2011 Federation of State Medical 2011 Boards Federation of State Medical Boards The Value and Use of CME in Medical Licensure ACCME Newcomers Workshop July 31, 2013 2011 Federation of State Medical Boards Objectives Describe the role of FSMB and state medical boards in public protection Explain the state medical boards CME requirements for licensure renewal Describe the framework for MOL as it relates to CME and the state medical boards 3 2011 Federation of State Medical Boards 1
Federation of State Medical Boards (FSMB) Not for profit established in 1912 Membership organization for state medical and osteopathic boards FSMB Mission: promote excellence in medical practice, licensure and regulation as the national resource and voice on behalf of state medical boards in their protection of the public 4 2011 Federation of State Medical Boards State Medical Boards 70 State Medical Boards 50 states with composite boards (licensing MDs and DOs) or allopathic boards 14 osteopathic boards 5 U.S. territories including Washington, DC, Guam, Northern Mariana Islands, Puerto Rico & Virgin Islands State Agency Many under umbrella organization, e.g. Dept. of Health Varying degrees of autonomy 5 2011 Federation of State Medical Boards Current Requirements for Licensure Renewal Periodic cycles (annual or biennial) Application for renewal Review applications for malpractice, disciplinary actions, etc. Documentation of CME (if required) Renewal Fee 6 2011 Federation of State Medical Boards 2
CME for Renewal of Licensure First mandated over 40 years ago Require demonstration of commitment to maintaining competence 64 jurisdictions require CME for re-licensure Requirements vary across jurisdictions Number of hours Content specific 7 2011 Federation of State Medical Boards CME Content Requirements Little specificity regarding relevance to practice Content requirements in response to legislative priorities: Pain management/end-of-life care Risk management Prevention of medical errors Medical ethics Domestic violence HIV/AIDS education 8 2011 Federation of State Medical Boards Current System of Verification Physician attestation to the completion of required # of CME hours and submit documentation Failure to complete or document completed CME may result in: Fines Reprimand Additional CME Denial of license renewal License revocation 9 2011 Federation of State Medical Boards 3
Maintenance of Licensure (MOL) The process by which a licensed physician provides, as a condition of license renewal, evidence of participation in continuous professional development that: Is practice relevant Is informed by objective data sources Includes activities aimed at improving performance in practice 10 2011 Federation of State Medical Boards FSMB House of Delegates 2004 Policy Statement State medical boards have a responsibility to the public to ensure the ongoing competence of physicians seeking licensure. 11 2011 Federation of State Medical Boards MOL Framework Evidence of physician self-evaluation and selfassessment Assessment of knowledge and skills Demonstration of accountability for performance in practice and/or patient care 12 2011 Federation of State Medical Boards 4
MOL Framework 3 components of effective lifelong learning 1. Reflective selfassessment (What improvements can I make?) 3. Performance in practice (How am I doing?) 2. Assessment of knowledge and skills (What do I need to know?) 13 2011 Federation of State Medical Boards MOL Framework and Recommended Tools COMPONENT 1: Reflective selfassessment COMPONENT 2: Assessment of knowledge and skills COMPONENT 3: Performance in practice MOC/OCC CME in practice area Practice-relevant MCQ exams (MOC/OCC) Standardized patients Computer-based case simulations Patient/peer surveys Procedural hospital privileging Observation of procedures Performance improvement CME/Projects (SCIP, IHI, IPIP, HEDIS) MOC/OCC AOA BOS Clinical Assessment Program 360 o evaluations Patient reviews Analysis of practice data CMS measures 14 2011 Federation of State Medical Boards FSMB House of Delegates 2010 Actions Adopted as policy the MOL framework and recommendations as proposed by the Advisory Group on Continued Competence of Licensed Physicians Directed FSMB to continue pursuing: - Research into the impact of MOL on patient care and physician practice - Pilot projects 15 2011 Federation of State Medical Boards 5
Current Activities Pilot Projects 9 state boards have expressed interest Conducted projects that will advance understanding of the process, structure and resource requirements First Pilot: State Readiness Inventory Survey Second Pilot: Physician Acceptability Survey 16 2011 Federation of State Medical Boards MOL Pilot States WA ME OR ID MT ND SD MN WI MI VT- M NY MA CT NH CA-O NV UT WY CO NE KS OK-M IA MO IL OH IN KY TN PA NJ MD DE WV VA NC RI AZ NM AR SC MS AL GA TX LA AK FL US Virgin Islands STATE BOARDS HI = Participating GU 17 2011 Federation of State Medical Boards Four Important Points about MOL 1. There will not be a mandatory, high stakes examination for MOL 2. State medical boards will not require specialty board certification, nor MOC or OCC, as a condition for medical licensure 3. MOL is not the same as MOC or OCC 4. Participation in MOC or OCC should substantially count toward any state s MOL requirements 18 2011 Federation of State Medical Boards 6
Future Impact of MOL When fully implemented, MOL will encourage and support lifelong learning by all of the nation s licensed physicians and create a system to confirm their practice improvement efforts. 19 2011 Federation of State Medical Boards Resources www.fsmb.org Information about re-licensure requirements http://www.fsmb.org/grpol_cme.html Information about MOL http://www.fsmb.org/mol.html 20 2011 Federation of State Medical Boards Kelly C. Alfred, MS Director, Education Services Federation of State Medical Boards 400 Fuller Wiser Road, Suite 300 Euless, TX 76039 817-868-5160 kalfred@fsmb.org Questions and Discussion 21 2011 Federation of State Medical Boards 7