate.
This brief "heads up" introduces the MOC program to those who have time-limited certificates and to those who will want to become involved immediately. It may also interest practicing radiologists with non–time-limited certificates who wish to renew their certifications for obtaining new state medical licenses or for demonstrating competence to a credentialing board or third party payer.
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  T. H. Berquist Maintenance of Certification: Everyone Needs to Participate Am. J. Roentgenol., September 1, 2008; 191(3): 635 - 636. [Full Text] [PDF]
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F. S. Chew A New Peer-Reviewed Publication from the American Roentgen Ray Society Am. J. Roentgenol., June 1, 2005; 184(6_supp): Siii - Siv. [Abstract] [Full Text] [PDF]
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R. J. Stanley Lifelong Learning Am. J. Roentgenol., January 1, 2005; 184(1): 1 - 1. [Full Text] [PDF]
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