Radiologists with lifetime certification aren't participating in the ABR MOC program

Radiologists with lifetime certification are more likely to forgo participation in American Board of Radiology (ABR) Maintenance of Certification (MOC) programs than those with time-limited certification, according to a new study published in the American Journal of Roentgenology.

In a study of Medicare and Medicaid data of more than 20,000 diagnostic radiologists, slightly more than 14% of those with lifetime ABR certification participate in the ABR MOC, compared to nearly all those with time-limited status.

“Many opinions have been expressed regarding MOC in radiology,” said Andrew B. Rosenkrantz, with NYU Langone Medical Center, MD, MPA in a prepared statement. “But there is actually very little public data on the matter. Through this work, we hope to bring objective findings to help inform the discussions.”

In 2002, the ABR changed its policy so that all diagnostic radiologists had to participate in the MOC program to ensure their radiology certificates remained valid. Those who already held lifetime validation, however, were exempt from participation, but were still encouraged to do so by the ABR.

Rosenkrantz and colleagues hypothesized that if radiologists thought the MOC’s benefits outweighed its costs participation rates would be high, even among groups who aren’t mandated by the ABR.

The researchers found that 56.4% of diagnostic radiologists participated in the MOC program; nearly all (99.6%) readers with a time-limited certificate participated and only 13.9% of those with a lifetime certificate took part in the ABR MOC program.

Broken down even further, rates of nonmandated participation were higher for academic compared to nonacademic radiologists (28% versus 11.3%), subspecialists compared to generalists (17% versus 11.5%) and those in larger practice groups.

Additionally, the researchers noted there was wide variation in participation from state to state. In South Dakota, nonmandated participation was 0.0%, compared to 32.6% in Virginia.

The findings, according to Rosenkrantz et al. suggest there may be some negative perceptions about the MOC or “diplomate dissatisfaction” with the program.

“Based on public criticisms of MOC, low participation rates among diagnostic radiologists not mandated to participate in MOC may relate to physician perceptions of the relevance and utility of MOC, the burden of time used to study for and take the examinations, and the high cost, including examination fees and travel,” the researchers wrote.

A program that validates lifelong learning could help justify the time, effort and money required for voluntary participation. More flexibility for diplomates to choose specific types of test items to reflect their particular area of focus could also improve participation, the authors concluded.