The content-area blueprint (see “Traditional IM Test vs. Focused Practice in HM Test” below) for the FPHM exam includes 15% of questions in the areas of quality and patient safety, along with another 15% in consultative and comanagement topics. Transitions of care and ambulatory questions make up another 15% of the exam.
“If there is one component of the exam that will [be HM-focused], it’s the questions of the exam that are focusing on the core principles of quality and patient safety,” Dr. Wiese says.
That’s music to the ears of many hospitalists—including Dr. Ammann—who know questions about managing cholesterol aren’t relevant to hospitalists. Dr. Ammann was an office-based physician before becoming a hospitalist in 2005. One year later, she was promoted to director of her group, which includes 14 physicians and two nonphysician providers.
“I was really hoping I would be able to [MOC] through the focused practice in HM,” she says. “I did practice office medicine, so I probably have a little advantage. But I was not looking forward to spending time learning and brushing up on things that I am not doing anymore—not only because I’m not doing it anymore, but it would be a waste of time because I’m not going to be doing it, either.”
One of her hospitalist colleagues is taking the traditional IM pathway to MOC, Dr. Ammann says, because “she doesn’t want to limit her scope.” But that’s not how Dr. Ammann sees the FPHM. She is committed to HM and doesn’t have “any problems kissing office medicine goodbye.”
“I think it will work out well for me, but I also think it will be great for our program to have a director who has a Focused Practice in Hospital Medicine,” she says. “It shows my commitment, and we can hold that up to the rest of the organization and say we really have someone who is concentrated in this field.”
Vikas Parekh, MD, FHM, is in his second year as the chair of SHM’s Education Committee, and says the first task at hand is to educate hospitalists about the new FPHM pathway to MOC. The University of Michigan hospitalist says his committee, working with ABIM and SHM staff, is focused on two major educational efforts: developing the SHM strategy to assist hospitalists with the new FPHM MOC pathway, and “fulfilling the needs of hospitalists, in terms of the resources they have for the MOC process.”
“We’ve already started down this route, in terms of developing resources,” Dr. Parekh says. “We’ve done a few things that have been easy. One is the ABIM learning session pre-course at the annual meeting. … It earns you points toward the medical-knowledge component.”
ABIM and ACP are the traditional avenues for medical-knowledge and practice-improvement requirements for the MOC process. SHM and ABIM currently are working to develop medical-knowledge modules in the domains of patient safety and quality improvement, areas most relevant to HM. Dr. Parekh expects those components to be available in early 2011.
“Practice improvement is likely to be our second main effort,” Dr. Parekh says. “SHM has a lot of resources within our resource rooms that have the shell of what you would really need to meet ABIM requirements for a PIM but aren’t quite complete or thorough enough, or have all the bells and whistles that ABIM wants them to have. … We think we can do a much better job focusing the PIMs to hospitalists.”