A physicians association representing some 120,000 practicing internists is up in arms over groundshaking new rules for board certification, known as maintenance of certification or "MOC."
Many of the new recertification requirements, which took effect Jan. 1, "are not evidence-based, but are expensive, burdensome, and detract from the care of the patient," says David Fleming, president of the American College of Physicians.
The new rules are so "logistically and emotionally burdensome," he says, that they "may drive smaller practices out of business."
The traditional recertification exam, a "secure" set of 200 multiple choice questions doctors must pass once every 10 years, now has a failure rate of 22% for those who take it the first time. For those who took it for the first time five years ago, only 9% failed, Fleming says.
Not only are many of the questions on the exam irrelevant, Fleming contends, but "the core general medicine questions that we were used to having in the past are no longer there. Instead, there's a lot of esoteric information you were expected to memorize, like knowledge of clinical situations and diseases that you never see."
The rules are perceived to be so onerous, that 10,000 internists have signed a petition calling for many of the new criteria to be killed.