MOC Reform -- Forensic and other subspecialty pathologists wanted!

[Mindy]

Hi:

It is amazing how many folks still post on SDN! It feels a bit like a reunion to sign in..

As you all probably are aware, the American Board of Pathology has rolled out new rules regarding recertification, namely that you need to keep your primary AP, CP, AP/CP certificate. Many of us, particularly in Forensic Pathology, had anticipated dropping the primary certificate and maintaining only the subspecialty (FP) portion.

The arbitrary change by the ABP has resulted in a sizeable portion of upset forensic pathologists.

I wanted to extend the offer to join our grassroots efforts in MOC Reform. Any specialty or subspecialty (even outside of pathology) is welcome. Send me an email at [email protected].

Please include your name, specialty, whether you need to participate in MOC or are grandfathered in, and to what extent you would like to participate. It is find if you simply would like to be kept informed of our efforts.

Kindest (and nice to see "Old Faces"),
Mindy

---

Members don't see this ad.

 

[ForPath]

I will be doing Pediatric and Forensic fellowships. That means, AP/CP recertification one year, then PP next year and then FP.
6 years break.
Everything again...

Awesome!

 

[univlad]

In order to maintain both certificates, you can take the combined exam which is a small AP or AP/CP module then your subspecialty modules and the exam is graded all together as one. I don't think it would be that hard to maintain both.

 

[univlad]

I will be doing Pediatric and Forensic fellowships. That means, AP/CP recertification one year, then PP next year and then FP.
6 years break.
Everything again...

Awesome!

You could do all the exams in one day. you could take a combined AP/CP and pediatrics or forensic exam in the morning and then in the afternoon the subspecialty exam you didn't take in the morning. Why spread it out over two years?

 

[ForPath]

OK. I was thinking that it has to be 10 year cycle for each recertification...

 

[univlad]

OK. I was thinking that it has to be 10 year cycle for each recertification...

You can take them in years 7-10 of the cycle and currently it is offered twice a year. Most people will "link" their subspecialty certificates to their primary certificate which means that you only have to fill out one MOC form every two years during the cycle.

 

[LADoc00]

Yah when I read that the FIRST thing that jumped out at me was Forensics is basically totally screwed.

I think it almost might be the death knell for FP. The even more worrisome thing is I dont ABP has any control over this. I think this is part of a larger movement by the ABMS secondary to AHA/Obamacare initiated quality changes.

I think you are screwed and not in a good way Mindy...

 

[ForPath]

But Cardiologist doesn't have to take IM boards again. He can, but doesn't have to...

 

[univlad]

Do they offer a combined IM/Cardiology in one exam? From listening to the CAP webinar earlier this month, it doesn't sound like it will be that difficult to maintain your AP/CP certification if you are super specialized. They offer the ability to combine your subspecialty exam and AP/CP into one exam where you only get a short AP/CP module followed by your 3 modules of your subspecialty exam. It's graded together as one exam and you maintain your certification for AP/CP and your subspecialty. I would anticipate that the general AP/CP module would be fairly general.

 

[dr4n6]

Yah when I read that the FIRST thing that jumped out at me was Forensics is basically totally screwed.

I think it almost might be the death knell for FP. The even more worrisome thing is I dont ABP has any control over this. I think this is part of a larger movement by the ABMS secondary to AHA/Obamacare initiated quality changes.

I think you are screwed and not in a good way Mindy...

Why would you think that FP's are totally screwed? As a boarded FP, I am a bit miffed why my FP colleagues would not recertify in AP. Last time I checked, AP was still a pretty significant portion of any FP practice.

 

[Autopsy101]

At the time I took the MOC exam, there was no module for autopsy, forensics, or toxicology. That seemed a little bit unfair to me. Hopefully, they have or will develop modules like that so there are more options since they are requiring the general AP/CP recertification.

