By Charles S. Abrams, MD

2008-11-01

Charles S. Abrams, MD, is a member of the ABIM Board of Directors and is the Chair of the ABIM Subspecialty Board on Hematology. He is an Associate Professor of Medicine at the University of Pennsylvania School of Medicine.

As a hematologist, and the recently elected Chair of the American Board of Internal Medicine (ABIM) Hematology Board, I thought I would explain what is required to remain board certified in our subspecialty. Although maintaining ABIM certification is not mandatory, it is an important marker of standard training and professional and clinical competence. In fact, many hospitals not only require initial certification in your practicing subspecialty, but also require ongoing participation in the maintenance of certification (MOC) program in order to maintain admitting privileges.

Personally, I've been through recertification once before — renewing my certification in hematology in 2005. Although I am currently certified through 2015, I have decided to begin to fulfill my MOC requirements now, rather than wait until one or two years before my certification expires. This is because I have seen some of my colleagues rushing to fulfill all of the requirements in that final year, or perhaps waiting until the last minute to schedule the exam, only to find that the examination dates do not match their schedules. Even though the requirements of MOC can be completed within one year, it is certainly a tougher and more stressful way to complete the process. By enrolling now, I plan to complete all of the requirements over the course of the next seven years without feeling rushed.

You can take the recertifying examination any time beginning in the sixth year of certification or recertification. In my situation, this will be some time after 2011. While 86 percent of the hematologists who took the MOC exam over the past five years passed on their first attempt, some physicians did need to retake the examination in order to ultimately pass. It is reassuring to know that 96 percent of those who had at least three opportunities to take an MOC exam ultimately passed. These pass rates are another reason to take the exam a few years before your certificate expires. Taking the exam early allows you the time to retake the test, if necessary, without endangering your status of uninterrupted certification in hematology.

In addition to passing the exam, recertification requires taking several open-book ABIM self-assessment tests directly related to the practice of hematology, including hematology knowledge modules. Alternatively, ASH members can complete the ASH-SAP/MOC product, which has been designated by ABIM for 70 points of MOC credit. It is worth noting that hematologists can meet all of the MOC requirements through the ABIM and ASH program without paying any additional fees.

Finally, the MOC process requires at least one Practice Improvement Module (PIM). PIMs are Web-based tools, worth 20 to 40 points each, that enable you to examine your practice and identify ways in which it can be improved. Available ABIM PIMs include Communication with Referring Physicians, Communication with Patients, and Osteoporosis (for physicians prescribing chronic steroid therapy). In addition, ASH offers PIMs related to the diagnosis and treatment of myelodysplastic syndrome, multiple myeloma, and idiopathic thrombocytopenic purpura that also fulfill MOC point requirements.

Once you have enrolled and paid the one-time MOC fee, you can meet all of the ABIM program requirements, including your ABIM modules and one exam, without additional charges from ABIM. The self-assessment points can be applied to more than one certification, and they last for 10 years. So, if you are dual-certified in hematology and medical oncology, the self-assessment points can be applied toward both certifications. You will, however, still need to take both exams. In addition, physicians participating in MOC can earn Category 1 CME credits for completing medical knowledge modules and PIMs, and for preparing for the exam.

The best source for information about MOC, including registration periods and exam dates, is the ABIM Web site. To enroll in MOC, visit ABIM Web site and select "Physician Login" at the top of the page.

FAQs About Maintenance of Certification

Do I have to renew my internal medicine certification to be able to renew in hematology?

No, in fact, the ABIM recommends that physicians maintain certification only in those areas that they practice. However, if you choose to maintain multiple certifications, points in self-evaluation can count toward multiple certificates.

Do I have to complete internal medicine modules?

Physicians can choose which modules they want to complete. There are several recommended for hematologists, and some medical societies and hospitals hold learning sessions that provide credit toward self-evaluation of medical knowledge for enrolled physicians.

What do I need to do to recertify in both hematology and medical oncology? Do I have to complete 100 points for each certificate?

No, 100 points can count toward both certificates. Keep in mind that the points you earn only last for 10 years, so planning ahead is important.

When do I take the exam?

You can take the exam any time beginning in the sixth year of your 10-year certification.

Do I have to earn all of my self-evaluation points before I take the exam?

No, you can earn points before or after you take the exam.

What should I do if my certification lapses or expires?

You should begin to complete any outstanding requirements (i.e., passing the exam in the next exam administration and/or self-evaluation modules). Upon your successful completion of all requirements, your certificate will be renewed.

How many points do I need?

You need to earn 100 points — with a minimum of 20 points in medical knowledge, and 20 points in practice performance. The additional 60 points can be from either or both categories. You do not need to complete the 100-point requirement before you take the recertifying exam, but you do need all of the points before your certification is set to expire.

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