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What is Maintenance of Certification?
In 2001, the American Board of Medical Specialties voted unanimously to expand recertification programs into maintenance of certification (MOC) programs — more comprehensive programs to assess the ongoing competence of physician specialists and their ability to provide quality health care in six general competencies:
- Medical knowledge
- Patient care
- Interpersonal and communication skills
- Professionalism
- Practice-based learning and improvements
- System-based practice
In the past, the certification process comprised successful completion of an approved educational program, an unrestricted medical license as evidence of professional standing, and passing the certification examination. Now nuclear medicine professionals can no longer simply take an exam to renew a certificate; lifelong learning must be documented.
The American Board of Nuclear Medicine (ABNM) MOC program is a process designed to document that nuclear medicine physicians maintain the necessary competencies to provide quality patient care in nuclear medicine. It is now an ongoing process and will require the assessment and improvement of practice performance by nuclear medicine physicians, as well as other physician specialists who wish to be certified, and/or maintain their certification, in nuclear medicine.
MOC Components and Requirements
There are four components of MOC. To renew a certification when it expires, a nuclear medicine physician will be required to present evidence of the following:
- Professional Standing — evidence of professional standing is provided by a medical license(s) that has no limitations on the practice of medicine and surgery in that jurisdiction.
- Lifelong Learning and Self-Assessment — evidence of a commitment to lifelong learning and involvement in a periodic self-assessment process to guide continuing learning. The ABNM requires each diplomate to obtain a minimum of 8 self-assessment credits per year in order to be eligible for the recertification exam. These credit hours may be obtained by completing the SNM Lifelong Learning & Self-Assessment Program (LLSAP) modules.
- Cognitive Expertise — evidence of cognitive expertise based on performance on an examination. That exam should be secure, reliable and valid. It must contain questions on fundamental knowledge, up-to-date practice-related knowledge, and other issues such as ethics and professionalism. This component consists of the recertification examination administered by the ABNM.
- Performance in Practice Evaluation — evidence of evaluation of performance in practice, including the medical care provided for common/major health conditions, and physician behaviors, such as communication and professionalism, as they relate to patient care. ABMS is developing tools and SNM plans to develop management modules in the future.
Why should I participate in MOC?
- Participation is mandatory for diplomates with time-limited board certification. Although participation in MOC programs is not mandatory for diplomates with lifetime certification, specialty boards are strongly encouraging all of their diplomates to participate in MOC.
- Medical knowledge: Your medical knowledge is enhanced when you stay current with the latest research and advances in your specialty.
- Your patients benefit: By staying up-to-date with the latest advances in your specialty, your patients can be assured that they are receiving high-quality medical care.
- Reimbursement: It is anticipated that third-party payers will require physicians to participate in a MOC program (Pay-for-Performance initiative).
- Privileges and Credentialing: In addition to maintaining your medical license, it is expected that most hospitals will require physicians to participate in a MOC program.
- Self-Governance: Instead of having the government dictate what constitutes high-quality medical care, the ABMS prefers that the specialties define and disseminate their own standards through their respective MOC programs.
- Malpractice Premium Reductions: Our research indicates that participation in a MOC program may result in reduced malpractice insurance premiums.
Maintenance of Certification for Nuclear Medicine Physicians
The American Board of Nuclear Medicine (ABNM) Maintenance of Certification (MOC) requirements will take effect in 2007. ABNM expects its diplomates with time-limited certificates to participate in MOC beginning in 2007. The ABNM is strongly encouraging all of its diplomates to participate in MOC programs as they are developed.
The ABNM initiated the time limited recertification requirement in 1992. All diplomates who have received ABNM certification since 1992 are required to take the recertification (MOC) board exam every ten years.
Diplomates with Lifetime Certification Update:
If a diplomate with lifetime certification (certified prior to 1992) chooses to participate in MOC, all 4 components of MOC must be completed, including the recertification (MOC) exam (Part 3). If you choose not to participate in MOC, the ABNM will not revoke your certification.
