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MOC: Options for pediatricians who choose to recertify
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In the January issue, I provided a general overview of maintenance of certification for pediatricians, and I noted how the process has evolved from permanent certification to time-limited certification to continuous maintenance of certification during the 80 years since pediatricians formed the American Board of Pediatrics.
Currently, as each pediatrician’s certificate comes up for renewal or a continuous maintenance of certification (MOC) cycle ends, the physician transitions into MOC as the process stands that particular year. This method of transition minimizes angst for individual diplomats, but it creates considerable complexity. For example, there are currently more than 150 combinations of requirements for American Board of Pediatrics (ABP) diplomats!
Individual requirements
Specific requirements for the number of activities an individual pediatrician must complete will vary and depend on when the pediatrician initially certified and whether he or she holds a time-limited certificate or is enrolled in continuous MOC. To maintain certification, a pediatrician must document self-assessment and lifelong learning activities as well as demonstrating meaningful involvement in quality improvement.
After your specific requirements are determined, you can find activities to best fit your current work and your needs and interests. There are literally hundreds of ways to meet the part 2 (lifelong learning and self-assessment) requirements, some created by the ABP and others created by other organizations, including pediatric subspecialty societies and the AAP. PREP/The Curriculum, offered by AAP, is a prime example of such an activity. Outside organizations generally charge for their activities, whereas activities created by the ABP incur no additional charge.
Virginia Moyer
Regarding MOC exams, the general pediatrics knowledge self-assessment is a 200-question activity designed to help diplomats gauge their readiness for the general pediatrics MOC secure examination. Other activities intended to help keep up with recent advances include: the Decision Skills module based on clinical scenarios that reflect common pediatric problems; specialty-oriented self-assessments based on current articles; and the newly launched “Question of the Week,” which features a scenario each week (50 per year), with two chances to answer the question and learn about the recent literature.
Nearly all part 2 activities also earn continuing medical education credit at no additional charge. A listing of all available part 2 activities can be found on the ABP website, www.abp.org (click on the “maintain certification” tab at the top).
The ABP understands that part 2 is the easy part — our friendly call center staff only fields occasional questions on part 2 activities. Part 4, improvement in practice, has been more challenging for the ABP to develop and for diplomats to engage in.
As diplomats transition into continuous MOC, they will need at least two part 4 activities to earn the minimum of 40 part-4 points that are needed during each 5-year cycle.
Various activities available
The ABP has created and/or sponsored more than 500 activities for part 4 credit. The good news is that if you are already engaged in quality improvement work, then the project(s) you are doing can earn part 4 credit, either via a Portfolio sponsor (many children’s hospitals and collaborative improvement networks are Portfolio sponsors), or via the ABP quality improvement project approval (QIPA) process, or by publishing a description of a quality improvement project that meets standards for quality improvement reporting excellence (SQUIRE) guidelines. There is a single fee for project approval that covers all of the diplomats who are meaningfully involved in the project.
The ABP is well aware that many diplomats are leading important efforts to improve quality but are not themselves directly involved with individual projects, and many are not in active clinical practice. The ABP is currently developing a set of criteria that will allow administrative leaders to apply for part 4 credit that recognizes their contributions to improved patient care.
The ABP also recognizes that some diplomats are not in clinical practice but still desire to maintain their ABP certification — some are parents who have chose to take time away from practice to raise a family, and others are pediatricians who are working in health-related fields but not in active practice, or quality leadership positions. Several of our performance improvement modules (PIMs), as well as the education in quality improvement for pediatric practice (eQIPP) modules from the AAP, include simulated data so that part 4 points can be earned by those who attest that they are not in active practice.
The future of MOC
The staff and board of directors of the ABP take seriously the responsibility to continuously improve our own processes.
First on the agenda is to update and improve the functionality of our website, especially to improve the searching function for part 4 activities for individual diplomats.
We are adding staff to reach out to diplomats who are doing important quality improvement work and to assure those diplomats can receive credit for the work they are doing.
We are expanding the Portfolio program so that organizations can provide an incentive to physicians (across multiple specialties) to engage with the organization’s priorities for quality improvement.
We are working with the other primary care specialty boards (Internal Medicine and Family Medicine) to enable our diplomats to access MOC activities that they have developed and vice versa.
And we are in the final testing stages to allow residents to earn part 4 credit during residency, which will then be “in the bank” for their first MOC cycle after they become certified.
Contact the ABP for more information; email: MOC@abpeds.org; or phone: 919-929-0461.
For more information:
Virginia Moyer, MD, MPH, is vice president of MOC and quality at the American Board of Pediatrics. Moyer can be reached at 111 Silver Cedar Court, Chapel Hill, NC 27514; email: vmoyer@abpeds.org.
Disclosure: Moyer receives a salary from the American Board of Pediatrics.