ACP American College of Physicians - Internal Medicine - Doctors for Adults

The Four Components of the ABMS Framework

Part 1

Demonstration of Professional Standing: fulfilled by maintaining a clear license to practice medicine and demonstration of good standing in the professional community.

Part 2

Demonstration of Lifelong Learning and Self-Assessment: currently fulfilled by completing one or more ABIM self-evaluation process (SEP) modules focused on medical knowledge, or an accepted substitute such as the MKSAP question modules (see MKSAP Maintenance of Certification Modules). This component of maintenance of certification is now part of the requirement for a total of 100 self-evaluation points (see The Modified ABIM Framework below).

Part 3

Cognitive Expertise: fulfilled by passing a secure examination, which is currently computer-based and administered at computer centers. A list of centers and more information about computer-based testing are available on ABIM Web site (www.abim.org). For more details about the writing of the ABIM recertification exam, please see the detailed description provided by ABIM about the exam development process.

Part 4

Evaluation of Performance in Practice: a modified ABIM framework that was instituted in 2006 now includes a required component of evaluating performance in practice. ABIM has offered several options by which candidates can fulfill this requirement, and these are described in detail on the ABIM website. This component of maintenance of certification is now part of the requirement for a total of 100 self-evaluation points (see The Modified ABIM Framework below).

For specific information about enrolling in the program, ordering modules, or registering for an exam see the ABIM Web site (www.abim.org) or call the ABIM help line at 800-441-2246, ext. 3598.

The Modified ABIM Framework

As of January 2006, the previous requirement for completion of five ABIM SEP modules evolved into a “point system” requirement that incorporates flexible options for self-assessment of knowledge and practice performance.

Each candidate now needs to complete a total of 100 self-evaluation points as part of the maintenance of certification process. The same points are applicable to all certificates and are valid for 10 years (i.e. extra points are not needed if a candidate is applying for both internal medicine and a subspecialty within the 10 year period during which the points are valid).

The required 100 points are divided in the following way:

• minimum of 20 points must relate to self-evaluation of medical knowledge;
• a minimum of 20 points must relate to self-evaluation of practice performance;
• and 60 points are elective and can relate to either category of self-evaluation.

Each of the 60-question ABIM SEP modules released before Spring 2007 counts as 20 points relating to self-assessment of medical knowledge, as does each 60-question MKSAP 13 question module. ABIM is now gradually retiring the 60-question modules that they have used in the past, and is now replacing them with 25-question "Update" modules, each of which provides 10 points of credit for self-evaluation of knowledge.

The MKSAP 14 question modules now under development as an alternative to the ABIM Update modules will also have 25 questions and earn 10 points of MOC credit.

How Will I Get Credit for Self-Evaluation of Practice?

A variety of options are now available for fulfilling the 20 point minimum requirement for self-evaluation of practice, and more will be available in the future. The number of points given for each option depends upon the amount of work involved.

There are three basic components to this self-evaluation of practice:

1) measuring practice performance from data that the physician collects or receives from another source
2) developing and implementing a plan for improvement;
3) assessing the impact of the improvement plan

Options that are now available for assessing practice performance include:

• ABIM Practice Improvement Modules (PIMs)
• ABIM survey modules (Peer and Patient Survey)
• Performance improvement programs that have been established by national societies, such as ACP’s Closing the Gap program
• Self-directed quality measurement and improvement, in which measurement data have typically been collected and provided by other sources

Credit for performance assessment is given with completion of one of these options; there is no grade given and thus no “passing” score. The ABIM’s PIMs and the Peer and Patient Survey count as 20 to 40 points, depending upon the particular module. The ABIM assigns points for Society-based options and for self-directed quality measurement and improvement options according to pre-established standards and criteria. See the ABIM website for further details about the requirement for self-evaluation of practice.