Anywho, I am Heather O'Hara, I'm a physician in Occupational Environmental Medicine, completed my residency at Meharry Medical College, I won't say the year, and I'm excited to be here as the chair elect of the American Board of Preventive Medicine, and that's just my disclosure. Objectives, you all can read through this, nothing really to disclose there, we're just going to talk about some updates and things that you all need to know. So overview, for those that maybe didn't go through residency or whatnot, ABPM specialties and subspecialties are under the ACGME in the way that our residents come through ACGME accredited programs. If you're a practice pathway person, or not practice pathway, but if you've been practicing and trying to get in that way, you know, there may be other complementary ways to get in as well. ABPM is continuing to grow, but we still have our three core specialties in OEM, general public health, public health and general preventive medicine, and then aerospace medicine. But we've also grown under our subspecialties to include healthcare administration, leadership and management, and then if you haven't been paying attention in the last few years, maybe since 2014, clinical informatics and addiction medicine as well. Folks that you may recognize, some names up here that you may recognize, specifically in the OEM realm, we have John Mayer, Jeff Levine, and Beth Baker, who also sit on the board, but then other folks being representative of all the specialties and subspecialties within the ABPM. This is the small but mighty group that keeps things going in the board. This is the ABPM staff, Chris Andrula, there, in the back. Just to point him out, he is here and helping me to make sure I say all the right things. But this is a wonderful group of folks to work with, they get work done, they really are active, and we're a very active group with them as far as the board is concerned. So the network. We are one of 24 member boards under the ABMS, so the American Board of Medical Specialties. We collaborate with other member boards to create policies and make operational standards, but we are also required to follow what ABMS puts down, i.e., the continuing certification program, which for some, you may remember the maintenance of certification that has now gone away, and now we're in this continuing certification program that is a new way to kind of capture and make sure that we're all meeting the requirements that are needed, but we'll talk about that in a moment. And I am going fast because I recognize you all have flights to catch. But just raise your hand if you have a question, or if I'm going too fast. Also with the American Board of Preventive Medicine, they have folks that are recommended to the ACGME Review Committee. So there are folks from the board that actually sit on the review committee. I actually am honored to have that voluntold position. So I... Thank you. But we do participate in the review committee at the ACGME level to make sure that the competencies that are needed and are being met by all the residency programs that are out there. Let's see. And Chris Andula is the ABPM CEO, also is an ex-officio member of that group as well. So getting into some more information here. We started 2014 because prior to this, I think our certification numbers per year were around 200, 300, Chris, I believe. And so in 2014, because of the first cohort of the clinical informatics diplomats, we grew to 656 in that year. And then you see another huge peak in 2018 where the addiction medicine group came into play. And now we're starting to see this little decrease, if you will, because the practice pathways of both of those subspecialties is closing. And so you're starting to see a decrease in the number of applicants or certifications that are being given. Sorry. And then you're talking about certificate data. So you have our time-limited and non-time-limited group. So maybe some of us in here still fit the non-time-limited group, but that group is going slowly away. And then for OEM, the majority are time-limited, and we have the largest group among the specialties for certificates that are being held by OEM folks or by the preventive medicine folks. And so this is just another representation of the specialties and how they kind of pan out across public health, GPM, aerospace medicine, and OEM. And so you can see we're at 47% to be followed by public health and then aerospace. And then the subspecialties. Addiction medicine, just wow. It just blew up, and it does hold the greatest number of certificates for all of the subspecialties as well at 63%. And then if you look at all three or all groups of specialties and subspecialties, addiction medicine also carries the majority of those certificates with not so close follow by OEM. Diplomat age by specialty and subspecialty. I think Kenji kind of pointed to this when he did his measures this morning in his talk. But you can see that we have a fairly seasoned group of folks in the OEM specialty. So looking at that, the average age is 62.6 across our diplomats. And then those that are over the age of 60 is at 61%. So we have a great group of really seasoned professionals in our specialty. Where are we? So for all three specialties, this includes public