The Maintenance of Certification (MOC) was mandated by the American Board of Medical Specialties (ABMS) in the year 2000 for their 24 specialty boards, including the American Board of Psychiatry and Neurology (ABPN). The rationale for creating the MOC was to address a perceived need by the public for greater accountability from physicians in terms of safe practice for protection of the public, continuous quality improvement, and competence.

If you were board-certified after 1994, you are required to participate in the MOC program. If you have a time-unlimited certificate in psychiatry, you are not required to participate although you will be publicly identified as “certification inactive” if you don’t. The MOC is for physicians who have time-limited certificates in psychiatry, which means during each 10 year cycle during their careers, they are responsible for demonstrating they are keeping up to date with their medical knowledge and practice.

There are several MOC components that diplomates are required to complete over the 10-year cycle. Many physicians believe they take time away from patient care and there is no high level research evidence showing that they improve patient outcomes, ensure safety, or enhance the physician-patient relationship. There is some evidence that they lead to non-profit boards making a great deal of money which tends to be associated with very large salaries of top executives. The Association of American Physicians and Surgeons (AAPS) filed a lawsuit in Federal court in April 2013 against the ABMS regarding antitrust concerns about MOC.

The Maintenance of Licensure (MOL) is another regulatory layer on top of Maintenance of Certification (MOC) promulgated by the Federation of State Medical Boards (FSMB) for the purpose of providing evidence that physicians are participating in a program of continuous professional development. According to the FSMB, if you’re compliant with MOC, you would be in substantial compliance with MOL.

It’s being proposed that MOL be a condition of medical licensure. The FSMB is a non-profit organization representing the nation’s 70 state medical boards with whom it is working to develop a MOL system for the United States. Implementation pilot projects are reportedly underway in several states including Iowa to study and implement MOL.

A resolution to support lifelong learning but oppose MOL was adopted in Iowa in April 2013 by the Iowa Medical Society House of Delegates. The resolution was sponsored by Dr. James Amos, MD and co-sponsored by the Iowa Psychiatric Society. MOL was defeated on the grounds that it would be duplicative as it really is not distinguishable from MOC, especially since the FSMB essentially makes MOC a sufficient condition for satisfying requirements for MOL. Several similar resolutions have been adopted in many states including New York, Michigan, Wisconsin, North Carolina, New Jersey, Ohio, Pennsylvania, California, and Oklahoma.

But the Iowa Board of Medicine (IBM) is still pursuing MOL implementation pilot projects. The next step for the IBM is to distribute an online survey to Iowa licensees to investigate a number of items, including board certification status, how licensees manage their continuing education, and hopefully, a poll query as to whether or not licensees favor the imposition of MOL.

This petition is for the purpose of supporting lifelong learning but opposing the implementation of MOL in Iowa. The IMS has already adopted a resolution to oppose MOL and the IBM knows that. Iowans and anyone else who supports this petition needs to send a strong, clear message to the IBM and the FSMB that we don’t want MOL in Iowa.

Thank you for your support in signing this petition.

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