Skip to main content
AAHPM Logo
Login
  • Join/Renew
  • Blog
  • Contact
Menu Search Account
  • Membership
    • Join/Renew
      • Member Benefits
    • Diversity, Equity & Inclusion
      • DEI Resources
    • Member Center
    • Getting Involved
    • Communities
      • SIG Instructions
      • Join a SIG
      • Member Councils
    • Mentoring
    • FAAHPM
      • Current Fellows
  • Education & Practice
    • Writing Instructional Objectives
    • Meetings
      • Annual Assembly
        • Back to Meetings
        • Assembly Home
        • About the Assembly
          • Why Attend
        • Educational Sessions
          • Plenaries
        • CE and MOC
        • Exhibits & Advertising
        • Call for Case and Scholar Posters
        • Assembly FAQs
        • Call for Papers and Posters
          • Topics for Assembly
        • Business Meeting
      • Leadership Forum: Ascend
      • State of the Science
      • State of the Science
        • Back to Meetings
        • Home
      • Board Review Course
        • Back to Meetings
        • Home
        • Schedule
      • Calendar
      • Intensive Board Review Course 2018 Recordings
      • IBRC18 - Additional Management Strategies for Cancer Related Symptoms
      • IBRC18 - Approaches to Care, including Hospice/Medicare
      • IBRC18 - Assessment and Care of the Dying Patient
      • IBRC18 - Communication and Teamwork
      • IBRC18 - Depression/Anxiety & Other Mood Disorders
      • IBRC18 - Ethical and Legal Decision Making
      • IBRC18 - Grief and Bereavement and Spiritual Care
      • IBRC18 - High Yield Pediatrics for the Boards
      • IBRC18 - Non-Pain Symptom Management – GI
      • IBRC18 - Non-Pain Symptom Management – Respiratory
      • IBRC18 - Non-Pain Symptom Management: Pot-Pourri
      • IBRC18 - Pain Management Overview
      • IBRC18 - Palliative Sedation/Physician-Assisted Dying/Discontinuation of Technological Support
      • IBRC18 - Practice Test Question Review Q&A (1)
      • IBRC18 - Practice Test Question Review Q&A (2)
      • IBRC18 - Practice Test Question Review Q&A (3)
      • IBRC18 - Prognostication
      • IBRC18 - Special Topics in Pain Management
      • IBRC18 - Symptom Potpourri
      • IBRC18 - Taking the Test Like a Pro
      • IBRC18 - Urgent Medical Conditions
    • Publications
      • JPSM
        • Members JPSM
      • PC-FACS
        • Members - PC-FACS
      • Quarterly
        • Members Quarterly Full Access
          • Summer 14 President's Message
          • Summer 14 Academy News
          • Summer 14 Advocacy Updates
          • summer 14 Art of Caring
          • Summer 14 Clinical Pearls
          • Summer 14 Progress Report
          • summer 14 communities
          • summer 14 Assembly
          • Fall14 Academy News
          • Fall 14 Advocacy Update
          • Fall 14 Annual Assembly
          • Fall 14 Art of Caring
          • Fall 14 Clinical Pearls
          • Fall 14 Feature
          • Fall 14 HMDCB
          • Fall 14 President
          • Fall 14 Progress
          • Winter 14 Clinical Pearls
          • Winter 14 Leaders
          • Winter 14 AAHPM News
          • Winter 14 Advocacy Update
          • Winter 14 Art of Caring
          • Winter 14 Board of Directors
          • Winter 14 Feature
          • Winter 14 HMDCB Exam
          • Winter 14 Paper Sessions
          • Winter 14 President's Message
          • Winter 14 Progress Report
          • Spring 15 President's Message
          • Spring 15 Clinical Pearls
          • Spring 15 Advocacy Update
          • Spring 15 Art of Caring
          • Spring 15 Feature
          • Spring 15 HMDCB Certification