health, GPM, aerospace medicine in the black and OEM in the blue, OEM is everywhere. The scale is maybe a little misleading in the fact that the smallest area could be anywhere from 1 to 50. So note that that could just be one person in that state. But it's state level, not city level. So don't look at the area and say, well, I'm here in St. Louis, and you don't have a dot in St. Louis, because that's not what it's representing. It's just at the state level. But we are everywhere. So that is good to know. And then the subspecialties as well are represented fairly well across the U.S. ABPM exam cycle, so OEM exam registrations and pass rates, we're at a 95% pass rate on the OEM exam, which is really good for this past 2023 test taking year. And as you can see, that's a little higher than some of the previous years. But I think in 2016, we had the highest, according to this information here. But it just shows that the folks that are training us are doing a good job of training those folks taking the test. So keep up the good work, program directors, if you're in here. I know some of them already got this information, so they may not be. Eligibility, medical license, current, unrestricted. Has to be in every state that you own a license in. None of them can have any restrictions on them or can't be revoked or suspended or anything like that. So just note that. So if you have anything like that, there may be an issue with the eligibility of your ability to take the test or be certified as a diplomat. Medical degree and then training and or practice, so residency, clinical training and graduate coursework can all be a part of those requirements. For the residency pathway, if we have any folks in here, two years of an ACGME accredited occupational environmental medicine residency. That can also include the Royal College of Physicians and Surgeons of Canada, which is consistent with what ACGME has done also to allow those. One year of PGY1 year, essentially, so postgraduate clinical training must be direct patient care. So we've had issues, not issues, but concerns around or thoughts around pathology possibly being able to fit in this, and that doesn't always work for the most part. But we do allow our program directors to kind of let us know what they believe could count. Master of public health degree and note coursework and not courses. So coursework in the five core areas, since we've changed their structure, we're kind of using that same language to be able to say that you have to have covered this coursework, but not actual courses. And if you are out of residency for 24 months or more, then you would also have to have at least one year of OEM practice. So within the past three years. So that would also be a requirement. So really honing in on the need to, if you have trained in residency, go ahead and take that test within that year, first year or two years of finishing residency, so you don't have to worry about this piece here. There are complementary and special pathway areas as well. So the complementary pathway is really there to accommodate our mid-career professionals. So this is another mechanism for getting eligible for the board test for the initial certification. And so you have to have one year of an ACGME accredited OEM residency training. That has to also include that eight months, which is, again, a requirement under ACGME. So I think the board is doing a good job of trying to make sure that we're having similar language in what the requirements are for the board versus what the requirements are for training, the MPH degree, and then in this situation, two years of OEM practice within the previous five years. The special pathway is where you already have an ABPM certification and you'd like to get OEM certified as well. And that allows you to do two years of OEM practice within the previous five years also. And then three letters of recommendation with two being from ABPM diplomats who are certified in OEM. So not just aerospace or PHCPM, but in OEM for the certificate that you're going into. For more information, application information or help, these are some QR codes that you can use to get that information for yourselves. This one, the first one is for the pathways, and the next one is the Am I Eligible tool, which has become very useful, and I'll wait for folks to take pictures or get on or whatnot before I move on to the next slide. All right. And then submitting your application. So the access is through the ABPM website listed there, and you can go into the Become Certified section and click Apply Now. The information that's on there is going to be just general information about things that you might need to get together in order to be able to submit your application. But ultimately, you're going to look at each pathway that you, the pathway that you meet the correct criteria for and find those things that you need to be able to submit in order to submit your application. The certification exam. So recognizing that there are folks that, it's not just a test that's made up of questions by the ABPM Board of Directors or by the ABPM staff. It's actually our peers in OEM that sit on this writing committee to be able to get the questions together, you know, and understand, vet them, understand what the, how they're performing when the test is being given. And so it's not a, it's a good amount of work. It's not a lot of work. But if you're ever interested, please don't hesitate to reach out so that, you know, we can consider you for any available slots that may come. And then the exam content, specifically, we're trying not to do any recall, but more so applying that knowledge that you have. Focuses on high frequency, high impact patient problems, and emphasizing clinical situations. So this is maybe a little bit different even than when some people took the board exam, you know, from before for the initial certification. They've really gotten into the ability to structure the questions so that they are absolutely testing the ability for someone to think as opposed to just recall information. In the exam content area, this is actually from the new blueprint. So this is what will be tested on in this year's initial exam. And this is the structure that it will use to include in clinical occupational medicine remains at the priority of all of that. But you may see some additional areas that weren't there before, or are being called out a little bit more. Exam questions are multiple choice. Usually A through D, but sometimes it may go A through E. Single best answer, and you are provided a calculator, drug name list, and normal range values. Not on the question, true, false. Those K-type where you have to say A and B, A or B and C, A or B, yeah, okay, no, those aren't there. Trick questions. They stopped doing trick questions. Actually, I don't know if they ever did. I'm sure they would say no, but we don't do trick questions. And then we don't do experimental questions. So every test on the, every question on the test is an actual question, okay? October to early November is the whole timeline of the exam. November and December are when the exams will be scored. December through January is where we go through the exam statistics, if you will, and determine which ones may be low performing, maybe need to be rekeyed, something like that. I mean, because mistakes happen, right? We're human. And then January, usually the board, well, not usually, the board reviews the results, and hopefully those exam scores will be sent out before the end of January, which I think we've been successful in doing for the last two to three years, right, Chris? Yes. So with the certificate, what it says is basically that you have met all the requirements for certification. Then the following January, so you took the board in, well, we'll just use this year, you took the board in October of 2024, your certificate will start January of 2025. And with that being said, as long as you stay compliant with the continuing certification program requirements, then it will, you'll be in good standing the whole time, and we'll get into some more details about the CCP. All ABPM diplomats with time-limited certificates are subject to the annual fee, and that is part of maintaining that compliance. So for dates, anybody wanting to take the board this year, note that you are coming up on the closing of the application window June 30th. So it's currently open. You can go ahead and get online if you're planning on taking it this year for the initial certification and get yourself registered. With the ABPM, the late application window starts July 1, and I mean, there's a fee associated with that late application, so you really want to focus on getting it in before June 30th. July 15th, the late application window closes, and again, the exam administration is from October 14th this year through November 3rd. All right. So what probably a good portion of you all are in here for is to find out more about the continuing certification program that we're really excited about. And we're in phase one, so don't think like you have to catch up. We're still in phase one. We're still trying to roll this thing out. And with that being said, phase one will end this year though. So we started it last year, January, and it will end December 31st, 2024. The only requirements for phase one are to maintain a full, valid, and unrestricted license to practice medicine, pay the annual fee, and earn 20 AMA, PRA Category 1 credits with six of them being ABPM certificate-specific. And you can choose what that is for yourself for your specialty certificate, okay? But six of them need to be specialty-specific. And the reason why 20 was chosen, because that is the least CME requirements of states that require CME that was found. So the ABPM staff did a deep dive into, you know, what does that look like for folks in other states? So somebody maintaining their, and I don't know where that state is, but somebody maintaining their license in California, if it's 20 CME credits, then you're essentially meeting the CME requirements for maintaining your continuing certification. Currently, the Longitudinal Assessment Program is not required, and Improving Health and Health Care is not required. Now, January 1, 2025, we'll start phase two. So phase two starts in January 1, 2025, goes through December 31st, 2029. So we have a pretty long period there where we're going to be in phase two, and we'll be starting then with all the other requirements, now adding on the Longitudinal Assessment Program, where you'll be required