Given that maintaining compliance with Maintenance of Certification is necessary for maintaining licensure to practice as a radiologist and provide quality patient care, it is important for radiology residents to practice fulfilling each part of the program during their training not only to prepare for success after graduation but also to adequately learn best practices from the beginning of their professional careers. This article discusses ways to implement continuous certification (called Continuous Residency Certification) as an educational model within the residency training program.
Introduction
Prior to 1994, the American Board of Radiology (ABR), which is one of the 24 national medical specialty boards that make up the American Board of Medical Specialties (ABMS), issued lifetime certifications for radiology residents who successfully passed the ABR board certification examination . However, because of rapid changes in practice, governmental influences, the adoption of new technology, and societal pressures, the ABMS recognized the need for physician competency to be re-evaluated throughout their career to ensure patients are provided with quality care. This propelled the ABMS to cease issuing lifetime certifications and instead offer time-limited certifications, which require physician specialists to demonstrate their continued competency periodically throughout their professional career . Each of the 24 national medical specialty boards transitioned to offering time-limited certifications, and in 2002, the ABR successfully completed this transition. With this change, the ABMS developed and implemented the Maintenance of Certification (MOC) program, which required physician specialists to demonstrate their continued learning and competency in their specialty to obtain recertification when their previous certification expires. This was a first step in the process of demonstrating continued competency and lifelong learning. However, the structure of maintenance of certification allowed for completion of the various components in a cramming type fashion rather than continual demonstration of competency and lifelong learning. Therefore, this process was reassessed, and the ABR has recently introduced a new certification process called “continuous certification.” Continuous certification is one in which certification will no longer have a “valid through” date and will instead issue certifications that are only valid if the physician meets the requirements of the MOC program. The four components of MOC remained the same ( Table 1 ). Compliance with the program demonstrates the physician’s commitment to professional development and providing quality care for patients. Under continuous certification, certified radiologists participating in the program will be evaluated annually on their progress in fulfilling the MOC requirements. The MOC program is currently optional for radiologists who possess lifetime certifications. For those radiologists who received time-limited certifications and those who received initial certification in 2012 or after, they will be required to participate in this program. The first complete progress evaluation will occur in March 2016 and will examine progress on fulfilling all four parts of MOC (see Table 1 ). The four parts of MOC include :
1. Evidence of professional standing: Evidence of a valid, unrestricted licensure to practice medicine in all states where an active license is held.
2. Lifelong learning and self-assessment: Lifelong learning and self-assessment requires completion of 75 American Medical Association category 1 continuing medical education credits every 3 years. At least 25 of these CME credits must be self-assessment CME (SA-CME) credits. The definition of self-assessment activities was expanded to include more than just SAMs, which were prequalified Self-Assessment Modules. Now, online materials and material with imbedded questions can be counted toward satisfying the SA-CME requirement without prior ABR qualification.
3. Cognitive expertise: Cognitive expertise requires having passed the MOC examination or ABR initial certification examination within the past 10 years.
4. Practice Quality Improvement (PQI): Completing a PQI project in the past 3 years . This project requires the physician specialist to identify an area of their practice that needs improvement and devise a plan to study the level of improvement needed in that area. After collecting relevant data and studying the results, the physician is required to determine the causes of any subpar performance and to devise and implement an improvement plan.
Table 1
How Does Continuous Certification Work?
MOC Year Look-Back Date Element(s) Checked 2012 3/15/2013 Licensure and examination 2013 3/15/2014 Licensure and examination 2014 3/15/2015 Licensure and examination 2015 3/15/2016 Licensure, continuing medical education/self-assessment–continuing medical education, examination, practice quality improvement, and fees 2016 3/15/2017 Licensure, continuing medical education/self-assessment–continuing medical education, examination, practice quality improvement, and fees 2017 3/15/2018 Licensure, continuing medical education/self-assessment–continuing medical education, examination, practice quality improvement, and fees 2018 3/15/2019 Licensure, continuing medical education/self-assessment–continuing medical education, examination, practice quality improvement, and fees 20XX 3/15/20XX Licensure, continuing medical education/self-assessment–continuing medical education, examination, practice quality improvement, and fees
MOC, Maintenance of Certification.
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The Value of MOC
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Components of CRC
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Part 1: Evidence of Professional Standing
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Part 2: Lifelong Learning and Self-assessment
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Part 3: Cognitive Expertise
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Part 4: PQI
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Conclusion
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References
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