          • Spring 15 Communities Update
          • Spring 15 Shaping the Future
          • Spring 15 AAHPM News
          • Summer 15 AAHPM News
          • Summer 14 Feature
          • Summer 15 AAHPM Summer Institute
          • Summer 15 Advocacy Update
          • Summer 15 Annual Assembly
          • Summer 15 Art of Caring
          • Summer 15 Clinical Pearls
          • Summer 15 Communities Update
          • Summer 15 Feature
          • Summer 15 HMDCB Exam
          • Summer 15 Meet Joe Rotella
          • Summer 15 President's Message
          • Summer 15 Quarterly Progress Report
          • Fall 15 Feature
          • Fall 15 AAHPM News
          • Fall 15 Annual Assembly
          • Fall 15 President's Message
          • Fall 15 Advocacy Update
          • Fall 15 Clinical Pearls
          • Fall 15 Art of Caring
          • Fall 15 Quarterly Progress Report
          • Fall 15 HMDCB Certification
          • Winter 15 AAHPM News
          • Winter 15 Advocacy Update
          • Winter 15 Annual Assembly
          • Winter 15 Art of Caring
          • Winter 15 Clinical Pearls
          • Winter 15 Feature
          • Winter 15 HMDCB Certification
          • Winter 15 President's Message
          • Spring 2016 Feature
          • Spring 2016 President's Message
          • Spring 2016 Clinical Pearls
          • Spring 2016 Art of Caring
          • Spring 2016 Ethics
          • Spring 2016 Communities Update
          • Spring 2016 Quarterly Progress Report
          • Spring 2016 AAHPM News
          • Summer 16 AAHPM News
          • Summer 16 Advocacy Update
          • Summer 16 Art of Caring
          • Summer 16 Assembly Recap
          • Summer 16 Clinical Pearls
          • Summer 16 Communities Update
          • Summer 16 Death Cafe
          • Summer 16 Feature
          • Summer 16 HMDCB Update
          • Summer 16 President's Message
          • Summer 16 Quarterly Progress Report
        • Fall 16 AAHPM News
        • Fall 16 Advocacy Update
        • Fall 16 Art of Caring
        • Fall 16 Assembly Promo
        • Fall 16 Clinical Pearls
        • Fall 16 Ethics
        • Fall 16 Feature
        • Fall 16 HMDCB Update
        • Fall 16 President's Message
        • Fall 16 Quarterly Progress Report
        • Winter 16 Advocacy Update
        • Winter 16 AAHPM News
        • Winter 16 Art of Caring
        • Winter 16 Clinical Pearls
        • Winter 16 Ethics
        • Winter 16 Feature
        • Winter 16 HMDCB Update
        • Winter 16 President's Message
        • Winter 16 Quarterly Progress Report
        • Winter 16 Assembly Paper Sessions
        • Spring 17 AAHPM News
        • Spring 17 Art of Caring
        • Spring 17 Clinical Pearls
        • Spring 17 Feature
        • Spring 17 HMDCB Update
        • Spring 17 President's Message
        • Spring 17 Quarterly Progress Report
        • Spring 17 Stay Certified
        • Summer 17 AAHPM News
        • Summer 17 Advocacy Update
        • Summer 17 Art of Caring
        • Summer 17 Clinical Pearls
        • Summer 17 Ethics
        • Summer 17 Feature
        • Summer 17 HMDCB Update
        • Summer 17 Pathways to Palliative Care
        • Summer 17 President's Message
        • Summer 17 Quarterly Progress Report
        • Summer 17 Annual Assembly
        • Fall 17 President's Message
        • Fall 17 Advocacy Update
        • Fall 17 Clinical Pearls
        • Fall 17 Feature
        • Fall 17 Pathways to Palliative Care
        • Fall 17 Art of Caring
        • Fall 17 Quarterly Progress Report
        • Fall 17 Annual Assembly
        • Fall 17 AAHPM News
        • Winter 17 AAHPM News
