References from the Vision Commission draft report:
1. Commission report, page 25, para 5: “The Commission heard compelling testimony from all stakeholders that loss of certification can lead to loss of employment or certain employment opportunities for diplomates or loss or reimbursement from insurance carriers." 2. Commission report, page 25, para 5: “It is not the intent of the ABMS Boards for continuing certification to be used as the only criterion for credentialing and privileging decisions. ABMS does not support he credential being used as the sole criterion to deny a diplomate an employment opportunity or loss of insurance reimbursement." 3. Commission report, page 14, para 9: “Diplomates cited that the content of the examination was not relevant, was not a reflection of the application of knowledge in the clinical environment and was not current with advances in medicine.” 4. Commission report, page 15, para 1: “Diplomates routinely access medical knowledge on their computers and smartphones while providing patient care. Assessments that rely exclusively on knowledge recall are not aligned with how diplomates practice." 5. Commission report, page 28, para 3: “There are gaps in the research evidence that conclusively demonstrate that diplomate participation in continuing certification leads to better patient outcomes." 6. Commission report, page 15, para 3: “It is recommended that the ABMS boards no longer use a single point-in-time examination (or single point-in time assessments) as the only measure to determine the continuing certification status of a diplomate. In addition, the Commission recommends ABMS Boards move to truly formative assessment approaches that are not high-stakes nor highly-secured formats.” 7. Commission report, page 15, para 3: “Diplomates did not consider more frequent, shorter assessments done in a highly-secured or remote proctoring environment (e.g. ABIM’s Knowledge Check-in) to be formative, but rather just more frequent high-stakes assessments in a different form.” 8. Commission report, page 17, para 3: It is acknowledged that measuring practice improvement can be challenging.” 9. Commission report, page 19, 3rd para: "The Commission appreciated the practical and significant difficulty placed on diplomates for meeting practice improvement requirements." 10. Commission report, page 19, 3rd para: “…diplomates did not find value in check box activities or activates not relevant to practice. Diplomates complained that requiring multiple PDSA (Plan-Do-Study-Act) cycles in a quality improvement activity or requiring improvement in an activity in order for the activity to count in the certification program was onerous and artificial." 11. Commission report, page 28, para 2:“Fees charged to diplomates should be the minimum necessary to finance Board operations and to have sufficient reserves to invest in programmatic initiatives that advance the quality and applicability of certification programs." 12. Commission report, page 30, para 4: “Some diplomates who testified expressed how they did not trust their Boards to appropriately manage resources. Specific issues include how some Boards have used diplomate fees in the past as well as how these Boards have transferred funds to associated foundations. They also questioned the judgement of the Boards leadership compensation, locations of board meetings, and other expenses not viewed as justifiable for certification programs.” 13. Commission report, page 29, para 2: “Boards’ finances were perceived as very opaque. Transparency about the efficiency of operations, the appropriateness of fees, and the stewardship of funds was essential to increasing diplomates trust."