Issues with the Maintenance of Certification program; Overcoming a ‘quadruple threat’

Issues with the MOC

In Dr. Nasrallah’s editorial “Revamp the MOC” (From the Editor, Current Psychiatry. September 2020, p. 7-10), he addresses the American Board of Psychiatry and Neurology (ABPN) Maintenance of Certification (MOC) program, which—in my opinion—is nothing more than a folly and a greedy money grab designed to extort revenue from practicing psychiatrists. Like Dr. Nasrallah, my initial board certification consisted of a written exam, followed by a face-to-face oral exam. Most candidates, myself included, did not relish the thought of being subjected to the scrutiny of an oral exam. It was truly an anxiety-provoking and nerve-wracking ordeal, but in the end, the exam revealed itself to be an amazingly effective and legitimate measuring stick.

I was not so fortunate to have been grandfathered with lifetime certification, so I have been forced to recertify twice now. I will be 70 years old when I will need to decide whether to recertify once again. It is my belief that the MOC process is cumbersome and nonsensical, having little, if any, relevance in assessing one’s competency. Again, the ABPN’s purpose is not to “protect the public” and ensure safe and competent care, but to generate tremendous revenue for the Board. How can any rational individual believe that this exam is a legitimate test of one’s knowledge and competency when the pass rates are so stratospherically high year after year? I do not know of a single individual who has failed the recertification exam, so it would appear that if you pay the fees and sit for the exam, you will pass. It saddens me that the Board can perpetrate such a hoax on the public, leading them to believe that the MOC actually means something.

The cost to recertify is not inexpensive. Apparently, in a desire to add to its coffers, the ABPN has recently implemented the Physician Folios portal, whereby psychiatrists are forced to pay an annual fee. Its purpose, according to the Board, is to provide“a dynamic conduit for important data exchange such as making updates to personal contact information, updating medical license information, and applying and paying for an examination.”¹ Give me a break!

It is my hope that a better, less expensive, more appropriate system is developed, allowing the psychiatrist to focus his/her efforts on treating patients.

Terrence Boyadjis, MD
Private psychiatric practice
West Chester, Pennsylvania

Reference
1. American Board of Psychiatry and Neurology. ABPN Physician Folios. https://application.abpn.com/webclient/landing_page.asp. Accessed October 20, 2020.

Dr. Nasrallah’s editorial about the MOC process is another addition to his collection of many of the best editorials I’ve ever read. I related fondly to his experiences taking the oral exam, which I took in 1972. I also became an examiner during the mid-1970s. Dr. Nasrallah continues to be a source of down-to-earth wisdom for our beloved profession.

Richard W. Worst, MD
Twin Falls, Idaho

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