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Background: Only 62.6% of fellowship‐trained and American Board of Internal Medicine (ABIM)‐certified geriatricians maintain their specialty certification in geriatric medicine, the lowest rate among all internal medicine subspecialties and the only subspecialty in which physicians maintain their internal medicine certification at higher rates than their specialty certification. This study aims to better understand underlying issues related to the low rate of maintaining geriatric medicine certification in order to inform geriatric workforce development strategies. Methods: Eighteen‐item online survey of internists who completed a geriatric medicine fellowship, earned initial ABIM certification in geriatric medicine between 1999 and 2009, and maintained certification in internal medicine (and/or another specialty but not geriatric medicine). Survey domains: demographics, issues related to maintaining geriatric medicine certification, professional identity, and current professional duties. Results: 153/723 eligible completed surveys (21.5% response). Top reasons for not maintaining geriatric medicine certification were time (56%), cost of maintenance of certification (MOC) (45%), low Medicare reimbursement for geriatricians' work (32%), and no employer requirement to maintain geriatric medicine certification (31%). Though not maintaining geriatric medicine certification, 68% reported engaging in professional activities related to geriatric medicine. Reflecting on career decisions, 56% would again complete geriatric medicine fellowship, 21% would not, and 23% were unsure. 54% considered recertifying in geriatric medicine. 49% reported flexible MOC assessment options would increase likelihood of maintaining certification. Conclusions: The value proposition of geriatric medicine certification needs strengthening. Geriatric medicine leaders must develop strategies and tactics to reduce attrition of geriatricians by enhancing the value of geriatric medicine expertise to key stakeholders. See related articles by Ouslander et al., Colenda and Applegate, and Chad Boult in this issue. [ABSTRACT FROM AUTHOR]

Abstract Objective To quantify ChatGPT's concordance with expert Otolaryngologists when posed with high‐level questions that require blending rote memorization and critical thinking. Study Design Cross‐sectional survey. Setting OpenAI's ChatGPT‐3.5 Platform. Methods Two board‐certified otolaryngologists (HZ, RS) input 2 sets of 30 text‐based questions (open‐ended and single‐answer multiple‐choice) into the ChatGPT‐3.5 model. Responses were rated on a scale (correct, partially correct, incorrect) by each Otolaryngologist working simultaneously with the AI model. Interrater agreement percentage was based on binomial distribution for calculating the 95% confidence intervals and performing significance tests. Statistical significance was defined as P

Medical board organizations have accumulated large asset balances, in part due to the monetization of physician board recertification, as well as capital gains in positive investment conditions. Physicians across the country have raised concerns regarding the effectiveness and efficiency of existing recertification processes, to which the American Board of Medical Specialties and independent accreditation boards have responded with newly instituted changes. The present article analyzes the publicly available F990 tax forms of the medical boards in an effort to provide data to the ongoing debate. Although some boards have begun to mobilize assets in recent years, many continue to accumulate wealth. It remains to be seen whether the new recertification programs will bring about change or perpetuate organizational wealth.

The article highlights Infectious Diseases Society of America's support for lifelong learning among infectious diseases physicians, urging the American Board of Internal Medicine (ABIM) to revise its Maintenance of Certification (MOC) program. Topics discussed include dissatisfaction with the current MOC program, the need for clinically relevant and inclusive professional development, and proposed changes to reduce burden and enhance flexibility in recertification.

