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Engaging in lifelong learning by maintaining certification has been a required method to confirm medical competence since 1933 through the American Board of Medical Specialties (ABMS). Established by the American Medical Association and the American College of Physicians in 1936, the American Board of Internal Medicine (ABIM) is one of 24 ABMS certifying member boards. In 1972, the ABIM began offering certification for rheumatology diplomates who had already achieved an ABIM certification in internal medicine. Today, the majority of the ACR’s 7,200 physician members—representing approximately 3.5% of ABIM’s 200,000 diplomates—are certified by the ABIM.
Since 1990, the ABIM assessment requirement for rheumatology maintenance of certification (MOC) has remained unchanged. It required a long-form test to assess medical knowledge every 10 years to maintain certification for a specific specialty. Over the past seven years, however, the ABIM has discussed plans to provide alternative maintenance assessments with more frequent assessment cycles involving different testing methods as an alternative to the 10-year MOC assessment requirement. These proposed changes led rheumatologists and other physicians to speak up with concerns and ideas for MOC reform.
Reforms are now on the horizon, with implementation expected in 2022. One important voice leading MOC reform for rheumatology is that of Salahuddin (Dino) Kazi, MD. A professor of medicine in the Division of Rheumatic Diseases, and vice chair of education and director of residency training in the Department of Internal Medicine, UT Southwestern Medical Center, Dallas, Dr. Kazi was named chair of the ABIM’s Rheumatology Certification Board in 2020. Dr. Kazi spoke with The Rheumatologist (TR) to share insights on the future of lifelong learning and MOC reform.
TR: In your role as chair of ABIM’s Rheumatology Certification Board, what are you learning and sharing about certification and what it means to maintain medical knowledge?
Dr. Kazi
Dr. Kazi: Many skills are required to be a successful physician. These include medical knowledge, decision making, communication skills and intangible qualities, such as empathy, compassion and the ability to [create and sustain] productive relationships with patients. Not all of these skills can be measured with confidence; however, medical knowledge remains a foundational pillar in the repertoire of a physician’s excellence. Both certification and MOC are designed to assess medical knowledge and judgment.
As chair of the ABIM Rheumatology Board, I am surrounded by members of the board who represent academic and community rheumatology practices, as well as patients. Their input and experience are valuable in my own approach to advocating for my fellow rheumatologists.
I also benefit from participating in the ABIM Council, comprised mostly of the chairs of all the specialty boards in internal medicine, as well as at-large and public members. Sharing knowledge across disciplines provides opportunities for the rheumatology board to optimize its approach and learn from the experience of others.