The American Board of Radiology (ABR) has initiated a new process called maintenance of certification. Maintenance of certification recognizes that there are several essential elements involved in delivering quality care that extend beyond medical knowledge that should be developed and maintained throughout one’s career. The new maintenance of the certification process is designed to evaluate, on a continual basis, the essential elements deemed necessary for radiologic physics, radiation oncology, diagnostic radiology, and subspecialties to deliver quality care with an emphasis on continual learning and practice improvement.
The Maintenance of Certification Model
The American Board of Medical Specialties (ABMS [www.abms.org]), the umbrella organization for the 24 medical specialty boards, is responsible for the emphasis on maintenance of certification. A task force of the ABMS used the framework of the essential components to develop a four-part model of maintenance of certification. The ABMS member boards have endorsed and accepted this model and have unanimously agreed to establish maintenance of certification programs in the near future. The four components of the model are
Part 1—Evidence of Professional Standing;
Part 2—Evidence of Lifelong Learning and Periodic Self-Assessment;
Part 3—Evidence of Cognitive Expertise; and
Part 4—Evidence of Satisfactory Performance in Practice.
In 2005, the first group of certificates of added qualification (CAQs) in neuroradiology will expire. Questions naturally arise as to the added value of CAQs in a subspecialty and why should any of us take the time, effort, and expense to recertify in our subspecialty. Some of the answers revolve around the following points:
There is a growing public demand to define responsible delivery of health care, including quality, safety, and cost as key criteria.
Organized medicine and nationally recognized institutions are also calling for increased scrutiny of individual health-care providers, including physicians, and they have the expectation of a continual process of growth and improvement.
There is an internal awareness by the physicians within the field of neuroradiology regarding the benefits of continued self-improvement and the stimulative effect of a periodic cognitive examination. The original CAQs in the mid-1990s certainly resulted in a great deal of self-assessment and improvement as individuals prepared for the examination, and most feel it raised the level of neuroradiology practiced nationwide.
The demonstration of ongoing learning and practice improvement is likely to become more and more important and perhaps even mandatory in some states or practice settings in the near future.
Recertification of the neuroradiology CAQ is the most available, most relevant, and most recognized way of demonstrating cognitive expertise in our subspecialty.
For the next 3–4 years, evidence of cognitive expertise (part 3 of the CAQ recertification examination) will be the available method of participating in maintenance of certification until the other components are better defined and implemented. The CAQ recertification examination (also known as the MOC examination) will first be offered in the later part of 2004 or 2005. The examination will be computer based, about 3–4 hours long, and offered in three or four cities in various parts of the United States.
For all of the above reasons the ABR and its two neuroradiology trustees believe it is in the best interests of the subspecialty of neuroradiology and the individual neuroradiologist to demonstrate continued learning and practice improvement by recertifying their neuroradiology CAQ.
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