What is MOC? The Maintenance of Certification (MOC) Program demonstrates to the public, your peers, and colleagues your support for continuous quality improvement, professional development, and quality patient care. It is an integral part of the quality movement in healthcare and is highly valued by patients and physician colleagues alike. MOC builds on the validity of the initial certification process and provides a framework for selfregulation by the profession to improve quality of care. The program embraces the adult learning principles of accumulated life experience, self-direction, goalorientation, achievability, and respect for diplomates’ achievements. MOC encompasses the essential competencies involved in delivery of quality care, which extend beyond medical knowledge. The MOC Program must be developed and maintained throughout your professional career. It is designed to evaluate, on a continuous basis, the six essential competencies (initially developed in residency training) by means of four parts. The six competencies are: • • • • • • Medical knowledge Patient care and procedural skills Interpersonal and communication skills Professionalism Practice-based learning and improvement Systems-based practice MOC uses four parts to evaluate the six competencies: • • • • Part 1: Evidence of professional standing Part 2: Lifelong learning and self-assessment Part 3: Cognitive expertise Part 4: Practice quality improvement For more information on the evidence for MOC, go to www.abms.org/EvidenceLibrary. Continuous Certification Status Check for “Meeting Requirements” How Do I Participate? Element Compliance Requirement The ABR is implementing a new integrated process that links the ongoing validity of certificates to meeting the requirements of MOC. Under the new process, known as “continuous certification,” ABR certificates will no longer have “valid-through” dates. Instead, on each new certificate in diagnostic radiology, radiation oncology, or medical physics, the date of initial certification will be noted and accompanied by the statement that “ongoing validity of this certificate is contingent upon meeting the requirements of Maintenance of Certification.” Licensure At least 1 valid state medical license CME At least 75 Category 1 CME credits in previous 3 years SA-CME At least 25 of the 75 Category 1 CME must be Self-Assessment CME (SA-CME) Exam Passed ABR Initial Certifying or MOC exam in previous 10 years PQI Completed at least 1 PQI project in previous 3 years Fees Current with MOC fees at any time during the previous 3 years For each diplomate who is a current enrollee in MOC, continuous certification has replaced the 10-year MOC cycle. Under the new policy, implemented in 2012, the total number of MOC requirements will not change. Progress will be evaluated annually in March, using a rolling calendar-year “look-back.” The first “full” annual look-back, including MOC Parts 1-4 and fees, will occur in March 2016. How Does Continuous Certification Work? MOC Year Lookback date Element(s) checked 2012 3/15/2013 Licensure and Exam 2013 3/15/2014 Licensure and Exam 2014 3/15/2015 Licensure and Exam 2015 3/15/2016 Licensure, CME/SA-CME, Exam, PQI, and Fees 2016 3/15/2017 Licensure, CME/SA-CME, Exam, PQI, and Fees 2017 3/15/2018 Licensure, CME/SA-CME, Exam, PQI, and Fees 2018 3/15/2019 Licensure, CME/SA-CME, Exam, PQI, and Fees 20XX 3/15/20XX Licensure, CME/SA-CME, Exam, PQI, and Fees Part 1: Evidence of Professional Standing This part requires valid, unrestricted licensure to practice medicine in all states in which the diplomate holds active license. A diplomate must report any state board action against a license to the board within 60 days. Part 2: Lifelong Learning and Self-assessment A minimum of 75 AMA Category 1 CME credits are required every three years. Of these, 80 percent must be related to radiation therapy or oncology, with the remaining 20 percent either in clinically related areas or in relevant topics such as risk assessment, ethics, statistics, the processes of continuous quality improvement, methodologies of outcomes measurement, etc. At least 25 of the 75 Category 1 CME credits must be self-assessment CME (SA-CME). In addition to ABR prequalified SAMs, the ABR will count all AMA Category 1 CME activities in “enduring materials” (including web-based and print) and “journal-based CME” formats toward the MOC self-assessment requirement. According to the recently adopted AMA policy for CME, these activities include the following features that suit them for use as self-assessment tools: • They provide an assessment of the learner that measures achievement of the educational purpose and/or objective(s) of the activity with an established minimum performance level; examples include, but are not limited to, patient-management case studies, a post-test, and/or the application of new concepts in response to simulated problems. • They communicate to the participants the minimum performance level that must be demonstrated in the assessment to successfully complete the activity for AMA PRA Category 1 Credit™. • They provide a reference to appropriate biblio graphic sources to allow for