Matching Lifelong Learning and Board Certification for Family Physicians

Helping you understand and meet the requirements of Maintenance of Certification for Family Physicians is a priority for your CAFP staff and the Continuing Professional Development Committee in the months and years to come.

Download our Roadmap to Maintenance of Certification.

What is Maintenance of Certification?

Since its inception the American Board of Family Medicine (ABFM) re-certification has required completing 300 hours of continuing medical education, an office record review (in most cases) and a cognitive examination every seven years. That changes this year. Maintenance of Certification (MOC) began as a 2000 mandate by American Board of Medical Specialties (ABMS) that all specialty boards institute a measure of lifelong learning and “practice-based” learning for certification and re-certification. MOC was developed to ensure continuing competence of physicians, and implementation began in 2004. The ABMS has been working with the ABFM and other specialty boards to develop the new process.

Over the next seven years, traditional board certification and re-certification examinations will be replaced by the new Maintenance of Certification for Family Physicians (MC-FP) program. This new process will provide a mechanism for continuous assessment of practicing family physicians. It is important to note that family physicians are not alone in MOC. All specialty boards are developing their own plans, and your specialty colleagues will be complying with similar programs.

MC-FP’s goal of professional development and competency is defined in four parts:

I. Professional Standing includes state licensure, peer review, and patient review. This component is currently being piloted by the ABFM in partnership with the ABMS. The mechanisms will probably be phone or web-based, and it is anticipated that this component will need to be completed only once during each seven year cycle.

II. Lifelong Learning and Self Assessment includes self assessment modules, clinical simulations, and CME. Self Assessment Modules (SAMs) are being developed by the AAFP, and completion of one SAM will be required each year for six years. If a diplomate holds a Certificate of Added Qualification (CAQ) in Geriatrics, Sports Medicine or Adolescent Medicine, he/she must complete one SAM in that CAQ area. The 60-question SAMs will be web-based, open book, and linked to educational materials. ABFP plans the following SAMs topics: 2005 Asthma and Coronary Artery Disease, and 2006 Congestive Heart Failure and Depression.

The second part will consist of patient simulations using the new Computer-Based Assessment System (CBAS) to demonstrate the physician’s ability to manage a medical problem prospectively over a period of time. Simulations will match the SAMs. The third part will be to maintain the previous requirement of 300 hours of continuing medical education per certification cycle (Part II components have been approved for 15 AAFP Prescribed credits and can be counted as part of this requirement).

III. Cognitive Expertise is the traditional examination. The exam will be a computer-based proctored exam, offered in multiple sites and on multiple dates each year. As it has been in the past, a diplomate tests every six to seven years and must pass the exam.

IV. Practice Performance will be implemented in 2005 and will address quality improvement in practice. It will include one project per re-certification cycle which must measure quality improvement in practice. FPs must successfully complete the project for re-certification. The project may initially be a modified version of the traditional ABFM Computerized Office Record Review transformed into a continuous quality improvement process designed to improve patient care. An alternative approach will be developed for FPs who do not have a continuity practice, i.e., those in administrative medicine or research.

What Will MC-FP Cost?

According to the ABFM, because the MC-FP process is “continuous learning,” rather than a single “exam event,” it has developed three alternative methods of paying for the process. For those entering MC-FP in 2005 these options are as follows:

• Single one-time payment: The entire cost of the seven-year process, including the re-certification exam at the end, can be paid in a lump sum of $1,150 before June 30, 2005.
• Annual payments for seven years: You can choose to pay $200 per year for each year in the seven-year cycle, for a total of $1,400. The first payment is due by December 31, 2005.
• Pay as you go: You can also choose to pay $50 per year to cover the cost of your participation in MC-FP, with a larger payment in year seven to cover the exam costs. ABFM anticipates the exam cost would be $1,150, making the total $1,500.

What CAFP and AAFP Can Do to Help

CAFP and AAFP are ready to assist each and every member with the MC-FP process. We’ll be publishing regular updates in California Family Physician, in Academy in Action, CAFP’s twice-monthly eNewsletter, and on in this space. We’ll be building MC-FP activities into each ASA; activities might include discussion groups for SAMs, computer practice tests, and more. And, we’ll be answering your individual requests for more information. If you tested last summer, open the envelope you received as you walked out the door. If you just got your ABFM notice, open it now and begin making plans. We’re just a phone call or e-mail away.

For more information, contact Shelly Rodrigues, CAE or call 415-345-8667.
For more information about the Maintenance of Certification process, please go to the ABFM's Web site.