Data from the American Board of Internal Medicine (ABIM) reveals that physicians who practice internal medicine and pass a knowledge assessment to maintain board certification within 10 years of their initial certification are much less likely to face state medical board disciplinary actions than those who do not pass the exam. To explore whether there is an association between Maintenance of Certification (MOC) exam performance and risk of disciplinary actions from state medical boards, ABIM researchers studied MOC exam results and any reported disciplinary actions for nearly 48,000 general internists who initially certified between 1990 and 2003. Approximately 2 percent of the population—949 physicians—were disciplined during the study period. The findings indicate that the risk of disciplinary action against physicians declines as scores on the MOC exam increase, indicating that more medical knowledge is associated with fewer disciplinary actions. The percentage of total disciplinary actions in this population that can be attributed to not having passed the Internal Medicine MOC exam is 35 percent. Poor exam performance is associated with more severe disciplinary actions. There was no difference in disciplinary rates associated with the amount of continuing medical education required for state medical licensure. The findings are published in the Journal of General Internal Medicine.