»» Good morning. Well, I hope that you're in the right place. We're going to be talking about what was formerly known as MOC Part IV. I'm Denise Kessler and I am the chair of the ACOM's MOC Part IV or now the IMP Committee. And I also have with me Kevin Patrick who has all the answers that you would need from ABPM on the current transitional program that they have in place. So I'm going to speak for just a second or two and then I'll turn it over to Kevin and then I'll come back and I'll talk to you about our ACOM program. We have no relevant financial disclosures. So people are always confused. What's ABPM? What's ACOM? ABPM is an organization that really grants certification to physicians in preventive medicine. So they have a very specific mission. You can't join ABPM, you can be one of their diplomates. Whereas the American College of Occupational and Environmental Medicine is a specialty society. So anybody can join who practices occupational and environmental medicine and the organization itself has a mission to really promote the advancement of occupational medicine. Actually ABPM does too, but they really have to focus on accomplishing their main goals. And I'll just say before I turn it over to Kevin that so ACOM really helps ABPM whenever we can to support activities such as what we're talking about today. All right, good morning. So the ABPM offers certification to physicians in the specialties of occupational medicine, public health and general preventive medicine, aerospace medicine, and the subspecialties of addiction medicine, clinical informatics, undersea and hyperbaric medicine, and medical toxicology. The ABPM around 2019 released an announcement that we were going to establish a transitional plan. This transitional plan was meant to provide diplomates a thoughtful, simple, and well-organized transition as we move away from the current maintenance of certification program to the new continuing certification program. As you can see, the program was scheduled to launch on February 1st of 2020, right when COVID-19 kind of came about, and that threw a little bit of a wrench into our transitional plan. So the ABPM is a medical board that is a part of the American Board of Medical Specialties umbrella. So we are one of 24 medical boards that must abide by ABMS's continuing certification standards. So they establish continuing certification standards. The ABPM as a member board then creates a maintenance certification program that fits within that framework. In October of 2021, ABMS approved their new continuing certification standards. So at this point in time, the ABPM's board of directors is looking closely at those standards and creating the new requirements for the future continuing certification program. As I mentioned, we had launched this transitional period on February 1st of 2020, and that is scheduled to continue through December 31st of this year. When COVID came about, the ABPM made some updates to transitional MOC requirements. Essentially, what the ABPM did was we waived MOC Part 2 and 4 requirements for qualified diplomats. You might be asking, how do I qualify for that waiver? To qualify for the waiver, all you are required to do is access your account on the ABPM's website. Make sure you've registered your account. For diplomats who are certified before 2017, you originally created your account on the ABPM's old website. We launched the new website in 2017, so if you hadn't logged into your account, you need to go to the new website, enter your main contact information, that'll locate your board certification, and then you'll be registered. That would essentially qualify you for the COVID-19 waiver. Today, we're going to go through and we'll talk about the four parts of MOC. Again, I would like to put out there that if you've qualified for the waiver, your MOC Part 2 and 4 requirements are going to be waived, but this will be more for diplomats who maybe have not qualified for the waiver, and we'll get into that as we go through the presentation. So, Part 1 of Maintenance of Certification is Professionalism. At all times, diplomates of the ABPM shall maintain a full, valid, and unrestricted license to practice medicine in all states, territories, or jurisdictions for which the diplomate has a license to practice medicine. This requirement remains unchanged. During the transitional period, all diplomates must meet this requirement. If you haven't logged into your ABPM account recently, your medical license information might not be up to date. While the ABPM does receive updates from the American Board of Medical Specialties, in order for the update to apply to your account, you must accept the update. So, if you haven't logged into your account to update your medical license information, I recommend doing that at some time during this conference if you have an opportunity. Also, you could stop by the ABPM's booth, and I can log into your account for you, and then we can approve any updates we currently have in our system. Part 2 of Maintenance of Certification is Lifelong Learning and Self-Assessment. Diplomates of the ABPM shall, for the calendar year of 2022, be required to complete 25 AMA Category 1 credits. In the past, the ABPM had a 10-year requirement. It was 250 hours over the 10-year period of time, 100 of which needed to be lifelong learning and self-assessment credits. In 2019, the ABPM announced that we are no longer going to require diplomates to complete LLSA credits as part of their recertification requirements. So, when we launched the transitional MOC requirements, we said, 25 credits a year, they can be any AMA Category 1 credits. Once again, this is only going to apply to a diplomate who does not qualify for the waiver. If you have qualified for the waiver, you do not have a CME credit requirement at this time. If you did not qualify for the waiver, or if you would like to use your ABPM Physician Portal as a place to store your CME credits, you're more than welcome to do