American Board of Pathology American Board of Pathology and and

Co-operating Societies MeetingCo-operating Societies Meeting

May 3, 2011May 3, 2011

Revised November 2012

Maintenance of Board Maintenance of Board Certification (MOC)Certification (MOC)

• ABP MOC is part of ABMS-wide MOC ABP MOC is part of ABMS-wide MOC process process

• All certificates beginning in 2006 are time All certificates beginning in 2006 are time limited (10 yrs)limited (10 yrs)

• MOC is a continuous process with specific MOC is a continuous process with specific deadlines; failure to comply results in deadlines; failure to comply results in expiration of certificationexpiration of certification

Requirements For MOC Requirements For MOC

Part I: Part I: Professional StandingProfessional Standing

Part II: Part II: Life-Long Learning and Self-Life-Long Learning and Self-AssessmentAssessment

Part III: Part III: Cognitive ExpertiseCognitive Expertise

Part IV: Part IV: Evaluation of Performance in Evaluation of Performance in PracticePractice

Part IPart IProfessional StandingProfessional Standing

• Maintain full and unrestricted license(s) Maintain full and unrestricted license(s)

• Foreign license accepted with English Foreign license accepted with English translationtranslation

• Document medical staff membership and Document medical staff membership and privileges privileges

Part IIPart IILife Long Learning-Self-Life Long Learning-Self-

AssessmentAssessment

• ““Content Specifications” are available on Content Specifications” are available on line and updated regularlyline and updated regularly

• Emphasize fundamental information for Emphasize fundamental information for daily practice and important, validated daily practice and important, validated new knowledgenew knowledge

• Specs are not templates for exams or Specs are not templates for exams or endorsement of authorsendorsement of authors

• These will: These will: • Serve as a template for CME and self-assessmentServe as a template for CME and self-assessment• Assist pathologists to prepare for MOC examAssist pathologists to prepare for MOC exam• Direct MOC test question developmentDirect MOC test question development• Focus on practical “need to know” information that Focus on practical “need to know” information that

is used in daily practice and required for is used in daily practice and required for competencecompetence

• Cover all disciplines of pathology Cover all disciplines of pathology

Part IIPart IILife Long Learning &Life Long Learning &

Self-Assessment Self-Assessment

• 70 AMA Category 1 CME credits/2 year cycle 70 AMA Category 1 CME credits/2 year cycle

• At least 20 of the CME credits/2 yr cycle must At least 20 of the CME credits/2 yr cycle must be SAMs be SAMs

• 80% of CME related to individual’s practice80% of CME related to individual’s practice

• A fellowship fulfills Part II requirements for 2 A fellowship fulfills Part II requirements for 2 year periodyear period

Self-Assessment Modules (SAMs)Self-Assessment Modules (SAMs)

Elements of SAMsElements of SAMs• AMA Category 1 CMEAMA Category 1 CME

• Self-administered examSelf-administered exam

• Minimum performance levelMinimum performance level

• FeedbackFeedback

• All SAMs are CMEs, but not all CMEs are All SAMs are CMEs, but not all CMEs are SAMsSAMs

Part IIIPart IIICognitive ExpertiseCognitive Expertise

• Exam may be taken beginning year 8 of 10 year cycle (first Exam may be taken beginning year 8 of 10 year cycle (first exam in 2014)exam in 2014)

• AP/CP diplomates may maintain their certification in AP/CP, AP/CP diplomates may maintain their certification in AP/CP, AP only, CP only AP only, CP only

• Diplomates with subspecialty boards may maintain Diplomates with subspecialty boards may maintain certification in subspecialty onlycertification in subspecialty only

• Surrendering certification is NOT RECOMMENDED Surrendering certification is NOT RECOMMENDED

Part IIIPart IIICognitive ExpertiseCognitive Expertise

• Modular exam to reflect practiceModular exam to reflect practice

• Consists of one 50 question general Consists of one 50 question general module and four 25 question modules module and four 25 question modules

• 80% practical (e.g. virtual microscopy, 80% practical (e.g. virtual microscopy, case-based questions); 20% written case-based questions); 20% written

• Scored as a single 150 question examScored as a single 150 question exam

Part IVPart IVPerformance in PracticePerformance in Practice

• Four peer attestations Four peer attestations (4(4thth and 8 and 8thth year) year)

• Lab accreditation Lab accreditation (2 yrs) except forensic (2 yrs) except forensic labslabs

• Laboratory PI and QA programs Laboratory PI and QA programs (2 yrs)(2 yrs)

• Individual participation at least one PI-QA Individual participation at least one PI-QA program/yr. program/yr. (2 yrs) (2 yrs)

Part IVPart IVPerformance in PracticePerformance in Practice

• Programs may be society sponsored or Programs may be society sponsored or by departments/institutionsby departments/institutions

