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317 Sheldon D. Horowitz and Richard E. Hawkins chapter 27 The Maintenance of Certification Program from the American Board of Medical Specialties and Its Member Boards The American Board of Medical Specialties (ABMS) is the umbrella organization for 24 medical specialty certifying boards. The ABMS mission is to maintain and improve the quality of medical care by assisting its member boards in their e√orts to develop professional and educational standards for the certification of physician specialists. The intent of certification, including initial certification and maintenance of certification (ABMS MOC®), is to provide assurance to the public that a physician specialist certified by an ABMS member board has successfully completed an approved educational program and an ongoing evaluation process designed to assess the medical knowledge, judgment, professionalism , and clinical and communication skills required to provide high quality patient care in that specialty. ABMS is a not-for-profit organization that oversees US physician certification of more than 750,000 physicians through its 24 member boards. Currently, ABMS member boards certify approximately 80 to 85 percent of licensed US physicians in more than 145 specialties and subspecialties .∞ Certification by an ABMS member board is used widely as an indicator of higher standards and better care. History and Evolution of Certification ABMS can trace its roots to the rise and growth of the medical specialty board movement in the early 1900s. This movement has been associated directly with significant advancements in medical science and the resulting improvements made in medical care delivery. Prior to the specialty board movement, there was no means to assure the public that a physician claiming to be a specialist was indeed qualified; each physician was the sole judge of his or her own qualifications to practice a given specialty. Specialty societies and medical education institutions first encouraged and assisted in the development of boards to define specialty qualifications and to issue credentials that would assure the public of a specialist ’s qualifications. As the original boards and societies matured, they contributed to the development of a system to provide recognition of qualified physician specialists. The concept of a specialty board was first proposed in 1908, though it was not until 1916 that the first specialty board, the American Board for Ophthalmic Examinations, was formed. In 1917, the board was o≈cially incorporated, and in 1933, its name was changed to the American Board of Ophthalmology. The board established the guidelines for training and evaluating candidates desiring certification to practice ophthalmology. 318 emerging themes and forces in cme Box 27-1 Core Competencies as Adopted by ABMS in 1999 Patient Care—Provide care that is compassionate, appropriate, and e√ective treatment for health problems and to promote health. Medical Knowledge—Demonstrate knowledge about established and evolving biomedical, clinical, and cognate sciences and their application in patient care. Interpersonal and Communication Skills—Demonstrate skills that result in e√ective information exchange and teaming with patients, their families, and professional associates (e.g., fostering a therapeutic relationship that is ethically sound and uses e√ective listening skills with non-verbal and verbal communication, and working as both a team member and at times as a leader). Professionalism—Demonstrate a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to diverse patient populations. Systems-based Practice—Demonstrate awareness of and responsibility to larger context and systems of health care. Be able to call on system resources to provide optimal care (e.g., coordinating care across sites or serving as the primary case manager when care involves multiple specialties, professions, or sites). Practice-based Learning and Improvement—Able to investigate and evaluate patient care practices, appraise and assimilate scientific evidence, and improve the practice of medicine. The second specialty board, the American Board of Otolaryngology, was founded and incorporated in 1924; the third and fourth boards, the American Board of Obstetrics and Gynecology and the American Board of Dermatology and Syphilology, were established in 1930 and 1932, respectively. These boards developed along the same path as their predecessors and shared common objectives. At a 1933 professional conference, representatives from these four pioneering specialty boards and the American Hospital Association, the Association of American Medical Colleges, the Federation of State Medical Boards, the American Medical Association (AMA) Council on Medical Education and Hospitals, and the National Board of Medical Examiners agreed that the examination and certification of specialists would best...

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