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#49854
11/04/2012 11:19 AM
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I have a question regarding board recertification. This will be my 3rd go around, every 10 years with internal medicince. My first time was for the original certificate, and in 2003 the first recertification. Maybe I am looking at the process as glass half empty instead of half full, but with the increased difficulties of just keeping a business going in this tough medical milieu, the time to keep the certificate current will impact directly on family time. How do you all feel about the recertification process, and is it worth it to keep the certificate current?
Personally, the day to day education with the resources at hand such as up to date, epocrates and medscape, I think supercede any board recertification process that intends to make one a better physician. I think a daily enmeshment of self imposed education to impart to our patients is the best way to stay current, and not a 2000 dollar plus certificate every 10 years we have to jockey for so we can contract with insurance companies. I am not concerned about failure of the recertification test, but a waste of my valuable time to "play the game" and go through the 100 points of modules and traveling and taking the test at a secure center, and realizing this is not making me a better physician, but a waste of money and valuable family time to "become a better physician" when in fact is what I do every day. Just feeling frustrated but wonder if I am way off base or do others have similar thoughts?
jimmie internal medicine gab.com/jimmievanagon
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jimmie, I think you may have been out of circulation for two long. Seven years into pediatrics, I studied for my boards using CDs from UCLA, which were incredible. Went through them twice. Turns out I different need to, but I passed in the 90s, learned a ton and diagnosed a girl with dermatomyositis the day after listening to the rheumatology section. Anyway, most boards including Internal Medicine according to my research don't just have you go do a written test (although it may be possible that you do on every other one). What they do is ask you to do the MOC, http://www.abim.org/moc/, which in peds is four segments and in IM, I believe, is five. You can do these at any time during the seven year period but they MUST be completed by the specified date. For peds, it was: 1. Professional standing and licensure (simple) 2. Lifelong learning skills and self assessment (simple) 3. Performance in practice (basically attestation -- done by my MA -- she recommended flu shots, then I recommended flu shots); this did take a month as you had to show improvement in the process -- read start off poorly. 4. Performance in Practice -- the only possible trip up. But, this is as close as what you stated. It is 100 case scenarios done very professionally. It is open book/Internet/journal I, personally, have always thought that open book tests allow more learning than studying for a test and trying to guess what the professor is going to test you on. Anyway, ask John (ryanjo), but I looked MOC up, and it is very similar if not exact to what we do/did in pediatrics.
Bert Pediatrics Brewer, Maine
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Jimmie, I feel like you do. My Internal Medicine Certification is through 2014. I certified in 1994 and recertified in 2004. I have bought the MKSAP (medical knowledge self assessment program) . The way I read it I can get 80 of the required 100 points by doing CME from the MKSAP modules. Then I am going to suffer through the 20 point online Osteoporosis practice improvement module. Finally there is the sit down test.
...KenP Internist (retired 2020) Florida
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Jimmie, are you aware that the topic you brought up is the source of a major controversy right now? There is a move to make maintenance of certification mandatory for licensure. On one side, there are those who say that this is an important way to improve the quality of care delivered, and weed out the "bad actors" in medicine. On the other are those who claim that this is another money grab by the AMA and the boards, and that MOC is an ineffective and unproven way to achieve those goals. Here is just one article about the controversy, with a discussion of one of the groups founded to fight mandatory MOC. Sermo has a lot of comments about the controversy.
Jon GI Baltimore
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Holy ...Batman!!!!
http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&cad=rja&ved=0CDYQFjAD&url=http%3A%2F%2Fpopwatch.ew.com%2F2009%2F12%2F28%2Fholy-batman%2F&ei=Iu2WUJi2FaKeiALD5IHgAw&usg=AFQjCNH9qZx7W62awESk6yDbtvEytAA_TQ
I think Bert is right, I have been out of circulation too long!!!
Thanks for all the info!!! I will have to look into this further but I think the safest approach is to go through with the recert process.
I think MKSAP16 is the way to go and the complete is $889, for a nonmember and has the print, digital, updates and board review, otherwise the digital is $469, print $519 and board review $99. As I understand too, you can get the 80/100 points going through the MKSAP16--uugghh nothing like putting it off to the last minute--maybe in 10 years it will be easier.
jimmie internal medicine gab.com/jimmievanagon
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For an internist that has gone thru the process, which self eval of practice module is the least painful?? @Ken -- did you get the complete MKSAP or just digital or paper??
jimmie internal medicine gab.com/jimmievanagon
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One other curious fact I learned yesterday. I have a good friend that is personal injury and medical negligence attorney. We rarely talk business--thankfully! But I asked him how often his specialty and lawyers in general have to recertify for licensure. Answer: ?
jimmie internal medicine gab.com/jimmievanagon
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As often as we get paid for phone conversations with patients.