to answer 30 questions for four out of the five years. That was chosen, and I think we were really thoughtful around these requirements, in that if there are life circumstances that prohibit you from taking the exam one year, or doing those questions one year, or, you know, something happens, you still have that fifth year to then meet the requirement, right? So four out of the five years. Again, we're following the guidance of what ABMS brings down, and then trying to interpret it and make it a usable, user-friendly, nice program for all of the diplomats. Just to clarify, that's for people who, so, if you've got your initial certifications 2025 or 2026, right? No, this is for everybody. This is, so if I'm due to renew in 2025, I've got to follow those. So if I have to renew in 2025, do I fall under this category, where I had to have done self-minimal investments four-yearly? So, and Chris, you can definitely stop me if I'm misspeaking. I believe everybody got an email to say that the certificates for those folks that were needing to renew by 2023 or 4, or 2029, sorry, thank you. So by 2029, if you were needing to renew by 2029, then you are automatically enrolled into this, and this will be your new date of renewal, if you will, right? So if your renewal is 2025, your new renewal is 2029, and Chris is going to clarify, because I might be misspeaking. It should. Okay, beginning in January of 2025, no matter when your certificate, whether it begins in 2025 or it has begun and you're in the middle of a term, you are required to meet these on an annual basis. So going forward, and they will be in five-year increments. So the first increment is phase two, which is 2025 through 2029. So each year, you will go to your physician portal. You will click a box and attest to the unrestricted medical license. You'll click a box saying, I met my 20 hours of CME. And you would then take the longitudinal assessment. And instructions will come out before January of 25 in terms of how to log in, set up an account, and take the longitudinal assessment. It is 30 questions. It's open book. And it's untimed. And really, the only thing you can't do is consult a colleague. We, as a board, have also concluded that it is OK and appropriate to use any AI for research relative to it, trying to be as flexible as we can be in terms of that. So you'll find out more information. But again, regardless of when your certification is, where you are in your term, phase two will begin January 1 of next year. Yes? So it may be simpler to say all diplomats as of January 25 start this process? All time limited. Yeah. Diplomates, yes. All that are required. Now, the reality is, if you already have a certificate, you're in phase one, which is hopefully you already have a physician portal set up. You have clicked the boxes on the attestation on the CME requirements and the licensure. And then, of course, pay the annual fee. And that's all you need to do for last year and this year. And then we're just adding that secondary layer on beginning in 2025. And what's open book, which means it's open book? Open book meaning you can search reference materials. There's no limitation. You'll be delivered a question. And you can answer one question at a time, 30 at one time, five at one time. It's on your schedule. And when you receive the question, you can either answer it if you know it. You can research it. So the reference material is being open book. It's not a closed book, high stakes exam. It is, we want to know that you have the answer. And we want it to be an environment where, like your practice, we don't expect you to know everything right off the cuff. But if you know where to get the material and the answers, and that's why we're trying to be flexible in terms of being able to use reference materials. Can I re-engage these questions? I'll show a slide where it's the LAP exam writing committee. So it's coming from peers. I'll show it in a second. The process for writing the exams is very similar from the initial certification exam to the longitudinal assessment. The one thing I will tell you that from a decision perspective, there are different questions. One of the things we learned during our pilot with our clinical informaticist is that the longitudinal assessment is more walking around knowledge. Because one of the feedback we received was it's really hard to study for this assessment every year. Well, you shouldn't have to study not only because they're untimed and they're open book, but it's also walking around knowledge. So it's knowledge that a specialist, in this case an occupational environmental medicine, should have. So while they're not, I wouldn't call them, I don't want to say they're not difficult, but they're walking around knowledge, which is a different type of question that is answered on the initial certification exam. Yes, ma'am. What about who were not in 2029? Is the process the same? The process repeats itself. So in fact, what happens is somebody who becomes certified in 26, that will be their year one of the five year increment. So we'll just keep going on. You'll see as we get to phase three. This is just a repetitive process that happens every five years. And hopefully, by giving that fifth year, the design is you get the first four years, you