New APA Journal Supports Lifelong Learning Activities

With the appointment of the ABMS Task Force on Competence in 1998, the organization began to develop the framework for the Maintenance of Certification (MOC) initiative. The work of the task force members was rooted in the belief that taking a recertification exam every 10 years was an inadequate measure of competency.

The MOC framework consists of a description of the competent physician, the six general competencies required of all physicians, four required components for each board’s MOC program, and the statement that all boards will transition their recertification programs to MOC programs.

The ABPN is gradually implementing the ABMS’s MOC initiative—one component at a time, according to ABPN Deputy Executive Vice President Thomas Kramer, M.D. The four required components involve the maintenance of professional standing, lifelong learning and self-assessment, periodic cognitive examination, and practice assessment.

Kramer told Psychiatric News that the ABPN had previously required that diplomates adhere to two of those components—maintenance of professional standing, or state licensure, and the periodic cognitive examination, or the recertification exam.

However, the remaining two MOC components—practice assessment and lifelong learning and self-assessment—have yet to become a reality for member boards like the ABPN. With regard to lifelong learning and self-assessment, the ABPN is “in the formative stages” of finding a way to ensure that psychiatrists and neurologists develop a self-assessment plan. Such a plan, Kramer said, would require physicians to assess themselves to identify any deficits in knowledge, develop a lifelong learning plan to compensate for those deficits and keep up with new information in the field, and execute the lifelong learning plan.

However, Kramer emphasized that the time when psychiatrists would need to demonstrate such a lifelong learning plan was not imminent and that it would take years before the ABPN would be ready to provide educational materials that would help diplomates assess themselves. “We have formed an MOC committee, which is just beginning to converse with our specialty societies about how they can provide materials for lifelong learning,” Kramer said.

“We are anticipating that professional organizations such as APA will petition us to provide some sort of ABPN-sanctioned lifelong learning,” he added, “But we have no system in place to certify educational providers yet.”

Under the old CME system, psychiatrists had little incentive to venture into unfamiliar areas of psychiatry. Physicians tended to rack up CME credit by sticking with those areas of psychiatry they knew and liked.

“CME is not content driven,” Kramer observed. When attending educational meetings, he said, physicians usually attend those sessions related to their major clinical interests. “In fact, if you want a tax-deductible ski vacation, you can go to a session totally unrelated to your area of interest and still receive CME credit.”

In the age of maintenance of certification, psychiatry is no longer a buffet where one can pick and choose one’s favorite food items. Psychiatrists will have to demonstrate knowledge in general, and if applicable, subspecialty areas of psychiatry to maintain their board-certified status.

To help psychiatrists stay current with the latest advances in psychiatry and prepare them for the introduction of the MOC initiative by ABPN, APA is coming out with a new educational tool.

FOCUS: The Journal of Lifelong Learning in Psychiatry will make its debut in January. Each quarterly issue will explore a major topic in psychiatry with a diverse selection of articles. Members will find original clinical articles, comprehensive review articles summarizing current research, practice guidelines, and self-assessment exams.

The co-editors of the journal are Deborah Hales, M.D., director of APA’s Division of Education, Minority, and National Programs, and Mark Rapaport, M.D., an associate professor of psychiatry and staff physician at the University of California San Diego School of Medicine and San Diego Veterans Affairs Healthcare System. Hales and Rapaport designed the journal to review systematically all the topics that psychiatrists need to know for recertification in a three-year cycle.

The journal will cover topics such as substance abuse, posttraumatic stress disorder, and geriatric psychiatry. The inaugural issue of the peer-reviewed journal will focus on bipolar disorder.

FOCUS also gives members the opportunity to earn as many as 40 CME credits a year by completing the self-assessment exams in each issue and at the end of the year.

A subscription to the journal includes a mailed paper copy as well as Web access. Those who wish to take their self-assessment exams on the Web can do so quickly and easily. Upon completion of the exam, a CME certificate is sent by e-mail. Subscribers can anonymously compare the results of their self-assessment exams with those of their peers either online or on paper.

“From the annual meeting and the American Journal of Psychiatry to our new products—the FOCUS journal, our new grand-rounds online program, and other electronic CME offerings in the works—we hope to offer a family of practical educational products,” Hales told Psychiatric News. “We believe these educational tools will help all psychiatrists keep up with new developments in clinical practice.”

APA’s grand-rounds online program is similar to that held at a hospital. In the online version, however, a fictional case scenario will be sent by e-mail to APA members who subscribe to the program. Those who are interested can discuss the case on an APA list serve.