• Programs must be ABP-approvedPrograms must be ABP-approved

• Society sponsored programs on ABP Society sponsored programs on ABP websitewebsite

AP/CP PART III MOC EXAMAP/CP PART III MOC EXAM

• One 50 question general AP/CP moduleOne 50 question general AP/CP module• 20 AP 20 AP • 20 CP20 CP• 10 Lab management10 Lab management

• PLUS four 25 question AP, CP, or PLUS four 25 question AP, CP, or Common ModulesCommon Modules

AP ONLY PART III MOC EXAMAP ONLY PART III MOC EXAM

• One general AP moduleOne general AP module• 40 AP questions40 AP questions• 10 Lab Management questions10 Lab Management questions

• PLUS four 25 question AP or Common PLUS four 25 question AP or Common ModulesModules

CP ONLY EXAMCP ONLY EXAM

• One 50 question general CP moduleOne 50 question general CP module• 40 CP40 CP• 10 Lab management10 Lab management

• PLUS four 25 question CP or Common PLUS four 25 question CP or Common ModulesModules

25 Question Modules25 Question ModulesClinical PathologyClinical Pathology

CP General CP General

CP Lab DirectorCP Lab Director

Hematology I & IIHematology I & II

CoagulationCoagulation

BB/TM I & IIBB/TM I & II Immunopathology Immunopathology

BB/TM-Coagulation BB/TM-Coagulation Microbiology I & IIMicrobiology I & II

CoagulationCoagulation Chemistry I & II Chemistry I & II

25 Question Modules25 Question ModulesAnatomic PathologyAnatomic Pathology

AP General I & II AP General I & II

Surg Path I & IISurg Path I & II

Surg Path & CytologySurg Path & Cytology

Cytology GeneralCytology General

Cytology-GynCytology-Gyn

Cytology, Non GynCytology, Non Gyn

Bone-Soft TissueBone-Soft Tissue

BreastBreast

CardiovascularCardiovascular

Dermatology NeoplasticDermatology Neoplastic

Dermatology-non-NeoDermatology-non-Neo

Endocrine Endocrine

GI-Liver-BiliaryGI-Liver-Biliary

25 Question Modules25 Question ModulesAnatomic Pathology (continued)Anatomic Pathology (continued)

Forensic PathologyForensic Pathology Medical RenalMedical Renal

GenitourinaryGenitourinary NeuropathologyNeuropathology

Gynecologic Gynecologic (including placenta)(including placenta)

Pediatric PathologyPediatric Pathology

Head & NeckHead & Neck Pulmonary-MediastinalPulmonary-Mediastinal

25 Question Common Modules*25 Question Common Modules*Anatomic and Clinical PathologyAnatomic and Clinical Pathology

* May be used as AP or CP modules

General Heme IGeneral Heme I (Lymph node-Spleen)(Lymph node-Spleen)

Flow Cytometry Flow Cytometry

General Heme IIGeneral Heme II (Blood, BM, Coag)(Blood, BM, Coag)

Molecular Pathology Molecular Pathology

Molecular-CytogeneticsMolecular-Cytogenetics Lab Management /Lab Management / InformaticsInformatics

General AP/CP MOCGeneral AP/CP MOC

• Test Development and Advisory Test Development and Advisory Committees (TDAC) determine content Committees (TDAC) determine content and distribution of questionsand distribution of questions

• Knowledge needed to practice and Knowledge needed to practice and validated new informationvalidated new information

Modification of ModulesModification of Modules

• Some organ-specific and CP areas may Some organ-specific and CP areas may have >1 module with graded difficulty have >1 module with graded difficulty

Subspecialty MOC ExamSubspecialty MOC Exam

Subspecialty TDACs will:Subspecialty TDACs will:

• Determine content and distribution Determine content and distribution of questionsof questions

• Write MOC questionsWrite MOC questions

Subspecialty MOC ExamsSubspecialty MOC Examswith no moduleswith no modules

• Blood Bank/Transfusion MedicineBlood Bank/Transfusion Medicine

• Chemical PathologyChemical Pathology

• CytopathologyCytopathology

• DermatopathologyDermatopathology

• Forensic PathologyForensic Pathology

• MicrobiologyMicrobiology

Subspecialty Exams Subspecialty Exams with Moduleswith Modules

• Hematology (total 150 questions)Hematology (total 150 questions)• Heme General (50)Heme General (50)• Lymph Nodes and Solid Tissue (50)Lymph Nodes and Solid Tissue (50)• Blood and Bone Marrow (50)Blood and Bone Marrow (50)• Hemostasis and Thrombosis (50)Hemostasis and Thrombosis (50)• Laboratory Heme w/out Coag (50)Laboratory Heme w/out Coag (50)• Flow Cytometry (50)Flow Cytometry (50)

