Longitudinal assessment

[michaelrack]

I just signed up for the longitudinal assessment option for MOC for my IM boards, instead of the 10 year exam. What would be the best resource for this assessment? Should I sign up for Up to Date, or the new version of MKSAP??
These days I practice mostly psychiatry and sleep medicine, rather than general IM. thank you

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[DrMetal]

I just signed up for the longitudinal assessment option for MOC for my IM boards, instead of the 10 year exam. What would be the best resource for this assessment? Should I sign up for Up to Date, or the new version of MKSAP??
These days I practice mostly psychiatry and sleep medicine, rather than general IM. thank you

As in, you're a trained and boarded psychiatrist? Or you practice armchair psychiatry like the rest of us.

If the former, why bother re-certing in ABIM?

 

[gutonc]

IIRC, @michaelrack is IM/Psych/Sleep. I could be wrong though.

Although @DrMetal and I have very different views on the role of board certification in the ongoing practice of medicine, I'm gong to agree with them here. Unless you have hospital or practice privileges that are contingent on your maintaining IM boards, why would you do that to yourself?

I have no intention of retaking my general IM boards (which actually expire on Friday) since I don't choose to practice general IM any longer. I will keep maintaining my subspecialty boards though.

I do know people who choose to maintain boards unnecessarily as a point of pride, proving to themselves (I assume, since nobody else actually cares) that they can do it. But I have better things to do with my time and money.

Should you decide to continue this route, the LKA is new enough that I don't know that we have good data to support the best study materials. I suspect MKSAP (or the millions of other options out there) will be more than enough.

 

[DrMetal]

Although @DrMetal and I have very different views on the role of board certification in the ongoing practice of medicine,

What's your viewpoint? (asking honestly, I don't know it).

I have no intention of retaking my general IM boards (which actually expire on Friday) since I don't choose to practice general IM any longer. I will keep maintaining my subspecialty boards though.

Nor should you, no subspecialist should. It's a ridiculous notion. We don't need our oncologists studying the latest indications for aortic valve repair, nor do we need our cardiologists studying indications for chemotherapy.

And to hell with the notion that we want every doctor to maintain broad knowledge in everything. By that logic, let's have everyone study everything! Let's go back and retake Step 1, we need to keep your biochemistry/microbiology knowledge sharp, right?

That's just not how the real world works.

I do know people who choose to maintain boards unnecessarily as a point of pride

A matter of pride? Or a matter of fear? (fear that they're going to lose something and be punished for it by the 'system').

 

[michaelrack]

As in, you're a trained and boarded psychiatrist? Or you practice armchair psychiatry like the rest of us.

If the former, why bother re-certing in ABIM?

I did a combined IM/psych residency, followed by a sleep fellowship, and certified in all 3 (sleep through ABIM). I also grandfathered into the Consult laision psych subspeciality, and am certified in it also. I like to keep all my certifications current, and do have some medical privileges in psych inpatient facilities. I havent ruled out getting into academics in a few years

 

[michaelrack]

Should you decide to continue this route, the LKA is new enough that I don't know that we have good data to support the best study materials. I suspect MKSAP (or the millions of other options out there) will be more than enough.

thank you

 

[DrMetal]

I did a combined IM/psych residency, followed by a sleep fellowship, and certified in all 3 (sleep through ABIM). I also grandfathered into the Consult laision psych subspeciality, and am certified in it also. I like to keep all my certifications current, and do have some medical privileges in psych inpatient facilities. I havent ruled out getting into academics in a few years

Sweet Jesus. So you're basically always studying for a test. Sad that we (as a profession) can't allow someone as accomplished as yourself to just practice and tend to his/her patients (or tend to your personal life, because your rejuvenation is just as important as your work).

Then yes, MKSAP all the way. It's the closest thing we have to the horse's mouth. I saw questions on the boards that were almost exact 'carbon copies' from MKSAP. It's clear that MKSAP and ABIM authors are either the same people or very buddy-buddy with each other.

 

[michaelrack]

Well, not really studying for a test.... just want a resource to help answer questions for the questions periodically sent to me by the ABIM, starting in January. For psychiatry, since it's 10 year tests are so easy, I am sticking with that model instead their longitudinal program of reading articles and answering questions on those. Still have to do the regular MOC cme for ABIM and abpn, but it's pretty easy for medicine, there's a lot free on medscape

 

[michaelrack]

But it sounds like mksap is the consensus

 

[CatFactorial]

What's your viewpoint? (asking honestly, I don't know it).



