American Academy of Emergency Medicine


I read your most recent article, “Is MOC a RPITA?” You wrote exactly what each of us is thinking. Much like the invasion of CMG’s into our specialty, we have only ourselves to blame for the situation we find ourselves in. The “right thing” for those most affected is never done unless they are actively involved in the process. If physicians would refuse to sign contracts and work for CMG’s, then CMG’s would not continue to grow and would disappear from the landscape. Sorry, I digress. As a specialty we have allowed others, including non-physicians, to dictate to us rather than work for us and in conjunction with us. As you referenced in the article, following the money usually gets to the root of the problem. The solution that you allude to finding is actually, at least partially, in your article. ABIM’s membership had to show a possible alternative before ABIM would listen.

To ABEM’s credit, they have developed a good infrastructure for test question development and test administration. Where they are failing is in establishing reasonable expectations and goals for recertification. We must take back control of our own board certification process. If ABEM continues its stance of not being responsive to the membership it serves then we need to eliminate or circumvent its control. I would suggest that AAEM develop an alternative board certification process. The process would still have individuals take tests through ABEM. Each physician could choose doing either the annual LLSA exams over ten years or take the ConCert exam at the ten-year mark. Physicians would provide documentation of successful completion of one of the two tracks and AAEM would then provide them with board certification.

ABEM would basically become a vendor for testing and would not control or be able to dictate the process. I am confident we all agree that board certification is beneficial to patients and our specialty. We just want a fair, effective, and minimally burdensome process to maintain it. Some may say this is a less than ideal process since it adds a step and involves an additional entity. Others may say it’s a significant improvement since it eliminates power being concentrated in one entity. Either way the process would be an improvement over what we are currently being subjected to.

— Best Regards,

I find your idea of allowing board-certified emergency physicians to choose either the ConCert or the LLSA tests creative and worthy. I hope both ABMS and ABEM are open minded, flexible, and reasonable enough to consider such excellent ideas and make MOC more evidence-based and far less burdensome. That would be preferable to AAEM getting into the board certification business or having other “alternative boards” spring up, but if ABMS and ABEM refuse to listen to their diplomates alternative boards are inevitable.

Thank you for your letter. I hope it prompts other members of AAEM to write in with their own outside-the-box thinking.

— The Editor


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