Pediatric recertification

CME for QOW

Written by Stuart Silverstein on Wednesday, 18 January 2017. Posted in Maintenance of Certification (MOC), Pediatric recertification

A MOC Earned is a CME Earned 

In our previous blog, we left you hanging regarding the timing and the amount of CME credit you could receive when you complete 20 QOWs and get 10 MOC Part 2 points.  

You get 1 CME hour for every MOC point you earn on the QOW module. Therefore, you get 10 hours CME credit for 10 MOC Part 2 points earned. That means, they expect you to spend 30 minutes on each question.

Apparently, the QOWs completed prior to January 4th will not count toward CME as noted in the screenshot below:

What happened to the 2 points I received way back in December 2016? 

Recall, that the letter I received from the ABP in December noted that I would get 2 MOC points (not eligible for CME). However, since I need to answer 20 questions to get my 10 points, what will these 2 points do for me? That is not clear since, like an ATM machine, the MOC points are dispensed in multiples of 10s and 20s. It might just be that I have 2 points floating around like a non functional skin tag.  

This is why the dashboard on my portfolio notes that I have 22/40 MOC Points instead of 20/40

However, I still have to answer 20 questions not 18 to get the 10 MOC points. This is noted in the screen shot below. What purpose these 2 extra points will serve remains a mystery. 

The screen shot of my dashboard outlines this clearly! So now it is time for me to begin answering the QOWs as I march toward the magic number of 20 for my MOC and CME double dipping adventure. See you at the completion of this trip.

 

What you need to Know

When you complete your 20 QOWs you get 10 Part 2 MOC credits and 10 CME hours. This only counts for QOWs answered after January 7th 2017.  It is not clear how Part 2 QOW points earned prior to January 7th will apply for MOC credit but we do know that they won’t count for CME credits. 

Questions about Questions of the Week 2017: QOW Equals MOC and CME

Written by Stuart Silverstein on Wednesday, 11 January 2017. Posted in Maintenance of Certification (MOC), Pediatric recertification

The year 2017 is barely more than a week old! Belated Happy New Year to everyone!

In case you missed it, 2017 promises to be full of exciting surprises, unusual Tweets and mercurial changes. In addition Donald J. Trump as president is bound to be interesting as well.

In a previous blog we discussed the Question of the Week as one of the easier ways to fulfill the Part 2 Pediatric MOC Credit.

Late December, I got the following email from the American Board of Pediatrics (ABP). 

This represents additional changes to a constantly shifting and confusing process.

Apparently the Question of the week is the ABP’s most popular Part 2 activity. Yay! Starting 2017 (the future is now here), there are several “enhancements”

While the enhancements were being configured, in early December, access to the QOW was disabled.  I have to admit I had no idea since I am not in a rush to complete this requirement.

After receiving this letter I learned the following:

Wow NOW CME MOC QOW[1]

Most of it is good news! When you complete the QOW, in addition to MOC credit you will also receive CME credit. Double dipping has never been better.

Less is More !

In the Pre -2017 era, you needed to successfully complete 25 Questions of the Week to get your 10 MOC credits. In the Post-2017, era you only need to complete 20 QOW to receive your 10 credits (and CME Credits as well)

More Underwhelming Changes

Additional information in this announcement included:

Medical Pearls: are available at the end of each questions

QOW Archiving: QOWs that have been on the shelf longer than 3 years will still be available. However you won’t be able to get MOC or CME credit for these oldies on the shelf.

References Hyperlinked: If a particular topic interests you, the references can be accessed through hyperlinks embedded in the QOW

These enhancements are interesting and nice but really not important for those of you looking for a quick and painless way to get your Part 2 credits.

Once you have fulfilled your Part 2 requirement this will, of course, be a useful resource and learn more about topics of interest and relevance to your practice.

More Questions were raised by the QOW Enhancements:

How many hours of CME credit will I receive for each set of 20  questions answered successfully? 

The letter also stated that I will receive 2 points for the QOW’s I already answered in 2016. 

Will I received CME credit for these 2 points earned in 2016?

Here is a snapshot of my current profile. I currently have 22 points toward my Part 2 requirement of 40 Points.

Once I continue this process, I will have the answers to this question and will be sharing this in a future blog! 

 

 

 

 

 

 



[1] Yes this is a play on the How Now Brown Cow elocution teaching exercise from the days of yore.

Be a Beta MOCA

Written by Stuart Silverstein on Friday, 16 December 2016. Posted in Maintenance of Certification (MOC), Pediatric recertification

The opportunity to enroll in the Pediatric MOCA program is here.  So what does that mean?

As we have noted in our blogs, the American Board of Pediatrics has agreed to test the MOCA alternative to the Prometric secured exam to test your “Cognitive Expertise” in Pediatrics. Most of would agree that anything is better than taking another exam!

