Trish Tivnan, Director, MOC and Core Competencies, ABPN 
The Maintenance of Certification Program (MOC) of the American Board of Psychiatry and Neurology (ABPN) was put into operation in 2007, as the first cohort of diplomates applied for the 2008 MOC examinations.
The mission of the ABPN’s Maintenance of Certification Program is to advance the clinical practice of psychiatry and neurology by promoting the highest evidence-based guidelines and standards to ensure excellence in all areas of care and practice improvement. As the 10-year cycle began, the ABPN Maintenance of Certification Committee, chaired by Victor Reus, M.D., further streamlined the timetable of MOC. Changes included structuring the program into two 5-year blocks, realigning Self-Assessment and Lifelong Learning, and configuring Performance in Practice (PIP) into three-year blocks.
The current program is being phased in incrementally, with the Self-Assessment component to be fully operational in 2010, and the Performance in Practice component in 2013. Currently, the structure is as follows:
• Part 1: Professional Standing specifies that diplomates must hold an unrestricted license to practice medicine in at least one state, territory, commonwealth, or possession of the United States or province of Canada. The ABPN accepts CMEs earned through the Royal College of Physicians and Surgeons of Canada.
• Part 2: Self-Assessment and Lifelong Learning requires that 150 of the 300 Category 1 CME hours needed or Lifelong Learning be accrued in the first 5-year block of the 10-year cycle and 150 be accrued in the second 5-year block. The Self-Assessment component requires the completion of one broad-based Self-Assessment in years 1-3 of the 10-year cycle, and one in years 6-8, when the cycle is fully in effect. The activity must cover current knowledge and/or current best practices in one or more of the required competency areas in a single assessment or in the sum of several combined assessments; include at least 100 questions; be affordable and accessible; provide feedback to be used as the basis for CME, Lifelong Learning, or career development.
• Part 3: Cognitive Expertise has replaced the recertification examination, and all diplomates are required to complete the cognitive MOC examination prior to the expiration date on their certificate. A passing score extends the renewal date of the certificate to December 31, ten years from the year of the examination. Practice-relevant, clinically oriented, multiple-choice, computer-administered examinations are delivered in over 200 Pearson VUE testing centers throughout the United States. In order to prepare for the examination, diplomates are advised to read current research, specialty journals, and practice guidelines, and to attend relevant CME programs.
• Part 4: Performance in Practice (PIP) stipulates that the PIP clinical modules be divided into three components; the first PIP unit be completed in years 1-3 of the cycle; the second PIP unit be completed in years 4-6 of the cycle; the third PIP unit completed in years 7-9 of the cycle. In addition, the units, composed of both a clinical module and a feedback module, must use data obtained from or pertinent to diplomates’ personal clinical practices; assess at least five cases in a specific category (e.g., diagnosis, type of treatment, treatment setting) over the previous three years; compare data from five clinical cases to best practices and/or practice guidelines published in the literature; provide performance feedback to diplomates concerning improvement in the effectiveness and/or efficiency in their practices, as related to the core competencies; require the development of plans by diplomates to improve their performance; reassess data from a review of five additional cases in the same category (clinical modules) or feedback from five different patients or peers (feedback modules) within 24 months, and provide feedback similar to that in the original assessments.
To date, a link to NetOutcomes, a program developed by the University of Arkansas, is available on www.abpn.com for Performance in Practice (PIP). In addition, the CAHPS program, an online survey relating to the PIP feedback modules, can also be accessed through www.abpn.com.
The Board has approved numerous broad-based self-assessment activities, as delineated in www.abpn.com. The ABPN will include links on www.abpn.com for programs that are consistent with ABPN requirements. However, diplomates are free to develop their own programs, and may request consideration of other practice-specific, Self-Assessment activities by submitting a detailed description of the activity to the Director of MOC and Core Competencies at the Board office.
Diplomates are required to maintain records of their Self-Assessment and Lifelong Learning (CME) activities and Performance in Practice modules. Diplomates must attest to completion of all components by signing the cognitive examination application form. Approximately 5 percent of all applications will be audited. If selected for an audit, the diplomate will receive a letter detailing the documentation required as evidence of completion of stipulated components. Requirements by year are outlined in a phase-in schedule of all components that is posted on www.abpn.com.
