Model Resolution on Maintenance of Licensure (MOL)

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Whereas: in 2010 the Federation of State Medical Boards, Inc., (FSMB) House of Delegates adopted the Maintenance of Licensure (MOL) framework, a process by which physicians periodically provide, as a condition of license renewal, evidence that they are actively participating in a program of continuous professional development that is relevant to their areas of practice, measured against objective data sources and aimed at improving performance over time; and

Whereas: the FSMB website states that, in lieu of MOL, the American Board of Medical Specialties Maintenance of Certification (MOC) program and the American Osteopathic Association Bureau of Osteopathic Specialists’ Osteopathic Continuous Certification (OCC) program incorporate activities generally consistent with the intentions of MOL, state licensing boards may elect to substantially or fully qualify licensees engaged in these activities; and

Whereas: medical organizations have for years opposed any effort to mandate the content of continuing medical education (CME) required for licensure because physicians themselves are in the best position to determine what educational opportunities will be most helpful in improving their practice, based on the type of patients that they see and the procedures that they perform; and

Whereas: there is no evidence that physicians who have completed the maintenance of board certification procedure make more accurate diagnoses or are more skillful at performing their treatments; and

Whereas: maintenance of board certification is extremely costly and time consuming, requiring time away from patient care or from more relevant study, and greatly exceeds the level of knowledge needed for basic medical licensure; and

Whereas: the materials that physicians are forced study to meet maintenance of board certification requirements may be biased, outdated, or irrelevant to the physician’s actual practice; and

Whereas: granting certain organizations the equivalent of monopoly power over maintenance of board certification, and thus licensing and medical practice itself, will tend to increase costs, potentially violate federal antitrust and interstate commerce legislation, and hamper innovation; and

Whereas: the reasons to oppose maintenance of board certification apply to MOL; and

Whereas: state licensing boards are free to adopt or reject the FSMB MOL program; and
Whereas: highly variable licensure requirements, including lack of mandatory continuing medical education (CME), have existed in different jurisdictions for decades, without noticeable difference in quality of medicine related to these varying requirements; and

Whereas: there is no evidence to indicate that the vast majority of physicians have any need for mandatory, government-prescribed CME to maintain excellent levels of ongoing education and competency; and

Whereas: as many as 25% of all physicians currently practicing medicine in the U.S. have never been board certified and are thus actively excluded from entry into MOC programs, creating hardship if imposed; and

Whereas: 50% of all board-certified physicians in the U.S. currently have lifelong certificates, have been and continue to practice as board-certified physicians and are also similarly non-eligible for MOC programs; and

Whereas: legislation has greatly expanded the scope of practice of care to lesser educated “midlevel providers” (i.e. nurse pacticitioners, physician’s assistants, CRNAs, etc.); and

Whereas: driving experienced physicians out of practice because of onerous, costly requirements will result in still more patients being forced to turn to nonphysicians for care, now, therefore, be it

RESOLVED, That the _____ Medical Association oppose any efforts by the _____ Medical Board to require the FSMB “maintenance of licensure (MOL)” program as a condition of licensure.

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