 

[univlad]

At the time I took the MOC exam, there was no module for autopsy, forensics, or toxicology. That seemed a little bit unfair to me. Hopefully, they have or will develop modules like that so there are more options since they are requiring the general AP/CP recertification.

It seems to me that most Forensic folks would want to the take the combined subspecialty/primary certification exam. Rather than taking the three module (150 question) AP/CP exam in the morning and the 150 Forensic exam in the afternoon and having them scored separately, i would think they would go for the options of fo the combined exam (option 5 below) which has the one general 50 questions AP/CP module that you'd have to take with AP/CP anyway followed by the 150 question forensic exam. This combined exam is scored as a single 200 quesiton exam and passing fufills the testing requirements for AP/CP and your subspecialty.

From the ABP's Webiste:

E. The ABP recognizes the breadth and variation of pathology practice, therefore:
1. The primary examinations (APCP, AP only, and CP only) are modular and diplomates can select modules at the time of the examination that are as relevant as possible to their individual scope of practice.
2. The subspecialty MOC examinations in Hematology, Molecular Genetic Pathology, Neuropathology, and Pediatric Pathology are modular and diplomates can select modules at the time of the examination. All other subspecialty exams are a single 150-question exam.
3. For both primary and subspecialty modular exams, all modules are graded together as a single 150-question examination for purposes of pass/fail.
4. See the
MOC Examination Modules under MOC General Information on the ABP Website for a list of modules available for each examination. The modules and their content are subject to change by the ABP.

5. Diplomates who hold both a primary and a subspecialty certification may opt to sit for a single examination that includes a 50-question primary certification module (AP and/or CP) and the 150-question subspecialty examination, which may be modular (see Section III.E.2). The combined primary and subspecialty exam is graded together as a single 200-question exam for purposes of pass/fail. A passing score will fulfill the Part III requirement for both certifications for the MOC ten-year cycle.​

 

[mlw03]

Why would you think that FP's are totally screwed? As a boarded FP, I am a bit miffed why my FP colleagues would not recertify in AP. Last time I checked, AP was still a pretty significant portion of any FP practice.

When did you last check? What kind of FP are you doing? Are you routinely ordering IHCs? Grading dysplasia? Looking at aspirative or exfoliative cytology specimens? Signing out complex tumor cases? Grading and staging cancer? Distinguishing cancer from mimics in the prostate or breast? That's what day to day hospital AP practice entails, and as an FP I don't do any of those things routinely. I occasionally have to diagnose a previously unknown cancer, and I do the best I can on H&E alone - no IHC and no molecular. I am very good at discussing asphyxia, blunt trauma, gunshot wounds, and other parts of FP, but pure AP stuff, not so much.
That's why I, and other young FPs I've talked to, have no interest in recerting in AP, and why some of us are considering dropping out altogether.

 

[mlw03]

It seems to me that most Forensic folks would want to the take the combined subspecialty/primary certification exam. Rather than taking the three module (150 question) AP/CP exam in the morning and the 150 Forensic exam in the afternoon and having them scored separately, i would think they would go for the options of fo the combined exam (option 5 below) which has the one general 50 questions AP/CP module that you'd have to take with AP/CP anyway followed by the 150 question forensic exam. This combined exam is scored as a single 200 quesiton exam and passing fufills the testing requirements for AP/CP and your subspecialty.

From the ABP's Webiste:

E. The ABP recognizes the breadth and variation of pathology practice, therefore:
1. The primary examinations (APCP, AP only, and CP only) are modular and diplomates can select modules at the time of the examination that are as relevant as possible to their individual scope of practice.
2. The subspecialty MOC examinations in Hematology, Molecular Genetic Pathology, Neuropathology, and Pediatric Pathology are modular and diplomates can select modules at the time of the examination. All other subspecialty exams are a single 150-question exam.
3. For both primary and subspecialty modular exams, all modules are graded together as a single 150-question examination for purposes of pass/fail.
4. See the
MOC Examination Modules under MOC General Information on the ABP Website for a list of modules available for each examination. The modules and their content are subject to change by the ABP.