In order to facilitate completion of MOC, the Board approved a policy that diplomates who complete Self-Assessment, Lifelong Learning, and practice improvement components can apply them to multiple certifications, thus fulfilling MOC criteria for one or more subspecialty areas.
In addition, diplomates who are certified in both psychiatry and neurology and who desire to maintain their certificates in both disciplines must only meet the CME, Self-Assessment, and Performance in Practice requirement for one specialty. However, they will be required to pass cognitive examinations in both psychiatry and neurology. Child psychiatrists also have the option to recertify in child psychiatry without recertifying in general psychiatry. In compliance with the American Board of Medical Specialties (ABMS), the ABPN has adopted revised definitions of “clinically active,” and “clinically inactive.”
Since the ABMS requested that each Board submit the clinical activity status of all diplomates in 2008, the ABPN Board will be soliciting submission of clinical activity status (as described below) through the Web site, www.abpn.com, and at specialty society meetings. If this information is unknown, this must be revealed. All information will be available to the public.
• Clinically Active: Any amount of direct and/or consultative patient care that has been provided in the preceding 24 months;
• Clinically Inactive: No direct and/or consultative patient care that has been provided in the preceding 24 months.
It is anticipated that numerous Self-Assessment and Performance in Practice programs will obtain Board approval and be posted on the Web site. To date, AACAP has a comprehensive module activity that is available to all AACAP members.
Any questions regarding MOC can be directed to Trish Tivnan, director of MOC and Core Competencies, at ptivnan@abpn.com or at 847.229.6557.
For information on how AACAP can assist in the recertification process, MOC related questions, information on AACAP’s Self-Assessment and Lifelong Learning modules and other CME activities, please contact Elizabeth Hughes, Assistant Director of Education and Recertification, at 202.966.7300 ext. 106 or Kaitlin Bresnahan, CME Coordinator, at 202.966.7300 ext. 139.
The Maintenance of Certification Program (MOC) of the American Board of Psychiatry and Neurology (ABPN) was put into operation in 2007, as the first cohort of diplomates applied for the 2008 MOC examinations.
The mission of the ABPN’s Maintenance of Certification Program is to advance the clinical practice of psychiatry and neurology by promoting the highest evidence-based guidelines and standards to ensure excellence in all areas of care and practice improvement. As the 10-year cycle began, the ABPN Maintenance of Certification Committee, chaired by Victor Reus, M.D., further streamlined the timetable of MOC. Changes included structuring the program into two 5-year blocks, realigning Self-Assessment and Lifelong Learning, and configuring Performance in Practice (PIP) into three-year blocks.
The current program is being phased in incrementally, with the Self-Assessment component to be fully operational in 2010, and the Performance in Practice component in 2013. Currently, the structure is as follows:
• Part 1: Professional Standing specifies that diplomates must hold an unrestricted license to practice medicine in at least one state, territory, commonwealth, or possession of the United States or province of Canada. The ABPN accepts CMEs earned through the Royal College of Physicians and Surgeons of Canada.
• Part 2: Self-Assessment and Lifelong Learning requires that 150 of the 300 Category 1 CME hours needed or Lifelong Learning be accrued in the first 5-year block of the 10-year cycle and 150 be accrued in the second 5-year block. The Self-Assessment component requires the completion of one broad-based Self-Assessment in years 1-3 of the 10-year cycle, and one in years 6-8, when the cycle is fully in effect. The activity must cover current knowledge and/or current best practices in one or more of the required competency areas in a single assessment or in the sum of several combined assessments; include at least 100 questions; be affordable and accessible; provide feedback to be used as the basis for CME, Lifelong Learning, or career development.
