Still, the new FPHM will differentiate hospitalists from nonhospitalists. To me, this is semantics, and the recognition that comes with the FPHM is enough to recognize what I do as “special.”
Will the Examination for the FPHM Reflect What I Do?
Yes. I’ve had several colleagues tell me they’ve heard that the examination will contain elements not found on the standard MOC test. This is true, but it also is the major benefit of the new test. As reported on the ABIM website, the FPHM MOC exam will consist of roughly 45% inpatient medicine, 15% consultative and comanagement work, 15% transitions and ambulatory medicine, 15% patient safety/quality improvement, 5% epidemiology, and 5% ethics and end-of-life care. In this respect, it better reflects what most of us spend most of our time doing—inpatient care, consultative medicine, and transitions of care. Those three areas comprise nearly 75% of the examination. The one area that is new is the focus on patient safety and quality. However, for a field built on the promise of improving the quality, safety, and efficiency of healthcare, this is a welcome change.
Will I Be Able to Prepare for the FPHM Exam?
Yes. Because the FPHM utilizes a different exam than the standard IM MOC, some physicians are concerned that they there are no avenues for preparation, but this is not true. While the exam will weigh various portions of the test differently (e.g., less ambulatory and more inpatient content), the inpatient content will be similar to what is currently on the standard MOC test. After all, heart failure, cellulitis, and pulmonary embolism are the same, regardless of the test it shows up on.
The difference is that there will be more of it—a good thing for the practicing hospitalist. Many of the standard IM test preparation options will help you prepare for the FPHM exam. The ABIM also offers HM knowledge modules as part of the enrollment fee, which, while not meant to be preparation for the exam, can help you identify gaps in your knowledge. The blueprint for the exam is on the ABIM website and can give you clues to areas in which to prepare.
It is true that there will be patient safety and QI content on the HM test, which might not be available for study in typical board review books. However, much of this is the kind of information hospitalists live every day, such as handoffs, transitions of care, and infection control.
Should I Fear the Change?
Humans are intrinsically wired to dislike change. It’s that old saw about choosing the devil we know rather than the devil we don’t. My guess is that much of the concern around the new process stems from this human sentiment—it’s just easier to not do the FPHM and go down the standard IM MOC route. We must avoid this temptation.
The FPHM is a key step in solidifying HM’s status in the healthcare milieu. It gives us credibility in a way no other designation can. It also allows those of us who are serious about an HM career to differentiate ourselves from those who masquerade as hospitalists. And, most importantly, it allows us to demonstrate to our patients our sincere commitment to improving the quality of the inpatient systems that envelop them at their sickest moments.
For that reason alone, I’m enrolling in the FPHM MOC. TH
Dr. Glasheen is physician editor of The Hospitalist.