are rewarded with a fifth year where you essentially can take off. Because if you've already met the four years, you kind of get that as a reward for your good effort. There was another question. Yes, sir. Yeah, so for those of us that have credentialing people that need to know, so right now my certificate expired January 25. So what does the board then send out as prevention? Yes, in fact, no matter when your certificate does expire, you can go to our website and click on the date of your expiration. And you can find out what we're doing for anybody in your situation, or really any certificate before December 31st of 29. You're going to automatically get an extension through December 31st of 2029, the end of phase two. So long as you continue to be compliant with that, it's just extended. Yes, ma'am. If you certify in more than one specialty, do you need to take this early to increase time? Great question. You do not have to replicate. The question was, if you're certified in more than one ABPM specialty, do you need to replicate this? The only thing that you need to do differently is you need to take every longitudinal assessment for every certificate you have. All you need is, no matter how many certificates you have with us, 20 hours of CME. That's all that's required. So it's just the longitudinal assessment. You'll have to take each one for each ABPM certificate you have. Another great question. One of the challenges with longitudinal assessment is the idea that it is not a closed book, highly secure exam. I think ABMS boards across the spectrum are struggling with that idea. Here is the rule of thumb. One, we're going to be going through a psychometric analysis very similar, although not identical, to what we do for our initial certification exam. A rule of thumb that we're using right now is if you score 60% or better, you're going to achieve a passing score. Below 40%, correct, it's unlikely that you will pass. The gray area is between 40% and 60%. That will be the challenge every year because we know there are certain years where we'll do better on the questions, and certain years we may have to actually exclude questions that don't perform very well. So for instance, somebody that January 1st, eager beaver, finishes all 30 questions. If you get 60% of those questions right, you can be very, very secure in the belief that you passed that eight years exam. However, the official results will not come out until the end of the year when all of the diplomates have been given an opportunity to answer all 30 questions. I know that might be a little bit of a frustration, but that will be the rule of thumb, that 60% plus, you're good to go. You'll know your raw score. You won't know the minimum passing score. And I know that there's a little nuance difference there, but my point is, if you're getting 60% of the questions correct, the raw score, you will know that you will achieve the minimum passing score. But you won't know the official minimum passing score until the end of each calendar year. Yes. I've just commandeered this, so. You know, this is what your staff were talking about. OK. I'm happy to. Was there another question, ma'am? How many attempts per calendar year each year? One attempt to answer each question. So the really cool thing about this process is that regardless of whether you get the question right or wrong, you will get not only a reference, but you will also get a critique. So there will be an explanation of why the answer that was correct was the single best answer. And there will also be, in a future incarnation, we will actually have CME that will be linked in the corner so that if it's something that, whether you got the question right or not, if you want to brush up on that particular subject area, we will have CME that you could click right to, to get part of your 20 hours of credit, or more particularly, to help educate you in terms of something you wanted to brush up on. There was a question here, and then we'll go back there. Can we stop and resume it later? Yes. The only thing you can't do is once you've opened a question, you have to answer that question. But you can answer one question one month, two questions the next month. There's no, you do not have to sit down and complete all 30 questions in one sitting. Yes, sir. For those who don't participate, I guess, they have a certificate in that time frame. Do they just expire at that time frame? If, I'm, we do not have a high stakes exam anymore from a continuing certification perspective. So the only exam that is given now is the initial certification exam. And then you roll right into the continuing certification program, which includes longitudinal assessment. Yes, when you, this is a simplistic view, but somebody that takes the exam this year, 1-1-25 will go to December 31st of 34. Now, that all assumes that there's a maintenance of compliance with continuing certification. If not, sooner or later you're going to notice from us that you're not in compliance. You're given a period of time to become in compliance. And then if you don't, there's other negative action that can be taken. But so long as you're in compliance, we are issuing certificates for 10 years still. In the back. What? Are these questions similar to the high stakes