The board certification movement was founded out of a concern for the quality of care, and today, more than 85% of all physicians licensed to practice medicine in the United States have been certified by an American Board of Medical Specialties (ABMS) member board. There is increasing evidence of a need for continuous monitoring and promotion of quality as well as for assessment and documentation that certified medical specialists are keeping up-to-date so that their continuing competence can be documented. To help, the ABMS established a program called Maintenance of Certification, a system that includes periodic examination of knowledge and the comprehensive evaluation of practice. Maintenance of Certification includes 4 major components: professional standing, including an unrestricted license to practice medicine; lifelong learning and self-assessment; demonstrated cognitive expertise; and practice performance assessment. The efforts of the Conjoint Committee on Continuing Medical Education press continuing medical education providers to facilitate self-directed learning and directed self-learning while driving lifelong learning and assessment into the clinical practices of all physicians who seek to continuously upgrade their knowledge, skills, and behaviors to provide quality medical care.