5. Diplomates who hold both a primary and a subspecialty certification may opt to sit for a single examination that includes a 50-question primary certification module (AP and/or CP) and the 150-question subspecialty examination, which may be modular (see Section III.E.2). The combined primary and subspecialty exam is graded together as a single 200-question exam for purposes of pass/fail. A passing score will fulfill the Part III requirement for both certifications for the MOC ten-year cycle.​

Yes, you are correct. If (and that's a big if) we do it, option 5 is how we will do it. But even the 50 question exam is unnerving when you haven't done that stuff in a decade.

To try and make this relevant, how would you all feel if you had to retake USMLE step 1 every decade because the ABP says so?

 

[Tiki]

Yes, you are correct. If (and that's a big if) we do it, option 5 is how we will do it. But even the 50 question exam is unnerving when you haven't done that stuff in a decade.

To try and make this relevant, how would you all feel if you had to retake USMLE step 1 every decade because the ABP says so?

It's not just forensics that is screwed. I do subspecialty GI in an academic center. I was worried enough about recertification for AP as I only sign out GI, now I'm forced to renew CP as well.

 

[dr4n6]

When did you last check? What kind of FP are you doing? Are you routinely ordering IHCs? Grading dysplasia? Looking at aspirative or exfoliative cytology specimens? Signing out complex tumor cases? Grading and staging cancer? Distinguishing cancer from mimics in the prostate or breast? That's what day to day hospital AP practice entails, and as an FP I don't do any of those things routinely. I occasionally have to diagnose a previously unknown cancer, and I do the best I can on H&E alone - no IHC and no molecular. I am very good at discussing asphyxia, blunt trauma, gunshot wounds, and other parts of FP, but pure AP stuff, not so much.
That's why I, and other young FPs I've talked to, have no interest in recerting in AP, and why some of us are considering dropping out altogether.

Granted most FP's do not routinely perform IHC's and other diagnostic modalities for working up a malignancy, but I am very confident that when a FP is in court that they always make mention of the fact that they are BC in both AP and FP and that they are holding themselves out as an expert in both AP/FP. The practice of FP is hardly limited to the examination of acute trauma but also involves the skills learned in residency, which is why I fail to understand why my FP colleagues think that it is acceptable to ignore that important aspect of the job.

 

[mlw03]

Granted most FP's do not routinely perform IHC's and other diagnostic modalities for working up a malignancy, but I am very confident that when a FP is in court that they always make mention of the fact that they are BC in both AP and FP and that they are holding themselves out as an expert in both AP/FP. The practice of FP is hardly limited to the examination of acute trauma but also involves the skills learned in residency, which is why I fail to understand why my FP colleagues think that it is acceptable to ignore that important aspect of the job.

I agree with much of what you said this time, but I disagree that FPs hold themselves as experts in both AP and FP. I know I don't. I tell attorneys and courts that I am a forensic pathologist, and that is my area of expertise. I explain my training if asked, but do not claim to be an AP expert. If asked, I would freely admit that despite my active board-certified status, that I should not be doing diagnostic surgical pathology or cytology.

 

[Over9000]

Yes, you are correct. If (and that's a big if) we do it, option 5 is how we will do it. But even the 50 question exam is unnerving when you haven't done that stuff in a decade.

To try and make this relevant, how would you all feel if you had to retake USMLE step 1 every decade because the ABP says so?

QFT.

I'm not a subspec, but I think that pathology as a whole is stuck in the 19th century. BOTH surgery AND medicine managed to realize that subspecialization was the way to go, yet us nitwits in pathology have to learn about and be certified in anatomic pathology (ridiculous name borne from the British moniker of "morbid anatomy" - more suited to a death metal band than a profession), and the PhD field of clinical pathology. God help you if you are forensic boarded - this field is about as far away from AP and CP as one can get. Yet, here we are, lumping them all together.