        • Winter 17 Annual Assembly
        • Winter 17 Art of Caring
        • Winter 17 Clinical Pearls
        • Winter 17 Feature
        • Winter 17 HMDCB Update
        • Winter 17 All About Essentials
        • Winter 17 Pathways to Palliative Care
        • Winter 17 President's Message
        • Winter 17 Quarterly Progress Report
        • Spring 18 Clinical Pearls
        • Spring 18 Diversity & Inclusion
        • Spring 18 Feature
        • Spring 18 HMDCB Update
        • Spring 18 Pathways to Palliative Care
        • Spring 18 Presidents Message
        • Spring 18 Quarterly Progress Report
        • Spring 18 AAHPM News
        • Spring 18 Art of Caring
        • Summer 18 AAHPM News
        • Summer 18 Advocacy Update
        • Summer 18 Annual Assembly
        • Summer 18 Art of Caring
        • Summer 18 Clinical Pearls
        • Summer 18 Ethics
        • Summer 18 Feature
        • Summer 18 HMDCB Update
        • Summer 18 Pathways to Palliative Care
        • Summer 18 President's Message
        • Summer 18 Quarterly Progress Report
        • Fall 18 AAHPM News
        • Fall 18 Annual Assembly
        • Fall 18 Art of Caring
        • Fall 18 Clinical Pearls
        • Fall 18 Diversity & Inclusion
        • Fall 18 Feature
        • Fall 18 HMDCB Update
        • Fall 18 Pathways to Palliative Care
        • Fall 18 President's Message
        • Fall 18 Quarterly Progress Report
        • Winter 18 AAHPM News
        • Winter 18 Advocacy Update
        • Winter 18 Annual Assembly
        • Winter 18 Art of Caring
        • Winter 18 Clinical Pearls
        • Winter 18 Ethics
        • Winter 18 Feature
        • Winter 18 Pathways to Palliative Care
        • Winter 18 President's Message
        • Winter 18 Quarterly Progress Report
        • Winter 18 HMDCB Update
        • Spring 19 Editors Message
        • Spring 19 Meet the President
        • Spring 19 Clinical Pearls
        • Spring 19 Art of Caring
        • Spring 19 Advocacy Update
        • Spring 19 Feature
        • Spring 19 Pathways to Palliative Care
        • Spring 19 Diversity and Inclusion
        • Spring 19 Quarterly Progress Report
        • Spring 19 HMDCB Update
        • Spring 19 AAHPM News
        • Summer 19 Presidents Message
        • Summer 19 Clinical Pearls
        • Summer 19 Art of Caring
        • Summer 19 Annual Assembly
        • Summer 19 Advocacy Update
        • Summer 19 Feature
        • Summer 19 Pathways to Palliative Care
        • Summer 19 Ethics and the Hidden Curriculum
        • Summer 19 Research or Quality Improvement
        • Summer 19 Quarterly Progress Report
        • Summer 19 HMDCB Update
        • Summer 19 AAHPM News
        • Fall 19 Presidents Message
        • Fall 19 Clinical Pearls
        • Fall 19 Art of Caring
        • Fall 19 Annual Assembly
        • Fall 19 Advocacy Update
        • Fall 19 Feature
        • Fall 19 Pathways to Palliative Care
        • Fall 19 Diversity, Equity, & Inclusion
        • Fall 19 Quality Improvement
        • Fall 19 Quarterly Progress Report
        • Fall 19 HMDCB Update
        • Fall 19 AAHPM News
        • Fall 19 State of the Science
        • Winter 19 Presidents Message
        • Winter 19 Editor's Message
        • Winter 19 Clinical Pearls
        • Winter 19 Art of Caring
        • Winter 19 Annual Assembly
        • Winter 19 Advocacy Update
        • Winter 19 Feature
        • Winter 19 Pathways to Palliative Care
        • Winter 19 Quarterly Progress Report
        • Winter 19 State of the Science
        • Winter 19 HMDCB Update
        • Winter 19 AAHPM News
        • Spring 20 Presidents Message
        • Spring 20 Meet the President
        • Spring 20 Clinical Pearls
        • Spring 20 Diversity, Equity, & Inclusion
        • Spring 20 Art of Caring
        • Spring 20 Advocacy Update
        • Spring 20 Feature
        • Spring 20 Pathways to Palliative Care
        • Spring 20 Quarterly Progress Report
        • Spring 20 HMDCB Update
        • Spring 20 AAHPM News
        • Summer 20 Presidents Message
        • Summer 20 Meet New AAHPM CEO
        • Summer 20 Annual Assembly
        • Summer 20 State of the Science
        • Summer 20 Clinical Pearls
        • Summer 20 Art of Caring
        • Summer 20 Advocacy Update
        • Summer 20 Feature
        • Summer 20 Pathways to Palliative Care
        • Summer 20 Quarterly Progress Report
        • Summer 20 AAHPM News
        • Summer 20 HMDCB Update
        • Summer 20 PCQC Update
        • Fall 20 Presidents Message
        • Fall 20 Art of Caring
        • Fall 20 Annual Assembly
        • Fall 20 Clinical Pearls
        • Fall 20 Lets Think About it Again
        • Fall 20 Advocacy Update
        • Fall 20 Feature
        • Fall 20 Pathways to Palliative Care
        • Fall 20 Diversity, Equity, & Inclusion
        • Fall 20 Quarterly Progress Report
        • Fall 20 HMDCB Update
        • Fall 20 PCQC Update
        • Winter 20 Presidents Message
        • Winter 20 Annual Assembly
        • Winter 20 Clinical Pearls
        • Winter 20 Lets Think About it Again
        • Winter 20 Art of Caring
        • Winter 20 Advocacy Update
        • Winter 20 Feature
        • Winter 20 Pathways to Palliative Care
        • Winter 20 Diversity, Equity, & Inclusion
        • Winter 20 Quarterly Progress Report
        • Winter 20 HMDCB Update
        • Winter 20 PCQC Update
        • Winter 20 AAHPM News
        • Spring 21 A Message from the CEO
        • Spring 21 Meet the President
        • Spring 21 Clinical Pearls
        • Spring 21 Art of Caring
        • Spring 21 Interview with AAFP President
        • Spring 21 Advocacy Update
        • Spring 21 Feature
        • Spring 21 Pathways to Palliative Care
        • Spring 21 Lets Think About it Again
        • Spring 21 Diversity, Equity, & Inclusion
        • Spring 21 Quarterly Progress Report
        • Spring 21 HMDCB Update
        • Spring 21 PCQC Update
        • Spring 21 AAHPM News
      • SmartBriefs
    • Self-Study
      • Board Prep Materials
      • Essentials
      • Primer
      • HPM PASS
      • HPM FAST
        • HPM FAST CME
      • Hospice Products
        • HMD Manual
        • HMD PREP
          • HMD PREP CME
      • Opioid REMS
      • Recordings
      • hpmpasscme
      • HPMQ
      • Opioid Resources
    • Fellowships
      • Competencies
        • Pediatric Competencies
      • Accreditation
      • NRMP Match
      • Grants
        • Ho/Chiang Foundation
      • Hospice Program Toolkit
      • CBME Recordings
    • CME
    • Quality
      • Measuring What Matters
      • Quality Reporting
      • Quality Resources
      • Quality Registries
      • Quality Improvement Education
    • Research
      • Research Funding
      • Successful Research Grants
    • COVID-19 Resources
    • COVID hotel
  • Advocacy
    • Stay Informed
    • Take Action
    • Key Issues
      • Opioids
      • Workforce
  • Career Development
    • Jobs
      • Virtual Career Fair
    • Clinical Training
      • Additional Training
    • Leadership Development
      • AAHPM Ascend
        • Leadership Forum Faculty and Facilitators
        • Ascend Schedule
        • Ascend Facilitators
      • AAHPM Elevate
    • Certification
      • Allopathic
      • Hospice
        • HMDCB Research
      • Osteopathic