so. The ABPM previously launched an attestation feature, and this is available through your Physician Portal. Once you log into your account, you would scroll to the Certifications section and select the CME attestation icon. That will bring you to this screen where you can do one of two things. The first one, you can say, yes, I've completed 25 credits for the calendar year. You can also upload attachments. So, if you attended today's or this week's conference, you received your CME certificates, you could upload your certificates to your Physician Portal. While the ABPM will not require you to do that during this transitional period, this could just be a place for you to house all of your certificates in a single location. If you do not want to just do the 25 credits manually, and you prefer to have a running total of exactly what courses you completed, you can do that by entering your credits manually. So, it's a bit hard to see on this slide, but kind of near the top, there's a little checkbox. You would simply check the box. That will bring you to a different screen, and you can enter each course you completed and how many CME you received for that specific course. Part three of maintenance of certification is the assessment of knowledge, judgment, and skills. This is typically referred to as the MOC exam. Diplomates with certification expiration dates through January 31st of 2023 are required to take the MOC exam as part of their recertification requirements. If your board certification expires beyond January 31st of 2023, you are not required to take the MOC exam. The ABPM is pleased to offer both in-person and remotely proctored MOC exam administrations for diplomats who are required to take the exam. We actually just held an exam here yesterday morning. We have two additional in-person exams scheduled for this year. Those will be taking place in Reno, Nevada later this month and in Denver, Colorado in June. We also have the remotely proctored testing option. This is where diplomats would have one full week, 24 hours a day to log in and complete the exam remotely. This can be done in your own home or office using your personal device. And registration for the MOC exam, if you are required to complete it, can be submitted through your physician portal on the ABPM's website. Today, I think most of you probably came to hear a little bit more about maintenance of certification part four, that being the improvement in medical practice activity requirement. So while Dr. Kessler will be giving you additional information about completing that activity with ACOM, I just wanted to provide you some information about this requirement when it comes to your board certification. When we look at the waiver, we previously said that MOC part four is waived for qualified diplomats. While that's true, we would also like to incentivize diplomats who complete a part four activity during this transitional period. So if you complete a part four activity with ACOM or another ABPM partner specialty society during the transitional period, so between February 1st of 2020 and December 31st of this year, you will receive current credit. So you'll complete your activity with ACOM. They will notify the ABPM. We will update your account to say, yes, the diplomat completed an approved part four activity. You will also receive future credit. So the ABPM, based on the ABMS's continuing certification standards, know that ABMS is going to require that we have one practice enhancement or improvement in medical practice activity every five years. Right now, it is the ABPM's plan to implement the part four requirement beginning in 2025. So if we have one activity every five years, the activity would need to be completed between January 1st of 2025 and December 31st of 2029. So if you complete a part four activity with ACOM through the end of this year, you will fulfill the improvement in medical practice activity requirement through December 31st of 2029. So that is just, again, while we've waived the requirement for COVID-19, we would like to incentivize diplomats who choose to complete an activity at this time by providing them with future credit. I noted that ACOM will notify the ABPM when an activity is approved, but we are also using an attestation feature for this requirement. So similar to part two, where you can log into your account and indicate that you've completed this requirement, you can do that for part four as well. So you would log in, scroll to the certification section, expand part four, and then select IMP attestation. From there, you can indicate that you've completed your specialty activity with ACOM. You can provide additional information and any sort of confirmation you receive from ACOM that your activity was approved. The ABPM, even if you log in and you attest that you completed this, we're still going to receive the confirmation from ACOM. We're still going to update our database, so that way we are providing you your future credit as well. Yes. You mentioned earlier that we can utilize the similar, but doing that through a different society to also submit here, or do we have to submit to ACOM first? So if you completed a part four, is this going to be with another ABMS member board or just another society? So if it's with another ABMS member board, what the ABPM offers is reciprocal credit. Reciprocal credit can be used to fulfill the current requirement. However, when we're looking at providing the future credit, that is only going to be activities that are completed with a partner specialty society. So if you would like to take that activity and then submit it to ACOM for their review as well, I think that would be the best option. That being said, if you would still like to document that you completed a part four activity with another ABMS member board, you can still do that through the attestation feature. What you'll notice is on the dropdown where you select the specialty society, there will be other, and there you