APA President Paul Summergrad, MD, and CEO and Medical Director Saul Levin, MD, MPA, have recommended to the American Board of Psychiatry and Neurology (ABPN) that Part 4 of the Maintenance of Certification (MOC) Program be eliminated. Part 4 is the “Improvement in Medical Practice” section, also known as Performance in Practice, or PIP.
The action, which was in response to APA members’ significant concerns over this portion of the MOC program, was taken in a letter sent to ABPN President and CEO Larry R. Faulkner, MD, yesterday. The letter was the result of a motion, spurred by the Assembly Executive Committee and made at the Board of Trustees meeting this past weekend in Arlington, Va., reflecting concerns over the limited evidence base for Part 4.
The ABPN is an independent board that operates under criteria established by the American Board of Medical Specialties (ABMS). Thus, APA is urging the ABPN to support APA’s position and advocate to the ABMS for the elimination of the Part 4 requirement.
The ABPN MOC program currently consists of four sections: Part 1, Professional Standing (licensure); Part 2, Lifelong Learning and Self-Assessment; Part 3, Cognitive Expertise (certification/recertification examinations); and Part 4, Improvement in Medical Practice (Performance in Practice-PIP).
“APA members have found Part 4 to be onerous, cumbersome, and not meaningful,” wrote Summergrad and Levin. “While we very much appreciate ABPN leadership’s efforts to create alternative pathways for meeting this requirement, neither our members nor the APA Board of Trustees support the continuation of Part 4 of MOC.”
The Board also established a joint Board-Assembly work group to evaluate the broad issue of maintenance of certification in psychiatry and its relationship to maintenance of state licensure and other accrediting bodies.
APA is not the only medical specialty to question the value of certain MOC requirements. The American Board of Internal Medicine, after input from its medical specialty members, announced last month that it was making substantial changes to its MOC requirements, including the suspension of Part 4.
In a statement released to APA members yesterday about its letter to the ABPN, Summergrad wrote, “We highly value our collaborative relationship with the ABPN and will work with them, other groups, and, of course, our members to resolve the widespread concern about these issues.”
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