Objective: To quantitatively assess radiologists' preferences for Maintenance of Certification (MOC) and Continuing Certification (CC) using a survey of attitudes and perceptions.Methods: A questionnaire that assessed attitudes and perceptions and included a discrete choice or trade-off task was developed by ACR staff in conjunction with an independent market research agency and the Survey Subcommittee of the ACR Task Force on Certification in Radiology. The trade-off exercise was integrated into this methodology to better understand the underlying utilities or preferences of the components of MOC-CC among respondents and to better enable specific recommendations on how to optimize the current program. The survey was administered via e-mail to 17,305 ACR members. The demographic and practice characteristics of the 1,994 (11.5%) respondents were similar to the ACR radiologist membership and correspond to a normal distribution. At a 95% confidence level, with a margin of error 2.1%, we believe that the respondent population fairly reflects the actual population.Results: Similar proportions judged the existing program as excellent or very good (36%), or fair or poor (35%), with 27% neutral. MOC-CC was perceived more often as excellent or very good by those who were grandfathered yet still participating in MOC, were in academic practice, were in an urban setting, were older, or had a role with the ABR. In contrast, MOC-CC was more often judged as fair or poor by those who were not grandfathered, were in private practice, were in a rural setting, or were younger. The current MOC-CC program is not well regarded by diplomates, with few showing preference or acceptability. The program's reception is most sensitive to the following attributes: absence or presence of a practice quality improvement requirement, Online Longitudinal Assessment content including or excluding general radiology in addition to one's specialty and inclusion or exclusion of self-assessment as part of the CME.Conclusion: ACR members diverged in their attitudes toward MOC, with differences among specific demographic and practice characteristics. The current package of features of MOC-CC was widely viewed as unsatisfactory, and a more optimal feature set arose from a simulation exercise. [ABSTRACT FROM AUTHOR]

Supplemental Digital Content is Available in the Text. Introduction: This article describes an article-based alternative for maintenance of certification that the American Board of Psychiatry and Neurology developed and began pilot testing in 2019. The rationale for and components of the pilot program are presented along with data on participant performance and feedback from the first year of implementation in three primary specialties (neurology, child neurology, and psychiatry) and one subspecialty (child and adolescent psychiatry). Methods: Evaluation of the pilot program was guided by a widely used validity framework. Data were collected that addressed the five categories of validity evidence: content, response process, internal structure, relation to other variables, and consequences. Results: Enrollment ranged from 66.7% for psychiatrists to 75.3% for child neurologists. For the 2019 cohort, the pass rates ranged from 92.6% for child and adolescent psychiatry to 98.7% for neurology, and very small numbers of diplomates failed or did not complete the process. For psychiatrists, there was a modest, but significant, relationship between performance on previous and subsequent maintenance of certification examinations. Ninety percent or more agreed that: the articles were easy to access and helpful to their practices; the mini-tests were a fair assessment of their understanding of the articles; and their test-taking experience was satisfactory. Discussion: Most eligible diplomates participated in the article-based pilot project, and they strongly preferred this format to the traditional multiple-choice examinations. Most important, the pilot was perceived to be a meaningful and relevant learning activity that had a positive effect on patient care. [ABSTRACT FROM AUTHOR]

Healthcare certification organizations carefully balance a commitment to bring value to their membership through programs that support lifelong learning and professional growth, while protecting the public by ensuring competent certified practitioners. These certifying bodies are challenged with remaining current with their maintenance of certification programs while keeping pace with the growing breadth of knowledge, industry standards and guidelines, innovative advances, and rapid technological gains in testing and assessment. Within the context of process innovation, the National Board of Certification and Recertification for Nurse Anesthetists (NBCRNA) evaluated the current landscape of Longitudinal Assessment (LA) as a potential strategy for the assessment of core knowledge as part of their Continued Professional Certification Program for Certified Registered Nurse Anesthetists. This manuscript details the evaluation of LA using a Logic Model as the tool to scaffold inquiry, a review of LA literature, an environmental scan of current LA programs with identification of LA program elements available, and the results of a LA feasibility study. The findings substantiate that continued professional certification which incorporates a LA strategy can augment lifelong learning, but is not an assessment strategy that can be implemented without thoughtful planning, customization and continuous maintenance. • Longitudinal Assessment (LA) is an evaluation strategy being trialed and implemented for recertification of practitioners. • LA is a process that uses modern technology to administer shorter assessments of specific content with immediate feedback. • The NBCRNA evaluated the utility of LA as a potential strategy for their Continued Professional Certification Program. • The considerations to develop, implement, evaluate, and maintain a LA program for the recertification is detailed here. [ABSTRACT FROM AUTHOR]