• Part 3: Cognitive Expertise has replaced the recertification examination, and all diplomates are required to complete the cognitive MOC examination prior to the expiration date on their certificate. A passing score extends the renewal date of the certificate to December 31, ten years from the year of the examination. Practice-relevant, clinically oriented, multiple-choice, computer-administered examinations are delivered in over 200 Pearson VUE testing centers throughout the United States. In order to prepare for the examination, diplomates are advised to read current research, specialty journals, and practice guidelines, and to attend relevant CME programs.
• Part 4: Performance in Practice (PIP) stipulates that the PIP clinical modules be divided into three components; the first PIP unit be completed in years 1-3 of the cycle; the second PIP unit be completed in years 4-6 of the cycle; the third PIP unit completed in years 7-9 of the cycle. In addition, the units, composed of both a clinical module and a feedback module, must use data obtained from or pertinent to diplomates’ personal clinical practices; assess at least five cases in a specific category (e.g., diagnosis, type of treatment, treatment setting) over the previous three years; compare data from five clinical cases to best practices and/or practice guidelines published in the literature; provide performance feedback to diplomates concerning improvement in the effectiveness and/or efficiency in their practices, as related to the core competencies; require the development of plans by diplomates to improve their performance; reassess data from a review of five additional cases in the same category (clinical modules) or feedback from five different patients or peers (feedback modules) within 24 months, and provide feedback similar to that in the original assessments.
To date, a link to NetOutcomes, a program developed by the University of Arkansas, is available on www.abpn.com for Performance in Practice (PIP). In addition, the CAHPS program, an online survey relating to the PIP feedback modules, can also be accessed through www.abpn.com.
The Board has approved numerous broad-based self-assessment activities, as delineated in www.abpn.com. The ABPN will include links on www.abpn.com for programs that are consistent with ABPN requirements. However, diplomates are free to develop their own programs, and may request consideration of other practice-specific, Self-Assessment activities by submitting a detailed description of the activity to the Director of MOC and Core Competencies at the Board office.
Diplomates are required to maintain records of their Self-Assessment and Lifelong Learning (CME) activities and Performance in Practice modules. Diplomates must attest to completion of all components by signing the cognitive examination application form. Approximately 5 percent of all applications will be audited. If selected for an audit, the diplomate will receive a letter detailing the documentation required as evidence of completion of stipulated components. Requirements by year are outlined in a phase-in schedule of all components that is posted on www.abpn.com.
In order to facilitate completion of MOC, the Board approved a policy that diplomates who complete Self-Assessment, Lifelong Learning, and practice improvement components can apply them to multiple certifications, thus fulfilling MOC criteria for one or more subspecialty areas.
In addition, diplomates who are certified in both psychiatry and neurology and who desire to maintain their certificates in both disciplines must only meet the CME, Self-Assessment, and Performance in Practice requirement for one specialty. However, they will be required to pass cognitive examinations in both psychiatry and neurology. Child psychiatrists also have the option to recertify in child psychiatry without recertifying in general psychiatry. In compliance with the American Board of Medical Specialties (ABMS), the ABPN has adopted revised definitions of “clinically active,” and “clinically inactive.”
Since the ABMS requested that each Board submit the clinical activity status of all diplomates in 2008, the ABPN Board will be soliciting submission of clinical activity status (as described below) through the Web site, www.abpn.com, and at specialty society meetings. If this information is unknown, this must be revealed. All information will be available to the public.
• Clinically Active: Any amount of direct and/or consultative patient care that has been provided in the preceding 24 months;
• Clinically Inactive: No direct and/or consultative patient care that has been provided in the preceding 24 months.
It is anticipated that numerous Self-Assessment and Performance in Practice programs will obtain Board approval and be posted on the Web site. To date, AACAP has a comprehensive module activity that is available to all AACAP members.
Any questions regarding MOC can be directed to Trish Tivnan, director of MOC and Core Competencies, at ptivnan@abpn.com or at 847.229.6557.
For information on how AACAP can assist in the recertification process, MOC related questions, information on AACAP’s Self-Assessment and Lifelong Learning modules and other CME activities, please contact Elizabeth Hughes, Assistant Director of Education and Recertification, at 202.966.7300 ext. 106 or Kaitlin Bresnahan, CME Coordinator, at 202.966.7300 ext. 139.