would indicate that you completed that with another ABMS member board. We also currently have a patient safety course requirement. So prior to February 1st of 2023, all ABPM diplomates must complete a one-hour patient safety course. The ABPM does maintain a list of pre-approved courses. However, we also put a criteria on the ABPM's website. So if you have completed a course that meets that criteria, you can submit that to fulfill your patient safety course requirement. Again, this is going to be done using the attestation form on the ABPM's website. I feel like most of you have probably completed a patient safety course as part of your state licensing requirements. So if you have, then you could obviously use that to fulfill your patient safety course requirement with the ABPM. Yes. Correct. So residents who completed residency or fellowship in 2012 or later are not required to complete a patient safety course. They will have fulfilled that requirement through their residency or fellowship. So we don't necessarily have a timeline. Typically we would say within the previous 10 years. We would also say within your certification cycle. So if your certificate started in 2015, probably since 2015, I would also say that we're providing a lot of flexibility with this requirement. That being because this falls under part two and part two is waived if you qualify for the COVID-19 waiver. So waived unless... Yeah. So if you have completed any patient safety courses, I would say in the past couple of years you could submit that. And again, the criteria is just one hour of CME credit that addresses patient safety topics. So we really provide our diplomates the ability to identify what they feel is an appropriate patient safety course and use that to fulfill the requirement. So we would like to provide diplomates as much flexibility as possible. Yes. So AOHC does have several courses this year that are approved for patient safety credit. Those are not going to be automatically uploaded to your Physician Portal. You would need to, after the conference, log in and attest to completing it. And my last slide is really just encouraging all of you to log into your Physician Portal and make sure that your contact information is up to date. The ABPM will be communicating important updates regarding the transition as well as the new requirements for continuing certification via email. So please make sure your email address is up to date. We also will be sending out a survey this summer to all ABPM diplomates seeking your feedback on the draft continuing certification requirements. So that'll be your opportunity to see what exactly the ABPM is planning to implement beginning next year. And then let us know your thoughts. Once we complete the survey and we receive diplomate response, we will look at the program and determine what revisions need to be made before sending the program to the American Board of Medical Specialties for review. Before we implement any updated requirements, they must be approved by ABMS. And we anticipate we'll be sending that to ABMS in Q3. So final requirements should be communicated in Q4 of this year. But once again, those will be sent to you via email. And if you have specific questions or concerns regarding your certification, if you have questions about whether or not you're up to date, if you've registered your account, if the COVID-19 waiver is applied to your board certification, please do not hesitate to stop by booth 214. I will be there today until 4 p.m. to answer any questions or concerns you have regarding your board certification. Thank you. The requirements for the waiver are simply to log into your account on the ABPM's website and make sure it's activated. So if you recertified in 2019, I believe is the date you mentioned, then your board certification is going to be qualified for the waiver because in order to recertify in 2019, you had to log into your account on the ABPM's new website. So we're really just looking for people to log into their accounts, make sure their contact information is up to date so we can connect with you as we release new updates. Final question. So if your certification period is like, let's say from 2015 to 2025 or 2017 to 2027, and it includes or overlaps the transitional period, I assume that because part of it is before the transitional, you are still required to have the MOC requirement, like one of them, and then over the course of the two, over the course of the 10 years, you are supposed to be required for two, but because of the waiver, I guess you are only required for one if it overlaps that period of time. So that's a great question. What the ABPM's current plan is, once we launch the new continuing certification program in 2023, that's going to start a new ongoing requirement for all diplomates. So we're not going to look back and say, well, you originally certified in 2015, so you should have completed one activity between 2015 and 2020. We're not going to go back and make sure you did that. We really would like to get everyone logged into their account, contact information up to date, so once we launch this new program, we can move forward with new requirements. We don't want to be looking back. We want to be looking forward. So for that question, your Part 4, all of it is going to be waived. You're not going to have to show completion of activity in the past. So like 2025, when I come up for a restart, I don't have to show any Part 4 even though I did one? Correct. Correct. So if you did one during the transitional period, that'd be great because you would then have fulfilled your requirement for 25 to 29. But we're going to say beginning in 2025, you have five years to complete your first activity. And actually, I would like to let Dr. Kessler get to her presentation, but we're definitely going to have time at the end for more questions. So we can address those at that time. That's good. That's a lot of good information, isn't it? Let's just reflect