FOCUSED PRACTICE IN HOSPITAL MEDICINE: THE BASICS

The American Board of Internal Medicines (ABIM) Focused Practice in Hospital Medicine Maintenance of Certification (MOC) program assesses, sets standards for, and recognizes the specific and unique knowledge, skills and attitudes of general internists who focus their practice in the care of hospitalized patients. To enter the Focused Practice in Hospital Medicine MOC program, you must have:

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Current or previous ABIM certification in Internal Medicine. Valid, unrestricted medical license and confirmation of good standing in the local practice community. Current Advanced Cardiac Life Support (ACLS) certification. At least three years of unsupervised Hospital Medicine practice experience at the time of entry. Formal fellowship training in a hospital medicine fellowship program can be counted toward the three-year practice experience criteria. Attestation by the diplomate and a Senior Hospital Officer (SHO) that the diplomate meets patient encounter thresholds for internal medicine practice in the hospital setting and professional commitment to hospital medicine.

Successful completion of the program identifies diplomates as ABIM Board Certified in Internal Medicine with a Focused Practice in Hospital Medicine. Note: This is a separate certification. Diplomates in the Focused Practice in Hospital Medicine program cannot hold an Internal Medicine certification and Internal Medicine with a Focused Practice in Hospital Medicine certification at the same time.

THE PRE-QUALIFICATION PROCESS

If you wish to enter the program, go to Physician Login at www.abim.org and on your home page, under My Maintenance of Certification Program, click on Enter Focused Practice in Hospital Medicine MOC Program. There you will begin the pre-qualification process, which requires you to complete a Web-based self-attestation, as well as the submission of the SHO attestation to your eligibility. The attestations must be submitted and approved prior to entry in the program. You can track your status in this process via the View Status of Entry into Focused Practice in Hospital Medicine MOC Program on your home page. The thresholds for internal medicine practice in the hospital setting and professional commitment to hospital medicine are:
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Direct Patient Care (i.e., full-time hospital practice): minimum of 1,000 hospital patient encounters (limited to one encounter per patient-day) per year for three years, or 3,000 over three years. OR

Clinical/Systems (i.e., full-time hospital medicine professional activity with part-time hospital practice): minimum of 250 hospital patient encounters (limited to one encounter per patient day) per year for three years, or 750 over three years; these encounters must comprise at least 75% of total clinical activity, and at least 50% of the remaining non-clinical professional time must be directed toward improving the care of hospitalized patients.

ABIM reserves the right to conduct a random audit of all applications to ensure the programs requirements are being fulfilled. The patient encounter volume thresholds must be fulfilled in the three years immediately prior to application for entry into the program. Please visit www.abim.org/Hospital-Medicine for more information.

ATTAINING THE FOCUSED PRACTICE IN HOSPITAL MEDICINE DESIGNATION

Once you complete the pre-qualification process, in order to achieve the Focused Practice in Hospital Medicine designation you must:

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Schedule, take and pass the ABIM Hospital Medicine Maintenance of Certification Examination. Maintain an unrestricted medical license. Have completed 100 points of self-evaluation within the past 10 years, with at least 60 points having been completed within the last three years. These 60 points must include 20 points of Self-Evaluation of Medical Knowledge, and 40 points of Self-Evaluation of Practice Performance.

You are eligible to schedule the ABIM Hospital Medicine Maintenance of Certification (MOC) exam once you are accepted into and enter the Focused Practice in Hospital Medicine MOC program. The computer-based Hospital Medicine MOC examination is offered twice a year in spring and fall at Prometric test centers, located worldwide. Please visit www.abim.org/hmexam to find exam dates and scheduling deadlines. The Hospital Medicine MOC exam is designed to evaluate the extent of your knowledge and clinical judgment in the areas in which you should demonstrate a high level of competence. Exam questions are developed by a team of hospitalists and general internists in practice and in academic medicine. MOC points earned prior to entering the Focused Practice in Hospital Medicine program may be credited to the program point requirements. However, it is possible the self-evaluation points you earned previously may expire prior to completing all of the program requirements. Your MOC Status Report on your personal home page in the Physician Login will track and automatically apply the valid self-evaluation points earned to the new program point requirements.