Competing Interests: Potential conflicts of interest. The author: No reported conflicts of interest. The author has submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

A gaping void of adequate lifestyle medicine (LM) training exists across the medical education continuum. The American College of Lifestyle Medicine's (ACLM's) undergraduate medical education (UME) Task Force champions the need for widespread integration of LM curriculum in UME by sharing ideas for catalyzing success, lessons learned, and publishing standards and competencies to facilitate curriculum reform. When it comes to graduate medical education and fellowship, the ACLM and American Board of Lifestyle Medicine have made great strides in filling the void, developing both Educational and Experiential Pathways through which physicians may become certified LM Physicians or LM Specialists (LMSs). The Lifestyle Medicine Residency Curriculum meets the Educational Pathway requirements and prepares resident graduates for the LM Physician board certification. LMS is the second tier of LM certification that demonstrates expertise in disease reversal. The LMS Fellowship is an Educational Pathway intent on American Board of Medical Specialties recognition of LM as a new subspecialty in the near future. Finally, continuing medical education and maintenance of certification equip physicians with LM training to support knowledge, application, and certification in LM. [ABSTRACT FROM AUTHOR]

Objective: To evaluate evolving practice patterns in secondary cleft rhinoplasty. Design: Retrospective review of data submitted during Maintenance of Certification (MOC). Setting: Evaluation of MOC data from the American Board of Plastic Surgery. Participants: Tracer data for secondary cleft rhinoplasty were reviewed from August 2006 through March 2020, and the data subdivided from 20062012 and 20132020 to evaluate changes in practice patterns. Interventions: Practice patterns in tracer data were compared to those from evidence-based medicine (EBM) literature over this time period. Main Outcome Measures: Practice patterns were compared to EBM trends during the study period. Results: A total of 90 cases of secondary cleft rhinoplasty were identified. The average age at operation was 13 years (range 4-77). Cumulative data demonstrated 61% to present with nasal airway obstruction and 21% to have undergone primary nasal correction at the time of cleft lip repair; 72% of patients experienced no complications, with the most common complications being asymmetry (10%) and vertical asymmetry of alar dome position (6%). Cartilage graft was used in 68% of cases, with 32% employing septal cartilage. Change in practice patterns between 2006 to 2012 and 2013 to 2020 demonstrated increase in dorsal nasal surgery (26% vs 43%, P =.034), use of osteotomies (14% vs 38%, P =.010), septal resection and/or straightening (26% vs 48%, P =.034), and turbinate reduction (8% vs 30%, P =.007). Conclusions: These tracer data provide long-term data by which to evaluate evolving practice patterns for secondary cleft rhinoplasty. When evaluated relative to EBM literature, future research to further improve outcomes can be better directed. [ABSTRACT FROM AUTHOR]

AbstractBackground: The Maintenance of Certification (MOC) program proposed by the American Board of Medical Specialties (ABMS) gained approval in 2006. The implementation of this program will impact all physicians who are board certified. Therefore, The Financial Status of the Medical Boards is an increasingly relevant topic of discussion amongst all physicians and those interested in medical education and certification. With this study we aim to bring greater attention to the already publicly available financial status of the Medical Boards (MB) so that it can become part of the ongoing discussion of MOC.Method: We analyzed the yearly revenue, expenses, net gain or loss and end of year balance for the ABMS and its 24 MB, additional member boards, as well as the Accreditation Council for Graduate Medical Education (ACGME), American Osteopathic Association (AOA) and Accreditation Council for Continuing Medical Education (ACCME) organizations.Results: We have commented on notable trends based on the available IRS Form 990s spanning from 1997 to 2012. When comparing the most recently available reported end of year balance to the first available reported end of year balance, 87% (27/31) of the member boards have reported an increase. All three of the additional organizations studied, ACGME, AOA and ACCME reported an increase as well.Conclusions: It is clear from the data and analysis that the majority of MB have financially benefited from the MOC program. It remains to be proven whether or not this economic benefit will translate into an improvement in physician education and patient care.

