Alternative Certification Pathways: Reclaiming Professional Autonomy

The Physicians for Certification Change (PCC) believe that professional certification should reflect clinical competence, not administrative compliance. For physicians who choose to join our Pledge of Non-Compliance, maintaining board certification through alternative, less burdensome organizations is a viable and increasingly common path.

Below is a detailed guide to alternative certification boards that prioritize Continuing Medical Education (CME) over repetitive, high-stakes testing.

1. National Board of Physicians and Surgeons (NBPAS)

Founded by Dr. Paul Teirstein and a coalition of concerned physicians, the NBPAS was established to provide a pro-physician, evidence-based alternative to the ABIM’s MOC process.

Core Philosophy: Lifelong learning is best achieved through continuous, self-directed CME rather than decennial exams or proprietary modules.
Eligibility: To be certified by NBPAS, a physician must have been previously certified by an ABMS member board, hold an unrestricted license, and have completed at least 50 hours of ACCME-accredited CME within the past two years.
Cost: Approximately $189 for a two-year certification (compared to the thousands required by ABIM).
Hospital Acceptance: Currently accepted by over 160 hospital systems and major insurers nationwide.

2. American Association of Physician Specialists (BCPS)

The ABPS is the third-largest nationally recognized multi-specialty certifying body in the United States. They offer a rigorous but transparent certification process that focuses on clinical knowledge relevant to actual practice.

Structure: Unlike the MOC system, the ABPS emphasizes recertification through a combination of CME, a simplified recertification exam, and peer reviews.
Recognition: ABPS standards are recognized by the U.S. Department of Labor and the Centers for Medicare & Medicaid Services (CMS).

Comparison of Certification Requirements

Feature	ABIM (MOC)	NBPAS (Alternative)
Primary Requirement	Proprietary MOC Modules	ACCME-Accredited CME
High-Stakes Exams	Required every 10 years	Not Required (Initial ABMS cert must be held)
Annual/Cycle Fees	$3,335+ (over 10 yrs for subspecialty)	~$189 per 2-year cycle
Administrative Time	Significant (Modules, Patient Safety)	Minimal (CME Documentation)
Focus	Compliance with Board Modules	Clinical Education & Practice

Frequently Asked Questions Regarding Alternatives

Will my hospital accept an alternative board?

Hospital bylaws vary. However, many medical executive committees (MECs) have the power to update their bylaws to include NBPAS or ABPS. We provide an Advocacy Toolkit on this site to help you petition your local board for these changes.

Can I be “Certified” but not “Meeting MOC”?

If you remain with the ABIM but boycott their modules, your status will read “Certified, Not Meeting MOC Requirements.” Many physicians find this an acceptable middle ground while they transition to an alternative board.

Does NBPAS require an initial ABIM certification?

Yes. NBPAS recognizes the value of the initial certification and rigorous training required to become a board-certified physician. It only seeks to replace the continuous MOC requirements that lack clinical evidence.

Taking the Next Step

If you are ready to move away from the current MOC system:

Review your hospital’s bylaws to see which boards are currently recognized.
Document your CME credits using the ACCME tracking system.
Apply for alternative certification to ensure no lapse in your professional credentials.