- Professional Standing — evidence of professional standing is provided by a medical license(s) that has no limitations on the practice of medicine and surgery in that jurisdiction.
- Lifelong Learning & Self-Assessment — evidence of a commitment to lifelong learning and involvement in a periodic self-assessment process to guide continuing learning. The ABNM requires each diplomate to obtain a minimum of 8 self-assessment credits per year in order to be eligible for the recertification exam. These credit hours may be obtained by completing the SNM Lifelong Learning & Self-Assessment Program (LLSAP) modules.
- Cognitive Expertise — evidence of cognitive expertise based on performance on an examination. That exam should be secure, reliable and valid. It must contain questions on fundamental knowledge, up-to-date practice-related knowledge, and other issues such as ethics and professionalism. This component consists of the recertification (MOC) examination administered by the ABNM.
- Performance in Practice Evaluation — evidence of evaluation of performance in practice, including the medical care provided for common/major health conditions, and physician behaviors, such as communication and professionalism, as they relate to patient care. ABMS is developing tools and SNM plans to develop management modules in the future.
Recertification Exam Dates:
Diplomates with lifetime certificates who choose to participate in MOC:
- certified between 1972 and 1976 are required to take the recertification (MOC) exam by 2015.
- certified between 1977 and 1986 are required to take the exam by 2016.
- certified between 1987 and 1991 are required to take the exam by 2017.
- those with time-limited certificates, who certified in 1992 and later, will take the exam at the normal time.
The ABNM has changed the start date for obtainment of self-assessment credits from 2006 to 2007. Self-assessment credits received by having completed the SNM LLSAP modules in 2006 will carry over to the 2007 requirement.
On an annual basis, ABNM diplomates must provide documentation that they have obtained a total of 50 hours of CME of which 25 hours are category 1 CME in order to be eligible for the recertification board exam. This includes 8 hours of category 1 CME from ABNM approved self-assessment modules. 70% of Category 1 credit needs to be in nuclear medicine (17.5 credit hours). Self-assessment credit may be obtained by completing modules included on the SNM's Lifelong Learning & Self Assessment (LLSAP) Web site. Look for a LLSAP purchase option included in your SNM annual membership renewal package. The modules will be available at a special discounted rate. By purchasing this package, you will obtain the 8 self-assessment credit hours that are required by the ABNM to maintain your certification.
An evaluation of Parts 1, 2, 3 and 4 of Maintenance of Certification requirements will be part of the re-certification process.
For more information regarding Maintenance of Certification, please visit the American Board of Nuclear Medicine Web site at www.abnm.org.
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Maintenance of Certification for Radiologists
Lifelong Learning: A minimum of 500 CME credit hours, approved by the Accreditation Council for Continuing Medical Education (ACCME), are required over the 10-year cycle, at least 250 of which must be in Category 1. Of the 500 hours, a minimum of 70% must be in specialty-specific or related areas. The remaining 30% can include specialty-specific material as well as clinically related areas or relevant topics such as risk management, ethics, statistics, the processes of continuous quality improvement, methodologies of outcome of measurement, etc.
Self-assessment: The self-assessment requirement may be satisfied by completing self-assessment modules (SAMs). These are educational venues (e.g., refresher courses, workshops, reading assignments, etc.), usually offered by the societies, that have been ABR-qualified. All SAMs are also qualified as Category 1 CME, and can serve to fill that requirement as well.
In a full 10-year cycle, the diplomate will be responsible for documenting successful completion of the equivalent of 20 or more SAMs.
Learn more about the American Board of Radiology Maintenance of Certification requirement by visiting the ABR Web site located at: http://www.theabr.org/MOC_SAMs.htm.
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| MOC For Canadian Physicians
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The Royal College of Physicians and Surgeons of Canada has approved the SNM Lifelong Learning & Self-Assessment (LLSAP) modules for Section 3 of the Maintenance of Certification (MOC) program. This CME activity is valid until the summer of 2010. For more information on accredited self-assessment programs, please visit the Royal College Web site.
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