Nor should you, no subspecialist should. It's a ridiculous notion. We don't need our oncologists studying the latest indications for aortic valve repair, nor do we need our cardiologists studying indications for chemotherapy.

And to hell with the notion that we want every doctor to maintain broad knowledge in everything. By that logic, let's have everyone study everything! Let's go back and retake Step 1, we need to keep your biochemistry/microbiology knowledge sharp, right?

That's just not how the real world works.



A matter of pride? Or a matter of fear? (fear that they're going to lose something and be punished for it by the 'system').

Not too ridiculous to maintain IM if in stem cell transplant

 

[DrMetal]

Not too ridiculous to maintain IM if in stem cell transplant

Yes, I need to have the stem cell transplant physician answering questions about SGLT2 inhibitors.

Look: I don't think it ridiculous for any physician to maintain knowledge (or gain new knowledge) in any subject matter that she sees fit. I would encourage it, and hope it gets done via high-quality CME or OJT.

But threatening someone's livelihood by mandating MOC (and make no mistake, it is a mandate when you've lobbied to convince insurance companies and institutions to require and police it) . . .that I'm against.

 

[CanIMakeIt]

It is so mind boggling. Why are the physicians so afraid to unite against this monstrosity? Ok one time board certification makes sense that you have basic competency in the subject area that you want to practice in - but mandating MOC - nonsense. CME - sure - we do that either way to keep up with new knowledge in the area that you practice.

 

[Benzo4every1]

IIRC, @michaelrack is IM/Psych/Sleep. I could be wrong though.

Although @DrMetal and I have very different views on the role of board certification in the ongoing practice of medicine, I'm gong to agree with them here. Unless you have hospital or practice privileges that are contingent on your maintaining IM boards, why would you do that to yourself?

I have no intention of retaking my general IM boards (which actually expire on Friday) since I don't choose to practice general IM any longer. I will keep maintaining my subspecialty boards though.

I do know people who choose to maintain boards unnecessarily as a point of pride, proving to themselves (I assume, since nobody else actually cares) that they can do it. But I have better things to do with my time and money.

Should you decide to continue this route, the LKA is new enough that I don't know that we have good data to support the best study materials. I suspect MKSAP (or the millions of other options out there) will be more than enough.

in case i ever move to a new job and needed.
my present job does not require IM to get hospital privileges. just pulm cc

 

[printer]

On a side note, for those of us who are new certifiers (e.g. within last 5 years), can someone help to clarify what is the exact MOC requirement schedule in light of the longitudinal assessments now? Someone once told me I don't need to worry about fees or MOC for the first 10 years, but the new longitudinal assessment is making me think otherwise - The ABIM website and the FAQs don't make this clear at all...

For example, on the ABIM website my certification years are:
Internal Medicine: 2017
Gastroenterology: 2021

Say if I wanted to keep both certifications up to date (I know may not be necessary, but just for sake of example) - does this mean I start the longitudinal assessments in 10 years? So for IM in 2027 and for GI in 2031?

Do I not start paying MOC yearly fees until after 10 years? The ABIM website states my fees are waived by fellowship participation, but also states at the same time states my $340 MOC fees are "DUE NOW"...

None of this is making any sense and it is really confusing me...can someone please help clarify? Would really appreciate it!

 

[ReviewOfSystems]

On a side note, for those of us who are new certifiers (e.g. within last 5 years), can someone help to clarify what is the exact MOC requirement schedule in light of the longitudinal assessments now? Someone once told me I don't need to worry about fees or MOC for the first 10 years, but the new longitudinal assessment is making me think otherwise - The ABIM website and the FAQs don't make this clear at all...

For example, on the ABIM website my certification years are:
Internal Medicine: 2017
Gastroenterology: 2021

Say if I wanted to keep both certifications up to date (I know may not be necessary, but just for sake of example) - does this mean I start the longitudinal assessments in 10 years? So for IM in 2027 and for GI in 2031?

