To recap what I discussed in Part 1 of this article (December 2014): As part of a trend across all medical specialty boards, the American Board of Psychiatry and Neurology (ABPN) instituted a recertification process for all new general psychiatry certifications, starting October 1, 1994.1 In 2000, the specialties that comprise the American Board of Medical Specialties (ABMS) agreed to develop a comprehensive maintenance of certification (MOC) process to demonstrate ongoing learning and competency beyond what can be captured by a recertification examination. All ABMS member boards now use a 4-part process for recertification.
A great deal of professional and personal importance has been attached to maintaining one’s general and subspecialty certifications. To that end, the 2 parts of this article highlight current ABPN MOC requirements and provide resources for understanding, tracking, and completing the self-assessment (SA) and performance-in-practice (PIP) components.
In this installment, I examine 3 components of MOC:
• continuing medical education (CME), including SA requirements
• improvement in medical practice (PIP)
• continuous maintenance of certification (C-MOC)
In addition to this review, all physicians who are subject to MOC should download and read the 20-page revised MOC Program booklet v. 2.1 (May 2014).2
Continuing medical education
The CME requirement is clear: All diplomate physicians must accrue, on average, 30 Category-1 CME credits a year; the CME must be relevant to the specialty or subspecialty in which the diplomate practices.3 For physicians who hold >1 ABPN certificates, the total CME requirement is the same; CME credits can be applied across each specialty and subspecialty.
The May 2014 MOC revision states that, for physicians who certified or recertified between 2005 and 2011 and who applied for the 2015 examination in 2014, the required CME credit total is 270.2 For all subsequent years of certification or recertification, including 2012, diplomates are enrolled in C-MOC, which is described below.2
To even out the accrual of CME credits across the prior 10 years, ABPN mandates that, for diplomates who certified or recertified between 2005 and 2011, one hundred fifty of the CME credits be accrued in the 5 years before they apply for the examination. Diplomates in C-MOC should accrue, on average, 30 CME credits a year in each of the 3-year blocks (ie, 90 units in each block).2
Self-assessment
SA is a specific form of CME that is designed to provide comprehensive test-based feedback on knowledge acquired, to enhance the learning process.4 SA CME feedback must include:
• the correct answer to each test question
• recommended literature resources for each question
• performance compared to peers on each question.
Given the structured nature of SA activities, beginning January 1, 2014, one must use only ABPN-approved SA products (see Related Resources for a list of APBN-approved SA products).5
Table 1 and Table 2 outline SA requirements for, respectively, physicians who certified or recertified from 2005 through 2011, and those who certified or recertified in 2012 (and later). The SA requirement increases after 2011 to 24 credits in each 3-year block (8 credits a year, on average).2 Multiple SA activities can be used to fulfill the credit requirement of each 3-year block.
Note: Credits accrued by performing SA activities count toward the CME credit total.
Improvement in medical practice, or PIP
Physicians who are active clinically must complete PIP modules. Each module comprises peer or patient feedback plus a clinical aspect. The May 2014 MOC revision simplified the feedback process to mandate peer or patient feedback—but not both, as required previously.2 For the feedback PIP module, the physician selects 5 peers or patients to complete review forms, examines the results, and creates a plan of improvement. An exception to this “rule of 5” applies to diplomates who have a supervisor capable of evaluating all general competencies, defined below.
Related Resources provides a link to ABPN-created forms.
Within 24 months, but not sooner than 1 month, 5 peers or patients (or 1 applicable supervisor) are selected to complete review forms; changes in practice are noted. The same peers or patients might be selected for a second review. As noted in Table 1 and Table 2, the number of PIP modules is fewer for physicians who certified or recertified between 2005 and 2011; from 2012 onward, 1 PIP clinical module is required in each 3-year block.2
There are 6 ABPN-approved feedback module options, of which the diplomate must choose 1 in any given block2:
• 5 patient surveys
• 5 peer evaluations of general competenciesa
• 5 resident evaluations of general competenciesa
• 360° evaluation of general competencies,a with 5 respondents
• institutional peer review of general competencies,a with 5 respondents
• 1 supervisor evaluation of general competencies.a