However, not taking the exam may or may not be the case and this is the reason that the ABP is allowing you to enroll in the new MOCA program. By enrolling in the MOCA program you will essentially be serving as a “beta tester” the rest of us. 

Who Can MOCA?

Enrollment in the program is limited to those of you who are due to take your Prometric exam at the end of the year. For those of you who must fulfill your Part 3 requirement by December 2017 you would have needed to enroll this past October. If you opted in, then you are among the chosen. If you did not opt-in you are among the frozen. That is the frozen who must still take the exam before the December deadline.  For the chosen few, who opted in here are your options:

 

If you have elected to enroll in the MOCA program, your exam requirement is postponed until December 2018. What do you have to do to deserve this reprieve?  You have to actually go through the program during the calendar year of 2017. In our next blog we will go over what this entails and where it gets you in your MOC cycle.

Above: When MOC Part 3 is postponed

Reset Your Part 3 MOC clock

on Wednesday, 13 July 2016. Posted in Pediatrics MOC , Pediatric recertification

I am at the point in my MOC cycle where I must complete my next Part 2 and Part 4 cycles by December 2020.  Interestingly enough, even though this is 4 years away, I noted that the date is December 17th, 2020. If I leave this all to the last minute, that can be a problem since most of us think in terms of the calendar year ending December 31st with the dropping of the Times Square ball. The Pediatric MOC ball drop occurs 14 days earlier.

However, I have no intention to leave this for the last minute let alone get even close to that deadline. In fact, as those of you following this blog already know, I currently have 10 out of my 40 MOC Part 1 points checked off through the ABP QOW outlined in a previous blog.

MOC

Above: How I feel when the ABP gives me MOC points

That said, my Part 3 Cognitive Expertise Exam isn’t due until the year 2023.  Since I am recommending staying ahead of the game and steering clear of deadlines, wouldn’t it make sense to just go ahead and take the exam now and postpone the deadline another ten years? That would make it so I would not have to take another exam until the year 2033 which sounds like a year in a science fiction movie. 

MOC FUTURE

Above: Planning my MOC future

So I went ahead to see how that would work while logged into my MOC portfolio and there I got the following recommendation:

“Your online MOC exam application should only be submitted in the year the exam is due and your General Pediatrics Maintenance of Certification Examination is not due until 2023. Registration for this examination will open January 1, 2023. If you would like to request to take your examination earlier than 2023, then please send that request to MOC Administration staff at This email address is being protected from spambots. You need JavaScript enabled to view it. for assistance.”

Above: What it feels like when logging into my ABP portfolio. For sound effects click here.

So it seems I would need special permission to take it early. However, taking it early will only postpone it another 10 years from now. That would mean my exam is postponed until 2026 not 2033. Alas, I might as well stick with the 2023 expiration date.  This is especially true since the ABP may be doing away with the secure exam for Part 3 Pediatric MOC credit. We will update you on this in a future blog. 

Above: Me racking up MOC points before they are due

The QOW Experience

Written by Stuart Silverstein on Tuesday, 01 March 2016. Posted in Maintenance of Certification (MOC), Pediatrics MOC , Pediatric recertification, Pediatric Maintenance of Certification

In my previous blog last week, I noted that the ABP QOW was a great way to get MOC Part 2 credit.  Each year, the ABP has been releasing 50 questions a year, one week at a time.  They have been doing so since December 2013 which means folks like me who are entering their MOC cycle can catch up if they would like.  For every 25 questions you answer correctly you get awarded 10 Part 2 MOC points out of the 40 required points.

Above GIF: How I feel when answering a QOW correctly

In the last blog, I had 11 out of the required 25 questions answered correctly. I also got 4 questions wrong.  This is the key, you must answer them correctly for it to count.   Since I am working on 2014 and 2015, there are 100 questions with a potential for 40 points available.  In that context it is very easy to get sloppy and answer the questions incorrectly.  And I have been guilty of this. However, since I am in year one of a 5-year cycle, this won’t be too costly since there are other Part 2 MOC modules available.  Even if I decide to get all of my MOC Part 2 points through the QOW, I have future years to continue the process.

Above GIF: My reaction when answering a QOW question incorrectly

Once you answer the question there is a forum for each question you can post comments to.

One reader even noted that he answered the question correctly on the Pre-Test but got it wrong after reading the abstract and discussion.  This reader’s advice was to not read the answers before reading the abstract.  This is personal taste.   The bottom line is: if you need these points this year, then you have to go through the abstract and discussion with emphasis on the conclusion and the parts of the discussion that focuses on the key points in the question.

If you have already gone through all of the archived questions then you will have to wait an entire week to move on to the next question since the QOW is question of the week!

When you answer the question correctly you must “claim your pearl “ by clicking the appropriate button illustrated in the screen shot below. Below that is the "post" button and "comment section". This is where you post your comments that other readers can read or just ignore.