on that for a second. Make sure you get your contact information updated on ABPM's website. That's going to be crucial for you. Make sure that there's no longer three questions per CME credit hour that you complete. I've had several people come and ask me about that. Those questions don't exist anymore. It's just completing your CME. So ABPM has made it very, very easy for you to do that. And again, what I'm going to be talking about is waivered, but it will give you the credit moving forward. And I know that there's probably some people in here and maybe listening to it live who are trying to figure out, am I going to retire by 2029, and do I not have to do anything? And that's very possible, but I'm still going to tell you about our program because I do think it can be very helpful for those that complete it. So again, ABPM can't do everything by themselves, and so they have stakeholders that they really involve in helping to complete some of the activities for their diplomates. And so ACOM has actually been involved with this Part IV IMP since 2008 is when it was first offered. It's available to anybody that's in any of the specialties or subspecialties within preventive medicine. So you've downloaded the module, what do you do now? There's really three possible options for you. One is relatively new, and that's having previously completed quality improvement project within an organization. And then we also have the direct clinical patient care or the population health non-direct patient care activities. So in looking at the previously completed organizational quality improvement project, again, that's a formal process that you would have done on your own outside of the ACOM. And so ABPM does have some specific requirements for that. It needs to be something that you've completed within your current 10-year cycle. You need to complete the activities using a standard quality improvement process. So you would have evaluated your practice or organization, designed and implemented interventions based upon that evaluation, and then re-evaluate. There's three steps within this part of the module. One is outlining the information that demonstrated that you adhered to a recognized quality improvement tool, that you meaningfully participated in the evaluation, design and implementation of that QI program. You identified an area for improvement and you implemented the Improvement Action Plan. And I have to say that there's not very many people that do this. We see it a lot I think with the military because they have a lot of quality improvement projects going on. The second step is to apply the ACOM competencies, at least one of them, to the project that you completed. The ACOM competencies are online on ACOM's website. Within the module there are also some select competencies just copied for your benefit. And then the final step is to identify and discuss improvement in two of the ABMS six core competencies. And I'll mention that again in a few minutes. So really that's it if you are participating in an organized quality improvement project. The other two options are direct clinical patient care and then population health and non-direct patient care activities. We really like the long titles and I apologize for that, but we try to be very inclusive in what we say. So for both of these options you would identify an area for improvement, assess your practice, design and implement a quality improvement plan, and then complete a second assessment. And then again, as in the other option, apply the ABMS core competencies to your project. I think this slide alone sounds very daunting. And especially if you're a busy clinician and trying to figure out how in the heck are you going to do an improvement plan. So we realize that and we try to make it as simple as we could for you. And we really want it to be relevant and helpful to you, not just an extra box you have to check off. So the first step would be to identify an area for improvement. So actually within the module it has you look at these three questions. What could result in meaningful improvement in your practice? How can you provide, and again it depends upon what you do, better patient care, administration, consulting, or population health management? How can I better address the important priorities in the programs that you work with, or the teaching that you do, or the research? When we first created this we were going to say, what keeps you up at night? What gives you insomnia where you wish you could actually really improve? And really, you come to your own conclusions as far as what you want to focus. So let's look at the direct clinical patient care. This is really a chart review. And you would pick this if you want to evaluate the documentation of your notes when you see patients. So within the module there's four possible categories that you could select from, musculoskeletal disorders, workability such as return to work or IMEs, environmental health and toxicology such as indoor air quality evaluations, or clinical preventive medicine such as tobacco use or seat belt use, or everybody now, vaccine use. So it's a matter of reviewing 10 patient charts from prior to starting your program. You would compare your own documentation to what is in the available templates in the module and see if you could identify an area where you didn't do very well in the documentation. So this is an actual excerpt from the musculoskeletal patient chart review template. All the templates look very similar as far as format. So in the first column, that's the most important part. That's where it actually says what should be in your note. And then you would just use the rest of the columns to identify if it was present or not. So was it there? Was it not? Or was it not applicable? Because that actually happens quite a bit. You know, we used to think that causation must always be in every chart, some of us. But you know what? Depending upon where you practice, you actually can't put causation