The ABIM responded by changing the requirements to appease its members. This has come with a significant degree of controversy for the American Board of Internal Medicine ( ABIM) whose maintenance of certification process was deemed to be too onerous and expensive without evidence of significant benefit. For all specialties, the combination of a certification exam and the maintenance of certification process has become big business. The American Board of Family Medicine ( ABFM) was one of the first specialty boards to mandate maintenance of certification (MOC) as well as a mandatory certification exam. The entire process can lead to a significant financial outlay, especially for newly graduating residents. Specialty board certification and the maintenance of certification process can be a nerve-wracking process for the busy clinician.
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