ABP_recertification_screenshot1

Once you answered 25 questions correctly and claimed all 25 pearls, you get a nice little sticker that says the following:  

screenshot_ABP_recertification

Your stats on that set of questions gets reset, thus I was unable to go back and get a screen shot for this blog.

I then went to my dashboard which is in the screen shot below. As you can see I now have 10 out of 40 required Part 2 MOC Lifelong Learning and Self Assessment Points needed by December 17th 2020.  

MOC_ABP_screenshot3

Of note you do not get CME Credit for completing the QOW. I will review the other modules that we recommend for Part 2 MOC Credit in future blogs some of which do provide an opportunity for free CME credit. The nice thing is you can get all of your credit through QOW and still take advantage of the other modules, which helps you to prepare for the Part 3 secured exam AND provides CME credit.

I am currently going through my next set of questions and have 10 out of the required 25 questions completed. As I move along in the cycle I will provide updates on my experience with advise on avoiding the pitfalls I encounter. 

easy_recertification_moc_pediatrics

ON Your MOC Get Set GO: A guide through the pediatrics MOC part 3

on Tuesday, 27 August 2013. Posted in Maintenance of Certification (MOC), Pediatric recertification

For those of you who need to take the MOC part 3 or “secured exam” you probably have realized that you cannot take it over the summer. This may be concerning if your certification is set to expire in December 2013. You now only have 4 months left to take the exam. Since you have only 2 shots at it, you should consider taking the exam in September.  

When I realized there was only 2 shots at it, I began to panic since I wanted plenty of time to prepare in case I didn’t pass. I chose to take the exam in early June.

So I went through the registration process and the day of the exam approached, It is good advice when they say allow a lot of time to find the Prometric Center. The test center was located in an unmarked building in an industrial park. The GPS on my android kept informing me that I had arrived at my location, which was an intersection between 2 dump trucks and a disco bowling alley.

When you finally arrive you are given a locker and informed that you have to empty your pockets. I suggest you bring some ibuprofen with you in case you get a headache. I sure wish I had. If you take other medication remember to take that with you as well.

prexam_feelings

How I felt when sitting for the exam

When you finally sit for the exam, you are in a room full of cubicles and while it is theoretically quiet, those who are easily distracted by a symphony of gum smacking keystroke click clack,in B Minor will need to find a way to filter out the noise. If you fit that description definitely bring earplugs. While they DO provide you with over the ear headphones, they are the kind that seems to have been made in the 1970’s. It has plastic edges that leave permanent scars behind your ears.  They did filter out some noise if you don’t mind the painful distraction of the hard edges cutting grooves into your outer ear.  I also suggest you bring light clothing with a zip up sweatshirt. You never know if it will be too hot or too cold there.

You won’t need a calculator because there is an on screen calculator there for you to summon up during the exam.

Exam layout

The exam is set up as follows:

You have to answer 2 sets of questions with 100 questions in each set. You have around 2 hours to answer each set and once you close out 1 set you cannot go back to it. During each question set you are given a warning when you have an hour remaining and 30 minutes remaining. In addition, there is a hold button for questions you are not sure of or just want to come back to. I suggest that you answer all the questions you are sure of first and place the ones you are not sure of on hold to come back to later. You need to make sure you release the hold button when you come back to answer the question!

I made the mistake of not realizing this. I went back and entered answers to these questions and thought I was done. However, when I looked at the main menu the questions were still listed as incomplete. Fortunately, I had time to spare

After I finished the first question set and reviewed my questions, I still had over a half hour left. It is tempting to use that time rather than move on to the next set. However, this is a test of stamina as much as it is a test of knowledge. Most of us have not taken standardized exams in years and are not used to this

I viewed myself as being on borrowed time regarding attention span, so I closed out this set, took a break and went onto the next set.  At that point I wished somebody had suggested I take along a light snack as I am suggesting you do. At that point I realized that I was also on borrowed time regarding my blood sugar levels dropping.

After the exam they informed me that it rang during the exam with various sounds and ring tones indicating I had texts coming in. In reality they could have told me this when I went for a bathroom break.  But I was very relieved that I was done with the exam and immediately changed my ring tone to Alice Cooper’s “School’s out for Summer“  .. at least I was done with this exam for the summer.

recertification_gif

How I felt after the exam

TL:DR (Too long, didn’t read):

 

  • Get there early to make sure you can find the Promtric ® center  
  • Bring ibuprofen  and any medication you might need with you.
  • Let folks know you will not be responding to phone calls or text messages since all your belongings will be placed in a locker (sort of like going to prison except they let you keep your belt and shoes)[1]
  • Bring earplugs
  • The computer has a calculator
  • Answer all the questions you know first and hold the ones you are unsure of for later and come back to them.
  • Unhold questions that were held after you answer them.