further study. Part 3: Cognitive Expertise The diplomate is expected to maintain the essentials of core knowledge fundamental to the practice of radiation oncology. This part requires having passed the MOC exam or an ABR initial certification exam within the past 10 years. The exam is proctored, secure, and computer-based. The exam is a comprehensive test covering the knowledge base required for the practice of radiation oncology. The examination covers eight clinical content areas: gastrointestinal cancers, genitourinary cancers, gynecological cancers, breast cancer, lymphomas and leukemias, head and neck cancers, pediatric cancers, and central nervous system tumors. Other topics include sarcomas, thoracic malignancies, palliation, radiation and cancer biology, and physics. Radiation and cancer biology, as well as physics, are related to day-to-day clinical practice. Diplomates may take the exam any time it is offered during the MOC process, including multiple times if necessary. An exam is offered two times per year. Diplomates’ practice experience can help them immensely as they take the exam. An exam study guide, which includes content distribution and sample questions, is available on the ABR website. Part 4: Practice Quality Improvement (PQI) ABR’s MOC Program provides its diplomates with a robust mechanism for continuous professional development. Through Part 4, MOC also offers a pathway to participation in practice quality improvement (PQI). The PQI initiative is a framework to facilitate improvement of medical care and/or its delivery for an individual, a group, or an institution. Quality and safety in medical care have become a national priority, and Part 4 of MOC permits radiation oncologists to demonstrate both their commitment to this enterprise and, in some instances, their compliance with associated external requirements. PQI and the PDSA Process PDSA stands for “Plan – Do – Study – Act,” a four-step process commonly used for continuous quality improvement. This simple but powerful tool may serve as the basis for an action-oriented iterative process by linking multiple PDSA cycles repeated in sequence. An initial cycle is performed to obtain baseline data, followed by subsequent cycles applied to assess the effects of quality improvement initiatives. PLAN. Identify an area of your practice judged to be in need of improvement and devise a measure to assess the degree of need. Develop a plan to implement the measure and obtain the required data. Finally, set a target or goal for the measure to be reached. DO. Set your plan in motion and collect data. STUDY. Determine how well your measure compares to the desired goal. Explore root causes for lacking goal achievement. ACT. Consider what can be done to address the root causes and develop an improvement plan to imple- ment during the next PDSA cycle. After improvement plan implementation, begin another PDSA cycle to assess the degree of any gain achieved. The cycle can be used continuously until the goal is reached or employed intermittently to document the stability of any gain achieved. More detailed PDSA information, along with generic templates that can be used as step-bystep guides in completing your projects, can be found on the ABR website. Part 4 (PQI) Frequently Asked Questions Does radiation oncology have defined topic areas for PQI projects? No. Numerous examples of PQI projects are available, but no specific topic areas have been defined. Please note that a PQI project is not required to be a research project for publication. Useful Links The American Board of Radiology www.theabr.org Maintenance of Certification (MOC) ASTRO Gateway www.astro.org (available through your My ASTRO account) CME Gateway www.cmegateway.org ABMS Public Website www.certificationmatters.org myABR https://myabr.theabr.org For Radiation Oncology How will my participation be recorded with the ABR? The ABR has established a personal portal on its interactive website (https://www.myabr.theabr.org) for each diplomate. Each ABR diplomate should sign in and “attest” to PQI participation and answer a few questions. Diplomates should keep records of their data and updated improvement plans in their own secure files. What documentation is required if I am audited? The ABR requires a short document that simply outlines the elements of your PQI project: data collection, data analysis, improvement plan, creation and implementation, and remeasurement. Is there an approved list of metrics that are acceptable for PQI projects? The ABR does not publish such a list. Diplomates are referred to lists of evidence-based and consensus-driven metrics developed by societies and other national quality-related organizations for their PQI projects. Please note that the ABR will conduct yearly, random audits. If you are audited, you will be asked to submit documentation of your current progress on MOC Parts 1,2, and 4. The American Board of Radiology is a Member Board of the American Board of Medical Specialties (ABMS): www.abms.org MOC Evidence Library: www.abms.org/EvidenceLibrary 5441 E. Williams Circle, Tucson, AZ 85711-7412 520-519-2152 • Fax: 520-790-3200 [email protected] 08/14