American Board of Pathology and Co-operating Societies Meeting May 3, 2011 Revised November 2012

Maintenance of Board Certification (MOC) ABP MOC is part of ABMS-wide MOC process ABP MOC is part of ABMS-wide MOC process All certificates beginning in 2006 are time limited (10 yrs) All certificates beginning in 2006 are time limited (10 yrs) MOC is a continuous process with specific deadlines; failure to comply results in expiration of certification MOC is a continuous process with specific deadlines; failure to comply results in expiration of certification

Requirements For MOC Part I: Professional Standing Part I: Professional Standing Part II: Life-Long Learning and Self- Assessment Part III: Cognitive Expertise Part IV: Evaluation of Performance in Practice

Part I Professional Standing Maintain full and unrestricted license(s) Maintain full and unrestricted license(s) Foreign license accepted with English translation Foreign license accepted with English translation Document medical staff membership and privileges Document medical staff membership and privileges

Part II Life Long Learning-Self- Assessment “Content Specifications” are available on line and updated regularly “Content Specifications” are available on line and updated regularly Emphasize fundamental information for daily practice and important, validated new knowledge Emphasize fundamental information for daily practice and important, validated new knowledge Specs are not templates for exams or endorsement of authors Specs are not templates for exams or endorsement of authors These will: These will: Serve as a template for CME and self-assessmentServe as a template for CME and self-assessment Assist pathologists to prepare for MOC examAssist pathologists to prepare for MOC exam Direct MOC test question developmentDirect MOC test question development Focus on practical “need to know” information that is used in daily practice and required for competenceFocus on practical “need to know” information that is used in daily practice and required for competence Cover all disciplines of pathologyCover all disciplines of pathology

Part II Life Long Learning & Self-Assessment 70 AMA Category 1 CME credits/2 year cycle 70 AMA Category 1 CME credits/2 year cycle At least 20 of the CME credits/2 yr cycle must be SAMs At least 20 of the CME credits/2 yr cycle must be SAMs 80% of CME related to individual’s practice 80% of CME related to individual’s practice A fellowship fulfills Part II requirements for 2 year period A fellowship fulfills Part II requirements for 2 year period

Self-Assessment Modules (SAMs) Elements of SAMs AMA Category 1 CMEAMA Category 1 CME Self-administered examSelf-administered exam Minimum performance levelMinimum performance level FeedbackFeedback All SAMs are CMEs, but not all CMEs are SAMsAll SAMs are CMEs, but not all CMEs are SAMs

Part III Cognitive Expertise Exam may be taken beginning year 8 of 10 year cycle (first exam in 2014) Exam may be taken beginning year 8 of 10 year cycle (first exam in 2014) AP/CP diplomates may maintain their certification in AP/CP, AP only, CP only AP/CP diplomates may maintain their certification in AP/CP, AP only, CP only Diplomates with subspecialty boards may maintain certification in subspecialty only Diplomates with subspecialty boards may maintain certification in subspecialty only Surrendering certification is NOT RECOMMENDED Surrendering certification is NOT RECOMMENDED

Part III Cognitive Expertise Modular exam to reflect practiceModular exam to reflect practice Consists of one 50 question general module and four 25 question modulesConsists of one 50 question general module and four 25 question modules 80% practical (e.g. virtual microscopy, case-based questions); 20% written80% practical (e.g. virtual microscopy, case-based questions); 20% written Scored as a single 150 question examScored as a single 150 question exam

Part IV Performance in Practice Four peer attestations (4 th and 8 th year) Four peer attestations (4 th and 8 th year) Lab accreditation (2 yrs) except forensic labs Lab accreditation (2 yrs) except forensic labs Laboratory PI and QA programs (2 yrs) Laboratory PI and QA programs (2 yrs) Individual participation at least one PI-QA program/yr. (2 yrs) Individual participation at least one PI-QA program/yr. (2 yrs)

Part IV Performance in Practice Programs may be society sponsored or by departments/institutions Programs may be society sponsored or by departments/institutions Programs must be ABP-approved Programs must be ABP-approved Society sponsored programs on ABP website Society sponsored programs on ABP website

AP/CP PART III MOC EXAM One 50 question general AP/CP module One 50 question general AP/CP module 20 AP20 AP 20 CP20 CP 10 Lab management10 Lab management PLUS four 25 question AP, CP, or Common Modules PLUS four 25 question AP, CP, or Common Modules

AP ONLY PART III MOC EXAM One general AP module One general AP module 40 AP questions40 AP questions 10 Lab Management questions10 Lab Management questions PLUS four 25 question AP or Common Modules PLUS four 25 question AP or Common Modules

CP ONLY EXAM One 50 question general CP module One 50 question general CP module 40 CP40 CP 10 Lab management10 Lab management PLUS four 25 question CP or Common Modules PLUS four 25 question CP or Common Modules

25 Question Modules Clinical Pathology CP General CP Lab Director Hematology I & II Coagulation BB/TM I & II Immunopathology BB/TM-Coagulation Microbiology I & II Coagulation Chemistry I & II

25 Question Modules Anatomic Pathology AP General I & II Surg Path I & II Surg Path & Cytology Cytology General Cytology-Gyn Cytology, Non Gyn Bone-Soft Tissue BreastCardiovascular Dermatology Neoplastic Dermatology-non-NeoEndocrineGI-Liver-Biliary

25 Question Modules Anatomic Pathology (continued) Forensic Pathology Forensic Pathology Medical Renal GenitourinaryNeuropathology Gynecologic (including placenta) Pediatric Pathology Head & Neck Pulmonary-Mediastinal

