When one interprets the meaning of a Picasso it takes time, discussions of what was truly meant with others and one often one goes through cycles until ultimately they arrive at their original interpretation. This situation is what the book Blink refers to as “thin slicing”.
This has been the case for the ABMS MOC CME white paper. After reading the document multiple times and engaged in multiple discussions we arrived back at much of our original thoughts.
We have no ownership on the interpretation of what the ABMS truely meant by many of their statements so in an interest to further move the discussion we have provided some background and questions that hopefully will help those in preparing their comments.
In addition to commercial support the Joint Working Group on MOC CME also explored the characteristics of CME that are of specific relevance for MOC. This discussion led the Joint Working Group to make two recommendations.
Recommendation 1: ABMS and the MOC Committee should assist the Member Boards in facilitating the development of approaches to CME for MOC Part II and Part IV that emphasize “informed learning” or “formative CME/CPD” for diplomates that incorporate specific characteristics (all of which are ACCME criteria in their bridge to quality requirements).
Recommendation 2: The ABMS and the MOC Committee should assist the Member Boards in developing approaches to Part II and Part IV MOC CME that emphasize coverage of all core competencies.
Based on these recommendations, it remains unclear exactly how ABMS and the MOC Committee will “assist” member boards. Here are some potential issues and questions that come to mind:
- Will member boards have to submit CME program proposals or grant requests to ABMS and/or MOC for approval?
- When in the stage of creating or proposing a CME program, will a CME provider be required to get “assistance” from ABMS?
- How much time/cost would this create for CME providers?
- Will there be guidelines on how ABMS and the MOC Committee will actually assist member boards?
The concern is that CME providers already identify gaps, incorporate characteristics that are relevant to physician’s scope of practices, utilize evidenced-based content, etc. These are all criteria incorporated into ACCME criteria, standards and policies. While it is certainly important to emphasize the role of MOC CME, identifying ways that the current CME system can address these issues without introducing new obstacles is important.
The final recommendation 4 The MOC Committee should continue discussions with the ACCME and others regarding the development of a “standard currency” for MOC CME that would ensure interchangeability of programming between Member Boards, and other stakeholders, and would also identify the special nature of CME programming that meets the identified characteristics of MOC CME.
Continued discussions with the ACCME are absolutely necessary for the implementation of CME for MOC referenced in the title of the document as opposed to MOC CME reference throughout the white paper. What is interesting is that there is already a “standard currency” of CME credit in the AMA PRA credit system. The fact that the AMA was left out of the document is telling in that what the ABMS may be proposing is a new “standard currency” for MOC CME. One could take this to mean that what they want is a new accreditation system in which the AMA and ACCME are marginalized. It is unclear if this was a mere oversight which can be easily fixed in the next draft.
It is unclear how such a move would not add to the paperwork burden for thousands of CME providers throughout the country.
Overall there is plenty here to comment on.
We are encouraging everyone to read the white paper for themselves and submit comments to the ABMS by March 1st to: