Objectives Understand the new ABP Maintenance of Certification (MOC) process and the role of ABP in...
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Transcript of Objectives Understand the new ABP Maintenance of Certification (MOC) process and the role of ABP in...
Objectives
bull Understand the new ABP Maintenance of Certification (MOC) process and the role of ABP in improving childrenrsquos healthcare quality
bull Understand the importance of collaboration for MOC
bull Understand how this affects you personally if you are certified in pediatrics
I have no conflicts of interest to declare
Understanding Maintenance of Certification - MOC
Objectives
bull Understand the new ABP Maintenance of Certification (MOC) process and the role of ABP in improving childrenrsquos healthcare quality
bull Understand the reasons for a change in the certification process
bull Understand the importance of collaboration for MOC
bull Understand how this affects you personally if you are certified in pediatrics
I have no conflicts of interest to declare
About the ABP
Independent certifying board that is not membership-based
Sole mission is to the public
One of the 24 specialty boards of the American Board of Medical Specialties (ABMS)
Created in 1933 by the pediatric community to certify physicians with specialized education and clinical expertise in the care of children
Includes 250 physicians who volunteer their time to set the standards of certification
The American Board of Pediatrics111 Silver Cedar CourtChapel Hill NC 27514
Number of Certified Pediatricians
0100002000030000400005000060000700008000090000
100000
of
Cer
tified
Ped
iatr
icia
ns
General Pediatrics Examination
First Year Fellows (ABP Subspecialty Tracking)
The Evolution of Board Certification
Permanent CertificationUntil 1988 certification was done by successfully passing a test of knowledge only once in a career typically at the end of training
Time-Limited CertificationBeginning in 1989 a diplomate was required to successfully pass a similar test of knowledge every 7 years
Maintenance of Certification (MOC)Beginning in 2010 diplomates will maintain certification by continual evaluation of the competencies verified during residency A secure test of knowledge is one part of this four-part program
The ABP certifies physicians who demonstrate a commitment to lifelong learning and providing the highest quality care
bull In a report published by the Commission on Graduate Medicine in 1940 the following paragraph entitled ldquoTime Limit on Certificationrdquo is included
bull ldquoMany persons argue that certification of a specialist indicates that he is up-to-date and competent at the time of examination but that this does not prove that he continues indefinitely thereafter to be competent and aware of all important new knowledge in his field This is obviously true and as the certifying Boards become established and as they complete the examination of the large group of physicians already practicing the specialties they may find it desirable to issue certificates that are valid for a stated period onlyrdquo
bull
The ABP in 1974
The year 2000hellip
The Reasons for the Changes
bull IOM reports Crossing the Quality Chasm and To Err is Human documenting the need for changes leading to improvement
bull Health care research that uncovered wide gaps in the quality and cost of care for conditions known to have a best practice
bull The public awareness about the quality gaps
bull The publicrsquos demand for accountability from all involved in the profession
A system based simply on a single or periodic tests of knowledge needed improvement
ldquoTrust me I am a physicianrdquo
ldquoShow me the Datardquo
Designed to Help Close the Gap
The Gap Between Knowing and Doing
Adults receive
recommended
appropriate care
54 of the time
(McGlynn)
Children receive
recommended
appropriate care
465 of the time
(Mangione-Smith)
Annals of MedicineNew Yorker June 1 2009
Atul Gawande
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Objectives
bull Understand the new ABP Maintenance of Certification (MOC) process and the role of ABP in improving childrenrsquos healthcare quality
bull Understand the reasons for a change in the certification process
bull Understand the importance of collaboration for MOC
bull Understand how this affects you personally if you are certified in pediatrics
I have no conflicts of interest to declare
About the ABP
Independent certifying board that is not membership-based
Sole mission is to the public
One of the 24 specialty boards of the American Board of Medical Specialties (ABMS)
Created in 1933 by the pediatric community to certify physicians with specialized education and clinical expertise in the care of children
Includes 250 physicians who volunteer their time to set the standards of certification
The American Board of Pediatrics111 Silver Cedar CourtChapel Hill NC 27514
Number of Certified Pediatricians
0100002000030000400005000060000700008000090000
100000
of
Cer
tified
Ped
iatr
icia
ns
General Pediatrics Examination
First Year Fellows (ABP Subspecialty Tracking)
The Evolution of Board Certification
Permanent CertificationUntil 1988 certification was done by successfully passing a test of knowledge only once in a career typically at the end of training
Time-Limited CertificationBeginning in 1989 a diplomate was required to successfully pass a similar test of knowledge every 7 years
Maintenance of Certification (MOC)Beginning in 2010 diplomates will maintain certification by continual evaluation of the competencies verified during residency A secure test of knowledge is one part of this four-part program
The ABP certifies physicians who demonstrate a commitment to lifelong learning and providing the highest quality care
bull In a report published by the Commission on Graduate Medicine in 1940 the following paragraph entitled ldquoTime Limit on Certificationrdquo is included
bull ldquoMany persons argue that certification of a specialist indicates that he is up-to-date and competent at the time of examination but that this does not prove that he continues indefinitely thereafter to be competent and aware of all important new knowledge in his field This is obviously true and as the certifying Boards become established and as they complete the examination of the large group of physicians already practicing the specialties they may find it desirable to issue certificates that are valid for a stated period onlyrdquo
bull
The ABP in 1974
The year 2000hellip
The Reasons for the Changes
bull IOM reports Crossing the Quality Chasm and To Err is Human documenting the need for changes leading to improvement
bull Health care research that uncovered wide gaps in the quality and cost of care for conditions known to have a best practice
bull The public awareness about the quality gaps
bull The publicrsquos demand for accountability from all involved in the profession
A system based simply on a single or periodic tests of knowledge needed improvement
ldquoTrust me I am a physicianrdquo
ldquoShow me the Datardquo
Designed to Help Close the Gap
The Gap Between Knowing and Doing
Adults receive
recommended
appropriate care
54 of the time
(McGlynn)
Children receive
recommended
appropriate care
465 of the time
(Mangione-Smith)
Annals of MedicineNew Yorker June 1 2009
Atul Gawande
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
About the ABP
Independent certifying board that is not membership-based
Sole mission is to the public
One of the 24 specialty boards of the American Board of Medical Specialties (ABMS)
Created in 1933 by the pediatric community to certify physicians with specialized education and clinical expertise in the care of children
Includes 250 physicians who volunteer their time to set the standards of certification
The American Board of Pediatrics111 Silver Cedar CourtChapel Hill NC 27514
Number of Certified Pediatricians
0100002000030000400005000060000700008000090000
100000
of
Cer
tified
Ped
iatr
icia
ns
General Pediatrics Examination
First Year Fellows (ABP Subspecialty Tracking)
The Evolution of Board Certification
Permanent CertificationUntil 1988 certification was done by successfully passing a test of knowledge only once in a career typically at the end of training
Time-Limited CertificationBeginning in 1989 a diplomate was required to successfully pass a similar test of knowledge every 7 years
Maintenance of Certification (MOC)Beginning in 2010 diplomates will maintain certification by continual evaluation of the competencies verified during residency A secure test of knowledge is one part of this four-part program
The ABP certifies physicians who demonstrate a commitment to lifelong learning and providing the highest quality care
bull In a report published by the Commission on Graduate Medicine in 1940 the following paragraph entitled ldquoTime Limit on Certificationrdquo is included
bull ldquoMany persons argue that certification of a specialist indicates that he is up-to-date and competent at the time of examination but that this does not prove that he continues indefinitely thereafter to be competent and aware of all important new knowledge in his field This is obviously true and as the certifying Boards become established and as they complete the examination of the large group of physicians already practicing the specialties they may find it desirable to issue certificates that are valid for a stated period onlyrdquo
bull
The ABP in 1974
The year 2000hellip
The Reasons for the Changes
bull IOM reports Crossing the Quality Chasm and To Err is Human documenting the need for changes leading to improvement
bull Health care research that uncovered wide gaps in the quality and cost of care for conditions known to have a best practice
bull The public awareness about the quality gaps
bull The publicrsquos demand for accountability from all involved in the profession
A system based simply on a single or periodic tests of knowledge needed improvement
ldquoTrust me I am a physicianrdquo
ldquoShow me the Datardquo
Designed to Help Close the Gap
The Gap Between Knowing and Doing
Adults receive
recommended
appropriate care
54 of the time
(McGlynn)
Children receive
recommended
appropriate care
465 of the time
(Mangione-Smith)
Annals of MedicineNew Yorker June 1 2009
Atul Gawande
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Number of Certified Pediatricians
0100002000030000400005000060000700008000090000
100000
of
Cer
tified
Ped
iatr
icia
ns
General Pediatrics Examination
First Year Fellows (ABP Subspecialty Tracking)
The Evolution of Board Certification
Permanent CertificationUntil 1988 certification was done by successfully passing a test of knowledge only once in a career typically at the end of training
Time-Limited CertificationBeginning in 1989 a diplomate was required to successfully pass a similar test of knowledge every 7 years
Maintenance of Certification (MOC)Beginning in 2010 diplomates will maintain certification by continual evaluation of the competencies verified during residency A secure test of knowledge is one part of this four-part program
The ABP certifies physicians who demonstrate a commitment to lifelong learning and providing the highest quality care
bull In a report published by the Commission on Graduate Medicine in 1940 the following paragraph entitled ldquoTime Limit on Certificationrdquo is included
bull ldquoMany persons argue that certification of a specialist indicates that he is up-to-date and competent at the time of examination but that this does not prove that he continues indefinitely thereafter to be competent and aware of all important new knowledge in his field This is obviously true and as the certifying Boards become established and as they complete the examination of the large group of physicians already practicing the specialties they may find it desirable to issue certificates that are valid for a stated period onlyrdquo
bull
The ABP in 1974
The year 2000hellip
The Reasons for the Changes
bull IOM reports Crossing the Quality Chasm and To Err is Human documenting the need for changes leading to improvement
bull Health care research that uncovered wide gaps in the quality and cost of care for conditions known to have a best practice
bull The public awareness about the quality gaps
bull The publicrsquos demand for accountability from all involved in the profession
A system based simply on a single or periodic tests of knowledge needed improvement
ldquoTrust me I am a physicianrdquo
ldquoShow me the Datardquo
Designed to Help Close the Gap
The Gap Between Knowing and Doing
Adults receive
recommended
appropriate care
54 of the time
(McGlynn)
Children receive
recommended
appropriate care
465 of the time
(Mangione-Smith)
Annals of MedicineNew Yorker June 1 2009
Atul Gawande
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
General Pediatrics Examination
First Year Fellows (ABP Subspecialty Tracking)
The Evolution of Board Certification
Permanent CertificationUntil 1988 certification was done by successfully passing a test of knowledge only once in a career typically at the end of training
Time-Limited CertificationBeginning in 1989 a diplomate was required to successfully pass a similar test of knowledge every 7 years
Maintenance of Certification (MOC)Beginning in 2010 diplomates will maintain certification by continual evaluation of the competencies verified during residency A secure test of knowledge is one part of this four-part program
The ABP certifies physicians who demonstrate a commitment to lifelong learning and providing the highest quality care
bull In a report published by the Commission on Graduate Medicine in 1940 the following paragraph entitled ldquoTime Limit on Certificationrdquo is included
bull ldquoMany persons argue that certification of a specialist indicates that he is up-to-date and competent at the time of examination but that this does not prove that he continues indefinitely thereafter to be competent and aware of all important new knowledge in his field This is obviously true and as the certifying Boards become established and as they complete the examination of the large group of physicians already practicing the specialties they may find it desirable to issue certificates that are valid for a stated period onlyrdquo
bull
The ABP in 1974
The year 2000hellip
The Reasons for the Changes
bull IOM reports Crossing the Quality Chasm and To Err is Human documenting the need for changes leading to improvement
bull Health care research that uncovered wide gaps in the quality and cost of care for conditions known to have a best practice
bull The public awareness about the quality gaps
bull The publicrsquos demand for accountability from all involved in the profession
A system based simply on a single or periodic tests of knowledge needed improvement
ldquoTrust me I am a physicianrdquo
ldquoShow me the Datardquo
Designed to Help Close the Gap
The Gap Between Knowing and Doing
Adults receive
recommended
appropriate care
54 of the time
(McGlynn)
Children receive
recommended
appropriate care
465 of the time
(Mangione-Smith)
Annals of MedicineNew Yorker June 1 2009
Atul Gawande
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
First Year Fellows (ABP Subspecialty Tracking)
The Evolution of Board Certification
Permanent CertificationUntil 1988 certification was done by successfully passing a test of knowledge only once in a career typically at the end of training
Time-Limited CertificationBeginning in 1989 a diplomate was required to successfully pass a similar test of knowledge every 7 years
Maintenance of Certification (MOC)Beginning in 2010 diplomates will maintain certification by continual evaluation of the competencies verified during residency A secure test of knowledge is one part of this four-part program
The ABP certifies physicians who demonstrate a commitment to lifelong learning and providing the highest quality care
bull In a report published by the Commission on Graduate Medicine in 1940 the following paragraph entitled ldquoTime Limit on Certificationrdquo is included
bull ldquoMany persons argue that certification of a specialist indicates that he is up-to-date and competent at the time of examination but that this does not prove that he continues indefinitely thereafter to be competent and aware of all important new knowledge in his field This is obviously true and as the certifying Boards become established and as they complete the examination of the large group of physicians already practicing the specialties they may find it desirable to issue certificates that are valid for a stated period onlyrdquo
bull
The ABP in 1974
The year 2000hellip
The Reasons for the Changes
bull IOM reports Crossing the Quality Chasm and To Err is Human documenting the need for changes leading to improvement
bull Health care research that uncovered wide gaps in the quality and cost of care for conditions known to have a best practice
bull The public awareness about the quality gaps
bull The publicrsquos demand for accountability from all involved in the profession
A system based simply on a single or periodic tests of knowledge needed improvement
ldquoTrust me I am a physicianrdquo
ldquoShow me the Datardquo
Designed to Help Close the Gap
The Gap Between Knowing and Doing
Adults receive
recommended
appropriate care
54 of the time
(McGlynn)
Children receive
recommended
appropriate care
465 of the time
(Mangione-Smith)
Annals of MedicineNew Yorker June 1 2009
Atul Gawande
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
The Evolution of Board Certification
Permanent CertificationUntil 1988 certification was done by successfully passing a test of knowledge only once in a career typically at the end of training
Time-Limited CertificationBeginning in 1989 a diplomate was required to successfully pass a similar test of knowledge every 7 years
Maintenance of Certification (MOC)Beginning in 2010 diplomates will maintain certification by continual evaluation of the competencies verified during residency A secure test of knowledge is one part of this four-part program
The ABP certifies physicians who demonstrate a commitment to lifelong learning and providing the highest quality care
bull In a report published by the Commission on Graduate Medicine in 1940 the following paragraph entitled ldquoTime Limit on Certificationrdquo is included
bull ldquoMany persons argue that certification of a specialist indicates that he is up-to-date and competent at the time of examination but that this does not prove that he continues indefinitely thereafter to be competent and aware of all important new knowledge in his field This is obviously true and as the certifying Boards become established and as they complete the examination of the large group of physicians already practicing the specialties they may find it desirable to issue certificates that are valid for a stated period onlyrdquo
bull
The ABP in 1974
The year 2000hellip
The Reasons for the Changes
bull IOM reports Crossing the Quality Chasm and To Err is Human documenting the need for changes leading to improvement
bull Health care research that uncovered wide gaps in the quality and cost of care for conditions known to have a best practice
bull The public awareness about the quality gaps
bull The publicrsquos demand for accountability from all involved in the profession
A system based simply on a single or periodic tests of knowledge needed improvement
ldquoTrust me I am a physicianrdquo
ldquoShow me the Datardquo
Designed to Help Close the Gap
The Gap Between Knowing and Doing
Adults receive
recommended
appropriate care
54 of the time
(McGlynn)
Children receive
recommended
appropriate care
465 of the time
(Mangione-Smith)
Annals of MedicineNew Yorker June 1 2009
Atul Gawande
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
bull In a report published by the Commission on Graduate Medicine in 1940 the following paragraph entitled ldquoTime Limit on Certificationrdquo is included
bull ldquoMany persons argue that certification of a specialist indicates that he is up-to-date and competent at the time of examination but that this does not prove that he continues indefinitely thereafter to be competent and aware of all important new knowledge in his field This is obviously true and as the certifying Boards become established and as they complete the examination of the large group of physicians already practicing the specialties they may find it desirable to issue certificates that are valid for a stated period onlyrdquo
bull
The ABP in 1974
The year 2000hellip
The Reasons for the Changes
bull IOM reports Crossing the Quality Chasm and To Err is Human documenting the need for changes leading to improvement
bull Health care research that uncovered wide gaps in the quality and cost of care for conditions known to have a best practice
bull The public awareness about the quality gaps
bull The publicrsquos demand for accountability from all involved in the profession
A system based simply on a single or periodic tests of knowledge needed improvement
ldquoTrust me I am a physicianrdquo
ldquoShow me the Datardquo
Designed to Help Close the Gap
The Gap Between Knowing and Doing
Adults receive
recommended
appropriate care
54 of the time
(McGlynn)
Children receive
recommended
appropriate care
465 of the time
(Mangione-Smith)
Annals of MedicineNew Yorker June 1 2009
Atul Gawande
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
The ABP in 1974
The year 2000hellip
The Reasons for the Changes
bull IOM reports Crossing the Quality Chasm and To Err is Human documenting the need for changes leading to improvement
bull Health care research that uncovered wide gaps in the quality and cost of care for conditions known to have a best practice
bull The public awareness about the quality gaps
bull The publicrsquos demand for accountability from all involved in the profession
A system based simply on a single or periodic tests of knowledge needed improvement
ldquoTrust me I am a physicianrdquo
ldquoShow me the Datardquo
Designed to Help Close the Gap
The Gap Between Knowing and Doing
Adults receive
recommended
appropriate care
54 of the time
(McGlynn)
Children receive
recommended
appropriate care
465 of the time
(Mangione-Smith)
Annals of MedicineNew Yorker June 1 2009
Atul Gawande
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
The year 2000hellip
The Reasons for the Changes
bull IOM reports Crossing the Quality Chasm and To Err is Human documenting the need for changes leading to improvement
bull Health care research that uncovered wide gaps in the quality and cost of care for conditions known to have a best practice
bull The public awareness about the quality gaps
bull The publicrsquos demand for accountability from all involved in the profession
A system based simply on a single or periodic tests of knowledge needed improvement
ldquoTrust me I am a physicianrdquo
ldquoShow me the Datardquo
Designed to Help Close the Gap
The Gap Between Knowing and Doing
Adults receive
recommended
appropriate care
54 of the time
(McGlynn)
Children receive
recommended
appropriate care
465 of the time
(Mangione-Smith)
Annals of MedicineNew Yorker June 1 2009
Atul Gawande
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
The Reasons for the Changes
bull IOM reports Crossing the Quality Chasm and To Err is Human documenting the need for changes leading to improvement
bull Health care research that uncovered wide gaps in the quality and cost of care for conditions known to have a best practice
bull The public awareness about the quality gaps
bull The publicrsquos demand for accountability from all involved in the profession
A system based simply on a single or periodic tests of knowledge needed improvement
ldquoTrust me I am a physicianrdquo
ldquoShow me the Datardquo
Designed to Help Close the Gap
The Gap Between Knowing and Doing
Adults receive
recommended
appropriate care
54 of the time
(McGlynn)
Children receive
recommended
appropriate care
465 of the time
(Mangione-Smith)
Annals of MedicineNew Yorker June 1 2009
Atul Gawande
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Designed to Help Close the Gap
The Gap Between Knowing and Doing
Adults receive
recommended
appropriate care
54 of the time
(McGlynn)
Children receive
recommended
appropriate care
465 of the time
(Mangione-Smith)
Annals of MedicineNew Yorker June 1 2009
Atul Gawande
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Annals of MedicineNew Yorker June 1 2009
Atul Gawande
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Time Magazine - June 29
More Data + Less Care =
Better Health + Lower Cost
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Sohellipwhat now
If the horse dieshellip
GET OFF
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
ACGME amp ABMS Competencies
Jointly developed six areas in which a physician must be
competent in order to deliver quality care
bull Professionalism bull Patient carebull Communication skillsbull Medical knowledgebull Practice based learningbull Systems based practice
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
The 6 Competencies
bull All six competencies are now measured during training programs
bull The Joint Commission has suggested their measurement for hospital credentials
bull The FSMB has incorporated them in their proposed MOL program
bull They form the basis for the MOC process
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
How often should doctors be assessed to ensure they remain qualified
Published by the Federation of State Medical Boards - 2008
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Table 2 All respondents Importance of various factors in demonstrating continuing competence for physicians who care for children
Please think about all doctors who take care of childrenOnce a doctor has started to practice how important are each of the following to make sure that the doctor continues to be qualified
Very important
Important
Not important
Unsure
Being checked for the quality of care for medical problems that they treat often
65 30 2 3
Having a low number of malpractice cases
61 30 4 5
Passing a written test of medical knowledge at regular intervals
57 31 7 5
Receiving high ratings from patients andor their families
52 39 6 3
Being a member of a professional group (such as the of Pediatrics)
46 37 13 4
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Maintenance of Certification (MOC)
bullA four-part process that continues to measure the six core competencies defined by the ACGMEABMS developed in 2001 (professionalism patient care practice based learning systems based practice communication knowledge)
bullAdopted as the standard of certification by all 24 specialty boards of the ABMS
bullMeeting MOC requirements has become public information for all diplomates of the ABP
bullThe four parts assess professionalism (Part 1) knowledge acquisition and self-assessment (Part 2) fundamental knowledge of the specialty (Part 3) and practice performance and improvement (Part 4)
bullAll MOC programs include a secure examination
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
The Four Parts
bull Part 1 assesses professionalismbull Part 2 shows evidence of knowledge
acquisition and self assessmentbull Part 3 assesses the fundamental knowledge
of the specialtybull Part 4 assesses a diplomatersquos ability to