© 2014 American College of Radiology. Radiologists in the United States are required to complete the Practice Quality Improvement (PQI) program as part of their Maintenance of Certification by the ABR. The Institute for Healthcare Improvement's (IHI) Model for Improvement (MFI) offers an alternative to the 3-phase approach currently advocated by the ABR. The MFI implicitly assumes that many interventions will need to be tested and refined for any meaningful project, and provides a project management approach that enables rapid assessment and improvement of performance. By collecting data continuously, rather than simply before and after interventions, more interventions can be tested simultaneously and projects can progress more rapidly. In this article, we describe the ABR's 3-phase approach, and introduce the MFI and how it can be employed to affect positive changes. Using a radiology case study, we demonstrate how one can utilize the MFI to enable rapid quality improvement.

As members of the American Board of Internal Medicine's (ABIM) Infectious Disease (ID) Board we've heard from many of our colleagues asking for greater flexibility in maintaining their ABIM Board Certification. The ID Board—and ABIM as a whole—has engaged with the physician community over the past several years to gain a deeper understanding of what is most important to them, and how an enhanced Maintenance of Certification (MOC) program could support their commitment to keeping up with advances in medical knowledge. This article serves as an update about how ABIM has evolved its assessments over time and on our progress in developing a new longitudinal pathway that is anticipated to become available in most specialties in 2022, and will launch in ID in 2023. [ABSTRACT FROM AUTHOR]

Abstract Background Historically, individual doctors were responsible for maintaining their own professional competence. More recently, changing patient expectations, debate about the appropriateness of professional self-regulation, and high-profile cases of malpractice have led to a move towards formal regulation of professional competence (RPC). Such programmes require doctors to demonstrate that they are fit to practice, through a variety of means. Participation in RPC is now part of many doctors’ professional lives, yet it remains a highly contested area. Cost, limited evidence of impact, and lack of relevance to practice are amongst the criticisms cited. Doctors’ attitudes towards RPC, their beliefs about its objectives and effectiveness, and their experiences of trying to meet its requirements can impact engagement with the process. We aim to conduct a scoping review to map the empirical literature in this area, to summarise the key findings, and to identify gaps for future research. Methods We will conduct our review following the six phases outlined by Arksey and O’Malley, and Levac. We will search seven electronic databases: Academic Search Complete, Business Source Complete, CINAHL, PsycINFO, PubMed, Social Sciences Full Text, and SocINDEX for relevant publications, and the websites of medical regulatory and educational organisations for documents. We will undertake backward and forward citation tracking of selected studies and will consult with international experts regarding key publications. Two researchers will independently screen papers for inclusion and extract data using a piloted data extraction tool. Data will be collated to provide a descriptive summary of the literature. A thematic analysis of the key findings will be presented as a narrative summary of the literature. Discussion We believe that this review will be of value to those tasked with the design and implementation of RPC programmes, helping them to maximise doctors’ commitment and engagement, and to researchers, pointing to areas that would benefit from further enquiry. This research is timely; internationally existing programmes are evolving, new programmes are being initiated, and many jurisdictions do not yet have programmes in place. There is an opportunity for learning across different programmes and from the experiences of established programmes. Our review will support that learning. Systematic review registration PROSPERO does not register scoping reviews.