Forensics should be its own residency. AP should change its name to something more telling, be a five year slog with an internship, and eliminate the forensics component altogether. CP...well...CP should go to the PhDs.

 

[Mindy]

Actually, after a fit of anger toward the ABP/ABMS, activism within the National Association of Medical Examiners, and a whole lot of ranting, I have simply decided that I will not take my recertification examination. I will maintain MOC up until the exam, and that is it. In fact, many many FPs feel exactly the same way. In a few years, board certified FPs more than 10 years out will be unheard of.

FPs are relatively underpaid, overworked public servants who already get very little respect for the work we do. Some not-for-profit (hah!) companies are not going to put me over a barrel anymore with this. I personally think other docs should stand up for themselves too.

So, I definitely was feeling screwed. Now I feel liberated. I won't even have to take a stupid FP trivia test. And quite frankly, who the heck is lining up to replace us??!

Mindy

edit for a ps: Of the pilot AP/CP ABP exam, some thirty-odd people took it and only 3 people failed. Guess what? All FPs!!!! Why 'cuz we're so dumb??? NO! Because the ABP does not represent forensic pathologists (think mandatory "Patient Safety Course" we now need for MOC).

 

[Mindy]

I am very happy to be just an FP, rather than AP. I could not care less about ringing out a bunch of credentials on the stand. Sometimes, now that I have been around the block, the lawyers don't even ask me. At the end of the day, its really whether or not a jury trusts and believes you. And I think if you know your junk, they trust and believe you. A lot of forensic pathology is common sense combined with an exquisite sense of anatomy and physiology (e.g., shot in the chest, lung now has a hole in it, blood pouring into chest cavity, can't exand lung, no oxygen, death). I do not need a bunch of symbols after my name to explain that to a jury. And a person with a lot of symbols after their name sometimes sounds like they are hiding behind their book smahts.

My two cents, not being re-certed (particularly in AP) won't hurt me at all.

Mindy

 

[LADoc00]

dr4n6= ABP plant poster.

In no scenario would a standard fully employed FP be ready for things like the newest NCCN guidelines, the newest IHC markers, the ever growing molecular triage for new malignancies and the every 3 year reclassification of things like lymphomas.

It might, MIGHT be possible for a FP to pass an super dumbed down AP exam after 10 years in practice but I expect the fail rate to be sky high.

 

[dr4n6]

Why is it that as forensic pathologists we constantly gripe about our salaries when compared to our surgical pathology colleagues, yet we seem to be content with diluting the quality of our work by complaining about maintaining our AP board certification? The majority of our cases are natural deaths and rely on our general AP skills, otherwise we should just allow individuals like Shawn Parcells to take over our subspecialty. Granted, there are going to be topics in a recertification exam that are not germane to the pure FP, but last time I checked we do sign DC's with cardiac, pulmonary and neuropath related causes of death and see no reason that we should not meet a minimal standard of competence in general AP. Done correctly, the practice of FP really is more than just trauma combined with a knowledge of anatomy/physiology.

 

[Mindy]

dr4n6: Don't insult me and other young FPs with the "diluting the quality of our work" nonsense. Where is your evidence for this? It simply does not exist. Have you seen ABMS' evidence library regarding MOC in general? It is very weak at best. Why don't you send me a PM with your identity or contact me in one of the million other ways forensic pathologists are capable of contacting me? If you really are an FP, I am sure you know or know of me. I have never hid behind a moniker here. My guess is that LADoc is right on about your motivations.

I guess you are not aware that attempts of tying MOC to state licensure are actively being pursued? Or that MOC is actually codified in federal law in the ACA? Or that some advocates of MOC down the road want physical and cognitive exams to prove doctors are "competent" to practice medicine (because doctors "are like airline pilots", and apparently there should be a mandate to retire at 65 according to some sources. Of course none of the benefits like less than 100/hr per month work rule). Do the homework yourself if you are not aware of these things.

In my opinion, MOC is simply regulatory control and capture of doctors. Period.