Do I not start paying MOC yearly fees until after 10 years? The ABIM website states my fees are waived by fellowship participation, but also states at the same time states my $340 MOC fees are "DUE NOW"...

None of this is making any sense and it is really confusing me...can someone please help clarify? Would really appreciate it!

From my understanding, you have to pay the MOC fees yearly regardless, as well as keep up with 1 MOC activity every 2 years/100 MOC points every 5 years requirement. Then if you are choosing to do LKA over the 10-year MOC exam, then you can enroll in LKA the year your traditional 10-year MOC would have been due (if available for that specialty). I plan to go for the LKA.

 

[zeloc]

From my understanding, you have to pay the MOC fees yearly regardless, as well as keep up with 1 MOC activity every 2 years/100 MOC points every 5 years requirement. Then if you are choosing to do LKA over the 10-year MOC exam, then you can enroll in LKA the year your traditional 10-year MOC would have been due (if available for that specialty). I plan to go for the LKA.

I don't understand, so what would be the cost if I last did my IM certification 10 years ago and it's due now? Either if I did the 10-year exam OR the LKA? The website doesn't make any sense.

Do MOC points replace CME? Is it a choice of an MOC activity (whatever that is) every 2 years OR 100 MOC points every 5 years?

 

[ReviewOfSystems]

LKA cost is included in the yearly MOC fees you pay, so you dont have to pay extra when its time to take it. If you want to do the 10-year exam, it is $700, separate from the yearly MOC fees. If you are due this year, pick which of the two you want to do. The only difference I know between CME and MOC is that CME is to maintain licensing and MOC is to maintain board certification. You have to do 1 MOC activity every 2 years to be considered to be actively participating in MOC, and then total 100 MOC points every 5 years to maintain board certification. What happens if you dont do a MOC activity every 2 years, I dont exactly know, but if you don't get the 100 points, then I assume you lose certification. You can often convert CME credits to MOC credits to submit them to ABIM. For example, if you do all your CME as UpToDate searches or attend a national conference (e.g., ACP), after you redeem your CME credits, you can go back in and "convert" them to MOC points- this is what I did and it was super easy to hit 100 points within 1 year.

 

[DrMetal]

What utter horse#$%^ we partake in. The only way we should need to 'maintain' our certification is to practice good medicine. We'll be taking assessments until we're 70-yo, meanwhile some NPs out there are getting free reign to do WTF they want.

 

[rokshana]

What utter horse#$%^ we partake in. The only way we should need to 'maintain' our certification is to practice good medicine. We'll be taking assessments until we're 70-yo, meanwhile some NPs out there are getting free reign to do WTF they want.

I dont understand why we keep harping on the mediocre processes that mediocre practitioners undergo to give mediocre care… is that really our metric now?

 

[gutonc]

I dont understand why we keep harping on the mediocre processes that mediocre practitioners undergo to give mediocre care… is that really our metric now?

It's just his hobby.

 

[michaelrack]

You do get some MOC credit for doing LKA. Get some additional free MOC on medscape and you should be fine

 

[DrMetal]

I dont understand why we keep harping on the mediocre processes that mediocre practitioners undergo to give mediocre care… is that really our metric now?

It's not our metric. It's that of an industry that has decided to marginalize the physician.

The problem is, we as a community of physicians are too scared or occupied to do anything about it, because we're busy dealing with silly things like MOC . . .because somewhere along the way, we decided that it wasn't enough to go to medical school, to complete a residency, +/- fellowships, to become initially BC'd, then to just practice and bear the fruits of our labor.

No . . . on top of all that, we have to pay $$$ and answer 25 multiple-guess questions/month, that if we refuse to do, we'll be stripped of our practices . Then the industrial machine will get exactly what it wants: the opportunity to replace us with cheaper alternatives, no matter the mediocrity.

But convincing physicians to battle against this is a hard battle, we're too dumb to realize our own demise.

I have a better chance of convincing you that the Lakers will win the NBA championship this year, and that's saying a lot.