Subspecialty MOC ExamsSubspecialty MOC Examswith moduleswith modules

• Molecular Genetic Pathology (150 total)Molecular Genetic Pathology (150 total)• MGP General I (75 questions)MGP General I (75 questions)• MGP General II (75 )MGP General II (75 )• MGP Oncology/Heme (25)MGP Oncology/Heme (25)• MGP Oncology/Solid Tumor (25)MGP Oncology/Solid Tumor (25)• MGP Infectious Disease (25)MGP Infectious Disease (25)• MGP Genetics (25)MGP Genetics (25)

Subspecialty ExamsSubspecialty Examswith Moduleswith Modules

• Neuropathology (total 150 questions)Neuropathology (total 150 questions)• NP General I (50)NP General I (50)• NP General II (50)NP General II (50)• Neuromuscular (25)Neuromuscular (25)• Developmental/Congenital/Pediatric (25)Developmental/Congenital/Pediatric (25)• Degenerative (25)Degenerative (25)• Neoplastic I (25)Neoplastic I (25)• Neoplastic II (25)Neoplastic II (25)

Subspecialty MOC ExamsSubspecialty MOC Examswith moduleswith modules

• Pediatric Pathology (total 150 questions)Pediatric Pathology (total 150 questions)• Pediatric General Pathology (100)Pediatric General Pathology (100)• Placenta/Perinatal (50)Placenta/Perinatal (50)• Pediatric Anatomic Pathology (50)Pediatric Anatomic Pathology (50)• Pediatric Laboratory Medicine (50)Pediatric Laboratory Medicine (50)

CP Only General ModuleCP Only General ModuleExampleExample

40 Practical, 10 Written40 Practical, 10 WrittenRange of # of Range of # of

QuestionsQuestions

TM/BBTM/BB 4-144-14

ChemistryChemistry 4-104-10

HematologyHematology 4-144-14

MicrobiologyMicrobiology 4-104-10

Adm/ManAdm/Man 1010

Bone and Soft Tissue GridBone and Soft Tissue GridTotal of 25 questionsTotal of 25 questions

Total # of questionsTotal # of questions

BoneBone 8-108-10

NeoplasticNeoplastic 5-65-6

Non-Non-neoplastic neoplastic

3-43-4

Soft TissueSoft Tissue 17-1917-19

NeoplasticNeoplastic 12-1312-13

Non-Non-neoplastic neoplastic

5-65-6

AdministrationAdministration 2-42-4

EXPIRATION OF CERTIFICATIONEXPIRATION OF CERTIFICATION

• Failure to report for two MOC cyclesFailure to report for two MOC cycles

• Announcement of expired Announcement of expired certificates certificates

How will information flow?How will information flow?

Candidate

Board Societies

Exam results

New and recertified

Diplomates

Registration with ABP #Documentation of MOC activities

Part II&IV

Part II&Part IV

ABP #

Frequently Asked QuestionsFrequently Asked Questions

Are these the final modules?Are these the final modules?

• Not necessarilyNot necessarily

• Changes will reflect practice Changes will reflect practice patternspatterns

• Example: academic pathologist Example: academic pathologist with subspecialty practice onlywith subspecialty practice only

May candidates synchronize their May candidates synchronize their reporting and testing cyclesreporting and testing cycles??

• Yes, if they occur within two years of one Yes, if they occur within two years of one anotheranother

– 2007 subspecialty certificate could be synchronized with 2007 subspecialty certificate could be synchronized with

2006 AP/CP MOC cycle2006 AP/CP MOC cycle– Supporting documentation in 2008, 2010, etc.Supporting documentation in 2008, 2010, etc.– MOC exam eligibility from 2014-2016MOC exam eligibility from 2014-2016– Second MOC cycle begins in 2016 Second MOC cycle begins in 2016

Is there a definition for “credits Is there a definition for “credits related to practice” for related to practice” for

CME/SAMs?CME/SAMs?

• Broad Broad interpretationinterpretation

• Use good Use good judgmentjudgment

When does the second MOC cycle When does the second MOC cycle start?start?

• From the date of the From the date of the examination? NOexamination? NO

• January 1 of the 11January 1 of the 11thth year year following certificationfollowing certification

What about diplomates practicing What about diplomates practicing in foreign countries who are in foreign countries who are

unable to maintain a US license?unable to maintain a US license?

• Official license accepted if accompanied Official license accepted if accompanied by an English translationby an English translation

How will Board communicate How will Board communicate changes to MOC?changes to MOC?

• ABP WebsiteABP Website

• MOC Booklet of InformationMOC Booklet of Information

• Spring meeting of co-operating Spring meeting of co-operating societiessocieties

• Announcements in journalsAnnouncements in journals

How do we make MOC more How do we make MOC more relevant?relevant?

• PQRS will incentivize MOCPQRS will incentivize MOC

• Maintenance of licensure = MOCMaintenance of licensure = MOC

• Diplomates with non- time limited Diplomates with non- time limited certificates enroll in MOCcertificates enroll in MOC