But, those who are trying desperately to force it down everyone's throat use the logic that you put forth: Shouldn't I want to collect a million more blue ribbons in order to prove myself worthy of practicing my craft?? The answer is no. I am done collecting blue ribbons. I prove my knowledge with each and every case I sign that is then distributed to a boatload of people and pried apart in courtrooms, in the media, and elsewhere routinely. I take no honor is my "AP Board Certification" which quite frankly I have yet to be able to really explain what it is to anyone anyway. AP was and is a means to an end for me. I would have taken an FP only board exam without complaining (much), but when the ABP arbitrarily pulled the rug out from under my plans the monday before Thanksgiving, I knew they did not have my best interest at heart. And to me they devalued "board certification" (again ????a mandatory Patient Safety Course for forensic pathologists???) I am happy enough to walk away and not be bothered.

You want me to take a test? Fine, come to the morgue and evaluate me on how I perform an autopsy. I will hold myself against anyone in the country. If nothing else, I am a very confident--and competent--forensic pathologist. On the other hand, playing 50-question Pathology Trivial Pursuit (or as I like to think of it, career gambling) is no way to decide who's a capable physician and who isn't.


Mindy

p.s. I don't gripe about my salary, so don't accuse me of it. As I said before, I am a public servant. I am a bargain for taxpayers and I am okay with that. Don't make me jump through more hoops, though.

 

[LADoc00]

I love Mindy getting all She-Hulked on this ABP plant. (grabs popcorn)

I completely agree with everything stated Mindy. This is a total travesty.

I say we riot.

P.S. can we get a IP trace on dr4n6 to make sure it doesnt trace back to Tampa. 33 total posts...Im getting a North Korean-type pringly sensation on this one.

 

[dr4n6]

I truly have no doubt that Mindy, and almost all properly trained forensic pathologists, are more than capable at the autopsy table and do not mean to question or second guess that skill set. The only point I am making is that forensics long ago moved far beyond gross morphological pathology as being our primary diagnostic modality. The practice of forensics is increasingly moving into the realm of molecular pathology and microscopic histopathology, which falls under the realm of anatomical pathology, and by ignoring that aspect of our subspecialty we are doing a disservice to our patients and to our subspecialty.

 

[Mindy]

Dr4n6:

I do not believe you practice forensic pathology. You simply do not know what you are talking about.

Is there some new hanging gene? Or heroin overdose sequence? Or brown stain for drowning???? See, I am in charge of *non-natural* deaths! Those sudden unexpected deaths in honestly healthy folks are actually fairly rare. But you would know all of this already, wouldn't you?

Do you even think it's ethical to look for genetic markers on our non-consented cases? Or should I have taxpayers foot the bill for $5000 cardiomyopathy work-ups?! Or how about the time away from work I will need to study AP trivia?

If there was more respect for the very important work I actually do, i.e. autopsies, then perhaps I would be less aggravated by all of this. But no, any two bit pathology-wanna-be can do my job unless I know some obscure translocation with dubious causation, right?

Mindy

 

[ForPath]

Mindy, please don't leave us again! This forum needs you

 

[Tissue issue]

Dr4n6:

I do not believe you practice forensic pathology. You simply do not know what you are talking about.

Is there some new hanging gene? Or heroin overdose sequence? Or brown stain for drowning???? See, I am in charge of *non-natural* deaths! Those sudden unexpected deaths in honestly healthy folks are actually fairly rare. But you would know all of this already, wouldn't you?

Do you even think it's ethical to look for genetic markers on our non-consented cases? Or should I have taxpayers foot the bill for $5000 cardiomyopathy work-ups?! Or how about the time away from work I will need to study AP trivia?

If there was more respect for the very important work I actually do, i.e. autopsies, then perhaps I would be less aggravated by all of this. But no, any two bit pathology-wanna-be can do my job unless I know some obscure translocation with dubious causation, right?

