The American Board of Radiology Maintenance of Certification Update

1. The American Board of Radiology Maintenance of Certification Update Presentor: Bhudatt R Paliwal, PhD Coauthors: William R. Hendee, PhD Stephen R Thomas, PhD June 17, 2004

3. KEY ASSUMPTIONS AND BELIEFS

4. KEY ASSUMPTIONS AND BELIEFS

5. Health Care Must Become IOM 2001 AIMS TO CROSS THE CHASM Patient and Provide Safe Evidence-Based Patient-Centered Timely Efficient, Equitable JCAHO (www.jcaho.org) DIMENSIONS OF PERFORMANCE Patient Safe Efficacious, Appropriate Respectful, Caring, Continuous Available, Timely Efficient, Effective

6. �And changing culture? �Once people have created a particular way of understanding the world, they tend to hold to it quite tenaciously. One tentative axiom would thus be that culture changes about as fast as its most recalcitrant powerful members change.� -Alan Wilkins and Kerry Patterson in Ralph Kilmann, et al. Gaining Control of the Corporate Culture Or, as a pioneering 20th Century physicist once remarked, �Scientific progress moves forward, one funeral at a time.�

7. MAINTENANCE OF CERTIFICATION American Board of Radiology

8. History of MOC 1936: ABMS Advisory Board reference to �Reregistration at Stipulated Intervals� Early 1940�s: Open discussions regarding issuance of certificates valid for a stated period of time only. 1973: First formal policy regarding recertification was adopted by the ABMS. 1993: ABMS reaffirmed its policy with all 24 member boards required to establish a mechanism to recertify diplomats. March 2000: Agreed that existing or planned programs of recertification would evolve into programs of Maintenance of Certification (MOC).

9. ABMS: Four Components of MOC Component 1: Professional Standing - Validity of the license to practice. Component 2: Lifelong Learning and Self-Assessment. - The requirement to keep current in the field. Component 3: Cognitive Expertise - Examination process. Component 4: Practice Performance - Assessment of patient care.

10. ABMS SIX COMPETENCIES OF MOC Professionalism Practice-Based Learning/Self Improvement Practice Knowledge Patient Care Interpersonal/Communication Skills System-Based Practice

12. Radiology�s Perspective of MOC 1998: Concerted efforts initiated by The ABR toward the development of its MOC process. Dec 2001: The ABR convened a meeting to engage each of its sponsoring organizations in planning MOC. Jan 2004: ABR convened a wider meeting of radiological organizations to discuss MOC implementation. The ABR is responsible for executing MOC in radiology. Establishing mechanisms for life long learning will be the responsibility of the other radiology societies.

13. The ABR MOC Coordinating Committee Members Radiologic Physics: Stephen R. Thomas, PhD, Chair Diagnostic Radiology: John Madewell, MD, MD Anderson CC Gary Becker, MD, Miami Card &Vas Inst Chris Merritt, MD, Philadelphia Radiation Oncology: Larry Kun, MD, St Jude�s Children�s, Memphis Larry Davis, MD, Emory University

14. Initiation of Time-Limited Certificates Diagnostic Radiology 2002 Radiation Oncology 1995 Physics 2002 CAQs Pediatrics 1994 Neuro 1995 Vascular and Interventional 1994 Special Comp Nuclear 1999

15. MOC Component 1:Professional Standing Three Elements: Letters of attestation Documentation of licensure or other regulatory agency certification for practice components (where applicable) Expertise based appointments or recognition

16. MOC Component 2:Life Long Learning and Self Assessment Two Categories of CME (CEC) Category 1: 250 credits over 10 year cycle Category 2: 250 credits over 10 year cycle Self-Directed Educational Project (Physics) ____credits per project

17. Self Assessment: At specific time points, candidates will be required to perform a self-assessment a to their overall progress in completing the requirements of the MOC process. Self-assessment as a global process is intended to bring all facets of essential professional development into focus. The diplomates will evaluate their performance in fulfilling the 4 components of MOC. Candidates will provide an assessment of the degree to which they have satisfied the requirements in correlation with their personal schedule for completion and submission of their MOC application. MOC Component 2 (continued):Life Long Learning and Self Assessment

18. MOC Component 3: Cognitive Expertise Expectation: That the individual 1.) maintains the fundamental core knowledge and 2.) remains up to date on evolving technologies, protocols and applications. In Physics: Three modules for the examination to be completed over the 10-year certification period. Format: Web based; proctored; multiple choice; open book, new module available on an annual basis. Upon passing, a certificate of completion is issued that would be submitted with the MOC application packet (web process). A candidate who fails an exam would have the opportunity to retake the exam the next year.

19. MOC Component 4:Assessment of Practice Performance Expectation: That the individual has maintained active, professional involvement in the discipline.

20. �It�s not the strongest of the species that survive, nor the most intelligent, but the one most responsive to change.� -Charles Darwin

21. �You don�t have to (change), survival is not compulsory.� -W. Edwards Deming