    • Continuing HPM Certification
    • Workforce Statistics
    • Scholarships
      • Access Fund
      • Leadership Scholars
      • International Physicians
      • Pediatric Scholarship
      • Research Scholars
    • Resilience and Well-being
  • About
    • History
    • Position Statements
      • Access to Palliative Care and Hospice Position Statement
      • Artificial Nutrition Position Statement
      • Research Ethics Position Statement
      • Palliative Sedation Position Statement
      • Physician-Assisted Dying Position Statement
      • Withholding Position Statement
      • Physician Assisted Dying Position Statement Review
      • Physician-Assisted Dying
    • Talking About HPM
      • Advance Directives-Talking HPM
      • Choosing a Hospice Program-Talking HPM
      • Defining HPM-Talking HPM
      • Explaining PAD-Talking HPM
      • Costs-Talking HPM
      • Withdrawing LST-Talking HPM
      • Choosing Wisely
      • Members Talking About HPM
    • Governance
      • Board of Directors
        • Board Only
        • Past Presidents
      • Committees
      • Staff
        • Staff
      • Revised Bylaws
    • Donate
      • AAHPM Giving Circle
    • Awards
      • Visionaries in HPM
      • Emerging Leaders
    • Social Media
  • Store
    • Browse All
    • Books
    • E-Learning
    • Recordings
    • Essentials
  • My Account
  • Username & Password
  • Manage Credit Cards
  • Demographics
  • My Classroom
  • Quarterly Newsletter
  • Pay Open Balances
  • Purchase History
  • Membership Details
  • My Communities
  • My Volunteer History
  • Uploaded Documents
  • Writing Instructional Objectives
  • Meetings
    • Annual Assembly
    • Leadership Forum: Ascend
    • State of the Science
    • State of the Science
    • Board Review Course
    • Calendar
    • Intensive Board Review Course 2018 Recordings
    • IBRC18 - Additional Management Strategies for Cancer Related Symptoms
    • IBRC18 - Approaches to Care, including Hospice/Medicare
    • IBRC18 - Assessment and Care of the Dying Patient
    • IBRC18 - Communication and Teamwork
    • IBRC18 - Depression/Anxiety & Other Mood Disorders
    • IBRC18 - Ethical and Legal Decision Making
    • IBRC18 - Grief and Bereavement and Spiritual Care
    • IBRC18 - High Yield Pediatrics for the Boards
    • IBRC18 - Non-Pain Symptom Management – GI
    • IBRC18 - Non-Pain Symptom Management – Respiratory
    • IBRC18 - Non-Pain Symptom Management: Pot-Pourri
    • IBRC18 - Pain Management Overview
    • IBRC18 - Palliative Sedation/Physician-Assisted Dying/Discontinuation of Technological Support
    • IBRC18 - Practice Test Question Review Q&A (1)
    • IBRC18 - Practice Test Question Review Q&A (2)
    • IBRC18 - Practice Test Question Review Q&A (3)
    • IBRC18 - Prognostication
    • IBRC18 - Special Topics in Pain Management
    • IBRC18 - Symptom Potpourri
    • IBRC18 - Taking the Test Like a Pro
    • IBRC18 - Urgent Medical Conditions
  • Publications
    • JPSM
    • PC-FACS
    • Quarterly
    • SmartBriefs
  • Self-Study
    • Board Prep Materials
    • Essentials
    • Primer
    • HPM PASS
    • HPM FAST
    • Hospice Products
    • Opioid REMS
    • Recordings
    • hpmpasscme
    • HPMQ
    • Opioid Resources
  • Fellowships
    • Competencies
    • Accreditation
    • NRMP Match
    • Grants
    • Hospice Program Toolkit
    • CBME Recordings
  • CME
  • Quality
    • Measuring What Matters
    • Quality Reporting
    • Quality Resources
    • Quality Registries
    • Quality Improvement Education
  • Research
    • Research Funding
    • Successful Research Grants
  • COVID-19 Resources
  • COVID hotel