Background: Little is known about how physicians experience preparing for board recertification examinations. As women make up a growing proportion of the primary care physician workforce, we aimed to explore how primary care physicians experience the personal and professional impacts of recertification examination preparation activities, and whether these impacts differ by gender. Materials and Methods: We conducted exploratory qualitative semistructured interviews with 80 primary care physicians, who had recently taken either the American Board of Family Medicine or American Board of Internal Medicine recertification examination and who practice outpatient care. We used an iterative recruitment approach to obtain a representative sample. We applied a team-based constant comparative analytic approach to identify and categorize themes related to how preparing for the recertification examination impacted their personal or professional lives, and then compared these themes by physician gender. Results: We interviewed 41 male and 39 female participants. Physicians most frequently described taking time from personal rather than professional activities to study, but often said this was ''no big deal.'' Physicians described impacts on personal life such as missing out on family or leisure time, conflicts with parenting responsibilities, and an increased reliance on their spouse for domestic and childcare duties. Female physicians more frequently described parenting and leisure time impacts than males did. Conclusions: Recertification examination preparation impacts physicians' personal lives in a variety of ways and are sometimes experienced differently along gendered lines. These findings suggest opportunities for employers, payers, and specialty boards to help physicians ease potential burdens related to maintaining board certification. [ABSTRACT FROM AUTHOR]

Introduction: The authors sought to identify how physician specialty certification is defined in the North American literature. Methods: A rigorous, established six-stage scoping review framework was used to identify the North American certification literature published between January 2006 and May 2016 relating to physician specialty certification. Data were abstracted using a charting form developed by the study team. Quantitative summary data and qualitative thematic analysis of the purpose of certification were derived from the extracted data. Results: A two stage screening process identified 88 articles that met predefined criteria. Only 14 of the 88 articles (16%) contained a referenced purpose of certification. Eighteen definitions were identified from these articles. Definitional concepts included lifelong learning and continuous professional development, assessment of competence and performance, performance improvement, public accountability, and professional standing. Discussion: Most articles identified in this scoping review did not define certification or describe its purpose or intent. Future studies should provide a definition of certification to further scholarly examination of its intent and effects and inform its further evolution. [ABSTRACT FROM AUTHOR]

Objective: The aim of the study was to evaluate a longitudinal assessment program for physical medicine and rehabilitation (LA-PM&R) as a replacement for the American Board of Physical Medicine and Rehabilitation maintenance of certification examination. Design: In this quality improvement study, randomly selected American Board of Physical Medicine and Rehabilitation diplomates were invited to participate in the LA-PM&R. Participants' maintenance of certification scaled scores were compared with LA-PM&R nonparticipants. We examined the association between LA-PM&R scores and maintenance of certification scaled scores and performance on clone items placed on both examinations. Results: There were 2222 American Board of Physical Medicine and Rehabilitation diplomates eligible to take the maintenance of certification examination from February 2018 to February 2019. Invitations were sent to 1050 randomly selected diplomates, of whom 448 initially agreed. Three hundred eighteen individuals completed more than two quarters of LA-PM&R participation and took the maintenance of certification examination. Two hundred sixty-six diplomates took the maintenance of certification examination in the same period who did not participate in LA-PM&R. The LA-PM&R group scored higher on the maintenance of certification examination than the control group (P < 0.05). Performance on the two examinations were highly correlated, r =.50, P < 0.0001. On clone items, LA-PM&R participants had 74% correct on the LA-PM&R but 86% correct on the maintenance of certification examination (P < 0.01). Conclusions: The LA-PM&R program leads to better learning and retention of information than the 10-yr maintenance of certification examination. [ABSTRACT FROM AUTHOR]

