2010 can be considered a banner year for the American Board of Family Medicine, or ABFM, for at least two reasons. First, this year marks the completion of the staged, seven-year transition of all ABFM diplomates into the new recertification paradigm, Maintenance of Certification for Family Physicians(www.theabfm.org), or MC-FP. And second, the ABFM just announced it will introduce some major changes to MC-FP beginning next year.
According to a message from ABFM President and CEO James Puffer, M.D., in the summer 2010 issue(www.theabfm.org) of the organization's newsletter, The Phoenix, the ABFM continues to seek ways to allow diplomates more flexibility in meeting MC-FP requirements. Since the program's inception in 2003, ABFM leaders and staff have listened carefully to diplomates' feedback and suggestions for improving the MC-FP process and have sought to accommodate their needs.
One recent change that has been overwhelmingly well received, Puffer says in the article, is giving ABFM diplomates the option to move from a seven-year to a 10-year MC-FP cycle. He adds that, to date, nearly all diplomates offered this opportunity have chosen the 10-year pathway.
"When we provided diplomates the opportunity to choose between either a seven-year or a 10-year MC-FP cycle, we suspected that the 10-year option would be appealing," Puffer told AAFP News Now. "However, we have been gratified that more diplomates are willing to meet the more rigorous 10-year pathway requirements in trade-off for extending the time that they would be required to take the examination by three years.
"We believe multiple reasons exist to explain this phenomenon, not the least important of which is the opportunity to take one less examination over the course of a typical 30-year career."
Currently, either option culminates with the administration of the cognitive examination (Part III).
However, in light of the many ways in which the MC-FP assesses diplomates' competencies on an ongoing basis, the ABFM has determined that the examination need not be given as frequently as in the past. Therefore, beginning with those who certify or recertify in summer 2011, the ABFM will unlink the examination temporally from the MC-FP cycle, and diplomates may take it at any point in the cycle they choose. The results of the examination will be valid for 10 years.
In addition, diplomates will be free to choose how they wish to complete their MC-FP Part II self-assessment module requirements and their Part IV (e.g., the ABFM's performance-in-practice modules; methods in medicine modules; and approved alternatives, such as the AAFP's Measuring, Evaluating and Translating Research Into Care modules) requirements during each three-year stage of the MC-FP cycle.
Each module will be assigned a point value, and diplomates will be required to accumulate a sufficient number of points every three years. The precise total of points needed to satisfy the requirement has yet to be determined.
Diplomates can decide how they wish to accrue the required point total as long as the activity combination completed during the three-year stage includes at least one Part II module and one Part IV module.
Thus, under the new schema, diplomates will need to fulfill the following four requirements during each three-year stage of the MC-FP cycle to maintain certification:
- meet ABFM licensure requirements (Part I),
- complete Part II and Part IV activities totaling a set number of points in any combination (diplomates will continue to receive CME credit for this activity),
- meet ABFM CME requirements (Part II), and
- have performed successfully on the examination within the previous 10 years (Part III).
According to the article in The Phoenix, the coming changes to the MC-FP should permit the ABFM to begin issuing certificates without end dates next summer, a practice that the American Board of Pediatrics began this year and that the American Board of Internal Medicine expects to begin in 2011, as well. The validity of the new ABFM certificates will be continuous as long as diplomates have met the first three requirements above by the end of each three-year stage and have performed successfully on the examination within the past 10 years.
The article also notes that allowing diplomates the chance to complete multiple Part IV activities in each stage would permit them to participate in CMS' Physician Quality Reporting Initiative or a health plan-sponsored pay-for-performance or physician recognition program each year and receive MC-FP credit for doing so if they choose to complete a corresponding performance-in-practice module.
Moreover, because the examination no longer will be tied to the end of the MC-FP cycle, a diplomate nearing the end of his or her career could time the administration of the examination so that the end of its 10-year validity coincided with his or her retirement date.
"One of the most important things that we learned from our diplomates during the initial transition to MC-FP was that they placed great value in completing their requirements on their schedules rather than ours," said Puffer. "We believe that these new changes will add even greater choice and flexibility in how diplomates meet these requirements going forward.
"We look forward to testing these assumptions with family physicians in several focus groups at this fall's AAFP Scientific Assembly before rolling out the improved program in the summer of 2011."