Mindy

I second the plea for you not to leave. FWIW, I feel this way about how surgical pathology has been treated- it's been downhill for a long time now.

 

[yaah]

Yeah, I hear there is a new molecular test which can tell you exactly how far away the gun was fired from.

As far as state licensure being linked to MOC, in my state my license requirements include nearly the same requirements as the board MOC (Paying $ + accumulating CME). The MOC adds letters of attestation, which is farcical in how worthless it is, and the exam which is also a farce.

What should boards do for recertification? I don't know really. But I don't think it's necessary if you maintain your medical license and you stay on staff at a hospital or maintain your job (if you're not affiliated with a hospital).

 

[mlw03]

Dr4n6:

I do not believe you practice forensic pathology. You simply do not know what you are talking about.

Is there some new hanging gene? Or heroin overdose sequence? Or brown stain for drowning???? See, I am in charge of *non-natural* deaths! Those sudden unexpected deaths in honestly healthy folks are actually fairly rare. But you would know all of this already, wouldn't you?

Do you even think it's ethical to look for genetic markers on our non-consented cases? Or should I have taxpayers foot the bill for $5000 cardiomyopathy work-ups?! Or how about the time away from work I will need to study AP trivia?

If there was more respect for the very important work I actually do, i.e. autopsies, then perhaps I would be less aggravated by all of this. But no, any two bit pathology-wanna-be can do my job unless I know some obscure translocation with dubious causation, right?

Mindy

I agree with Mindy - no way Dr4n6 is a practicing FP in the US/Canada. His/her statements do not reflect the practice of FP, period.

The practice of FP is NOT moving to molecular, at least not on a day to day basis. I've made a diagnosis based solely on a molecular test once is 3.5 years of FP practice thus far (a particular type of cardiomyopathy). Day to day, it's what Mindy has said - overdoses, hangings, shootings, drownings, etc. There's not a brown stain determining whether I'm dealing with a single-edged knife versus a doubly-edged knife. I do that with my eyes and my hands, just like it's been done for over 50 years, and will continue to be done.

I could go on restating Mindy's excellent points (and she and I are professionally acquainted - like she said, FP is a small field, we know most of each other), but I don't see a point here. While FP is based in AP, day to day practice is not surg path, period, and I do not think the ABP particularly cares about assuring my competence in FP with this rule change. I believe it is a money grab, pure and simple.

 

[Over9000]

Mindy, you seem quite prolific and competent. Have you considered suggesting that FP break off from AP/CP become its own specialty, much like rad onc did decades ago when it was part of radiology?

Very little of what comprises FP overlaps with daily AP/CP. Their lumping together is based on 19th century thinking, and I think they should be separated.

 

[mlw03]

Mindy, you seem quite prolific and competent. Have you considered suggesting that FP break off from AP/CP become its own specialty, much like rad onc did decades ago when it was part of radiology?

Very little of what comprises FP overlaps with daily AP/CP. Their lumping together is based on 19th century thinking, and I think they should be separated.

This is something that has been considered and discussed, yep. There are plenty of us in FP that think this idea has merit, with a similar analogy. Is FP grounded in anatomic path, yes, but like you said, the day to day practice is wholly different.

 

[Tissue issue]

Just when you think you've seen it all.................

http://drwes.blogspot.com/2014/12/the-abim-foundation-choosing-wisely-and.html?m=1

 

[mlw03]

Just when you think you've seen it all.................

http://drwes.blogspot.com/2014/12/the-abim-foundation-choosing-wisely-and.html?m=1

Can anyone be surprised by this sort of thing? I doubt Dr. Bennett was driving around Tampa in a 1984 Pinto when she ruled the ABP. I have no problem with people getting paid fairly for a legit service, but there is clearly a conflict of interest when the testing bodies have such monopolistic power.

 

[Over9000]

Can anyone be surprised by this sort of thing? I doubt Dr. Bennett was driving around Tampa in a 1984 Pinto when she ruled the ABP. I have no problem with people getting paid fairly for a legit service, but there is clearly a conflict of interest when the testing bodies have such monopolistic power.