Introduction: Specialists in a Maintenance of Certification program are required to participate in assessment activities, such as chart audit, simulation, knowledge assessment, and multisource feedback. This study examined data from five different specialties to identify variation in participation in assessment activities, examine differences in the learning stimulated by assessment, assess the frequency and type of planned changes, and assess the association between learning, discussion, and planned changes. Methods: E-portfolio data were categorized and analyzed descriptively. Chi-squared tests examined associations. Results: A total of 2854 anatomical pathologists, cardiologists, gastroenterologists, ophthalmologists, and orthopedic surgeons provided data about 6063 assessment activities. Although there were differences in the role that learning played by discipline and assessment type, the most common activities documented across all specialties were self-assessment programs (n = 2122), feedback on teaching (n = 1078), personal practice assessments which the physician did themselves (n = 751), annual reviews (n = 682), and reviews by third parties (n = 661). Learning occurred for 93% of the activities and was associated with change. For 2126 activities, there were planned changes. Activities in which there was a discussion with a peer or supervisor were more likely to result in a change. Conclusions and Discussion: Although specialists engaged in many types of assessment activities to meet the Maintenance of Certification program requirements, there was variability in how assessment stimulated learning and planned changes. It seems that peer discussion may be an important component in fostering practice change and forming plans for improvement which bears further study. [ABSTRACT FROM AUTHOR]

Physician credentialing processes aim to improve patient safety and quality, but little research has examined their direct relationship with surgical outcomes. Using national Medicare claims for 2009 to 2013, the authors studied the association between board certification and completion of Maintenance of Certification (MOC) requirements and surgeon rates of complications for 8 elective procedures. Exemplar surgeons were defined as those in the lowest decile of complication rates, and outlier surgeons were those in the highest decile. The analysis included 1.9 million procedures performed by 14 598 surgeons (64% orthopedics, 17% general surgery, 11% urology, 7% neurosurgery). Board-certified surgeons were less likely to be outliers (odds ratio 0.79 [0.66-0.94]). However, completion of MOC was not associated with differences in complication rates in orthopedic surgery or urology. Incorporating additional assessment methods into MOC, such as video evaluation of technical skills, retraining on state-of-the-art care, and peer review, may facilitate further improvements in surgical quality. [ABSTRACT FROM AUTHOR]

The American Board of Internal Medicine (ABIM) is implementing new methods for the development of examination content in response to feedback from the internal medicine community and in recognition that there is always room for improvement in the assessment of the skills and knowledge of practicing physicians. First, ABIM is exploring a new cognitive model-based approach to content development in efforts to improve exam relevancy. Second, ABIM has created a new Item-Writing Task Force in an effort to ensure a broad representation of internists from across the country who are engaged in all aspects of clinical practice. Through these mechanisms, the goal is the improved fairness and validity evidence of examinations that are relevant to how medicine is practiced today. [ABSTRACT FROM AUTHOR]

Abstract Background Establishing and managing a board certification system is a common concern for many countries. In Japan, the board certification system is under revision. The purpose of this study was to describe present status of internal medicine specialist board certification, to identify factors associated with maintenance of board certification and to investigate changes in area of practice when physicians move from hospital to clinic practice. Methods We analyzed 2010 and 2012 data from the Survey of Physicians, Dentists and Pharmacists. We conducted logistic regression analysis to identify factors associated with the maintenance of board certification between 2010 and 2012. We also analyzed data on career transition from hospitals to clinics for hospital physicians with board certification. Results It was common for physicians seeking board certification to do so in their early career. The odds of maintaining board certification were lower in women and those working in locations other than academic hospitals, and higher in physicians with subspecialty practice areas. Among hospital physicians with board certification who moved to clinics between 2010 and 2012, 95.8% remained in internal medicine or its subspecialty areas and 87.7% maintained board certification but changed their practice from a subspecialty area to more general internal medicine. Conclusion Revisions of the internal medicine board certification system must consider different physician career pathways including mid-career moves while maintaining certification quality. This will help to secure an adequate number and distribution of specialists. To meet the increasing demand for generalist physicians, it is important to design programs to train specialists in general practice.