in your chart. So we wanted to make sure that people could have that option of indicating that it's not applicable. So in this particular example, the person might choose treatment prior to arrival because in their documentation it was only present 70% of the time. And I say they might because we leave it with flexibility so that maybe you don't think that that's important. But as you look at other things, you realize that there's something that would be very essential that was missing in two charts. So you might want to pick that instead of the treatment prior to arrival. Again, it really comes down to you thinking about it and thinking what would really help your own practice. So let's put that in the parking lot for a second. That's how you identify your area for improvement. The last option is population health and non-direct patient care activities. This is basically anything else that a person could do in practice. But we specifically identify anything in public health, employee health, health promotion and wellness programs, teaching, research, management, administration, or corporate or legal consultation. In this one, it's really driven by your own documents. So it's not like the chart review where you have this template and you compare it. This is really you looking at your information from your own career and really trying to identify an area to improve. So we ask you to take your CV and then at least two other documents. So if you have annual performance evaluations, you could use that. If you've applied for a grant or given a publication submission or you've done an educational session such as at AOHC, you could use the feedback from any of that. And if you don't have any of that, we also have a template for a letter of opinion that you could use from a supervisor, customer, learner, or someone that you supervise to try to get additional information. So just about that letter template, there's actually, you don't have to use these. That's the most important thing because sometimes people feel like they have to. So you don't have to use them. There's two templates. One is pre-project and one is post-project. So really the biggest difference is the one question identified on the slide there. Pre-project would be, is there an area where, in your opinion, the physician could show improvement? And then the post-project letter template asks, in your opinion, did the physician show improvement in the selected goal? The same person can do the letter pre and post, or it could be different people. So again, you would review the compiled data, hopefully not over a glass of wine. But if that helps you to come to an answer, then use that glass of wine and really try to determine if you see something that really jumps out at you where you might improve. And so we've created two possible options depending upon if you're able to identify an area or not. So option A is if there's something that's readily identifiable. So I gave some examples here. Let's say you applied for a grant that you didn't get and the feedback was that your objectives weren't written as well as they could have been. Or maybe in your annual performance evaluation you realized that if you knew how to do budget creation, that might help your career. Or you gave a presentation and the feedback from those that attended really felt that you could do a little bit better job. Or you just look at your CV and you have one of those moments of, man, I wish I would send in for publications. And that's what you would select. And then option B is, you look at all that information and gosh, there's nothing there to improve. And in that particular case, what you would do would select a skill that's associated with one of the ACOM's occupational and environmental medicine competencies in which to improve. So you don't have to like be poor in that skill. It just has to be a skill that you really feel it would benefit you personally in your practice if you were to target that for improvement. So the example I have here is the competency of hazard recognition, evaluation, and control. And within that is the skill, communicate concerns related to health hazards to appropriate employer health and safety professionals, participate in mitigation efforts. So just in that skill alone is a lot of possible options for what you could do. Maybe you want to improve your presentation skills. Maybe you want to improve your written skills. Maybe you want to do something about participate in mitigation efforts. So you can really pick what it is that you would like to target for improvement. It's important within the module to document why you selected that target area for improvement. Remember these are going to be reviewed by the MOC Committee members. So they are physicians who practice occupational medicine. But they also have an obligation to make sure that they can understand that you went through the process. So it really helps if you can document why you selected that. And really if you can identify your baseline. So I gave some examples here as well. Maybe you want to learn how to create better procedures or policies. Well what's your current status? Maybe you've never had to create policies before. Or maybe you've created policies but then you get the feedback that they're way too wordy and you have all this extra information in there that doesn't need to be in there. Or if you want to learn how to do DOT exams, have you done them before? Or maybe you used to do them back before you have to be certified to do them. And now you want to do them again. So just really think about what your baseline is when you are doing the module. All right. So at this point in time, whether you did the chart review or whether you did the Population Health option, you've identified an area for improvement. So then you would put into place your Quality Improvement Plan. So you need to develop a plan of action for how you're going to improve and implement it, then reassess. Sorry, I realize my