Betsy's an idiot. Her obsolete idea of maintaining educational standards is to ensure that the only measurable task that residents need to do is fifty bloody autopsies. Whether they make it through the four years without seeing medical derm, liver neoplasia etc. is irrelevant.

I suspect this is a very self-serving, political approach since if residents were required to have a broad exposure to and experience with enough real-world pathology to be comfortable, most of the programs in the US would close. Not to mention medical autopsies are generally harmless, which negates the need for programs to recruit top-quality resident physician talent.

The big issues with our profession begin at the roots - the recruitment and training level.

 

[Ziehl-Neelsen]

Can anyone be surprised by this sort of thing? I doubt Dr. Bennett was driving around Tampa in a 1984 Pinto when she ruled the ABP. I have no problem with people getting paid fairly for a legit service, but there is clearly a conflict of interest when the testing bodies have such monopolistic power.

She drove a Benz. I know this because she almost ran over my residency classmate on the morning of the CP exam.

I know.

 

[KCShaw]

I don't check in much over here, but this has been entertaining.

This whole farce would be more amusing if it didn't have such an actual effect. The system seems to encourage subspecialization at the training level, but discourages it at the recert level where the stakes are still quite high for most. The quirk for FP's is that we still have an opportunity to thumb our noses at the ABP/ABMS and move on with life without MOC/recert (or we could develop an alternative certification). There are some downsides to that approach, but on the individual level it's currently do-able and still expect to have a reasonable career. I doubt that's going to be the long term solution for a majority of folks, but that remains to be seen.

One problem with implementing a fundamental shift in FP training is that I don't know that ME offices really provide a broad enough background *by themselves*. Just as there is value in high school, college, and medical school, I do think there is value in some AP (and CP) training before FP, but not exactly in the fashion typically required for budding surgical pathologists. The problem is bridging that gap, because the average pathology residency program isn't going to tailor a short program solely to streamline someone to being an FP -- especially when we're only talking about perhaps 35-45 such residents per year. Perhaps it could be done if ME offices contracted with a residency program or pathology group for specific rotations, but that would require appropriate funding, etc. Regardless, it would be a substantial undertaking.

In the meantime, don't confuse the value of prior training as part of a foundation, with any value in MOC/recert. Devaluing experience (right now, experience just means you're getting closer to presumed incompetence) in favor of 'academics' and trivia is a big fat fail -- they may have some uses along the journey, but they cannot be the end goal, one ring to rule them all, only to be revisited again and again.

 

[dermpathdoc]

wel

Actually, after a fit of anger toward the ABP/ABMS, activism within the National Association of Medical Examiners, and a whole lot of ranting, I have simply decided that I will not take my recertification examination. I will maintain MOC up until the exam, and that is it. In fact, many many FPs feel exactly the same way. In a few years, board certified FPs more than 10 years out will be unheard of.

FPs are relatively underpaid, overworked public servants who already get very little respect for the work we do. Some not-for-profit (hah!) companies are not going to put me over a barrel anymore with this. I personally think other docs should stand up for themselves too.

So, I definitely was feeling screwed. Now I feel liberated. I won't even have to take a stupid FP trivia test. And quite frankly, who the heck is lining up to replace us??!

Mindy

edit for a ps: Of the pilot AP/CP ABP exam, some thirty-odd people took it and only 3 people failed. Guess what? All FPs!!!! Why 'cuz we're so dumb??? NO! Because the ABP does not represent forensic pathologists (think mandatory "Patient Safety Course" we now need for MOC).

if you are DO and had taken the AOBPa route you would only need to take the Forensic exam for MOC/recert. AP/CP MOC is not necessary

 

[dermpathdoc]

also..anyone read the NEJM blog entry on MOC this month?

 

[mlw03]

also..anyone read the NEJM blog entry on MOC this month?

Nope, could you share a link please?

