MOC Part IV

MOC stands for Maintenance of Certification and Part IV refers to the Practice Performance Assessment component of MOC. Here are the 4 parts of MOC defined by the American Board of Medical Specialties.

• Part I Licensure and Professional Standing: Hold a valid, unrestricted medical license
• Part II Lifelong Learning and Self-Assessment: Educational and self-assessment programs determined by your Member Board
• Part III Cognitive Expertise: Demonstrate your specialty-specific skills and knowledge
• Part IV Practice Performance Assessment: Demonstrate your use of best evidence and practices compared to peers and national benchmarks

Depending on your medical specialty, you may have noticed recent changes to Part IV. In fact, these changes have generated significant confusion (and controversy) among physicians who are not accustomed to the routine practice of individual performance assessment and quality improvement.

The American College of Cardiology Foundation has put together a nice MOC Part IV Activity Decision Tree. You'll notice that if you're not currently engaged in direct patient care, you may contact ABIM to see if you are entitled to a waiver for Part IV.

ABMS Board Eligibility Periods and Transition Dates

Last week, the American Board of Medical Specialties (ABMS) published their "ABMS Board Eligibility Periods and Transition Dates." Most physicians have between 5 to 7 years to remain "board eligible" before they must either: 1) become board certified, or 2) start over. I'm over-simplifying, but gone are the days of being grandfathered into a "board eligible" status (BE or board eligible was never formally recognized by the ABMS until now).

When you see a job advertisement that specifies that a physician must be BE or BC, you'll know what they're talking about:

BE = board eligible
BC = board certified

The ABMS Board Eligibility Policy can be viewed here.

Clinical Informatics Becomes a Board-certified Medical Subspecialty Following ABMS Vote

September 22, 2011
AMIA to offer prep courses for clinicians who sit for Board Exam

Washington, DC—Today, AMIA—the association for informatics professionals—announces the success of a multi-year initiative to elevate clinical informatics to an American Board of Medical Specialties (ABMS) subspecialty certified by an examination administered by the American Board of Preventive Medicine and available to physicians who have primary specialty certification through the American Board of Medical Specialties. Joining such subspecialties as pediatric anesthesiology, medical toxicology, sports medicine, geriatrics medicine, and cardiovascular disease, clinical informatics (CI) certification will be based on a rigorous set of core competencies, heavily influenced by publications on the subject that were developed by AMIA and its members, many of whom have pioneered the field and supported CI’s new status as an ABMS-recognized area of clinical expertise. The goal for the first board exam is to have it available in Fall 2012, with the first certificates awarded early in 2013. To prepare physicians who wish to sit for this examination, AMIA is developing preparatory materials both as online and in-person courses starting Spring 2012.

"It is entirely appropriate and timely to certify clinical informatics as a specialized area of training and expertise in an era when more and more clinicians are turning to data-driven, computer-assisted clinical decision support to provide care for their patients," said AMIA’s Board of Directors Chair Nancy M. Lorenzi, PhD, of Vanderbilt University Medical Center. “Clinical informatics blends medical and informatics knowledge to support and optimize healthcare delivery."

Clinical Informatics emerging as an ABMS-approved medical specialty

Right now, you can get a master's degree in informatics. You can complete a fellowship in informatics. However, there is no established "Clinical Informatics" medical speciality recognized by the American Board of Medical Specialties (ABMS). That's about to change.

According to a story on InformationWeek Health Care:

A committee of the American Board of Medical Specialties (ABMS) on July 27 recommended that clinical informatics be defined as a subspecialty of the American Board of Preventive Medicine and the American Board of Pathology, the two specialty boards that cosponsored the proposal. The ABMS board of directors and the ABMS assembly are expected to approve the recommendation in late September.

...board-certified physicians... will be eligible to sit for the board exam in clinical informatics... physicians currently working in the clinical informatics field will not have to go through a training program to sit for the board exam... there will be a pathway to board certification that doesn't require training in a certified program if candidates have significant experience in the field...

Medical students and residents don't know about the preventive medicine residency

Over the years, I've spoken with a number of medical students and residents who knew nothing about the preventive medicine residency.

These medical students and residents are not familiar with the ACPM - American College of Preventive Medicine or the American Board of Preventive Medicine (ABPM). You can become board certified in preventive medicine. Medical students and residents are also not familiar with the Preventive Medicine Residency & Fellowship programs offered by the CDC. They don't realize that they can get an MPH while they go through a preventive medicine residency.

The American Board of Medical Specialties (ABMS) recognizes preventive medicine as a specialty and here's a list of preventive medicine general and subspecialty certificates:

General Certificate(s)

• Aerospace Medicine*
• Occupational Medicine*
• Public Health and General Preventive Medicine*

Subspecialty Certificates

• Medical Toxicology
• Undersea and Hyperbaric Medicine

To learn more about preventive medicine, start with the American College of Preventive Medicine (ACPM) and the American Board of Preventive Medicine (ABPM).

Medical students are least familiar with these specialties

Medical students are least familiar with these Recognized Physician Specialty and Subspecialty Certificates: (listed on the American Board of Medical Specialties)

American Board of Preventive Medicine
Aerospace Medicine*
Occupational Medicine*
Public Health and General Preventive Medicine*
Medical Toxicology
Undersea and Hyperbaric Medicine

American Board of Medical Genetics
Clinical Biochemical Genetics*
Clinical Cytogenetics*
Clinical Genetics (MD)*
Clinical Molecular Genetics*
Medical Biochemical Genetics2
Molecular Genetic Pathology

American Board of Nuclear Medicine
Nuclear Medicine

American Board of Physical Medicine and Rehabilitation
Physical Medicine and Rehabilitation
Hospice and Palliative Medicine
Neuromuscular Medicine
Pain Medicine
Pediatric Rehabilitation Medicine
Spinal Cord Injury Medicine
Sports Medicine

Multiple career options through preventive medicine

So many medical students are unaware of preventive medicine. They don't even recognize that it's on the American Board of Medical Specialties (ABMS) list. There's no mandatory requirement to go through preventive medicine rotations during medical school, so most students don't get exposed to this specialty. Here's some data from the ABPM (American Board of Preventive Medicine) about preventive medicine:

Preventive medicine has three specialty areas with common core knowledge, skills, and competencies that emphasize different populations, environments, or practice settings:

• aerospace medicine,
  
• occupational medicine, and
  
• public health and general preventive medicine.

The ABPM also offers fellowships in preventive medicine as well. Currently, there are two subspecialties (but I imagine this list will grow in the future):

• Medical Toxicology
  
• Undersea Hyperbaric Medicine

To learn more about preventive medicine, visit the American Board of Preventive Medicine (ABPM) website here: http://www.theabpm.org