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Explore This IssueSeptember 2013
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More than 2,000 years ago, the Greek philosopher Heraclitus said, “Nothing endures but change.” The ABIM Maintenance of Certification (MOC) program began in the 1990s and transitioned to include practice-improvement activities in 2006. Certificates obtained prior to 1990 have been termed “time unlimited,” meaning that MOC has been optional for some. In the March 2012 issue of The Rheumatologist, James O’Dell, MD, the immediate past president of the ACR, introduced us to the multidimensional meaning of grandfather. We met his grandchildren, Georgie and Aiden, and we learned about his experience as a rheumatologist with an American Board of Internal Medicine (ABIM) certification obtained prior to 1990—a so-called grandfather in terms of his certification status. He tried to demystify the MOC process, while highlighting the ACR’s portfolio of educational programs and products that help our members through the process. Developed to meet the unique educational needs of the rheumatologist, our self-assessment tools, practice-improvement programs, and in-person review courses have received accolades from participants, the ABIM, and our colleagues in other subspecialty societies. I have just been through the MOC process for the second time—at once cursed and blessed to be young enough to have a time-limited certificate issued in the early 1990s!—and have treasured the CARE modules, MOC Review Course, and AIM program that have helped to keep me current.
The ACR has been strongly committed to providing educational as well as informational support for our journeys as lifelong learners. The ABIM has been working with the American Board of Medical Specialties, its parent organization, to respond to increasing pressure for public accountability and transparency, while working to streamline seemingly endless requirements for reporting and credentialing of one sort or another. There is synchrony in the desire to utilize our lifelong learning activities to improve patient care. There is a hope that some changes in the MOC program may facilitate the end of redundancies in reporting and credentialing for local and federal governmental agencies, insurers, and our own hospitals and health systems—to let us get back to our patients!
In January 2014, the ABIM will begin reporting whether or not physicians are “Meeting MOC Requirements” in place of awarding the current 10-year, time-limited certificates. The ABIM website will read, “Certified—Meeting MOC Requirements” instead of listing a certification year range.
At the program launch, everyone holding a current certificate and valid license will be “Meeting MOC Requirements.” Physicians will remain board certified until their current certification expires, regardless of participation in the new MOC program. This language will appear both in the ABIM profile and on the public website where patients can search to see a physician’s certification history.
This new MOC program will involve more frequent participation to meet the requirements. Physicians will be required to earn 100 MOC points every five years and to pass an exam every 10 years. An activity, regardless of point value, must be completed every two years; these points count towards the required 100 total.
All physicians not currently enrolled in MOC will need to sign in to the ABIM website by March 31, 2014, to activate their accounts to receive the updated status of ‘Meeting MOC Requirements.’
How Do I Enroll?
Along with the rollout of this new program, the ABIM is creating a new, personalized physician portal on its website. When you log into your ABIM account starting January 2014, you will see information for completing MOC that is specific to you. The new portal will show the appropriate next steps based on your current certification status and include links to both ABIM and ACR products for earning MOC points.
The ABIM now uses the term “activate” instead of “enroll.” All physicians not currently enrolled in MOC will need to sign in to the ABIM website by March 31, 2014, to activate their accounts in order to receive the updated status of “Meeting MOC Requirements.”
When you activate your account on the ABIM website, you will identify the certificate(s) you plan to maintain and pay the MOC program enrollment fee. You may choose to pay this fee at once or over a 10-year period. If you are currently enrolled in MOC, you will not owe any additional fees until your current MOC program enrollment expires.
What if I Am a “Grandfather”?
Grandfathers, or those with time-indefinite certificates, will remain certified but will be reported as “Meeting MOC Requirements” or “Not Meeting MOC Requirements” on the ABIM website. To be listed as “Meeting MOC Requirements,” you will be required to activate your account by March 31, 2014, pay the enrollment fee, and complete the program requirements. You will need to complete an MOC activity by December 31, 2015, earn 100 total MOC points by December 31, 2018, and pass the exam by December 31, 2023.
How Do I Earn MOC Points?
The two primary categories for MOC points are medical knowledge and practice assessment. Currently, physicians must earn at least 20 points within each of these categories, and this requirement remains the same in the new MOC program. New in 2014, physicians will also be required to complete patient survey and patient safety modules every five years. The patient survey and patient safety modules will carry point values and will be counted toward the required total. Points earned will apply to all certificates you choose to maintain.
The ABIM is in the process of creating additional patient safety and patient survey modules to grow their current module library. When enrolled in MOC, you have complimentary access to the ABIM’s modules.
What Programs Does the ACR Offer for MOC Credit?
The ACR continues a strong commitment to support you throughout the MOC process. Our current online modules—Continuing Assessment, Review, and Evaluation (CARE) (2011, 2012, 2013) and Assess, Improve, Measure (AIM) (Gout and Rheumatoid Arthritis)—will continue to be available for 20–30 MOC points per program. The AIM modules can be completed as part of your participation in the ACR’s new registry, an early attempt to sync your Physician Quality Reporting System efforts with MOC activities. A new initiative this year has the ACR creating a topic-specific CARE program, called CARE: Geriatrics, which will be available in January 2014 for 10 MOC points.
Additionally, the ACR hosts two live MOC courses each year: the ACR/ABIM Maintenance of Certification Learning Session–Update in Rheumatology, next held October 25, 2013, in San Diego, and the Rheumatology Maintenance of Certification Course, next held March 21–23, 2014, in Atlanta. The MOC courses provide case-based reviews of relevant ABIM rheumatology blueprinted content and allow for self-assessment and faculty presentations that can be tailored to the needs of the audience. New at the 2013 Annual Meeting, MOC points will be offered via the popular Review Course by responding to a posttest of questions based on the information covered during the course; this program will carry a value of 10 MOC points.
What Are My Next Steps?
In January 2014, log into your ABIM Physician Portal to activate your account and review your specific requirements. Per the requirement that all physicians complete at least one activity every two years, by December 31, 2015, you will need to complete an MOC activity. All diplomates will need to complete their first round of 100 MOC points by December 31, 2018.
Join us in San Diego in October to start—or to add to—your MOC journey in a seamless fashion with your favorite CME activity or the Review Course, or logon to the ACR website and navigate your way to a CARE module or an AIM program. Stay tuned—we will continue to work to support and to inform as you continue to meet the challenge to “Advance Rheumatology!”
Dr. Uknis is professor of medicine and senior associate dean for admissions and strategy at Temple University in Philadelphia. Contact her at [email protected].