Jon GI Baltimore
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jimmie internal medicine gab.com/jimmievanagon
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@Ken -- did you get the complete MKSAP or just digital or paper?? I got the complete. With member rates and some preorder deal (15% off), it was the best option.
...KenP Internist (retired 2020) Florida
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You have to look through them and see which is easiest. Have to be careful that it doesn't require working in a group. I just looked until I found the easiest. I am sure they are different each year and for IM. Get something like HbA1C or something.
Bert Pediatrics Brewer, Maine
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I intended to say thank you all for confirming my feelings, so thanks guys. The websites Jon and Dave directed me to have been helpful as well. I am not a member of ACP, so decided on the print only MKSAP16 for $519. Also $1675 for MOC re-certification. Will eventually get the board review for $99. So knowing there are kindred spirits out there makes the process a bit more palatable, and made parting with the cash a bit easier somehow, and now looking forward to working through some of the modules at my own pace. But when I am 59, unless this re-certification process changes my mind significantly, will likely not go through with it again in 10 years.
jimmie internal medicine gab.com/jimmievanagon
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$519 self induced headache.
I just received my print MKSAP Part A today, and decided to start the Neurology module tonight.
The fun begins!!!!!
jimmie internal medicine gab.com/jimmievanagon
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how often his specialty and lawyers in general have to recertify for licensure. Answer: ? In Ohio during the mid 70s malpractice rates were going out of sight. Some physicians actually protested with a "slow down" treating patients. At the state level our lawmakers, majority attorneys, hastily convened and came up with a solution. Limits on total claims, joint and several liability, pain and suffering? Well, no, none of those. The grand solution was....to require physicians to have CME. Having seen the cottage industry spring up I have to chuckle at the "solution".
Bob Allergy Mansfield, OH ****************** Where am I going and why am I in this handbasket?
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Pleasantly surprised after finishing my Neurology Module-MKSAP16. The information was well presented and the open book test forum very helpful, especially the explanation of answers. The online submission to ABIM for module points and CME after finding the answer page was easy. Only 5 more modules to complete part A. It was an excellent review.
jimmie internal medicine gab.com/jimmievanagon
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Ken and others,
Just as a followup, thanks for the great advice. Went through all 11 modules of the MKSAP16. Then all the questions and answers again in preparation. A week out from the re-cert test and still waiting on the results, and it may be up to a 3 month wait.
However, the MKSAP16 was a very thorough, systematic review and prepared me extremely well for the 180 questions, so whether I pass or not is really a moot point. Trudging through the MKSAP16 was a great reminder that the daily dip in Epocrates, Medscape and Up to Date has kept me abreast.
I do sincerely appreciate all the input and helping me get my head on straight to get through this test, and will leave you with this little poem that reminds me a bit of this ACUB.
For once, then Something (Robert Frost)
Others taunt me with having knelt at well-curbs
Always wrong to the light, so never seeing
Deeper down in the well than where the water
Gives me back in a shining surface picture
Me myself in the summer heaven godlike
Looking out of a wreath of fern and cloud puffs.
Once, when trying with chin against a well-curb,
I discerned, as I thought, beyond the picture,
Through the picture, a something white, uncertain,
Something more of the depths?and then I lost it.
Water came to rebuke the too clear water.
One drop fell from a fern, and lo, a ripple
Shook whatever it was lay there at bottom,
Blurred it, blotted it out. What was that whiteness?
Truth? A pebble of quartz? For once, then, something.
jimmie internal medicine gab.com/jimmievanagon
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Nice, but it doesn't rhyme.
Bert Pediatrics Brewer, Maine
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Jimmie,
I faced the same question when I was originally deciding to take my boards. That many years ago, it was common for an internist to practice without boards unless he/she wanted to work in academia, and the exam had about a 50% failure rate. I really agonized over it.
Then (this being in San Francisco in 1970), a friend introduced me to the I Ching, and we consulted it. What I got was the hexagram for "Increase", that went something like
"It furthers one to undertake something "It furthers one to cross the great water "The time of Increase does not last; therefore it must be taken when the opportunity presents itself."
I took that to mean that, pass or fail, I would benefit from the study, and the grade should be immaterial. I was almost disappointed in myself to find I was excited when I passed.
If your practice is restricted to only a limited area of Internal Medicine, maybe that's what you should review. But I do think the review is useful.
David Grauman MD Department of Medicine Commonwealth Health Center Saipan, Northern Mariana Islands
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@Bert,
This one is a bit more sublime and it does rhyme:
Jack and Jill went up the hill, To fetch a pail of water, Silly Jill forgot her pill, And now they have a daughter.
@David,
I am feeling very much the same way, a bit disappointed in caring so much about the final grade on the recert test.
jimmie internal medicine gab.com/jimmievanagon
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