voice is a little weak today. So when you do it, you can do any recognized quality improvement tool. We do give information on the Plan to Study Act within the module. And it's really again to plan how improvement in your medical practice will be accomplished. And you already actually started it by identifying the area for improvement. Because that is the important step within doing a quality improvement process. Then you would develop your plan of action. It's very well simplified in the module to a checkoff list. It's important to know that you should do two action items. But it can be something such as an institute, a new form or database. Identify a job duty for support staff, such as maybe you decided you need to see if they were previously treated elsewhere. So you ask your nurse to gather that information. You could review evidence-based guidelines. Or we also have other where you can really identify what it is that you're going to do. And then you would put their plan of action into place for at least four months. And then you would complete a second assessment. So if you did the chart review, you would do a second chart review. You would look at 10 charts that you did after you implemented your improvement plan and see if you improved. Or if you did the Population Health Module, you would gather your data again and see if you improved or not. And just seeing if you improved or not is really all that we ask you to do. And you know, especially for the chart review, nobody has ever not improved. So it's really something that will benefit your practice and you will get credit. And with the population health too, people improve. And so it's not like an exam that you have to take and pass. Then the final step for absolutely everybody is to again, apply the ABMS core competencies, two of the six, to your project. So the core competencies for ABMS are the same as for residencies in the ACGME. So it's medical knowledge, patient care, systems-based practice, interpersonal communication skills, professionalism and practice-based learning and improvement. So these are identified and defined within the module. And that's it. You finish the project. Yay! So what happens then is you would submit your module to ACOM. Again, the committee members are the reviewers. So we ask that you give us at least two months to review before your deadline because they're all working full-time and they need time to actually do the reviews. As Kevin said, we will notify ABPM that you've successfully completed it, but we also recommend that you go ahead and log into your portal and make sure that it's there. And there's been a lot of questions that we have been asked and answers that we have given over the years. So yes, you will find an area in which you can improve. That question is usually asked by people who have never actually started it. So once they start the process of looking at their practice, they're able to identify an area. It's really looking at how you as an individual practice. So if you're going to do the chart review, it's your chart documentation, not somebody else's. However, let's say you're the medical director of a clinic and you're so busy with the administration of that, that you don't see patients or you don't see enough patients. Then you could pick the Population Health Module and you could review other documentation within your clinic through one of those options. The ABMS core competency questions are directed at the project you just completed and not a different topic area. And if you move to a new job, after completing your initial review, it's appropriate to use the information from your new job to do the second assessment. Nowadays it seems to happen a lot where people are changing jobs. So just be aware of that. And is your practice too unique to fit into any category? And we will work with you because we know that we are very diverse and we have all sorts of different practices going on. And sometimes it is kind of a challenge to determine what you might do. So we're happy to help. And feedback is important. So please let us know if you see areas for improvement. And this is our current members of the committee. We have been in place since 2008 and when we had very little turnover in the committee. But we joined the volunteer selection process when it started. And so we will have new members. So we would be delighted if you would join in the future. Because you're really helping your fellow diplomates to accomplish what they need to accomplish. Dr. Carl Auerbach is taking over after this session as the new chair. And I will be rotating off. This is a presentation I've given since 2008 in very different formats from the beginning till now. So it's been my absolute pleasure to help you. These are more websites that are available to you. So please especially log on to ABPM and find out your answers. ACOM also has information. And we make sure that it's correct on our website. And that's it. Is there any questions? Well, my practice is really, I do IEBs full time and medical legal work for maternities and so forth. So I did this once before based on my record reviews for individual IEBs. And I didn't get much out of it. It was a lot of work. And I had to really struggle hard to find improvement in that. Not that I'm patting myself on the back. But IEBs are a different process. But one thing I can think of is, which I would enjoy doing, would be learning how to interpret electrodiagnostic studies, which is what we do. Would that be a project that could fit into this? That sounds like a beautiful project. And probably what happened is when you did it before, it was in an earlier version. Because as we move through the years, we modified the program to more fit what people are doing. So that would be an absolute wonderful thing. It would be great if everybody could really enjoy doing this. And so that's why we have that option where you could just pick a competency and really improve in that. Yeah, thank you for