25 Question Common Modules* Anatomic and Clinical Pathology * May be used as AP or CP modules General Heme I (Lymph node-Spleen) (Lymph node-Spleen) Flow Cytometry General Heme II General Heme II (Blood, BM, Coag) (Blood, BM, Coag) Molecular Pathology Molecular-Cytogenetics Molecular-Cytogenetics Lab Management / Informatics Informatics

General AP/CP MOC Test Development and Advisory Committees (TDAC) determine content and distribution of questionsTest Development and Advisory Committees (TDAC) determine content and distribution of questions Knowledge needed to practice and validated new informationKnowledge needed to practice and validated new information

Modification of Modules Some organ-specific and CP areas may have >1 module with graded difficulty Some organ-specific and CP areas may have >1 module with graded difficulty

Subspecialty MOC Exam Subspecialty TDACs will: Determine content and distribution of questionsDetermine content and distribution of questions Write MOC questionsWrite MOC questions

Subspecialty MOC Exams with no modules Blood Bank/Transfusion Medicine Blood Bank/Transfusion Medicine Chemical Pathology Chemical Pathology Cytopathology Cytopathology Dermatopathology Dermatopathology Forensic Pathology Forensic Pathology Microbiology Microbiology

Subspecialty Exams with Modules Hematology (total 150 questions) Hematology (total 150 questions) Heme General (50)Heme General (50) Lymph Nodes and Solid Tissue (50)Lymph Nodes and Solid Tissue (50) Blood and Bone Marrow (50)Blood and Bone Marrow (50) Hemostasis and Thrombosis (50)Hemostasis and Thrombosis (50) Laboratory Heme w/out Coag (50)Laboratory Heme w/out Coag (50) Flow Cytometry (50)Flow Cytometry (50)

Subspecialty MOC Exams with modules Molecular Genetic Pathology (150 total) Molecular Genetic Pathology (150 total) MGP General I (75 questions)MGP General I (75 questions) MGP General II (75 )MGP General II (75 ) MGP Oncology/Heme (25)MGP Oncology/Heme (25) MGP Oncology/Solid Tumor (25)MGP Oncology/Solid Tumor (25) MGP Infectious Disease (25)MGP Infectious Disease (25) MGP Genetics (25)MGP Genetics (25)

Subspecialty Exams with Modules Neuropathology (total 150 questions) Neuropathology (total 150 questions) NP General I (50)NP General I (50) NP General II (50)NP General II (50) Neuromuscular (25)Neuromuscular (25) Developmental/Congenital/Pediatric (25)Developmental/Congenital/Pediatric (25) Degenerative (25)Degenerative (25) Neoplastic I (25)Neoplastic I (25) Neoplastic II (25)Neoplastic II (25)

Subspecialty MOC Exams with modules Pediatric Pathology (total 150 questions) Pediatric Pathology (total 150 questions) Pediatric General Pathology (100)Pediatric General Pathology (100) Placenta/Perinatal (50)Placenta/Perinatal (50) Pediatric Anatomic Pathology (50)Pediatric Anatomic Pathology (50) Pediatric Laboratory Medicine (50)Pediatric Laboratory Medicine (50)

CP Only General Module Example 40 Practical, 10 Written Range of # of Questions TM/BB4-14 Chemistry4-10 Hematology4-14 Microbiology4-10 Adm/Man10

Bone and Soft Tissue Grid Total of 25 questions Total # of questions Bone8-10 Neoplastic Neoplastic5-6 Non- neoplastic Non- neoplastic3-4 Soft Tissue Neoplastic Neoplastic12-13 Non- neoplastic Non- neoplastic5-6 Administration2-4

EXPIRATION OF CERTIFICATION Failure to report for two MOC cycles Failure to report for two MOC cycles Announcement of expired certificates Announcement of expired certificates

How will information flow? Candidate Board Societies Exam results New and recertified Diplomates Registration with ABP # Documentation of MOC activities Part II&IV Part II&Part IV ABP #

Frequently Asked Questions

Are these the final modules? Not necessarily Not necessarily Changes will reflect practice patterns Changes will reflect practice patterns Example: academic pathologist with subspecialty practice only Example: academic pathologist with subspecialty practice only

May candidates synchronize their reporting and testing cycles? Yes, if they occur within two years of one another Yes, if they occur within two years of one another –2007 subspecialty certificate could be synchronized with 2006 AP/CP MOC cycle –Supporting documentation in 2008, 2010, etc. –MOC exam eligibility from –Second MOC cycle begins in 2016

Is there a definition for “credits related to practice” for CME/SAMs? Broad interpretation Broad interpretation Use good judgment Use good judgment

When does the second MOC cycle start? From the date of the examination? NO From the date of the examination? NO January 1 of the 11 th year following certification January 1 of the 11 th year following certification

What about diplomates practicing in foreign countries who are unable to maintain a US license? Official license accepted if accompanied by an English translation Official license accepted if accompanied by an English translation

How will Board communicate changes to MOC? ABP Website ABP Website MOC Booklet of Information MOC Booklet of Information Spring meeting of co-operating societies Spring meeting of co-operating societies Announcements in journals Announcements in journals

How do we make MOC more relevant? PQRS will incentivize MOC PQRS will incentivize MOC Maintenance of licensure = MOC Maintenance of licensure = MOC Diplomates with non- time limited certificates enroll in MOC Diplomates with non- time limited certificates enroll in MOC