MOC: An 'Insult to Oncologists' Engaged in Patient Care

This transcript has been edited for clarity.

This is Dr Mark Lewis for Medscape Oncology. This month, I want to address Maintenance of Certification. I am far from the only doctor, and certainly far from the only oncologist, to recently comment on the topic of Maintenance of Certification. Of course, this is happening in a wider debate about our relationship as subspecialists to the ABIM, the American Board of Internal Medicine, and what they deem acceptable for the recertification of doctors in practice.

My take is that every oncologist is already engaged in lifelong learning. One of the things I tell my patients is that if I practiced exactly the way I was trained to practice — and I had a very good fellowship program with superb faculty — if I practiced the way they taught me, it would now be malpractice. I finished my fellowship in 2012, just over a decade ago. The rate of progress in the interim is simply staggering. It looks so different now than it did then.

For instance, 2011 was my first experience ever using a form of immunotherapy. It was an anti–CTLA-4 agent, ipilimumab, and I was treating metastatic melanomaI learned in that instance just how effective these drugs can be, but also how toxic they can be. Ever since then, I've been refining my use of immunotherapy. We do that iteratively. We do that as we encounter patients and as we try to meet their needs.