A Look at Maintenance of Licensure and its Effect on Continuing Medical Education

What is Maintenance of Licensure?

In a continuous effort to improve patient safety, state medical boards and professional medical organizations are looking for new ways to improve physician competence, reduce medical errors and increase accountability. The Federation of State Medical Boards (FSMB) responded to this need with the establishment of the Committee on Maintenance of Licensure to help state medical licensing boards address licensing issues. The first product of the FSMB licensure committee was the development of a statement of purpose. In 2004, the FSMB House of Delegates passed a resolution declaring that “state medical boards have a responsibility to the public to ensure the ongoing competence of physicians seeking re-licensure.”¹

In April 2010, the FSMB proposed a new system, Maintenance of Licensure (MoL), in which a licensee periodically provides, as a condition of license renewal, evidence that he or she is actively participating in a program of continuous professional development that is relevant to their area of practice. Ideally, professional development should be measured against objective data sources with the goal of improving professional performance over time.² The purpose of MoL is to encourage and support lifelong learning by all licensed physicians.³

Under the current system, licensure renewal is enforced through state medical licensing boards. Current requirements vary from state to state. Most states require physicians to participate in a certain amount of continuous medical education (CME) credit hours. However, they are generally not required to attend activities that are specifically related to their area of practice. Furthermore, more than 10 percent of U.S. licensing jurisdictions have no requirement for CME to maintain medical licensure.⁴

Under the proposed FSMB system, physicians will participate in more robust continuous professional development that is relevant to their area of practice. The FSMB hopes to join the current CME system with maintenance of clinical competency and quality among all licensed physicians. The challenge is to create a system that can be aligned with other existing, lifelong learning initiatives, such as the Maintenance of Certification (MoC) program implemented by the American Board of Medical Specialties (ABMS), the Osteopathic Continuous Certification (OCC) program implemented by the American Osteopathic Association’s Bureau of Osteopathic Specialists.²

Research suggests that physician knowledge and skill deficits may develop as the years progress and they are further removed from their formal medical training. This reinforces the need for lifelong learning and continuous professional development. Considerable evidence is available to support the value of performance-based CME and continued professional development, which are essential aspects of the new FSMB framework for MoL.⁵ Data support the use of CME as a tool for physician learning if it is part of a system of professional development that includes self-assessment, remediation and re-assessment.¹ In their CPPD Report, the American Medical Association (AMA) calls on “all members of the CME community to be actively involved in identifying physicians’ needs related to their ability to practice safe and effective medicine and to provide CME activities to address those needs.”⁴

REFERENCES:

1. Federation of State Medical Boards. Public policy compendium. Available at: www.abms.org/About_Board_Certification/MOC.aspx. Accessed January 29, 2011.
2. Federation of State Medical Boards. FSMB report provides roadmap for maintenance of licensure. Available at: http://www.fsmb.org/pdf/mol-nr-042610.pdf. Accessed January 28, 2011.
3. Maintenance of Licensure: Frequently Asked Questions. Available at: http://www.fsmb.org/pdf/mol-faqs.pdf. Accessed January 29, 2011.
4. American Medical Association. Maintenance of Licensure and Continuing Medical Education. Available at: http://www.ama-assn.org/ama1/pub/upload/mm/455/cppd24.pdf. Accessed January 28, 2011.
5. AAOS. Physician maintenance of licensure. http://www.aaos.org/news/aaosnow/oct10/managing7.asp. Accessed January 29, 2011.

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CFMC’s Office of Continuing Education supports its customers in taking their education national through the use of CFMC’s new product: online eLearning services. By combining our experience in continuing education content with superb technological resources, CFMC’s Office of Continuing Education now develops and executes high-quality online healthcare educational courses.

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Visit yourCEsource.org for more information about our continuing education services to award credit to physicians, nurses, psychologists, and others. You may also call Lorraine Pickrell at 1-800-950-8250, ext. 3372.

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