exam that you're doing for initial certification? Or are they going to be more complex, more of a problem for students? They're similar in terms of presentation. They will have a STEM and four answers, single best answer. For longitudinal assessment, they are more walking around knowledge. I don't want to equate that to less complex, because I think there's very complex questions that can be created that have concepts that I would consider to be walking around knowledge for our occupational environmental medicine specialists. Each year, the intention is to outline the areas of the blueprint that will be covered by that year's questions. So trying to facilitate to the extent people would like to brush up on any particular subject matter areas, they'll have that at the beginning of the year. And then, again, with the format, which open book, untimed exam, we hope that that's providing enough flexibility to either have the answer at the top of your head or know where to get that answer. Yes, ma'am. Oh, I'm sorry. Go ahead. I'm sorry, Heather. She's just had her head up for a while, so. Say you take your exam in January 2025, and you get 35% and you're thinking, probably going to make the cut. Is there a remediation process? Is there an opportunity? And what's the process? Great question. The next five years is an expanded pilot. So at the end of this five-year period, there may be, and we don't know this yet, but there may be some remediation, which would be the discussions now are around additional CME requirements and the areas that you're scoring the least well in. But at the end of this five-year period, there is no discussion about any revocation of certificates. That's not, because we know that we're going to have learnings through this next five years. And in fact, questions that may work well for public health general preventive medicine may not be the type of questions that you want to use for occupational environmental medicine. So over this period of time, we're going to be able to tweak the program, and it would be unfair to penalize our diplomates while we're figuring out the right types of questions to ask. So there may be some type of nominal remediation, but it will be limited to continuing CME requirements. There was a question back there. So is there an email that we can send our individual questions about when we took the exam, certified, or where we fall? And I'm only asking because back in July of 2023, I sent two emails to abpm at abpm.org, and I never heard back. And it sounds like a lot of folks in this room have very similar questions. And I just want to give it a form of branding, to say, hey, abpm, this is my situation. I paid for the exam in July 2022. I took the exam January 23. Where do I stand? Yep. Do I owe you money? Do you owe me money? Like, what's happening? So who can I email? I can answer the question if we owe you money. No. Yes, 100%. There was, at the beginning of this presentation, the email. I believe it had the email addresses for staff. And I'll get out of the way so everybody can take pictures. I welcome any emails directly to my email. I hope it's up here. Let's see. Do you have a phone number that somebody wanted to get in touch with? Who's the person from which phone number? Believe it or not, we do not have a phone number. We actually want people to send emails. And I'm sorry to know that you didn't receive a response, because our system is built to send questions to specific people inside our office. Whether it be continuing certification, it goes to a specific individual. Initial certification, it goes to a different individual. So let me get out of the way. But I welcome you to send it directly to me. I'm happy to answer those or get you to the right person. It seems you guys took the feedback from the diplomats that the mock exam was something we needed. You guys took that and ran with it. And it sounded like it was a fantastic job. Wow. Thank you. Thank you. Yeah, I appreciate that. We did a lot. Believe it or not, and I'm sure that for those of you who have been diplomats for a while, we sent out surveys. I'm hoping that you participated and responded. We did take that to heart. We listened. And we think we have one of the, if not the best, most flexible program of any of the boards. And I will tell you, from an annual fee perspective, we are the lowest of any of the boards. And we are lowest by 50%. So we're not even close to the next most expensive program. Yes, ma'am. So those of us that are granted to work with, but some states, if you apply for a license, require that you do seven exams less in a year. So I ran into that. So my question is, how do we show that we've got what it takes? What I would encourage you to do is to participate in the continuing certification program we have. But it doesn't affect your capacity to go on. It doesn't affect your own. The easy answer is, I don't know another way other than to participate in the continuing certification program. And by the way, we encourage our non-time limited diplomates to participate because we really think that we got this one right. This is going to be flexible. It's going to be relevant information. We're hearing very similar things in terms of people appreciating the system now and the flexibility. So we don't