 

[Poeppel]

I think this is the article dermpath is talking about:

http://www.nejm.org/doi/full/10.1056/NEJMp1407422

Being in Canada, why not just wash your hands of the whole American MOC affair? Is ABP certification/recertification required to continue to work as an FP there?

 

[mlw03]

I think this is the article dermpath is talking about:

http://www.nejm.org/doi/full/10.1056/NEJMp1407422

Being in Canada, why not just wash your hands of the whole American MOC affair? Is ABP certification/recertification required to continue to work as an FP there?

I'm thinking about it, and I'm not sure. I have no plans to leave, but no one really know if American offices are going to care if their younger FPs drop MoC.

 

[LADoc00]

hahahahaha So essentially from that article all these medical specialty boards are blowing our cash on hookers and blow? (and "investment condos")...figures.

 

[mlw03]

News on this topic from the IM community:

http://www.abim.org/news/abim-announces-immediate-changes-to-moc-program.aspx

 

[Mindy]

I wanted to make sure everyone saw this article. It is about the ABIM, but still quite relevant.

http://www.newsweek.com/ugly-civil-war-american-medicine-312662

Mindy

 

[Mindy]

Another anti-MOC petition is gaining steam. I am tempted to start one for pathologists.

https://www.change.org/p/american-a..._msg&utm_content=ma_sap_share2:share_controls

Mindy

 

[Over9000]

Another anti-MOC petition is gaining steam. I am tempted to start one for pathologists.

https://www.change.org/p/american-academy-of-dermatology-immediately-remove-all-maintenance-of-certification-moc-requirements-for-dermatologists-who-have-passed-the-american-board-of-dermatology-certification-exam-and-leave-in-place-the-more-reasonable-continuing-medical-edu?recruiter=243888136&utm_source=share_petition&utm_medium=facebook&utm_campaign=publish_share&utm_term=des-md-google-custom_msg&utm_content=ma_sap_share2:share_controls

Mindy

Do it.

I'm not surprised the derms are getting on this. They are the most enterprising people in medicine. We in pathology are the opposite.

While you're at it, try to make forensics into its own direct-match specialty. It'd be a boon for your field, and free up some AP teaching time for residents.

 

[KCShaw]

I wanted to make sure everyone saw this article. It is about the ABIM, but still quite relevant.

http://www.newsweek.com/ugly-civil-war-american-medicine-312662

Mindy

Takes more steam out of the weak and never believable argument that revenue has nothing to do with it, when board exec salaries reportedly leap from ~200k to 400-800k in 12 years. Sure there's not much context for that, but those ain't just cost-of-living increases. Have to agree with the quote in the last paragraph, “It is time for practicing physicians to take back the leadership.” And really, there is no built in way to do that other than organize something new, as they did with NBPAS.

For FP's, my impression has been that the court system really doesn't care. People without boards -- heck, apparently even non-physicians in some cases -- qualify and testify as experts in forensic pathology, or at least testify as to autopsy findings and their opinions on same. That might not fly everywhere in all cases, but the court system is certainly not a gateway or measuring stick for what is ideal. FP's who want to stop drinking the rancid milk of the ABP while being beat over the head with a pointy stick will likely only have to face the question of how many employers will require specifically maintaining ABP certification. It's other physicians that I suspect will have a much more difficult time battling about this with hospital credentialing committees and that kind of crap, assuming there is a move away from existing board recerts and/or toward something like NBPAS. It's all about getting a critical mass of docs on board -- authority comes with numbers and enough willingness to stop paying out to the old system.

 

[Over9000]

del.

 

[Mindy]

Mods: can you move Senior pathologist's posts to a new thread? It does not belong in this one.

Update: Thanks Mods for moving Senior Pathologist's posts. Also, just to be clear to anyone perusing this thread (and hopefully Over9000 agrees!), Over9000 was responding to Senior Pathologist's posts, not mine. I am spelling this out because I do plan on announcing a petition for pathologists very soon.