Maintenance of Certification (MOC)

HRS staff actively monitors and responds to actions of the American Board of Internal Medicine (ABIM) that impact HRS physician members. 

ABIM MOC Requirements
Below is a high-level summary of ABIM requirements that impact physicians certified in CCE.
For comprehensive coverage of ABIM MOC requirements, go to www.ABIM.org .

 
ABIM MOC REQUIREMENT Details
Overall – Required Points Some MOC points must be earned every 2 years to be listed as “participating in MOC” on the ABIM website.  100 MOC points must be earned every 5 years to retain certification.
Underlying Certifications Electrophysiologists may choose to maintain ONLY their CCE certification (without the need to maintain the IM or CVD certifications). However, if an underlying certification lapses, the ABIM website will display only the certification in CCE. 
Part I: Licensure Physicians must possess a valid, unrestricted and unchallenged medical license in the United States, its territories or Canada.
Part II: Lifelong Learning and Self-Assessment, including Patient Safety Accredited CME providers (such as HRS) may award MOC credit for CME activities that meet specific ABIM requirements. Patient safety and patient survey requirements have been suspended through 12/31/2018.
Part III: Long-Form Assessment (secure exam) every 10 years OR Knowledge Check-in every 2 years

Until 2020, electrophysiologists must pass a secure exam every 10 years to remain certified in CCE. Starting in 2020 for CCE (2019 for CVD and 2018 for IM), there is an option to take a 10-year or 2-year assessment. Both options would be open- book with one, ABIM-specified outside resource. Two unsuccessful attempts on the 2-year assessment result in need to take the 10 year assessment (or other, not-yet-specified option).

A “Society Maintenance Pathway” also is under consideration by the ABIM. Conceptually, this pathway would use society generated self-assessment program (SAP) content.

Part IV: Practice Improvement Part IV requirements for practice improvement have been suspended through 12/31/2018. The ABIM is exploring options for requirements in 2019 and beyond.
ABIM website 

The ABIM website publicly reports the following information:

  • Current certification status (e.g., Clinical Cardiac EP: Certified)
  • Participating in Maintenance of Certification: Yes or No
  • Initial Certifications: Name and year of each certification
Fees (annual and 10-year) Fees have been capped at their 2015 rates through 2017. 
 

HRS Position

HRS recognizes that there is a place for a meaningful and reasonable recertification process, and HRS leadership continues to champion the concerns of HRS physicians certified by the ABIM.

In March 2017, during a meeting of HRS and ABIM leadership, HRS emphasized its commitment to lifelong learning and to the belief that MOC should be awarded for continuous learning, with immediate assessments rather than periodic “high-stakes” examinations that cover the full breadth of the field of electrophysiology.

Additional considerations regarding the two-year option include the following:

  • The assessment should be modular instead of covering the full breadth of the field.
  • Modules should be customizable, including core content and content relevant to practice.
  • An open-book approach is an improvement, but physicians should be allowed to choose from multiple sources, as they would in “real world” practice.
  • Alternatives to camera monitoring to ensure security should be investigated.
  • More details of the new assessment, including the cost structure, will be needed to evaluate whether the 2-year option is less burdensome than the 10-year option.
  • Time is of the essence – the slow pace of change continues to frustrate HRS members.
  • The “Society Maintenance Pathway” (using SAP content) is of great interest, and HRS wants to evaluate this option. Details are needed in order to ensure that the necessary infrastructure and processes to support this option are in place. 

HRS continues to pursue multiple options for members to meet MOC requirements. We will continue to work with the ABIM and other societies toward such solutions.

HRS Members and Board Certification: Background

The Heart Rhythm Society (HRS) has a diverse set of members, but the largest group is comprised of physicians certified in Clinical Cardiac Electrophysiology (CCE) from the United States. 74% of U.S. Board-certified CCEs are members of HRS.

Board certification is intended to ensure that health care professionals achieve and maintain common standards for patient care. Certification for CCEs is provided by the American Board of Internal Medicine (ABIM) which operates as one of the 24 member boards of the American Board of Medical Specialties (ABMS) to maintain standards for professional certification.

25% of all U.S. physicians are certified by the ABIM. To achieve initial ABIM certification in CCE, a physician must first be certified in both Internal Medicine (IM) and Cardiovascular Disease (CVD), although certification may be maintained in CCE only.

The ABMS mandates that its member boards implement a four-part Maintenance of Certification (MOC) program, and each member board creates its own policies and procedures governing MOC. In 2014, the ABIM introduced a host of new requirements that many physicians considered too burdensome, too costly, not based upon evidence and not relevant to practice. After a strong backlash, many of the new requirements were shelved by the ABIM in early 2015. Since then, the ABIM has been working more closely with medical societies to review and revise requirements.