Posts by Burke Kealey

New ABIM MOC Two-Year Plan for Internal Medicine Threatens the Focused Practice in Hospital Medicine

After two years of study and conversation with the Internal Medicine community, the American Board of Internal Medicine announced just before the holidays that it has landed on a “next step” for maintenance of certification. In a video message to the members, CEO Dr Richard Baron says, “Medicine today is transforming at a rapid and dynamic pace, and ABIM is transforming with it.” If you recall back in October, I wrote about the ABIM surveying the membership around the different options of an “every two year test plan”, “an every five year plan”, and keeping the current ten-year plan. The ABIM has announced that the two-year plan will be offered as a choice in 2018 for Internal Medicine, or diplomates can opt to stay with the current ten year plan. What we know now is based on a December announcement that can now be found on the ABIM website. The…

The ABIM Has New Plans for MOC and Wants Your Opinion. Give It to ‘Em!

  We have more details on what the ABIM is considering regarding changes to the Maintenance of Certification (MOC) process since they last announced some very high-level ideas in the spring. The ABIM is now requesting feedback through a member survey on some proposed options to update its controversial MOC process. Specifically, they are outlining two main alternatives to the current 10-year high-stakes, high-prep, high-anxiety MOC exam: a 5-year pathway and a 2-year pathway. The chart below from the ABIM blog hits the key points. The email to the membership with the survey link attached goes into more depth about what each proposal could entail but also adds some things not shown in the table, the most key of which is that both of these options would be “low stakes”. Specifically, they call out the fact that “if you don’t do well on one assessment, you will not lose your certification”. This, if…

The Next Step In Transparency With Our Patients

HPI: The patient is a 54yo very obese depressed man with history of drug abuse, non-compliance with meds, and possibly undiagnosed OSA readmitted today for pain control after claiming to have “run out” of his opiates after discharge from the hospital AMA 2 days ago following knee surgery. Have you ever written like this in your patient notes? Since the Health Insurance Portability and Accountability Act (HIPPA) was passed in 1996 - and even long before that - patients have had the ability to request to see and read their medical records. In the era of defensive medicine, we have been asked to imagine the plaintiff’s lawyer sitting on our shoulder and reading whatever we write in the medical record. It hasn’t been stressed nearly as much to imagine our patients sitting on that other shoulder, and with good reason. In actuality, it was a pretty rare event for patients…

The AMA Weighs in on MOC and High-Stakes Exams

The assault on Maintenance of Certification (MOC) and the use of high-stakes exams continues. The AMA House of Delegates met this month in Chicago and came up with a set of resolutions addressing the use of high-stakes exams: "RESOLVED, That our American Medical Association call for the immediate end of any mandatory, secured recertifying examination by the American Board of Medical Specialties (ABMS) or other certifying organizations as part of the recertification process for all those specialties that still require a secure, high-stakes recertification examination. "RESOLVED, That our AMA continue to work with the American Board of Medical Specialties (ABMS) to encourage the development by and the sharing between specialty boards of alternative ways to assess medical knowledge other than by a secure exam." "RESOLVED, That our AMA continue to support the requirement of Continuing Medical Education (CME) and ongoing, quality assessments of physicians, where such CME is proven to…

The ABIM Announces a New Plan and This Time It May Actually Mean Something

This morning the American Board of Internal Medicine (ABIM) published on its website a press release about new testing options for MOC.  The statement is short on details, but promises substantial change. The plan, arising from the recommendations in last year’s Assessment 2020 Task Force report and created after gathering input from stakeholders and physicians, describes an alternative to the traditional 10-year secure exam. Candidates may either choose the traditional 10-year exam or this new plan. As someone who just last fall suffered through hundreds of study hours and the indignities of the testing center security measures in completing and passing my 10-year exam in Focused Practice in Hospital Medicine Exam, my curiosity is piqued. The three facets of the new plan from the press release: 1. “Take the form of shorter assessments that doctors can choose to take on their personal or office computer—with appropriate identity verification and security—more…