ABPN Implementing Recertification Changes
Psychiatrists and neurologists who take the recertification examination in 2007 will face new requirements under the maintenance of certification process.
Starting next year, physicians taking the exam will need to have completed 30 hours of specialty- or subspecialty-specific category 1 continuing medical education credits. Over the next 10 years, that requirement will grow to 300 hours of CME over a 10-year period. Other new requirements will be phased in over the next few years, according to Katie DiOrio, a spokesperson for the American Board of Psychiatry and Neurology (ABPN).
Impetus for the maintenance of certification process comes from the American Board of Medical Specialties, which began developing maintenance of certification several years ago. The basic requirements–evidence of professional standing, self-assessment, and lifelong learning; demonstration of cognitive expertise; and evaluation of performance in practice–apply to all 24 medical specialty boards. The ABPN is still working out the details of the self-assessment activities and performance-in-practice modules, including how to provide the tools for ABPN diplomates to fulfill these components.
“Maintenance of certification implementation is really in its infancy,” Ms. DiOrio said. She advised board diplomates to continue to visit the ABPN Web site at www.abpn.com
Among other requirements, starting with the 2010 examination year (applications for which are due in 2009), diplomates of the ABPN will be required to have completed at least one major self-assessment activity over the 10-year cycle.
Psychiatrists have several approved options in this area. They can complete the American College of Psychiatrists' Psychiatrists In-Practice Examination, postreading questions from the journal Focus, or the American Psychiatric Association's Practice Guidelines Program.
The self-assessment requirement was originally scheduled to go into effect next year, but officials at ABPN postponed implementation to give physicians more time to complete the activities. ABPN officials also wanted more time to approve additional programs for diplomates to use in fulfilling the component. In an effort to gather information about how many physicians have already started using self-assessment tools, ABPN officials are asking physicians to note on their maintenance of certification applications any self-assessment activities that they have completed, Ms. DiOrio said.
The other new requirement being phased in as part of the new maintenance of certification process is a performance-in-practice component, which is aimed at evaluating whether a physician has participated in performance improvement activities over the 10-year cycle. Beginning in the 2013 examination year, psychiatrists and neurologists will need to complete one module in this area. Three modules will be required by the 2017 examination cycle.
Each module will include chart reviews of five cases from a specific diagnostic category, along with feedback from either five peers or five patients seen in the past 3 years. To complete each module, physicians also will be required to compare clinical case data with published practice guidelines or with their peers and obtain feedback on their performance and on how to improve the effectiveness of their practice. Physicians will also need to develop a plan to improve their performance.
Within 24 months of the original assessment, physicians will be asked to reassess their practice using five cases in the same diagnostic category and to get feedback from either at least five peers or five patients.
For physicians who are actively involved in continuing education and are current on the literature, the CME and self-assessment requirements being phased in over the next few years will not be an additional burden, said Dr. Deborah J. Hales, director of the division of education at the American Psychiatric Association.
Performance-in-practice, however, will require more work by physicians. APA officials are working to make the performance review process a learning experience for physicians and to make it easier through online tools, Dr. Hales said.
Elizabeth Hughes, assistant director of education and recertification for the American Academy of Child and Adolescent Psychiatry, agreed that physicians should be aware that the performance-in-practice component is coming. At this point, though, there is still not a clear picture of how those requirements will be implemented, she said.
In the meantime, Ms. Hughes' advice is to stay up-to-date in the field. Don't wait until the last 2 years before recertification to do the work. “It's designed to be an every-year process,” she said.
The APA provides recertification resources online at www.psych.org/edu/recertification.cfm