MAINTAINING THE FOCUSED PRACTICE IN HOSPITAL MEDICINE DESIGNATION

To maintain the Focused Practice in Hospital Medicine designation, you must:

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Earn 100 self-evaluation points, with at least 20 points from completing Self-Evaluation of Medical Knowledge modules and 40 points from completing Self-Evaluation of Practice Performance modules, in a five-year period. Re-attest to hospitalist practice experience every five years. Maintain an unrestricted license and a current ACLS certification. Schedule, take and pass the Hospital Medicine MOC exam once every 10 years.

Note: Given that this is a new program focused on the ever-changing hospital medicine environment, there may be additional requirements for maintaining this certification in the future.

INITIAL DESIGNATION
Exam Pass Hospital Medicine MOC Exam

MAINTAIN DESIGNATION
Pass the Hospital Medicine MOC exam once every 10 years

MOC Points

100 points in past 10 years, 60 of those points in past three years

100 points every five years

Licensure

Maintain unrestricted license & ACLS certification

Maintain unrestricted license & ACLS certification Self/SHO Attestation every five years

Attestation

Self/SHO Attestation

SELF-EVALUATION OF MEDICAL KNOWLEDGE

ABIM medical knowledge modules provide evidence of engagement in periodic self-assessment to guide continuing learning. Each module allows you to perform a diagnostic self-assessment of your strengths and weaknesses in important aspects of the knowledge base underlying each certification area.
Medical Knowledge Modules for Focused Practice in Hospital Medicine
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A new Annual Update in Hospital Medicine (10 points each) is released every year and there are always three modules available. Care for the Underserved Module (10 points)

Point-of-Care Clinical Question Module (20 points) Society of Hospital Medicine's (SHM) Hospital QI and Patient Safety module and Hospital QI and Patient Safety II module (10 points each) must be ordered through SHM.

Clinical Skills Module (20 points)

Additional medical knowledge options can be found at www.abim.org/mk

SELF-EVALUATION OF PRACTICE PERFORMANCE

Self-Evaluation of Practice Performance provides you with various pathways to apply quality measurement to your practice and then use the resulting data to improve care. These include ABIM PIMs Practice Improvement Modules and the ABIM-Approved Quality Improvement (AQI) pathway.
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Visit www.abim.org/pimdemo for PIM tutorials. AQI is worth 20 points. Visit www.abim.org/aqi for more information. Earn rewards and recognition from several major health plans for completion of PIMs.

Practice Performance Options for Focused Practice in Hospital Medicine

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Clinical Supervision (20 points) Communication - Recent Visit (20 points) Communication with Referring Physicians (20 points) Communication Subspecialist (20 points)

You can also earn 20 points of Self-Evaluation of Practice Performance credit through ABIMs AQI program. If you participate in an approved program, you may attest to your participation in this activity for practice performance credit. Visit www.abim.org/aqi for a complete list of AQI programs such as SHMs Boost and VTE Prevention.

ABIM Measures Library

Physicians who have completed a QI project within the past 24 months (Completed Project PIM - 20 points) or are beginning a QI project (Self-Directed PIM - 20 points) can utilize pre-approved measures from the ABIM Measures Library or other evidence-based measures. Visit http://www.abim.org/ml to view the Measures Library.
S Additional practice performance options can be found at www.abim.org/pp. Select the "Practice Performance Selector Tool" for details. P

Have questions? Call 1-800-441-ABIM (2246) or e-mail us at request@abim.org, Mon. - Fri., 8:30 a.m. - 8 p.m. ET, and Sat., 9 a.m. - 12 p.m. ET.
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2012 American Board of Internal Medicine. All rights reserved. ABIM is one of 24 medical specialty boards that make up the American Board of Medical Specialties (ABMS).

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* current as of 9/21/2012 E141-09-2012