Feature

 Feature

HPM Maintenance of Certification: Why It's Important, How to Prepare

Lana Christian, MS

Board certification is the gold standard that demonstrates a physician’s knowledge and expertise in a particular specialty or subspecialty. It may also be required for many positions, such as being on hospital staff or on a panel for an insurance company. With the first cohorts of ABMS- and AOA-certified Hospice and Palliative Medicine (HPM) subspecialists quickly approaching the end of their initial certifications, anxiety may be running high about maintaining this certification.

The evolving changes in the Maintenance of Certification (MOC)/Osteopathic Continuous Certification (OCC) process can seem chimeric, which poses challenges to those navigating the MOC waters. In addition, certain barriers frustrate many physicians as they work through the MOC program, including changing requirements, high costs, and increasing demands on their time. Why is MOC important for the field of hospice and palliative medicine, and what can HPM subspecialists preparing for their MOC/OCC Part III exam do now to ensure they are ready and eligible?

Maintenance of Certification Process

MOC and OCC are the processes by which all ABMS and AOA boards ensure physicians’ continuous professional development. Using ABMS and ACGME core competencies as its foundation, MOC and OCC establish broad requirements for all primary boards. MOC and OCC consist of several parts (Table 1), which reflect the boards’ focus on continuous professional development.

Rather than being a single event, certification is now a continuous, lifelong commitment to professional development. Certification and maintenance of certification are highly visible indicators that physicians know current standards of practice and are committed to providing quality patient care.

Importance of Subspecialty Certification in HPM

More than 70% of all hospitals have a palliative care program in place, and increasing numbers of other provider organizations are offering palliative care programs, as well. The challenge is to staff them with enough qualified physicians.1

Certification is widely considered the gold standard of expertise in medicine because of its unique physician-directed approach for assessing qualifications. While medical licensure sets the minimum competency requirements to diagnose and treat patients, it is not specialty specific. Board certification demonstrates a physician’s exceptional understanding of a particular specialty and/or subspecialty. Although certification is voluntary, the government, healthcare systems, insurers, and patients recognize it as an essential measure of the physician’s knowledge, experience, and skills to provide quality health care within a given specialty or subspecialty.

Workforce Shortages

The National Priorities Partnership names palliative and end-of-life care as one of six national health priorities that can create lasting change across the healthcare system,2 and the Institute of Medicine recommends “expanding training opportunities to ensure clinicians across disciplines and specialties who care for people with serious illness are competent in basic palliative care.”3

Despite these prominent recommendations, a shortage of qualified HPM physicians—and current pathways to subspecialty certification—exist.1,4 A study published in 2010 in the Journal of Pain and Symptom Management calculated that more than 6,000 full-time equivalents (FTEs)—or 8,000 to 10,000 physicians—were needed to meet the needs of hospice and palliative care programs at that time. Up to 18,000 physicians were needed if all hospices and palliative care programs used exemplary staffing models.4 Today population growth, aging, and broadened palliative care services have pushed that number higher.

 Table1 Spring16

How to Prepare Now to Maintain Your HPM Certification

 Figure1 Spring16

 AAHPM, ABMS, and ABIM offer many resources to help you find MOC-approved activities and earn MOC points:

  • AAHPM's UNIPACs are approved by ABIM for MOC Part II (life-long learning and self-assessment) points.
  • HPM PASS, 3rd edition, HPM FAST (four modules produced by AAHPM), and HMD PREP are approved for MOC points by six ABMS boards: internal medicine, family medicine, anesthesiology, psychiatry and neurology, and radiology.
  • For additional MOC activities, search the ABMS MOC Directory (https://www.mededportal.org/abmsmoc/continuingeducation/) or the ABIM Directory (http://www.accme.org/MOClist) hosted by the Accreditation Council for Continuing Medical Education.
  • Osteopathic physicians are encouraged to request approval of MOC points with their Osteopathic Board for any activities that have MOC approval.
  • Visit ABIM’s website to obtain the HPM exam blueprint. This is available to all physicians, regardless of their board specialty. AOA’s website has a similar blueprint available to all osteopathic physicians.

To dialog about about MOC, visit AAHPM Connect (http://connect.aahpm.org/home), participate in the online communities discussion, and read late-breaking news on AAHPMblog.org.

