As members of the medical profession, physicians are called upon to use our special knowledge and skills for the good of others. In the May issue of Academic Medicine, Wynia and colleagues encourage us to supplement the predominant professionalism focus on principles, traits, and behaviors with a more transcendent view of professionalism as a belief system. In this system, individual physicians and our professional organizations jointly declare a shared resolve to professional standards that incorporate commitment to scientific knowledge, high levels of competence in the activities of our medical work, and a humanistic approach to the patients, families, and communities we serve.
This overarching view of professionalism has been inherent in the history and conduct of American Board of Medical Specialties (ABMS) Board Certification. Protecting the public through establishing and assessing professional standards that include knowledge and clinical activities was fundamental beginning almost a century ago when the first board, the American Board of Ophthalmology, was founded in 1917. This view of professionalism was fundamental to the movement from single point in time certification to periodic certification to the current ABMS Maintenance of Certification® (MOC) program.
Dr. Fred Hafferty is a co-author of this paper. Whenever I see Fred’s name, I am reminded of one of his most important contributions to medical education: the naming of the hidden curriculum and the role it plays in setting and actually achieving (or not) the professionalism we seek. Context and environment are important. The article reminds us that the overarching professionalism sought by the authors needs the commitment and engagement of three groups: individual physicians (where our focus on traits, virtues, and behaviors has rested), professional organizations (professional societies, ABMS Member Boards) and places of practice (hospitals, health systems, and accountable care organizations, etc.).
The Standards for the ABMS MOC Programs that will take effect in January 2015 recognize the role of ABMS and our Member Boards in achieving a broad view of professionalism. In addition to outlining a program that incorporates high standards for physician and clinician-scientist diplomates, the standards call upon ABMS and the Member Boards to meet our primary obligation to the public with assessment systems that contribute to ongoing learning and are relevant and meaningful to our diplomates; regular organizational review that incorporates input from our diplomates and the public we serve; and continuous quality improvement.