[1] In a future blog we will discuss some smart phone apps that auto respond to texts 

Just answer the questions, you’ll get the points

Written by Stuart Silverstein on Friday, 21 June 2013. Posted in Maintenance of Certification (MOC), Pediatric recertification, pediatrics board review

As of the previous blog, I obtained a total of 30 Part 2 points.  These were achieved relatively painlessly

10 Points: General Knowledge 2013 General Pediatrics Comprehensive Knowledge Self-assessment 

For this activity there was no minimum score required and was very painless 

20 Points: 2013 General Pediatrics Decision Skills Self-assessment 

In this activity there was a minimum number of points that WAS required. However, this activity contained sections that were relevant to clinical practice AND appears to be helpful in preparing for the Part 3 Prometric Exam. I would go ahead an classify this as relatively painless, especially since as noted in our previous blog you can take your time to search the interweb for the answers. I will note here that after going through this process the ABP really designed this portion to help you out.

A minimum of 40 Part 2 points is needed to meet the requirement and completing these activities brought me to 30 points. So, I needed 10 more points. Be careful though, many of the Part 2 activities are not so painless since you are required to get a minimal number correct to get your points. 

You are permitted to retake any one of these tests but be warned, you only get one shot at retaking it. And for these activities, you have to actually know the subject well or be willing to read the material that accompanies these activities. Most of the self-assessment topics are subspecialty based, and quite esoteric for those who are not in that field, and possibly esoteric and boring even to those in that subspecialty. This wasn't going to work for me! I don't mind earning my points and learning but I want it to be material that is relevant to the work I do as a General Pediatrician. 

So there I was in search of user friendly and hopefully relevant activities where I could either get the answers based on my current fund of knowledge and/or would find it easy to read up on the correct answers (which of course is the goal of the Pediatric MOC / recertification process anyway).  

So I decided to check out the American Academy of Pediatrics PREP Self Assessment Questions that are also approved for MOC as well as CME credit.   

First you have to get there though the following link http://pedialink.aap.org/ and assuming you are a member of the American Academy of Pediatrics and registered with the PREP program, you log in under your username and password. 

You should click onto the "CME tab" rather than the "MOC tab".

Now you will be faced with 2 radio button "Mode" options 

1) Learning

2) Exam

Fortunately, the correct mode is the one that is also the default mode: LEARNING

This is the mode that must be selected and submitted in order to get the MOC Credit

Sometimes it pays to be paranoid. I did call and confirm that "learning mode" was the correct mode. I also wanted to confirm that the minimal score required was 80%.

While they did confirm that 80% correct was required to be eligible for MOC Credit this requirement did not apply to the 2011 PREP Self-Assessment.

Therefore, completion of the 2011 AAP: Prep Self Assessment Questions does not require a minimal number correct to get MOC or CME credit. 

You can get 0% correct or 100% correct and this is not reported to the ABP. The AAP only reports that you have completed the activity. (Of course this means anyone can fulfill this obligation, even Hodor from HBO's "Game of Thrones" could complete this activity if placed in front of the keyboard.) 

Hodor_pediatrics_MOC

I would like to point out that this is not consistent with the spirit of this MOC activity and we are in no way encouraging it. Such a casual and meaningless approach is not the intended goal of the ABP.  However, it is refreshing and less stressful to know that you can go through this exercise and actually learn without worrying if you will get the MOC / CME points. 

Since there is no minimum, this was an excellent painless method to obtain 20 Part 2 Points 

Although, as they say on TV, this offer is for a limited time only. This gift, (20 Part 2 points, regardless of the number you answer correctly) must be completed before December 31, 2013. 

Choice c pediatrics

I personally recommend the 2011 PREP Pediatric Self Assessment as one of the activities for your 20 points and that is exactly what I did, and am now the proud owner of 20 additional points.. 

My total Part 2 Points is now : 50  

10 Points : General Knowledge : 2013 General Pediatrics Comprehensive Knowledge Self-assessment 

20 Points : 2013 General Pediatrics Decision Skills Self-assessment 

plus 

20 Points 2011 PREP Self-Assessment

Thankfully, I have fulfilled my Part 2 Point requirement with 10 points to spare. Now, the 20 additional points out of the 100 total can come from Part 2. So I have 10 points toward this flexible requirement. 

My new search is to find an additional painless way to obtain 10 more Part 2 Credits.  At this point I have decided to go with Part 2 points since Part 4 Performance in Practice is still an unknown process.  So my search for continues. 

I also have to enroll and register for my Cognitive Expertise - Secure Exam (Part 3) exam at a local Prometics (R) center . I wish to take this exam before July 1, since you cannot take the exam during the months of July and August and I wish to have a margin of error in case I have to take the exam again, in the fall i.e. I don't pass the first time. 

Next blog I will have an update on my search for 10 more Part 2 points. Also, I will update all of you on the process of registering for the Prometrics test and the real rate limiting step which is actually committing to an exam date. I hope you find this blog series helpful. Feel free to contact me with any questions via email or commenting below.