Objective: To quantify ChatGPT's concordance with expert Otolaryngologists when posed with high-level questions that require blending rote memorization and critical thinking., Study Design: Cross-sectional survey., Setting: OpenAI's ChatGPT-3.5 Platform., Methods: Two board-certified otolaryngologists (HZ, RS) input 2 sets of 30 text-based questions (open-ended and single-answer multiple-choice) into the ChatGPT-3.5 model. Responses were rated on a scale (correct, partially correct, incorrect) by each Otolaryngologist working simultaneously with the AI model. Interrater agreement percentage was based on binomial distribution for calculating the 95% confidence intervals and performing significance tests. Statistical significance was defined as P  < .05 for 2-sided tests., Results: In testing open-ended questions, the ChatGPT model had 56.7% of initially answering questions with complete accuracy, and 86.7% chance of answer with some accuracy (corrected agreement = 80.1%; P  < .001). For repeat questions, ChatGPT improved to 73.3% with complete accuracy and 96.7% with some accuracy (corrected agreement = 88.8%; P  < .001). For multiple-choice questions, the ChatGPT model performed substantially worse (43.3% correct)., Conclusion: ChatGPT currently does not provide reliably accurate responses to sophisticated questions in Otolaryngology. Professional societies must be aware of the potential of this tool and prevent unscrupulous use during test-taking situations and consider guidelines for clinical scenarios. Expert clinical oversight is still necessary for myriad use cases (eg, hallucination)., Competing Interests: None., (© 2023 The Authors. OTO Open published by Wiley Periodicals LLC on behalf of American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Background: Breast augmentation is the most common aesthetic surgery performed in the United States. Despite its popularity, there is no consensus on many aspects of the procedure.Objectives: The authors assessed current trends and changes in breast augmentation from January 1, 2011 to December 31, 2015.Methods: A retrospective cross-sectional study of 11,756 women who underwent breast augmentation based on the American Board of Plastic Surgery (ABPS) Maintenance of Certification Tracer Database was performed.Results: There were clearly dominant trends in how ABPS-certified plastic surgeons performed breast augmentations. Most surgeries were performed in freestanding outpatient (47.3%) or office operating room (33.7%). The inframammary fold incision was most popular (75.1%), followed by periareolar (17.8%) and transaxillary approaches (4.1%). Implants were more commonly placed in a submuscular pocket (30.6%) compared with dual plane (26.7%) or subglandular (6.7%). Silicone implants (66.8%) were favored over saline (25.1%), with a statistically significant increase in silicone prostheses from 2011 to 2015. Data were "not applicable" or "other" in the remainder of cases. Administration of both preoperative antibiotics (3.8% in 2011, 98.7% in 2015, P < 0.05) and deep venous thromboembolism (DVT) prophylaxis (3.8% in 2011, 90.6% in 2015, P < 0.05) dramatically increased during the study period. Overall adverse events (7.4%) and reoperation rates (2.2%) were low.Conclusions: Changes in standard of care for breast augmentation are reflected by the evolving practice patterns of plastic surgeons. This is best evidenced by the dramatic increase in use of antibiotic and DVT prophylaxis from 2011 to 2015.Level Of Evidence:4: [ABSTRACT FROM AUTHOR]

Highlight • As part of Maintenance of Certification (MOC), the American Board of Psychiatry and Neurology (APBN) developed a patient satisfaction form. • We are not aware of any studies of the ABPN satisfaction survey. • We compared the ABPN survey to the Clinically Useful Patient Satisfaction Survey (CUPSS). • The psychometrics of the CUPSS were stronger, and it was preferred by patients as a measure of satisfaction with the initial evaluation. Abstract As part of Maintenance of Certification (MOC) for physicians, the American Board of Psychiatry and Neurology (APBN) developed a patient satisfaction form. We are not aware of any studies of the ABPN satisfaction survey. The goal of the present study was to examine the psychometric characteristics of the ABPN survey, and to compare it to a satisfaction measure that was designed to assess satisfaction with the initial evaluation. Two hundred seven patients completed the APBN measure and the Clinically Useful Patient Satisfaction Scale (CUPSS) after their initial meeting with the psychiatrist. The patients also completed a questionnaire asking which of the two scales were better measures of satisfaction with the initial evaluation. The items on both scales were negatively skewed, and approximately 90% of the ratings on the APBN scale received the highest rating. Both scales had high internal consistency. All items were significantly correlated with indicators of global satisfaction. There was sufficient variability in satisfaction ratings to detect differences amongst clinicians. Significantly more patients indicated that the CUPSS was a better indicator of their satisfaction with the evaluation. The results of the present study raise some concerns about the ABPN measure. There was evidence of a ceiling effect, and this ceiling effect raises questions about the usefulness of the scale for the purposes of self-improvement. The psychometrics of the CUPSS were stronger, and it was preferred by patients as a measure of satisfaction with the initial evaluation. [ABSTRACT FROM AUTHOR]