 

[zeloc]

LKA cost is included in the yearly MOC fees you pay, so you dont have to pay extra when its time to take it. If you want to do the 10-year exam, it is $700, separate from the yearly MOC fees. If you are due this year, pick which of the two you want to do. The only difference I know between CME and MOC is that CME is to maintain licensing and MOC is to maintain board certification. You have to do 1 MOC activity every 2 years to be considered to be actively participating in MOC, and then total 100 MOC points every 5 years to maintain board certification. What happens if you dont do a MOC activity every 2 years, I dont exactly know, but if you don't get the 100 points, then I assume you lose certification. You can often convert CME credits to MOC credits to submit them to ABIM. For example, if you do all your CME as UpToDate searches or attend a national conference (e.g., ACP), after you redeem your CME credits, you can go back in and "convert" them to MOC points- this is what I did and it was super easy to hit 100 points within 1 year.

Included in the yearly MOC fees I pay? I haven't paid any. I thought it was optional. This is a requirement now to maintain board certification?

So then I understand it's $220 for the first year, then $120/year after that, and these fees include the LKA. Why would anyone ever take the 10-yr exam for an extra $700 if I have to pay yearly regardless? I guess the idea is to avoid the trouble of of dealing with it every year, but one still has to pay the yearly amount.

 

[zeloc]

Also I understand LKA is done by calendar year, so it would be advantageous to sign up before March 31 if one is doing it?

I'm not sure there is any point in studying for this. If the decision is made after 5 years and they give you feedback and access to the questions you have completed for some period of time after that, one can just learn from those questions and read up on any weak areas as time goes on?

Can anyone clarify if one gets immediate access to questions/explanations after completing them, and for how long does it last?

 

[zeloc]

On a side note, for those of us who are new certifiers (e.g. within last 5 years), can someone help to clarify what is the exact MOC requirement schedule in light of the longitudinal assessments now? Someone once told me I don't need to worry about fees or MOC for the first 10 years, but the new longitudinal assessment is making me think otherwise - The ABIM website and the FAQs don't make this clear at all...

For example, on the ABIM website my certification years are:
Internal Medicine: 2017
Gastroenterology: 2021

Say if I wanted to keep both certifications up to date (I know may not be necessary, but just for sake of example) - does this mean I start the longitudinal assessments in 10 years? So for IM in 2027 and for GI in 2031?

Do I not start paying MOC yearly fees until after 10 years? The ABIM website states my fees are waived by fellowship participation, but also states at the same time states my $340 MOC fees are "DUE NOW"...

None of this is making any sense and it is really confusing me...can someone please help clarify? Would really appreciate it!

From my understanding, you have to pay the MOC fees yearly regardless, as well as keep up with 1 MOC activity every 2 years/100 MOC points every 5 years requirement. Then if you are choosing to do LKA over the 10-year MOC exam, then you can enroll in LKA the year your traditional 10-year MOC would have been due (if available for that specialty). I plan to go for the LKA.

I could be wrong, but I believe you are still considered board certified but not participating in MOC within 10 yrs of when you took your exam. Eg, if you look up a physician on their site, you can find those that are board certified but not participating in MOC. So maybe it is possible to wait until 2027?

 

[michaelrack]

Also I understand LKA is done by calendar year, so it would be advantageous to sign up before March 31 if one is doing it?

I'm not sure there is any point in studying for this. If the decision is made after 5 years and they give you feedback and access to the questions you have completed for some period of time after that, one can just learn from those questions and read up on any weak areas as time goes on?

Can anyone clarify if one gets immediate access to questions/explanations after completing them, and for how long does it last?

you get immediate feedback after most questions. I guess it lasts until u decide to go on to the next question, or until you end the session

 

[ortnakas]

I could be wrong, but I believe you are still considered board certified but not participating in MOC within 10 yrs of when you took your exam. Eg, if you look up a physician on their site, you can find those that are board certified but not participating in MOC. So maybe it is possible to wait until 2027?

That would make sense, but no. I got board certified last year and mine says “participating in MOC.”

 

[zeloc]

That would make sense, but no. I got board certified last year and mine says “participating in MOC.”

Are you paying MOC fees?

 

[zeloc]

you get immediate feedback after most questions. I guess it lasts until u decide to go on to the next question, or until you end the session

I called and asked and they said there is access for 1 year. Don't know if that's the case.

It's also by calendar year, so it's advantageous to sign up earlier in the year.

Since there's no feedback until year 2, does anyone have an idea of % of questions that one should get right? I've seen 65-75% mentioned for the traditional boards on this forum.