Be Decisive With Pediatric Decision Making Self Assessment Part 2

Written by Stuart Silverstein on Monday, 10 June 2013. Posted in Pediatrics MOC , Pediatrics Recertification, Pediatric recertification, pediatrics board review

I am happy to report that I did reach the 80% mark and am now the proud owner of 20 more Part 2 Pediatric MOC points. This brings my total up to 30 Part 2 Pediatric MOC points.

How did I approach it differently this time? 

1)    For one thing I made sure I was very certain I had the correct answer (should be obvious).

2)    If it seemed to be challenging I held off on answering it.

3)    Free throws  - I went through the ones that to me were pretty easy to figure out fairly quickly.

4)    Challenging Layups - If I still wasn’t sure I went back and made notes on the information that was being presented and often this was enough to make the answer apparent.

5)    Needs some time - In some cases this was not enough and the obvious answers didn’t seem to be correct.

6)    All along the way I kept track of the percentage correct, with each correct answer I got closer and closer to the 80% number.

7)    I also tracked the number of incorrect answers I was getting and yes even despite this approach I still answered questions incorrectly.

8)    Since this is an open book, which is now an outdated term; more like an open google test. I used google for the “ needs some time” category. The way I did it was by simply searching for the clinical descriptions and lab findings .

9)    More often than not this helped me discover the correct answer and I actually found myself learning along the process.

10)  Once I reached the magical number 0f 80% I still had a couple more questions to go but the pressure was off.

11)  But I and you should still want to get as high a score as possible. After all, this is a really good opportunity to learn. Although the process is challenging the American Board of Pediatrics (ABP) really set it up so you review a lot of material.

12)  So I took a different approach this time and reached 84% and now am the proud owner of 20 points toward fulfilling my Part 2 Pediatric MOC requirement.

13) Yes that means I got 8 wrong, which is quite close to comfort, in missing out on an opportunity to get 20 points on what I believe is one of the more useful, and least painful ways to get your Part 2 Pediatric MOC points.

Be decisive with Pediatrics Certification Review

 

Recall that I already got 10 points on the dashboard for completing 2013 General Pediatrics Comprehensive Knowledge Self- Assessment and now have 30 Points.

Therefore, I suggest you go through this process the way you would approach anything that required concentration. If this means putting on your thinking caps and playing ocean sounds then do it. (see previous blog)

Remember to be methodical; they are presenting material in broad strokes. The question consisted of a history, physical and lab / imaging studies.  I made a list of all the pertinent positive findings and pertinent negative findings. This allowed me to filter out irrelevant negatives.

I noted when something had “quotes” around it, it meant that things weren’t necessarily what the patient was describing, and I made a “beware” notation on my notes.

One of the benefits of this section is once you have “committed to an answer” you can print out the case summary which helps outline fine points of difference in differential diagnosis which is sure to be helpful in preparing for the secured Part 3: Pediatric MOC exam.

So my scorecard so far is

Part 2 Points:

2013 General Pediatrics Comprehensive Knowledge Self-Assessment: 10

2013 General Pediatrics Decision Skills Self-Assessment:  20

Still need 10 more to meet the minimum of 40 Part 2 points. I will need 30 more points if I want to use Part 2 points for the 20 “either Part 2 or Part 4 “ category toward the total 100 points needed for Parts 2 and Parts 4. Wow, I think I just confused myself.

I will let you know in the next blog where my search for the most useful and least difficult to pass MOC Part 2 activities 

Be Decisive With Pediatric Decision Making Self Assessment Part 1

Written by Stuart Silverstein on Friday, 31 May 2013. Posted in Maintenance of Certification (MOC), Pediatrics MOC , Pediatrics Recertification, Pediatric recertification, Pediatric Maintenance of Certification

Pediatrics MOC 

When we last left off, I had only receive 10 Points toward my total of 20 Part 2 Lifelong Learning and Self Assessment points:

I was previously going through the Pediatric Decision Making Self Assessment activity. Which when completed would yield me 20 more points on the Big Board, half of the 40 points required for Part 2: Pediatric Maintenance of Certification (MOC).

However, this was not a softball toss since a minimum score of 80% was required to grab this 20-point brass ring. Simple enough?

Pediatrics MOC decision skills self assessment  

How I felt when I found out I needed 80% correct answers on the pediatrics decision skills self assessment test

 

Not really! You are given 50 case scenarios, and a score of 80% means you cannot miss more than 10 of these (you might want to check the math). It is all or none, you might understand much of what you are reading but if you choose the wrong answer there is no going back. This is not one of those CME tests you answer until you get the right answer which by the way, is my favorite type of CME test since the creation of the internet by Al Gore.

It really isn’t a “self assessment” since you are being assessed by the American Board of Pediatrics based on the decisions you “commit to”. I would call it more of an assessment by the ABP of whether you can keep your Pediatric certification. But lets not get caught up in semantics.