Currently nearly 7,000 certified HPM physicians are in practice at least part time in the field. Many were initially certified during a grandfathering period when previous certification by the American Board of Hospice and Palliative Medicine and/or practice hours could serve as a prerequisite for HPM certification.

Since 2012, however, the pipeline for newly certified HPM subspecialists has narrowed, limited by the new requirement that physicians complete a 12-month fellowship before they are eligible to sit for initial subspecialty certification. Moreover, with fellowship slots in short supply—approximately 300 per year— the maximum potential to counteract natural attrition while continuing to grow the workforce is a little more than 600 HPM physicians per recertification cycle (see Table 2). “With this potential for newly certified specialists being much smaller, maintaining HPM certification is more important than ever,” said Dawn Levreau, AAHPM’s director of workforce and leadership.

Table2 Spring16

It is important to recognize that part of the strategy for managing the workforce is the growing number of advanced practice nurses and physician assistants practicing in hospice and palliative care. A variety of certifications in hospice and palliative care for nurses at various practice levels are available through the Hospice and Palliative Certification Center.

Updated Standards in Flux

In 2015 ABMS standards were updated to place greater emphasis on practical application, including patient safety, performance improvement, working with teams, and incorporating judgment into examinations.5 As individual boards tackle how to translate those goals into MOC activities, the ultimate silver lining will be a more relevant, accessible, useful program. In the interim, the state of flux may offer some serendipities.

For example, ABIM has temporarily suspended the MOC Quality Improvement requirement (Part IV)— which involves a practice assessment—until a broader array of more accessible activities is available. That means if you are an internal medicine physician who is due for HPM recertification in 2018, you can earn all 100 MOC points as medical knowledge points between now and December 2018, according to Furman McDonald, MD MPH, senior vice president for academic and medical affairs at ABIM. A plus for all physicians is that most boards now recognize a much wider array of activities that can count toward MOC points.

If you are a dual-boarded diplomate, your selfevaluation requirement may be waived so that you are required only to complete it for one member board in order to receive credit. If this is true for your boards, you need only to attest that you are current and participating in the other board’s MOC program before you take the HPM MOC exam.

Disparities in Requirements

Primary boards have the freedom to tailor specific MOC requirements to their specialty. So, despite the fact that ABIM and AOBIM administers the HPM exams to all qualified candidates, activities that can fulfill each part of MOC differ by specialty. This, plus MOC’s continuing evolution, have created some confusion and challenges for physicians approaching their HPM recertification date.

The good news is that the boards have broadened the activities eligible for Part II MOC points, and the American Board of Medical Specialties has created an MOC directory where diplomates from across specialties can find activities relevant to their practice. There is no parallel directory for osteopathic physicians.

One way to approach this shift to a model of lifelong learning is to engage in some MOC activities every 2 years to show you’re participating in MOC and review your board’s MOC requirements every 2 years to make sure you are on target to meet those requirements.

Time and Money

involves substantial time and financial investments. Some may feel the purse strings ease a bit because now half of the primary boards that grant HPM as a subspecialty certificate do not require MOC for both the primary and subspecialty boards (see Figure 1). For osteopathic physicians, only those whose primary specialty certification is family medicine need to complete both primary and subspecialty OCC.

Growing and sustaining the hospice and palliative care workforce is one of the five strategic objectives of the Academy. Julie Bruno, MSW LCSW, director, education and training for the Academy, states, “Our goal is to make sure everyone understands the process and timelines for MOC, OCC, and the exams. Subspecialty certification is critical to the field.”

Depending on when your initial certification expires, you have more or less time to ensure that you have sufficient MOC points and prepare for the exam. This underscores the importance of planning.

Conclusion

Lois Nora, MD JD MBA, president and CEO of ABMS, recently completed her MOC and sat for her neurology board. She said, “I don’t think any of us look forward to taking an exam. But I’ve been impressed over time with the number of people who have told me retrospectively that preparing for the exam and taking the exam were meaningful to them. This rigorous process is a very important component of us demonstrating to the public who we are as specialists and how we continue to grow and learn.”

