The Process and Timeline
ABIM and SHM began working toward an HM-focused pathway about five years ago, and the two groups announced the FPHM program in September 2009. ABIM is in the process of retooling its website for the new MOC pathway. The entry system—to sign up and begin the MOC’s attestation process—was made public in March. The registration interface for the secure exam opened to the hospitalist community May 1, says Eric Holmboe, MD, ABIM’s chief medical officer.
“Diplomates can signify their interest and start the attestation process, which will allow them to get formal entry into the pathway,” Dr. Holmboe says. “Once they receive the attestation confirmation back, they can start doing the requirements around the medical knowledge and performance and practice requirements. Those are all available on the website. … We’re excited. The first phase of the project is live. This is a brand-new pathway for MOC, and we’re really hopeful people will find it valuable and useful.”
Board recertification is no easy task, and prospective diplomates should organize a plan of attack based upon individual workloads and regular involvement in performance-improvement programs. Some hospitalists will only need six to nine months to complete all the requirements and take the exam; others might take a conservative approach and need one to two years.
“Eighteen months is very reasonable,” Dr. Holmboe says. “Because of the 40-point requirement for the evaluation of performance and practice, that means you have to do the hospital-based PIM or self-directed PIM, or some combination thereof, twice. So if you haven’t been active in QI projects in your hospital, you really need to get going.”
Some hospitalists and HM groups work on quality-improvement (QI) projects regularly. Dr. Ammann plans to use a recent QI project looking at her group’s compliance with antibiotic selection for pneumonia to satisfy one of her required PIMs.
“[The three-year] requirement should be easy for directors because we’re always doing that kind of work anyway,” she says. “We just finished a project where we had to improve our compliance with antibiotic selection. We looked at our processes and found that our pathway wasn’t clear, and it could be interpreted a couple different ways. So our chief of medicine and I just changed the pathway, put it out there, and since then, our compliance has consistently been 100%.
We have two quarters of data, and I’m going to use that for my PIM, which is nice, because it’s done.”
For hospitalists whose certification runs out in 2011 or beyond, Dr. Holmboe suggests the following timeline:
Now through end of 2010
- Register for the Focused Practice in Hospital Medicine MOC pathway on ABIM’ website (www.abim.org/moc/policies. aspx
- Complete the attestation process;
- Get involved in an appropriate (hospital-based) performance-improvement activity; and
- Complete Update in Hospital Medicine using ABIM or ACP medical education modules.
I hope the test focuses more on what I’m doing … stroke, quality measures. Hospitalists know that stuff like the back of our hand.
—Cathleen Ammann, MD, medical director, hospital medicine division, Wentworth-Douglass Hospital, Dover, N.H.
First six months of 2011
- Complete the next yearly Update in HM module;
- Develop a strategy to prepare for the exam, which is given in the fall; and
- Plan and complete your second performance improvement activity.
Second half of 2011
- Prepare for the exam; and
- Pass the exam.
Start Process Now, Start Earning Points
ABIM is encouraging prospective FPHM diplomates to begin working on medical-knowledge modules. Most are designed to “stretch folks and to get them to look things up.”