get CMEs, but they'll be a link that we can give you all the links. I would encourage you to send, in this particular instance, I would encourage you to send the email to Marzina Marciniak. So for those of you who took pictures, the person who is the CCP contact at ABPM is Marzina Marciniak. And she was one of the people up there. Yes, sir. So at the end of the year, as far as we know in the past, will there be a link to the CME of any of these questions? Will you go back to repertory? When we do it, yes. Yes, 100%. Because the questions, unlike initial certification questions, for lack of a better term, you burn the questions once you use them because they're not secure. So they're not subject to repetition. Now, we will have, in future incarnations, and this is where I'm talking about tweaking the program, we will have spaced repetition, clones. So it won't be the exact same question. The fact pattern may be different. And that's so that we can establish learning. So if somebody got it wrong the first time, they may get a cloned question to make sure that there's learning going on in the process. But those are future incarnations. I also have a question. Allison. Yes, ma'am. The only thing I would just point out is that to just be really careful with these things we're saying, so if you're doing credentialing or credentialing or you're applying for state licenses and you have to do that every single year, they really, truly ask very binary questions. Have you taken an exam? Have you ever had a past problem on an exam or anything like this? And so you kind of put an injectory. You shouldn't be putting people in injections because they really, this is very modern for those old time archaic structures, right? Fair. Fair. Agreed. And I think you're highlighting one of the big things. This assessment, and it is truly, I think, more of an assessment than an exam. But it is not over until the five years are over. So I don't want somebody to be answering a question, you didn't get the minimum passing score in year two. That's not a failed exam because the assessment is the entirety of the five years. And once you meet the four out of five years, so if you're in year two and you may have not, let's say you didn't meet a minimum passing score in year one, you haven't failed the assessment. It's still ongoing. So you could, in that instance, that person could check, no, I haven't had any problems with assessment or exams. We're not here, listen, this, I'm hoping, and I'm getting the sense that you're receiving this, this is not a gotcha moment. This is not intended to be a high stakes issue. This isn't intended to be, we can continue to certify in good faith that the people who are meeting our program have sufficient competencies to be called a specialty in this area. Now, it lacks any, you have to be able to address the people that don't meet the standard. And I think we have a very, we will ultimately, when the pilot's over, we'll have a very methodical way to do that. And still there will be re-entry. Because it's meaningless if you don't hold the people that aren't meeting the standard accountable. By the same token, this is not meant to be the gotcha moment. It is meant to facilitate progress, facilitate education. And I think we've hit it out of the park on this one. And you could thank the board of directors. I wish I could tell you it was me. I'm the administrator that gets all the benefits and all the clapping. It's Heather and the other board of directors at ADPM that have put in a tremendous amount of work and are facilitating this program that's been very well received. Thank you. I certainly think so. That's exactly right. Appreciate that. Yeah, thank you. And I'm sorry for commandeering your presentation. No, look. I appreciate the assistance, yes. So, anywho, getting through these slides a little bit more quickly, maybe. Come January 1, 2030 and 2039, now you're gonna ask questions about this. We haven't fully figured out what that improving health and healthcare is going to look at. Like, that's being completely open and honest. We're just trying to get through the stepwise manner. We are talking about it. We are trying to figure it out. But we don't know yet. More to come closer to January 1, 2030, okay? So, somebody asked about where do these questions come from? Here's your longitudinal assessment program subcommittee members. These are the folks that are writing the questions, okay? Again, if you have interest in writing questions, you should reach out to the board so that they can get your information and make sure that you can get in contact with the right person to get on these committees. But as you can see, it's a good representation of some really well-known folks in OEM that are serving on the board, on the exam writing committee for the LAP. Okay. And then the last slide is just questions, but I hope that Chris was able to answer all of your questions. But I'm happy to entertain any more if you have. Other than that, thank you so much for sticking around. And everyone have safe flights back to their respective homes. Yes.

Heather O'Hara

Occupational Environmental Medicine

American Board of Preventive Medicine

certification

continuing certification program

CME credits

longitudinal assessment

phase two