Pediatrics MOC correct answer

How I feel when I get a pediatrics MOC question correct

I was handled a nice big slice of humble pie when I did not hit the decision making hammer hard enough to hit the 80% bell. It seems I missed the 80% by taking this activity too lightly. I did it in several sittings. Often when I was tired at the end of a long day or while listening to the theme song from Law and Order on iTunes rather than ocean sounds as recommended in a previous blog. 

Honestly, I did not follow my own advice of going through the answers in detail.  I just wanted to get through them and get my 20 points so I can continue working as a pediatrician.

I now faced just one more chance to ring the bell, there would not be a 3rd chance to get my ticket punched on this relatively easy and useful activity.

This is a very useful activity since it really has value clinically and for preparing for the MOC Pediatric Recertification “secured“ exam.  

In several instances you are presented with very similar patients, i.e. 12 year old with leg pain, but the clinical presentation are quite different.  This is a great exercise in teaching and demonstrating why and how reading the question is so important and is really hitting at differential diagnosis.  

In my next blog, I will tell you how my second attempt went. Stay tuned!

Jumping into the Part 2 MOC Pool

on Wednesday, 01 May 2013. Posted in Maintenance of Certification (MOC), Pediatrics MOC , Pediatrics Recertification, Pediatric recertification, pediatrics board review, Pediatric Maintenance of Certification

Well it is now May and more than ¼ into the calendar year. The deadline for completing the Pediatrics MOC (Maintenance of Certification) cycle including the exam is looming. Since I do need to leave a margin of error, I have decided now is the time to get through Part 2 of the MOC cycle and begin thinking about Part 4. Recall, I already completed Part 1 by having a medical license.

Pediatrics Recertification

I discovered that Parts 2 and Parts 4 are intimately linked like Heckle and Jeckle

Between Parts 2 and Parts 4, I must complete 100 points divided as follows:

  -Part 2 – Lifelong Learning Cognitive Expertise: 40 Points

  -Part 4 - Performance in Practice: 40 Points

 

Therefore, I must get at least 40 points through Part 2 Activities.  There is an additional 20 points that I can decide between Part 2 and Part 4 Activities.  At this point I am not sure which way I will go with this.  This is because Part 4 Performance in Practice is a large unknown. 

 

This still begs the question, if Parts 2 and 4 are activities done in concert with each other, why aren’t these PARTs 2 and 3 with the exam being Part 4.  As if the process isn’t convoluted enough.

 

This is like Billy Crystal inAnalyze This asking ”How can we talk about the first thing without discussing the 2nd thing first???”

 

Part 2 is primarily questions and answers on relatively known territory. In a previous blog I noted that there are 3 options for Part 2.

At the time of that writing I didn’t pay any particular attention to the details of these 3 options. That was because I wasn’t personally going through the process.  I now have learned more and will share that with you now..  Boy this has more subplots and number patterns than an episode of Touch.

The components are as follows with my analysis of each:

 

            Knowledge Self Assessment- While there are a variety of options which you can search for the one I suggest as a no–brainer is the “American Board of Pediatrics General Pediatrics Comprehensive Knowledge Self- assessment, 2013” which consists of 200 multiple choice questions selected from the secure exam (aka Part 3) pool. You get to kill 2 MOC birds with 1 stone. You get 10 “Part 2 points” while practicing for the test and assessing your areas of strength and weaknesses.

You are also told that your chances of passing the secure exam can be predicted based on how you do on this set of questions as follows:

 

Your score

Likelihood of passing the Secure Part 3 Exam

80% or greater

Likely

66% -79%

“Uncertain

65% or less

 FUGGETABOUTIT [1]

 

Pediatric Recertification

 

The best part of all is there is no minimal number correct to pass.  You can also take this as many times as you want and essentially know these questions cold.  You get “immediate feedback“ which simply means you will be told either you answered the question correctly or you answered it incorrectly. In addition, you will be told which answer was correct.

However, you will not be provided with detailed answers. This is where a good review book will come in handy. You can take notes or study in real time regarding the details of the topic being questioned and learn it for the next time the concept is tested or when you come across it clinically, which is supposedly the point of all this.

I was so excited about this that I re-enrolled for another set of questions. After answering the questions again, I got a confirmation of completion email from the ABP which stated that I can check my dashboard to see how it was applied. I assumed I would be getting 10 more points. WRONG! You only get credit for this set of questions once and once only.

 

I really do suggest you take the time to write down the specific topics you do not do well on and START with those topics when reviewing for the Part 3 recertification exam requirement. There are also a limited number of images you have to click on for some of the questions, much like you will have to do on the actual exam.

There are other sets of questions you can choose from.  To my own peril I thought the same rules applied that no passing grade was required.  At this point it appears, that for the other options you need to get 80% correct. Unlike other CME question sets, you do NOT get to answer them over and over until you get them right. Here you only get ONE more opportunity to answer the questions you got wrong.  If you still don’t reach the 80% threshold, that module is not available for you this year.

