Certification and MOC -- What the Research Shows:

Clinical judgment and the ability to deal with uncertainty are especially critical with respect to misuse and overuse of processes of care.[1]
Misuse and overuse of processes of care (e.g., overprescribing antibiotics and unnecessary imaging and procedures) put patients at greater risk for unnecessary complications.[2]
Physician knowledge and clinical judgment are central to making correct diagnoses.[3]
Diagnostic errors are prevalent and consequential among physicians and may not simply resolve with more practice experience.[4, 5]
One study found that premature closure, i.e., the failure to continue considering reasonable alternatives after an initial diagnosis was reached, was the single most common cause of diagnostic error. Other common causes included faulty context generation, misjudging the salience of findings, faulty perception, and errors arising from the use of heuristics.[6]

Physician Skills Deteriorate Over Time

On average, clinical skills tend to decline over time.[5]
Amount of clinical experience does not necessarily lead to better outcomes or improvement of skills.[5]
Fewer than 30% of physicians examine their own performance data.[7]
A physician’s ability to independently and accurately self-assess and self-evaluate is limited.[8]

Testing Clinical Knowledge and Judgment
Secure examinations of medical knowledge and clinical judgment can provide an effective means to assess whether physicians have incorporated new knowledge and have synthesized the knowledge over time.[9]
The ABIM Certification and Maintenance of Certification examinations in internal medicine and its subspecialties are designed to evaluate the extent of the candidate’s knowledge and clinical judgment in the areas in which an internist or subspecialist should demonstrate a high level of competence.[10]
These exams assess expertise in the broad domain of internal medicine or in the particular subspecialty and the diagnosis and treatment of both common and rare conditions that have important consequences for patient.[10]
The majority of questions on the ABIM exams require integration of information, prioritization of alternatives, and/or utilization of clinical judgment in reaching a correct conclusion.[11]
ABIM exam questions test “efficiency” or conservative management in health care. [12]
High performance on the ABIM Certification examination predicted decreased risk for future disciplinary action for American or Canadian medical school graduates.[13]

Mortality was lower for patients with acute myocardial infarction cared for by certified physicians.[14]
Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified.[14]
Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery.[15]
Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with better performance on Medicare quality indicators for diabetes and mammography screening.[16]
There is a positive association between the rate at which preventive care services were delivered for Medicare patients and certification status in internal medicine or family medicine.[17]
Time since physician's last board certification correlates with decline in quality of care for patients being treated for high blood pressure.[18]