Request ASN to Disassociate KSAP from MOC

Dear fellow Nephrologists,

ASN recently launched KSAP in addition to its NephSAP as another self-assessment study tool. As we appreciate the effort and welcome the new product, it is concerning that KSAP is based on ABIM's "examination blueprints" and have MOC points tied to it. I have asked ASN to untie KSAP to MOC in the following email 3/2015:

"It is great to have a question bank offered by the ASN to help fellows, as well as practicing Nephrologists, for testing our knowledge.  This tool was unavailable when I graduated from my fellowship. The efforts the ASN and the question writers and reviewers have put forth, is very much appreciated. However, I feel strongly that there should be no association between KSAP and MOC.
 

As you are no doubt aware, there have recently been escalating controversies with MOC.  In particular,

·        Newsweek article by Kurt Einchenwald
·        The BMJ blog post by Dr. Elisabeth Loder
·        A debate from the National Board of Physicians and Surgeons by Dr. Teirstein

In addition, ABIM’s financial transparency has continue to be questioned. Needless to say, myself and many others believe that the ABIM and its MOC are in trouble from an ever widening credibility gap.

 

I have written to ASN multiple times expressing my opposition of ASN implementation of MOC. I believe that ASN should stand firm and not solicit points for MOC before it is proven to be beneficial for Nephrologists and our practice. With ABIM’s shady image, I am disappointed to see that the ASN continues to be complacent with ABIM’s grand plan by promoting MOC. It is puzzling to me why the ASN, an organization cherished by Nephrologists for its education value, has not distanced itself from the deeply corrupted and quickly falling ABIM.  Why have we still not been formally polled about our opinion on MOC? Why does the highly anticipated KSAP have to be tied to the ABIM MOC program?

Therefore, I would like to suggest a few things for ASN to consider:

 

1.    Conduction of a poll on Nephrologists’ view on MOC, including each part of the MOC program. I think this is essential and long overdue. Following the poll, the ASN should show members the results, similar to the ACC.  I would acknowledge that other Nephrologists might have very different view from mine, which no matter the result, would prove valuable to the ASN leadership on this important issue.

2.    Disassociation of KSAP from MOC. There is no evidence that MOC equates to competency or quality of care whatsoever. Repeated “studies” conducted by ABIM board members themselves have been unable to demonstrate benefit. KSAP is embraced because of the content -- irrespective of MOC.  Tying it to ABIM MOC  forces Nephrologists to enroll in an onerous program with dubious goals. This stance is now shared by the Dermatology society which has advanced a proposed resolution to stop MOC.

3.    Develop an ASN-based certification program.  ABIM may well become irrelevant sometime in the near future, either due to upcoming investigations and/or losing credibility and faith from physicians. Both Endocrine and Cardiology societies have initiated discussions about alternate certification methods.  Case in point -- ASN already has developed a strong in-training exam for fellows.  It would be logical to partner with organizations such as NBME for the next step and develop a certification examination.  Certification by this exam could be sanctioned by a new board (see below), or ASN itself.

4.    I have sent you the information on the new board, the National Board of Physicians and Surgeons, and would continue to ask if it is possible for the ASN to work with NBPAS to facilitate new certification and MOC goals for nephrologists. "