So I decided to try my hand at the next  option which are:

Subspecialty Questions

Well here again, you have to get at least 80% correct and do not have unlimited attempts to answer the questions you got wrong. After a humiliating attempt to answer subspecialty questions I decided to try my hand at the 3rd Part 2 activity, which is:

Decision Self Assessment Skills

This is worth 20 Part 2 points and is more in line with General Pediatrics. Interestingly, it actually is fun.

Here you are given a patient brief history and are provided with a medical history , physical findings and diagnostic studies. There are 50 such questions.

You then have to either pick a diagnosis, or decide what study to do next etc. There are more than 4 choices here. After going through all this, you are either right or wrong.

Here you also have to get 80% correct which means you can only get 10 wrong in order to hit the bell and get your 20 points.

If you do not get 80% you get to take it again. However if you still get less than 80% on your second chance, you are done and will have to find other activities to get your Part 2 card punched.

In this case you ARE given detailed explanation and summary but only after you have committed to an answer.

I am currently in the middle of this and will update my status with the next blog. If I successfully complete this activity I will have 30 total points (20 here and 10 from the General Pediatric Knowledge Self Assessment)

I will still have to choose another activity worth 10 points to get my 40 Part 2 points.

I will need another 20 Part 2 points if I choose my combination points to be Part 2 rather than Part 4.

Once I complete the Decision Skills section… hopefully successfully I will write about my next steps on the road to MOC.

By the way we invite you to discuss your experiences and if you found any relatively painless approved activities for completing the Part 2 requirement.



[1] Outside of Brooklyn the phrasing is different. 

 

The Sounds of Studying for the Board Review Thinking Cap!

Written by Stuart Silverstein on Wednesday, 20 March 2013. Posted in USMLE review, Neonatology review, board review, Pediatric recertification, Neurology Board Review, pediatrics board review, Pediatric Maintenance of Certification

One of the most important steps in setting aside time to study is to actually set aside the time to study.

It can be challenging to separate regular (aka more enjoyable comfort zone time) from the time you must set aside to study for whichever board exam you are preparing for.

We suggest studying in a specific place or even engaging in a certain action that puts you in the mindset that this is the time I will be reviewing for the pediatrics, neurology or neonatology boards.  This was probably the origin of the “thinking cap” where one put on a special cap when one had to do serious thinking. I know of someone that does not need to wear glasses but puts on plain glass frames when they sit down to study (sounds crazy, but works for him!)

Pediatrics Board Review Thinking Cap

Consider this a reset button, which puts the brain and body on notice that this is time to get down to business and do some serious board review studying. Call it “board review conditioning”.

Well, once you have put your brain on notice, where will you do the studying? We suggest picking a place that is specifically designated as “the” board review location.  This can be a room in your home, a conference room in your office, or perhaps a conference room in the public library. This should be a place that has as few physical distractions as possible.

Now that you have separated the time and space, how do you filter out the distraction of sound and in some cases the distraction of silence?

neurology board review too quiet

Everyone is different.  Some people study better with total silence, some like white noise, and some even like a lot of noise.  Any of these sounds is difficult to reproduce in the setting you have selected as the ideal location to focus on pediatrics board review questions, for example:

While we usually recommend resisting temptation to be distracted by the Internet in general when blocking out time to study, one important exception could be logging into one of the many websites that provides ambient sound.

One of the websites we have found most useful is nature sounds for me which is a free online tool to play nature sounds on your headphones to help provide the ambient sounds you work best with. There are 4 channels that allow for 4 separate sounds to be played at once (i.e. birds, river etc.)

We have found this to be an excellent tool to filter out or even filter IN noise. For example, let’s say you study best with ambient background conversations, the kind you would get at a local café. However, you prefer a location where you won’t meet anyone who might start talking to you and pull you away from the important pediatrics board review material you wish to focus on? This tool will provide you with “ambient conversations“ so you can have your café cake and eat board review questions in an environment without actual people.

The sounds range from ambient ocean waves to kitchen sounds, seagulls, owls, and even wolves. If you find sustained sounds distracting you can even vary the sounds so the conversations come and go, the same for the seagulls and rain.

We suggest you try this wonderful and free tool, and consider the headphone to be the noise cancelling thinking cap you need to put on when you have set aside time to do serious board review thinking.

Zen and the Art of Pediatric MOCcycle

Written by Stuart Silverstein on Tuesday, 15 January 2013. Posted in Pediatric recertification, Pediatric Maintenance of Certification

I recently heard about a pediatrician, who procrastinated as long as he could to put his toe into the uncertain waters of the “MOC” process until the deadline for “enrolling” in the MOC process was less than a month away. That pediatrician was me!  

 I not only had to  put together the book used by so many of our colleagues, but I also have to go through the process myself.  I can tell you the latter is much more difficult.  It is much easier to teach and preach than to perform.

