A Follow-Up on Your Feedback Regarding ASCO’s Proposed Alternate Pathway for MOC

A Follow-Up on Your Feedback Regarding ASCO’s Proposed Alternate Pathway for MOC

Julie Vose, MD, MBA, FASCO

@DrJulieVose
Dec 16, 2016

In mid-September, I reached out to you and asked for feedback on the ASCO MOC Task Force proposal that outlines an alternate pathway for maintaining certification through the ABIM.  I appreciate the many constructive and thoughtful comments I received.

This week, ASCO representatives met with the ABIM to discuss our proposal in greater detail and to identity essential elements for an alternate recertification process.  Though there are many things to work out, I am optimistic that our continued collaboration with ABIM will lead to a process that is less cumbersome and aligns with the practice of oncology in a more meaningful manner.

Also this week, you received correspondence from the ABIM providing more detail on their plan for an alternate pathway for maintaining certification.  This will be available to internal medicine Diplomates in 2018, with the anticipation that other subspecialties will soon follow.  Ultimately, I anticipate that you will have a choice in your path for maintaining certification.  Choices may include: 1) the current path with the ABIM 10-year exam, 2) the new alternate pathway to be offered by the ABIM sometime after 2018, and 3) an alternate pathway developed collaboratively by ASCO and ABIM.

Below are answers to the most commonly posed questions from the survey feedback responses.  While the plan from the ASCO MOC Task Force that we previously presented is likely to change as collaborative discussions with the ABIM continue, I hope that it provided insight on the vision of the ASCO Task Force.

Again, thank you all for your input!  Please don’t hesitate to contact me with additional thoughts or questions.

Frequently Asked Questions: Follow-Up to Request for Feedback Regarding ASCO’s Proposed Alternate Pathway for MOC

Below are answers to frequently asked questions regarding the alternate pathway for maintaining certification proposed by the ASCO Task Force. It is noteworthy, however, that this remains in a state of flux and some of the details may change as we actively collaborate with ABIM to co-create a new maintenance of certification pathway.  We will keep you apprised of decisions as we move forward.

What is meant by “open book”?

In ASCO’s proposal, open book means that you will have access to educational resources and materials while taking the required assessment.You will be free to choose and utilize any resources that you find helpful.ASCO will share recommended resources but you are not limited to those suggestions.

Where will testing occur? At home or office? Testing center?  ASCO MOC App?

ASCO has proposed that assessments will be offered online and can be taken at any location.They will not be administered at a testing center.

What topics are included in the core assessment?

The final content areas in the core will be determined by the ABIM Medical Subspecialty Board members and ASCO. The core assessment will cover topic areas that are common to all oncology practice, no matter what the practice profile may be.Potential topics include tumor biology, therapeutic principles, epidemiology/screening/prevention, genetics/genomics, anticancer therapies (molecular targeted, immune, hormonal, biologic, etc.), pharmacology/chemotherapy, toxicity management, supportive care/symptom management/palliative care/end-of-life care and communications, clinical trials, and ethics.

Who will write the questions? Will they be peer reviewed?  How will you ensure that they are clinically relevant?

ASCO expects that questions will be written by practicing oncologists (ASCO members) that have the requisite expertise in the topic areas.They will also undergo training on how to write effective assessment items.All questions will be edited and will be reviewed by at least 2 oncology professionals with expertise in the topic area.

All questions will be mapped to a test blueprint that closely aligns with the new ABIM test blueprint for oncology.Recently, the ABIM did a survey to better define areas of primary clinical relevance.All certified medical oncologists were invited to participate by providing ratings of relative frequency and importance of blueprint topics in practice.As a result, the revised ABIM blueprint is now more reflective of what is seen in practice.

What is the evidence supporting administration of a written examination to improve patient outcomes?

Evidence supporting an examination format fall into two categories: 1) declining competence, particularly in knowledge, with time, and 2) linkage of certification exams to quality of care and patient outcomes(Hawkins RE, et al. Acad Med. 2016;91:1509-15). In regard to declining competence over time, O’Neill and others found that consistent participation in MOC is associated with an increasing knowledge base over time (O’Neill TR, Puffer JC. Acad Med. 2013;88:780-7). There have also been numerous studies that have shown that certifying exam performance is related to quality of care and patient outcomes (Hawkins RE, et al. J Contin Educ Health Prof. 2013;33 (suppl 1):S7-19).

Is participation in a Quality Improvement project a required element? 

Participation in a QI project is not required currently by ABIM, and ASCO does not propose it be required either.The Practice Assessment component for MOC is voluntary.Currently, those participating in QOPI, QOPI Certification, or the Quality Training Program (2017) may apply for MOC points for these activities.The role of a point system for the alternate pathways may change. More information will be provided as it becomes available.

What is “test item writing CME/MOC”?

In 2017, ASCO will offer two new opportunities for question writers to earn MOC points for their work.Those that are part of the ASCO University Question Writing Group or the Test Development Materials Committee that writes questions for the Fellows In-Training Examination may receive 10 MOC points and CME credits for this work.In order to participate in either of these groups, individuals must attend a one-day workshop at ASCO to obtain training on how to write effective questions.In the future, those that write questions for the ASCO MOC assessments that are part of this proposal will also be eligible to receive points through a similar mechanism.

How will maintenance of certification be accomplished for physicians no longer in clinical practice - for example, those who are now doing drug development?

There is not yet a clear answer to this question. In the ASCO proposed model, all med/heme oncologists would be required to take a core assessment.The content in this assessment will focus on areas that are common to the practice of oncology, no matter what the more specific practice profile is.The model proposed by the ASCO Task Force also recommended a second, smaller assessment in a defined topic area (for example, in a content area consistent with a diplomate’s practice/work focus.)

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