assess and improve the quality of their practice
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Part 1 MOC ndash Professional Standing
Requirement for Part 1
All diplomates must hold a valid unrestricted medical license
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Part 2 MOC ndash Knowledge Self Assessment
Requirements for Part 2
All approved Part 2 activities are assigned a point value by the ABP Diplomates must complete activities provided by either the ABP or approved outside providers
You must have at least 40 points of Part 2 activities per 5-year MOC cycle
40-point minimum per 5-year MOC cycle
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Part 3 MOC ndash Cognitive Expertise
1993 - 20021969ABMS introduces
Recertification
1980-1991Closed Book(voluntary)
1993-2002Open Book Exam
(every 7 years)
2003-presentSecure Exam
(every 7 years)
2010+Secure Exam
(every 10 years)
Requirement for Part 3
Successfully pass a secure test of knowledge every 10 years in each area of certification
Although the MOC cycle is 5 years a secure test of knowledge is only required
every 10 years
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
MOC Examinations
bull The MOC exams are produced separatelybull The content outline is used for both the initial
certification exams and the MOC examsbull The percentage of questions in each content
area is basically the same for both examsbull What differs is the type of question chosen
for the 2 examsbull The intended purpose of the exams is not the
same
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Part 4 MOC ndash Performance In Practice
Requirements for Part 4
Option 1 The Part 4 MOC requirement for Performance In Practice can be met by completing web-based Quality Improvement activities
Option 2 Participate in an ongoing ABP-approved collaborative Quality Improvement project
40-point minimum per 5-year MOC cycle
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
ABP ldquoFlurdquo Immun PIMAAP NutritionABMS Patient Safety
Examples of Option 1(Web-based QI Project)
Part 4 MOC ndash Performance In Practice 28
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
29
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Part 4 MOC ndash Menu of Options
Web Based Modules MOC Points
EQIPP Modules from AAP (asthma ADHD nutrition immun development)
15
Performance Improvement Modules (PIMs) from ABP 5-10
ABMS Patient Safety Module 15
Other ABMS board modules 5-10
ABP Approved QI Projects
Vermont Oxford Network (2 projects) 20
California Perinatal Quality Care Collaborative 20
NACHRI Blood Stream Infection Project 20
Iowa BCBS Asthma and Immunization 20
UPIQ (state wide obesity project in Utah) 20
Cystic Fibrosis Foundation 20
CHCA (2 projects on hospital codes and throughput) 20
2 options for completion
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
0
2
4
6
8
10
12
22 9 4 16 28 15 19 10 2 5 11 25 7 3 20 14 26 27 29 13 21 6 23 17 12
BS
I Rat
e
PICUs
Mean and Median BSI Rate by PICUs
Mean BSI rate
Median BSI rate
Part 4 Established QI Projects
Eliminating Bloodstream Infections
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
In the first 6 months 29 childrenrsquos hospitalsreduced infection ratesin the PICU by nearly50 percent by adhering to a rigid set of evidence-based practices shown to prevent infections in children
51 improvement 85 lives saved over 850 infections prevented $25 million saved over first 30 months Now with 62 units
Part 4 Established QI Projects
Eliminating Bloodstream InfectionsNCHRI led national collaborative
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Part 4 ndash Demonstrated Results in Quality Improvement
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
ImprovementCollaborative on
Reliability|q
PerformanceFeedback Reports
|q
P4PProgram
|q
qP4P
Deadline
zSelf -
ManagementCollaborative
Initiated
qWeb-based
RegistryLaunched
ProjectInception
|q
qPerfect Care
IncludingFlu Shot
Long Term Goal = 95
0
10
20
30
40
50
60
70
80
90
100
Oct 0
3
Nov 0
3
Dec 0
3
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug 0
4
Sep 0
4
Oct 0
4
Nov 0
4
Dec 0
4
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug 0
5
Sep 0
5
Oct 0
5
Nov 0
5
OVPCA Network Practice 1 Practice 2 Practice 3 Practice 4 Practice 5 Practice 6
Cumulative of Asthma Population with Perfect Care Network and Select Practices
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
0
10
20
30
40
50
60
70
80
90
100O
ct 03
Nov
03
Dec
03
Jan
04
Feb
04
Mar
04
Apr 0
4
May
04
Jun
04
Jul 0
4
Aug
04
Sep
04
Oct
04
Nov
04
Dec
04
Jan
05
Feb
05
Mar
05
Apr 0
5
May
05
Jun
05
Jul 0
5
Aug
05
Sep
05
Oct
05
Commercially Insured MedicaidUninsured
Long Term Goal = 95
Results 44 hospital admissions 22 urgent careED visits 30 missed school days
ldquoPerfect Carerdquo composite measure of severity classified identified management plan and controller medications for patients with persistent asthma
Copyright copy 2005 Cincinnati Childrenrsquos Hospital Medical Center all rights reserved
Part 4 ndash Demonstrated Results in Quality Improvement
Perfect Care for Asthma (Cumulative )
13000 children with asthma165 pediatricians
44 practices
13000 children with asthma165 pediatricians
44 practices
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
MOC PointsADHD Performance Improvement Module
ADHD eQIPP Module^
Asthma Performance Improvement Module
Asthma eQIPP Module^
Nutrition eQIPP Module^
Vermont Oxford Network (Project 1)