I invite those of you who are and/or will be going through the MOC process in the coming weeks to join me on what I hope will be a humor-laden description of this confusing process which will cover more than merely preparing for an exam.  That isn’t to say that preparing for and taking a proctored exam is an easy task for us working stiffs who spend all day helping patients and then answering to the needs of a family when we get home. Many of us have not taken an exam since Bill Clinton was actually the president, and not a hired gun giving speeches at the DNC.  

 

For most of you, this process will begin with a good news/bad news letter.  The good news is you have been given 2 more years to prepare for the proctored exam.

The bad news is you will have to enroll in the MOC process, and go through MOC cycles” to maintain your certification.  The proctored exam is just one part of the on the MOC–cycle trip.  The MOC process is not a cheap one and proportionately higher for us pediatricians who cannot compete with our more fortunate procedure reimbursed colleagues. We will cover that in future blogs.

 

Circling the Cycle:

Part 1: Professional Standing – Also known as having a valid medical license.

Part 2: Knowledge Assessment:  Differentiated into 2 subcategories[1]

  • Knowledge Self Assessment- 200 online questions, which you don’t even have to pass to get credit.
  • Decision Self Assessment – 50 multiple choice questions based on patient cases , this time you have to get a passing grade

Part 3:  Cognitive Expertise:  Also known as the proctored exam, or the big test, the one you had to take every 7 years and now have to take every 10 years while MOC cycling.

Part 4: Performance in Practice:  This is the part that had and still has me as confused as an octogenarian staring at iPod®.   As of this writing I am still not clear on what the heck we are expected to do.  This is not a simple matter of answering questions online or even preparing for and taking an exam. This involves something along the lines or doing a quality improvement study in your practice. 

I began reading this, and flies began landing on my eyes without my noticing while I reviewed the 2 choices for fulfilling this requirement which were:

  • Established Quality Improvement Projects:  Where you collaborate with other groups and practices.  Lots and lots of moving wheels.
  • Web Based Improvement Activities: These seem to be off the shelf activities conducted within your practice and presumes you will want to do this with in conjunction with the other physicians in your practice.

 

The other day I tried to make sense of this part of the MOC process.  I stared and read it over and over until my mind went blank.  The next thing I remember was sitting at Brazilian Steakhouse  and some guy named Raul was serving me sliced Turkey from a cutting  board at my table.  I guess I was so traumatized that I must have suffered retrograde amnesia. [2]  Therefore I will have to cover this in greater detail when I return to this part of the MOC requirement as I tackle it myself.

 

Coming Attractions

 

In the future, patient surveys will be added to the mix. Yes!  Patient surveys handed out to parents who will provide their opinion of communication style and availability.  It is not yet clear if you will have to hand this out randomly, or cherry pick your favorite patients for their input.  As if there aren’t enough challenges, practicing medicine will become American Idol where you will have to perform for a panel of judges. What’s next?  Patients commenting on your doctoring skills on your Facebook® wall and hitting “Like” buttons?

 

We will keep you posted when and if you will have to face such a tribunal!

 

For me the process began with what seemed like a bombardment of some 300 email and snail mail letters that I ignored until I realized those ignored letters is not good for my professional standing with the board.  I was also thankful that the ABP has not discovered Facebook® or Twitter® where I would sure to face the electronic equivalent of being placed in the public stocks.

 

Qualify to Enroll

 

I had until December last year to “qualify” to enroll in the MOC process, s I finally took the first steps to “qualify” for the enrollment process.  Up until that moment, as the author of “Surfing your Way to Recertification”, I have been receiving calls, emails and, yes, Facebook messages from friends asking about the process.  Much to my shock, when replying to my friends, I found myself stammering and changing the topic to the weather or local traffic reports. Until then I couldn’t give first hand advice and guidance.

 

In order to qualify I had to get through Parts 2 and 4.  Part 1, providing proof that I had a medical license which was easy enough.  Then again, if you don’t have a medical license why would you be going through all of this torture?

 

Over the coming weeks, we will muck through the MOC process together.  Unlike the ABP, we actually are familiar with Facebook ® and Twitter®, and I invite you to “like” us on Facebook and “follow our Tweets” on Twitter®.  We also want to note that this blog and our materials will help you get through and demystify the process.[3]



[1] Which makes this all even more convoluted and confusing, since they are 2 activities why not just assign them each an independent number. ?

[2] Folks, this was inserted the sake of humor,  it didn’t really happen so please do not write us to let us know that you had the same experience, as you might be better served seeking psychiatric assistance if that is the case.  

[3] We are not here to provide inside information on questions asked on the exam, answers to the questions, or otherwise reveal any other part of the MOC process, or the exact areas of knowledge that will be tested. We do welcome general feedback and shared experiences going through the process, but are not looking for nor will we be accepting such exam specific information.