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Monday, July 16, 2012

Passing the American Board of Internal Medicine MOC

I took the American Board of Internal Medicine maintenance of certification test on April 25, 2012. On June 26, 2012 the board notified me by e-mail that I passed the written test, the final step.

I started the whole process June 30, 2010, by paying for the $1570 fee to the ABIM and began to do the self study and practice evaluation modules. I was able to do the self guided modules on the website pretty easily while working full time, but I'm not sure they were that valuable, since completing them just required a multiple choice test that I did while looking for specific answers. I guess that is pretty similar to how I solve academic problems for my practice, but I don't think the information sunk in too well. The best self study module was a totally self guided one in which I asked questions as they arose with my patients and later went back and found resources to answer them and described the process.

The biggest hurdle for me was the Practice Improvement Module which required that I survey a number of my patients regarding what they noticed about my practice. I chose preventive care, so they responded to questions about that plus general questions about how they were treated. This was time consuming and a little bit disruptive, but actually in a good way, and I ended up reviewing quite a bit of material about recommended screening procedures and looking at what kind of data they were based on, and really paid attention to the controversies that arose during that time about changes in recommendations. This piece took maybe 3 months.

When I had completed the required self study and practice improvement modules the board notified me that I could take the test. I scheduled that, at a testing center not too far away, and took an update CME (which I described in a previous blog in gory detail.) I also signed up for the MKSAP (the medical knowledge self assessment program) which was excellent and really sunk in well, but was very time consuming to do right. This is as it should be, since it does take time to enter a whole mongo ton of information into my brain. I was glad I was doing hospitalist work, though, so I could have large blocks of time off to study.

The test was long, but not horrendously arduous, and seemed fair. I also wrote about this in a separate blog so I won't belabor it.

The final scores were reported differently than when I took the test 20 years ago, but I'm thinking I did about as well. I missed 20 out of a total of 180 questions which put me in the top 10 percent of people taking the test. That's good, in a way, but also a little horrifying since all of those questions were things I probably should have known, and 90% or more of the people qualifying to take the test get more wrong. About 70% of test takers pass, and the standardized passing score was 366. Mine was 651. I'm not sure how they calculate the standardized scores, but it kind of looks like you could get almost half of them wrong and still pass. Some of the questions I got wrong I might have argued that a reasonable physician would disagree with the chosen answer, but some I probably just didn't know.

So I passed. Yay! I think I will probably make a point of doing the MKSAP as a kind of regular thing so I will keep up to date on the wide and wonderful body of knowledge that is internal medicine.


PCP said...

Which PIM did you do while working as a hospitalist? This has been a major roadblock for me and there is limited help online about that.

Janice Boughton said...

I did mine while I was still in primary care practice, but this page ( talks about doing something that works with hospitalist medicine. You could mine data already gathered by the quality improvement people in the hospital. They would probably think it was great that a hospitalist took an interest. If you are a long term hospitalist at an institution you could start a quality improvement measurement project and I bet you could get lots of help from the people already involved in doing those measures in the hospitals. Sounds kind of dry, but it's what's going on right now.