the wonderful presentation. I have two questions, actually. Like the first one, for the part four, the AECOM module, like can it fit on all three parts, like population, health, patient care? So is it the same module and the same template that can fit on all the three parts of doing it, like population, health, patient care? There's a specific question for me. So it's the, I'm not sure if I have your question correct or not, but they're all within the same module. So you'll download the whole module, and you'll be able to look at any of them to decide what you want to do. And my second one, like there's so much information on population. So what exactly is required for those physicians who need to recertify within the next two to three years and how can that be achieved here? I'm going to give Kevin that question. So right now, if you recertify in the next two to three years, but your certificate is beyond January 31st of 2023, your only requirement is to log into your account on the ABPM's website and to maintain an active license to practice medicine. The ABPM's plan is to launch what we're calling phase one of the new continuing certification program in 2023, and all diplomats holding time-limited certificates will be required to start participating at that time. As I mentioned earlier, those requirements have yet to be finalized. They're currently in their draft form, and we'll be, again, communicating those via a survey to the diplomat population in the coming months. Once approved by ABMS, we'll be sending out communications about what those final requirements are for 2023. But just providing some context to what the draft requirements are, if we were looking at the calendar year for 2023, I would anticipate that all ABPM diplomats would have three major requirements. The first requirement, maintain an active license to practice medicine. So that remains unchanged from the previous continuing certification requirements. I also anticipate in 2023 we will implement a CME credit requirement. Unlike the previous requirement where you had 250 credits over 10 years, we anticipate this is going to be an annual requirement. Again, speaking about the draft requirements, because these are not yet finalized, the draft would be 20 CME credits annually, and six of those credits would need to be certificate-specific. Unlike the previous requirements where you would have to go to the ABPM's website, find a credit or an educational activity that's approved for lifelong learning and self-assessment credit, I do not anticipate we'll be bringing back that requirement. This would be up to the diplomat to determine, is this educational activity relevant to my certificate? If so, you would just attest that, yes, you've completed the 20 credits, yes, six of those were relevant to my certificate, and then at the end of the year, the ABPM will implement an audit process. We would audit up to 5% of the diplomat population, and if you are selected, you would simply submit a CME certificate saying this is what I completed this year, here are the six credits that were relevant to my specialty. The third requirement would be an annual fee. So as the ABPM is transitioning away from the high-stakes MOC exam, which had an associated $1,750 exam fee, and we implement the new longitudinal assessment program, our plan for that would be implementation in 2025, but this new annual fee is going to cover participation in that longitudinal assessment component. So moving forward, when we look at your continuing certification requirements, there wouldn't be that high-stakes exam, but you would be required to participate in longitudinal assessment, and your payment for the annual fee would cover your participation in that program. So 2023, 2024, those would be your requirements. As we move further into the continuing certification program and implement the newer additional components to continuing certification, those being longitudinal assessment and then practice enhancement or improvement medical practice, those would be phased in in 2025. So regardless of your expiration date, if it is in 2025 or 2027, you will all begin participating in continuing certification in 2023. As we move through the program, we get to your original expiration date, the ABPM is still in discussions on whether we would simply extend your cycle for additional time or issue a new certificate for a new 10-year cycle. That process has yet to be determined, but we anticipate we'll have a finalized plan by the end of this year. So I would say for right now, your only requirement, activate your account on our website, make sure your information's up to date, and then we'll be implementing the new requirements in 2023. Yes? I have a question. If you're a different specialty to the ABPM, are you going to have to do per specialty or is there going to be overlap? So there's going to be overlap. The ABPM is going to allow reciprocity both within the ABPM and outside of the ABPM. So if you are dual-boarded with the ABPM, your requirement will be 20 CME, six of which are specialty-specific. If you are certified with the American Board of Family Medicine, for example, you can still use the credits you're accumulating through or for their maintenance certification program because, again, the requirement is 20 AMA, PRA, Category 1 credits, so those can count. But then you would need six that are relevant to your ABPM certification. Yes? Also, is there going to be an IMP that's going to be needed? So the IMP, again, when we look at this, this requirement's going to be launched in 2025, so I think we still have a lot of time to determine what that requirement's going to look like. But, again, we're going to offer some sort of reciprocity. That's one thing ABMS is encouraging all member boards to do. So we are definitely going to be offering reciprocity. What that's going to look like has yet to be determined. In the past, the requirement was two IMP activities every 10 years. One had to be