Vermont Oxford Network (Project 2)
California Perinatal Quality Care Collaborative
Blood Stream Infection Project
^Developed and administered by the AAP requires payment directly to AAP for accessABP-approved on-going quality improvement initiatives
Part 4 Menu of Options (example) Plus CAPHS
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
MOC PointsCincinnati Childrenrsquos Hosp Advanced Assess Project
Iowa BCBS Asthma and Immunization Project
CF Foundation Improvement Collaborative
Envision New Mexico 1^ Care Preventative Services CollaborativeCHCA Hosp Code Blues and Throughput Projects
Utah Pediatric Partnership for Improving Healthcare Quality Vermont Oxford Network (Project 2)
Peds GI IBD Collaborative (Trailblazers)
Improving Performance (IPIP) in Practice Primary Care Collaborative
ABP-approved on-going quality improvement initiatives Applications received Applications in development
Part 4 Menu of Options (example)
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
The ABP in 1974
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
General Pediatric Certificate HoldersDistribution of Certificate Type
(as of December 31 2008)
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
General Pediatric Certificate Holders (Permanent)
Distribution by Age(as of December 31 2008)
Age Group n lt 51 43 02
51 to 55 3996 144
56 to 60 6878 248
61 to 65 6740 243
66 to 70 4769 172
71 to 75 3054 110
76 to 80 1102 40
81 to 85 629 23
86 to 90 345 12
gt 90 128 05
TOTAL 27684 ---
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
It is no longer enough for physicians to indicate they are board certified said speaker Barry M Straube MD They must maintain their certification
Dr Straube is the chief medical officer and director of the Office of Clinical Standards and Quality Centers for Medicare and Medicaid Services
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
bullFederation of State Medical Boards White Paper on MOL
bullMay include an examination every 10 years
bullHas 4 parts
bullStrongly suggests that meeting the requirements of ABMS MOC will fulfill MOL requirements
Maintenance of Licensure (MOL)
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Wikipedia Entry
Ironically and fairly hypocritically many of the certifying boards such as the American Board of Internal Medicine and the American Board of Pediatrics have grandfathered physicians certified prior to circa 1990 ie there is no requirement for such physicians to recertify These are of course the very physicians who have had substantial time elapse since their training and so as implied above are deliverers of inferior care Astoundingly many of the current members of both boards have chosen not to recertify themselves although this is recommended by the very boards of which they are members
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Lifetime CertificationOn November 30 2009 James A Stockman III MD president of the American Board of Pediatrics (a Member Board of the ABMS) admitted under oath at a North Carolina Medical Board hearing that 41 of ABMS boarded physicians are board certified for life [2]Many leaders in the medical field found this statistic and Dr Stockmans testimony to be a great surprise --- that 41 of ABMS board certified physicians (the Gold Standard in board certification) are not required to be re-certified every several years like its competitors (AOA and ABPS) require
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Association Between Maintenance of CertificationExamination Scores and Quality of Carefor Medicare BeneficiariesEric S Holmboe MD Yun Wang PhD Thomas P Meehan MD MPH Janet P Tate MPHShih-Yieh Ho PhD MPH Katie S Starkey MHA Rebecca S Lipner PhDArch Intern Med 2008168(13)1396-1403
Assessing quality of care knowledge mattersHolmboe ES Lipner R Greiner A
What is the evidence for Certification and MOC
JAMA 2008 Jan 23299(3)338-40
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
bull Mortality was lower for patients with acute myocardial infarction cared for by certified physicians[14]bull Certified cardiologists saved more lives than certified primary care doctors than doctors who are not board certified[14]bull Certification in surgery was a significant predictor of lower mortality and complication rates for colorectal surgery[15]bull Higher scores on the ABIM internal medicine Maintenance of Certification examination are associated with betterperformance on Medicare quality indicators for diabetes and mammography screening[16]bull There is a positive association between the rate at which preventive care services were delivered for Medicare patientsand certification status in internal medicine or family medicine[17]bull Time since physicians last board certification correlates with decline in quality of care for patients being treated for highblood pressure[18]
Certification is Associated with Better Care
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
The Nuts amp Bolts of MOC
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Objectives
bull How to complete your current MOC requirements
bull What is ldquonewrdquo in the new version of MOCbull MOC The reasons for the change bull Completing Part 2 and Part 4 requirementsbull Part 3 of MOC - The Examinationbull The ABP Web site and your ABP portfolio
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
bull If you were certified or recertified from 2003 to 2009 these changes apply to you (ends 2016)
