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College, ABIM reach new agreement on recertification

From the December ACP-ASIM Observer, copyright 2002 by the American College of Physicians-American Society of Internal Medicine.

By Phyllis Maguire

PHILADELPHIA—At its October meeting, the Board of Regents approved a new agreement with the American Board of Internal Medicine (ABIM) on recertification.

A "memorandum of understanding" drafted by the two organizations spells out new mechanisms that will give the College and other specialty societies a role in shaping the recertification process.

"This agreement provides a framework that the College and internal medicine subspecialty groups can use to work with the ABIM," said John Tooker, FACP, MBA, the College's Executive Vice President and Chief Executive Officer. "We will now be able to collaborate to improve the current Continuous Professional Development (CPD) program and further develop recertification."

The memo, which was approved earlier in the month by the ABIM's board of directors, seeks to resolve many of the concerns College members have expressed about the recertification process.

First, it establishes a set of principles delineating the separate roles of medical societies, which will provide the educational components for recertification, and the ABIM, which will evaluate diplomates' competence.

Second, the memorandum creates a formal working relationship between societies and the ABIM. Under the terms of the document, a liaison committee will meet twice a year and as needed. The liaison committee will also advise the ABIM's recertification committee on all aspects of the recertification process.

The liaison committee will include representatives from the ABIM, the College and up to nine other specialty societies and organizations. It will be charged with reviewing and commenting on all new and existing CPD pathways and their components.

"This new committee removes the arm's-length relationship that has existed up to now between medical societies and the ABIM on recertification," Dr. Tooker said. "It allows any of the participating societies to bring new initiatives concerning CPD to the table—a dialogue that wasn't available before."

Dr. Tooker also predicted that when implemented, the new agreement will help make the recertification process more flexible. "It should achieve many of the goals the College and the ABIM have been working toward in their discussions over the last two years," he said.

The memo also calls for the evaluation of all recertification pathways and components. It also sets new criteria to assess CPD components, including establishing the relevance of CPD in a variety of practice settings; reducing the redundancy of CPD components; accommodating different learning styles among diplomates; and being sensitive to the time and money that diplomates spend on recertification.

The agreement also spelled out new developments and changes in the recertification process:

  • The ABIM agrees to allow diplomates to complete MKSAP self-assessment questions to meet up to two medical knowledge self-evaluation program (SEP) modules. MKSAP substitution modules will each contain 60 questions, which will be produced by the College and scored by the ABIM.

  • The ABIM will offer a computer-based exam as soon as possible to reduce the time and money diplomates now spend on the exam. ABIM officials say the internal medicine recertification exam should be available online as early as May 2003. Subspecialty exams are not expected to be available electronically until November 2003.

  • Until 2010, diplomates may choose and complete five SEP modules according to their own schedule. The ABIM had previously announced that diplomates had to begin completing SEP modules no later than year four of their 10-year recertification cycle.

  • Both the College and the ABIM will work to develop less burdensome pathways to dual recertification in both internal medicine and subspecialties.

  • The ABIM will not require recertifying diplomates to complete any of the newer SEP components—the practice improvement, clinical skills or patient/peer feedback modules—until 2010. (Those modules will, however, be available to diplomates who want to complete them.) In addition, the new peer/patient feedback module will remain optional until its use can be shown to be valid and applicable to practicing internists.

  • The ABIM will consider linking CME material to the CPD program.

Recertification every 10 years is now mandatory for internists and internal medicine subspecialists who initially certified in 1990 or later. The approved memorandum of understanding is available to ACP-ASIM members only.

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