through an ABPM partner specialty society, and the other one could be through reciprocity with another ABMS member board. So we're going to be looking closely at that and making sure we're providing flexibility for our diplomates. Mm-hmm? Yes? I have two boards in the ABPM. Can I use one part board for two? Yes. So if you complete one improvement medical practice activity, it's going to apply to both of your board certifications with the ABPM. And same with CME. If you complete 20 CME for your Occ Med certification, it's going to be applied to your public health certification as well. So you wouldn't need to complete 40 hours instead of 20. You don't need to complete two activities. You would just complete one. Yes? How about the fee if you get two or three boards in preventive medicine? Do you pay two or three fees, or is one covered? So there is a fee per certificate. The first certificate fee is $175. If you have a second certificate, the fee for your second is $150. If you have a third certificate, I believe the third fee goes down to $100. So there is a discount for each additional certification that you hold, but there is a per certificate fee. Yes? If we wish to complete the Part 4 activity by the end of the year, do we need to build in the two months for the review? No. It's preferred, but we understand if things don't work out that way. From the ABPM's perspective, we will use your submission date. So if you submit by December 31st, and we understand that that is a holiday season, that that is going to take up to two months to review the activities, we will use your submission date. So if there is additional people submitting activities, they have a backlog of activities to review, we're going to provide, again, flexibility and make sure that we're providing credit for activities that are completed. Any other questions? It might be helpful to give the group a handle on how much time should be spent on the activity, the Part 4, because, as you know, we've had people who have put in what seems like exorbitant hours, great projects, but it looks like they were doing it almost full time, and others who have really just been a little too quick to suddenly have a result. So without pinning down, can we give a general guide? Boy, being set up by my vice chair. That's a great question, because you're right. We do have people who spend way too much time on it, which is one of the things why the ABMS core competency question is about the project, because some people would go way above and beyond. This really is not that time-consuming. It's ten patient charts that a person reviews. And, again, you look at that template, and it's going to be very obvious. If you have everything is 100 percent, that's almost rare. It occasionally happens. But you can still just pick something else to improve upon. So I don't know if I can give an actual time that you should spend on this, because I don't want ABMS to say, oh, you should have more time than that. I mean ABPM. But it isn't really that onerous, and it doesn't really take that much time. I'm not sure, Carl, if you were going to give some kind of recommendation or thoughts on that. I mean, a chart review might, depending on what it is, might take you 15, 20 minutes to walk through the key items on a chart, and so you've got ten of them. You do your plan study act, whatever method you choose. I mean, I'm guessing ten hours over whatever period might be something to keep in mind as, hey, if I'm going much more than that, maybe I'm doing too much. Maybe I'm really getting into the weeds beyond what's possible. Now, if you want to do that, that's fine. I mean, I heard somebody say they do IME. I think we had one submission where every word in that IME was checked by this individual manually, and they would, or she went back and, you know, made a change and did it again. You know, those IMEs are 20 pages sometimes, whatever they are. So some realistic number. If you're starting to find, oh, it's day after day after day that I'm doing this, you've probably gone a little overboard. That's just my thoughts on reviewing these over the years. Thank you, Carl, for that. Yes? If we take it past the board exam, let's say January 23rd, or 2022, and you guys implement the annual fee for the participation in the program, would people who pass their boards, would they have to pay that annual fee then if they hold the current board? Yes. So all diplomates holding time-limited certificates will be enrolled in the annual fee structure beginning in 2023. Even the diplomates who have a certificate that expires January 31st of 2023 and are completing their recertification requirements, their new certification cycle will start January 1st of 2023 and will continue for 10 years, but they will be enrolled in the annual fee structure as well. So the one thing that I want to leave you with is, you know, I think that you can kind of get that Kevin really cares and really wants to help. And I think, you know, when I look back to when I was a younger physician, I was scared to death of people like the ACGME RRC when I was a program director, or ABPM as a diplomate. These are not scary people. These are people who are really here to help. They will answer your questions. That's why Kevin is here today to help with this presentation, is to make sure that you do have the information that you need. So please feel free to reach out with any of your questions and never be scared of them because they're just trying to help as well. You are their diplomates, and they want you to be successful. So just keep that in mind as you move forward. I don't see any more hands up, so I think we will call that a day. Thank you so much for your attention, and I hope this was helpful. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you. Thank you.

Denise Kessler

ACOM

MOC Part IV committee

Kevin Patrick

ABPM

continuing certification program

waiving MOC Part 2

waiving MOC Part 4

qualified diplomates

transitional period