bull MOC was based on a 7-year cyclebull The requirements for Parts 1 2 and 4
must be completed by the end date on your certificate
bull You do not need to sit for a Part 3 MOC examination by the end of your present cycle
Initial Version of MOCCertificates awarded 2003 to 2009
Overview
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Initial Version of MOC
PART 2 Requirements
bull Required to complete one Part 2 activitybull Any approved activity counts for any
certificatebull Activities can be AAP ABP or from other
sponsors
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
bull Need to complete one Part 4 activity (practice assessment and improvement activity)
bull May be Patient Safetybull Or participation in an approved
collaborative improvement projectbull Or a Web-based PIM on ABP Web site
(eg influenza immunization PIM)
bull Or AAP product such as EQIPP PIM (eg nutrition)
Initial Version of MOC
PART 4 Requirements
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Keeping Track of Your MOC Requirements
My ABP Portfolio Log In
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Keeping Track of Your MOC Requirements
MOC Portfolio Landing Page
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Keeping Track of Your MOC Requirements
Diplomate Progress Report
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
The New Version of MOCAs of January 1 2010
bull Cycle begins with certification awarded in 2010
bull Overlaps with initial version for 6 yearsbull Now based on 5-year cycle of MOC
(Part 2 and 4 requirements must be completed during 5-year cycle)
bull Approved activities are assigned a point valuebull Need to earn total of 100 points in 5 years
Part 2 40 pointsPart 4 40 points Optional 20 points
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
bull Any approved Part 2 activitiesbull Any activity counts for any area of
certificationbull Need 40 points in 5 years (Generally 2)
bull Search for activities at wwwabporg
The New Version of MOCAs of January 1 2010
PART 2 Requirements
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
The New Version of MOCAs of January 1 2010
PART 4 Requirementsbull Any approved Part 4 activitiesbull Any approved activity counts toward any
area of certificationbull Search activities via the Activity Catalog at
wwwabporgbull Need 40 points in 5 years
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Keeping Track of Your MOC Requirements
Requirements Page
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Keeping Track of Your MOC Requirements
Diplomate Progress Report
o Keeps track of points
o Displays reminders when certification is at risk
o Shows up-to-date address and email
o Diplomates are responsible for updating personal contact information in their portfolio
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Catalog Search
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Catalog Search ndash Part 2
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Catalog Search Results
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Activity Profile
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
ABP Web site Home Page
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Certificates Expiring in 2010
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
FAQs for 2010-2015 Expirees
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
2009 20112010 2012 2013 20152014 2016 2017 20192018 2020 2021 20232022
MOC and you v12 new diplomates 2010
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
100 pointsParts 2 amp 4
InitialGP
exam
SSexam
SSexam
GPexam
Begin 5 yearcycle
Register amppay fee every
5 years
Register amppay fee every
5 years
Maintain unrestricted medical license
GeneralPediatricianInitially CertifyingIn 2010
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
ldquoPublic demand is the only true stimulus for tradesmen and professional men (women) alikerdquo
Charles Mayo
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-
Questions
- Objectives
- Slide 2
- About the ABP
- Slide 4
- General Pediatrics Examination
- Slide 6
- The Evolution of Board Certification
- Slide 8
- The ABP in 1974
- Slide 10
- The Reasons for the Changes
- Designed to Help Close the Gap
- Slide 13
- Slide 14
- Sohellipwhat now
- ACGME amp ABMS Competencies
- The 6 Competencies
- Slide 18
- Slide 19
- Slide 20
- Maintenance of Certification (MOC)
- The Four Parts
- Part 1 MOC ndash Professional Standing
- Part 2 MOC ndash Knowledge Self Assessment
- Part 3 MOC ndash Cognitive Expertise
- MOC Examinations
- Part 4 MOC ndash Performance In Practice
- Slide 28
- Slide 29
- Part 4 MOC ndash Menu of Options
- Slide 31
- Slide 32
- Part 4 Established QI Projects Eliminating Bloodstream Infections
- Part 4 ndash Demonstrated Results in Quality Improvement
- Slide 35
- Slide 36
- Part 4 Menu of Options (example) Plus CAPHS
- Part 4 Menu of Options (example)
- Slide 39
- Slide 40
- General Pediatric Certificate Holders Distribution of Certificate Type (as of December 31 2008)
- General Pediatric Certificate Holders (Permanent) Distribution by Age (as of December 31 2008)
- Slide 43
- Slide 44
- Slide 45
- Slide 46
- Slide 47
- Slide 48
- Slide 49
- Slide 50
- Slide 51
- Slide 52
- Slide 53
- Slide 54
- Slide 55
- Slide 56
- Slide 57
- Slide 58
- Slide 59
- Slide 60
- Slide 61
- Slide 62
- Slide 63
- Slide 64
- Slide 65
- Slide 66
- Slide 67
- Slide 68
- Slide 69
- Slide 70
- Slide 71
- Slide 72
- Slide 73
- Slide 74
- Slide 75
- Slide 76
- Questions
-