Since 1936, the American Board of Internal Medicine (ABIM) has administered written tests for board certification. Before 1990, this certification was time-unlimited. Subsequently, to maintain certification internists must pass an examination every 10 years. Recently, the ABIM has required physicians to complete ABIM-sanctioned Maintenance of Certification (MOC) programs before sitting for examinations; in 2014 it changed certification labeling for those with time-unlimited certification but not participating in MOC to not meeting maintenance of certification requirements. This decision has proven controversial.

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