The ABIM 2020 Assessment and Innovations in Progress

Although the ABIM 2020 report was tasked separately from the MOC program in general, its recommendations will affect MOC in the future. The goal of this report was to ascertain how to make the certification process more relevant, accessible, adaptable, affordable, engaging, and efficient.

Three overarching recommendations came from that report:

  • Replace the 10-year MOC exam with shorter, more frequent exams.
  • Focus assessments on cognitive and technical skills (to ensure application of knowledge).
  • Recognize specialization (so that maintaining a subspecialty can stand on its own for MOC without requiring underlying certification).

Although the report’s recommendations are still just that, some recommendations are already on the drawing table. Exams will become more user-friendly, as at least some of them move from testing centers to the workplace or home with remote proctoring. Continuous quality improvement (quality activities that physicians are doing within their own practices and health systems) will be integrated into MOC. Activities that integrate HPM into medical care within a hospital community will likely be awarded MOC points. Such innovations should start appearing in the next few years. Recognizing specialization without requiring underlying certification is already a reality in five of the 10 ABMS boards that offer HPM certification.

An ongoing survey of diplomates is providing valuable input on these and other tangible ways to improve MOC. How the survey and report results might affect future credentialing is yet to be determined, so continue to check with your primary board to learn the latest developments.

References

  1. Punke H. Workforce Shortage Threatens Future of Palliative Care. Becker Hospital Review. November 05, 2013. http:// www.beckershospitalreview.com/hospital-physicianrelationships/ workforce-shortage-threatens-future-ofpalliative- care.html. Accessed February 9, 2016.
  2. National Quality Forum. Input to the Secretary of Health and Human Services on priorities for the 2011 National Quality Strategy. October 15, 2010.
  3. Meghani SH, Hinds PS. Policy brief: The Institute of Medicine report Dying in America: Improving quality and honoring individual preferences near the end of life. Nurs Outlook. 2015;63:51-59.
  4. Lupu D. Estimate of current hospice and palliative medicine physician workforce shortage. J Pain Symptom Manage. 2010;40(6):899-911.
  5. American Board of Medical Specialties website. ABMS specialty and subspecialty certificates. http://www.abms. org/member-boards/specialty-subspecialty-certificates/. Accessed January 11, 2016.

Bibliography

ABIM Assessment 2020 task force. Recommendations to the American Board of Internal Medicine (ABIM): A vision for certification in internal medicine in 2020. http:// transforming.abim.org/assessment-2020-report/. Published September 2015. Accessed April 11, 2016.

Rosenbluth G, Tabas JA, Baron RB. What’s in it for me? Maintenance of certification as an incentive for faculty supervision of resident quality improvement projects. Acad Med. 2016;91(1):56-59.

Sklar DP. What happens after medical school? Current controversies about licensure, maintenance of certification, and continuing professional development. Acad Med. 2016;91:1-3.

Lana Christian, MS, is a freelance medical writer baseed in Texas. Learn more and contact Ms. Christian at http://createwriteinc.com.

Read the next article or go to the table of contents.

Essential Practices in Hospice and Palliative Medicine

This newly updated and rebranded comprehensive self-study provides a critical foundation for those who want to incorporate principles of hospice and palliative medicine into their daily lives.

Learn More

Quick Links

  • Job Mart
  • JPSM
  • CME/CE Certificates
  • Purchased Downloads
  • Terms and Conditions
  • Privacy Policy

For Exhibitors and Advertisers

  • Commercial Support
  • Exhibiting and Advertising
  • Mailing Labels

For Students and Residents

  • Membership
  • Careers
  • Fellowships
  • Publications
Facebook Twitter Linked In Visit our patient website: PalliativeDoctors.org

AAHPM Logo

8735 West Higgins Road, Suite 300 Chicago, IL 60631

Phone 847-375-4712 Fax 847-375-6475 E-mail info@aahpm.org

Copyright © American Academy of Hospice and Palliative Medicine