Physicians who maintain board certification within 10 years of their initial certification are more than two times less likely to face state medical board disciplinary actions than those who do not, according to recent research.

Maintenance of certification (MOC) has a strong association with risk of disciplinary action, the study in the Journal of General Internal Medicine reports. Previous research had suggested that physicians who pass initial certification exams administered by the American Board of Internal Medicine (ABIM) after medical training are five times less likely to face disciplinary actions than doctors who do not become board certified.

“ABIM data indicates that a vast majority of internists pass the certification exam after training and periodic MOC exams through their careers. Even more ultimately pass on subsequent attempts,” according to an ABIM statement accompanying the report. “To explore whether there is an association between MOC exam performance and risk of disciplinary actions from state medical boards, ABIM researchers studied MOC exam results and any reported disciplinary actions for nearly 48,000 general internists who initially certified between 1990 and 2003.”

Research findings include the following:

• The risk of disciplinary action against physicians declines as scores on the MOC exam increase. The researchers say this indicates that more medical knowledge is associated with fewer disciplinary actions.

• Thirty-five percent of total disciplinary actions in the study population can be attributed to not having passed the Internal Medicine MOC exam.

• Poor exam performance is associated with more severe disciplinary actions.

• There was no difference in disciplinary rates associated with the amount of continuing medical education (CME) required for state medical licensure.

The researchers conclude that completing CME alone, in the amounts required for state licensure, does not reduce the risk of disciplinary actions.

• Researchers estimated that the number of patients potentially cared for by physicians with disciplinary actions could total hundreds of thousands to a few million.

An abstract of the report is available online at: