The Case for Continuing Certification

By Stanley J. Miller, M.D.*     

Last July, when I accepted the position of ABD Associate Executive Director for Continuing Certification, I also accepted the challenge to keep transforming the program into an increasingly valuable tool that helps all of us to stay on the cutting edge of new discoveries and evolving best practices in our field.

Of course, that was the idea behind the Maintenance of Certification (MOC) program that has been a requirement for three decades. We are all aware of improvements that needed to be made to MOC, and with your feedback and participation, we are reshaping this tool to meet the needs of dermatologists in today’s practice environment.

We now call it Continuing Certification because we hope it does more than ensure that you maintain the knowledge you had when you were initially certified. Instead, it supports an ongoing process of lifelong learning in your specialty and/or subspecialty.

One of the most significant changes is the evolution of assessment. Instead of taking a high-stakes, high-stress exam once every 10 years, we now have CertLink®, the new online assessment platform that the ABD and nearly all medical specialty boards have adopted.

Through CertLink, diplomates access a secure portal to answer 13 questions every 3 months. The process is both educational and evaluative – and it’s a fun and valuable challenge. You can use written references and online resources while answering the questions – i.e., it’s open book. For me, the best part is that I know immediately if my answer is right. Rationale and references to support the correct answer are also provided. Plus, there is no additional cost to participate.

If you miss a question, you will get the same question again in another quarter. If you have read and comprehended the rationale for the question, then it’s likely you will get the question right the second time around; and your first, incorrect answer will be discarded from your cumulative score. This is assessment for learning instead of assessment of learning.

If you haven’t done so already, you can sign up now through November 15 to start participating in CertLink in January 2022.

I’m often asked for proof that continuing certification activities improve patient outcomes. The evidence is growing (check out the American Board of Medical Specialties Continuing Certification Reference Center). We know that our clinical skills decline over time, (Holmboe ES, Lipner R et al 2008), and participation in continuing certification improves clinical performance and patient outcomes.

But for me, proof lies in the experience of dermatologists who are dedicated to life-long learning. Here are some combined results from surveys of CertLink users:

  • 88% agreed/strongly agreed that CertLink questions were useful learning tools.
  • 82% agreed/strongly agreed that CertLink helped them identify knowledge gaps.
  • 80% agreed/strongly agreed that CertLink helps provide better care to patients.
  • 84% agreed/strongly agreed that CertLink helps them stay current in their specialty.
  • 87% agreed/strongly agreed that CertLink questions were relevant to their practice.

I thought the anonymous comments were even more revealing:

  • It’s a great learning experience.
  • The platform is user friendly; the questions are relevant and the articles to read are truly key articles in the dermatology field.
  • CertLink is a much better way to ensure that physicians are up to date compared with a single lengthy exam every 10 years.
  • I like the fact that missed questions can be readdressed in the next round.
  • It really motivates me to study, and I am so happy I enrolled in it.
  • I love the flexibility of taking it from home any time during a three-month window.

The praise is gratifying. The suggestions/criticism may be more helpful, though, as we continue to work to improve the platform and the questions. CertLink is a tool for all of us. We want to know how to make it better. I encourage you to give us feedback. Here are some examples from the surveys:  

  • The pictures need to be sharper/higher resolution.
  • I would like to see a more individualized explanation of why the answer is correct or incorrect to make sure I am learning what I need to.
  • You should be able to pause a question. It’s not unusual to get interrupted when you’re answering questions, especially if you’re on call.
  • I had trouble loading articles.
  • The site could definitely improve its flow from reading material to questions.
  • I had to answer a question without reading the article because I didn’t know it was an article question. There was no warning that I should stop and read the article.
  • I had to change browsers. It should work on all browsers.

We may not be able to make all the changes diplomates suggest but knowing what your pain points are helps us to keep making it a better resource for life-long learning. Send your suggestions and questions to us at


*About the Author

Dr. Miller is the ABD Associate Executive Director for Continuing Certification. He has been in private practice in Towson, MD, since 2002, and is affiliated with the University of Maryland St. Joseph Medical Center. Previously, he spent 10 years as a full-time faculty member at Johns Hopkins Hospital. His experiences in both academic medicine and private practice have prepared him to lead the ABD’s continuing certification program. During the nine years he served on the ABD board of directors (plus two additional years as a CertLink consultant), he led the development of the CertLink platform.