AMA Addresses Maintenance of Certification, Licensure, Discrimination Against International Medical Graduates

These are among the issues addressed by the AMA House of Delegates at its meeting last month in Chicago:

• The Council on Medical Education report “Aligning the Evaluation of Physicians Along the Medical Educational Continuum”asks the AMA to support the concept that the evaluation of physicians as they progress along the medical education continuum should include assessments of each of the six competency domains of patient care, medical knowledge, interpersonal and communication skills, professionalism, practice-based learning and improvement, and systems-based practice. Further, the AMA should encourage study of competency-based progression within and between medical school and residency through its Accelerating Change in Medical Education initiative and work with the Accreditation Council for Graduate Medical Education to study how the Milestones of the Next Accreditation System can support competency-based progression in residency.

• The Board of Trustees report “Abolish Discrimination Against IMGs” asks that the AMA support principles related to medical licensure of international medical graduates (IMGs), including uniformity of licensure requirements for IMGs and graduates of U.S. and Canadian medical schools and elimination of discrimination against physicians on the basis of national origin and/or the country in which they completed their medical education.

• The Council on Medical Education report “Update on Maintenance of Certification and Osteopathic Certification” encourages AMA members to be proactive in shaping Maintenance of Certification (MOC) and Osteopathic Continuous Certification by seeking leadership positions on the American Board of Medical Specialties (ABMS) member boards, American Osteopathic Association specialty certifying boards, and 16 MOC committees. It further asks that the AMA work with interested parties to ensure that MOC uses more than one pathway to assess accurately the competence of practicing physicians, to monitor for exam relevance, and to ensure that MOC does not lead to unintended economic hardship such as hospital decredentialing of practicing physicians.

• The Council on Medical Education report “Update on Maintenance of Licensure (MOL)” asks that the AMA establish guidelines for implementation of state MOL programs that include, among others, the following principles: any educational activity under consideration should be developed in collaboration with physicians, should be evidence-based, and should be specialty-specific. Accountability for physicians should be led by physicians, and any proposed MOL activity should undergo an in-depth analysis of the direct and indirect costs, including physicians’ time and the impact on patient access to care, as well as a risk/benefit analysis, with particular attention to unintended consequences.

• The Council on Science and Public Health report “Concussion and Youth Sports”calls on the AMA to promote the adoption of requirements that athletes who are participating in school or other organized youth sports and are suspected by a coach or other individual responsible for the health and well-being of athletes of having sustained a concussion be removed immediately from the activity in which they are engaged and not return to competitive play, practice, or other physical sports–related activity without the written approval of a licensed physician. It further asks the AMA to encourage physicians to assess the developmental readiness and medical suitability of children and adolescents to participate in organized sports and assist in matching a child’s physical, social, and cognitive maturity with appropriate sports activities. Physicians should also counsel young patients and their parents or caregivers about the risks and potential consequences of sports-related injuries, including concussions and recurrent concussions.