Changes to the American Board of Internal Medicine's Maintenance of Certification Program: Preserving Core Assessment Values As Maintenance of Certification (MoC) for practicing physicians has evolved into more continuous programs, controversy has arisen over how physicians should self-regulate their profession and serve the public trust in doing so. As a result, the American Board of Internal Medicine (ABIM) has focused on making substantial changes to its MoC program by inviting physician members of the internal medicine community to play critical roles in shaping the program's processes through innovation. Much of the recent focus has been on changing the high-stakes assessment to one that is more relevant and authentic to practice, less burdensome and anxiety provoking for physicians, and more continuous over the course of their career. However, at the same time, ABIM has been careful to preserve the core values of integrity and fairness that are central to testing programs especially when making consequential decisions about test-takers in order to ensure that public expectations are met. This paper lays out the case for a continuous certification program with consequences and the story of how substantial changes were made using an evidence-based approach involving the physician community. [ABSTRACT FROM AUTHOR]

Certification is often viewed to promote lifelong professional development. Industry accreditation agencies include standards for the Maintenance of Certification (MOC) that emphasize the measurement or promotion of continued competency throughout an individual's professional career. In 2013, NBCOT partnered with BreakAway Games to create the NBCOT Navigator®, a virtual continuing competency assessment platform that uses gaming technologies to present a variety of assessment tools that allow certificates to demonstrate their knowledge in specific practice areas. This article is an overview of our team's effort in conceiving, developing, and employing the NBCOT Navigator. The article contains a summary of recent user experiences as well as a description of outreach visits with key stakeholder groups. Generalized recommendations for future design and development of advanced technology-enabled MOC tools are postulated based upon our experiences. [ABSTRACT FROM AUTHOR]

For almost 100 years, the American Board of Medical Specialties (ABMS) and its 24 Member Boards have been entrusted with the responsibility of overseeing the process by which physicians become Board Certified and continue their certification across their careers. Continuing certification provides a framework that helps physicians keep up to date with the myriad of medical advances, to continually improve, and to objectively demonstrate their commitment to maintaining knowledge and skills to the patients, families, and communities who depend upon them. A robust and rigorous certification system is important to the profession, to individual physicians, and to patients and other members of the public who rely upon this credential for the quality it represents.

Continuous quality improvement is a component of professionalism. Maintenance of Certification (MOC) is a mechanism in the USA for physicians to keep current with medical knowledge and contribute to practice improvement. Little is known about primary care physicians’ perceptions of the practice improvement (Part IV) components of MOC. We aimed to determine primary care physicians’ perceptions of their professional responsibility to participate in Part IV MOC. This was a cross-sectional study of primary care physicians using the American Medical Association Masterfile. We developed a nine-item survey, designed from expert consensus and literature to determine views on Part IV MOC as a professional responsibility. We surveyed 1500 randomly selected primary care physicians via mail from November 2014 to May 2015. The response rate was 42% (627 of 1,500): 47% (273 of 585) were family practitioners and 49% (289 of 585) were internists. Factor analysis revealed a two-factor survey, with five items pertaining to positive views of MOC Part IV and four items pertaining to negative views. Internists were more likely to view MOC Part IV as time consuming (82.0% vs. 70.3%, P = .001), expensive (50.9% vs. 38.8%, P = .004), and not relevant to practice (39.1% vs. 23.8%, P